scholarly journals Arthroscopic findings after shoulder dislocation

2009 ◽  
Vol 66 (7) ◽  
pp. 517-521
Author(s):  
Ivica Medenica ◽  
Aleksandar Radunovic ◽  
Dragan Madzarac ◽  
Miodrag Zoric ◽  
Dubravko Bokonjic ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Clinical Examination ◽  
Shoulder Joint ◽  
Biceps Brachii ◽  
Posterior Part ◽  
Group I ◽  
Arthroscopic Findings ◽  
Arthroscopic Finding ◽  
Forearm Flexor ◽  
Anterior Posterior

Background/Aim. Recurrent instability of the shoulder joint is frequently difficult to differentiate from diseased or injured rotator cuff or tendon of the forearm flexor (m. biceps brachii). Shoulder joint arthroscopy has been only recently introduced into instable shoulder joint lesion examination. The aim of this study was to present and analyze an arthroscopic finding on instable shoulder joint in order to determine causes and mechanisms of instability, as well as principles of surgical treatment. Methods. Arthroscopy of the shoulder joint was performed in 158 patients with at least one documented shoulder joint dislocation. These patients were divided into two groups. The group I included the patients with one to three dislocations, while the group II those with more than three dislocations. Preoperative diagnosis was based on anamnestic data and clinical examination using specific tests, and on the diagnosis of shoulder joint using radiography or computed tomography. Results. Out of the total number of the patients 138 (87.34%) had injury of the anterior patellar brim, 119 (75.32%) had failure of the anterior capsule, 126 (79.75%) had compressive cartilage injury of the posterior part of the head of the upper arm bone (Hill-Sachs lesion), 102 (64.56%) had insufficiency of glenohumeral tendon, 11 (6.96) had complete cut of the rotator cuff, 23 (14.56%) had injury of the posterior patellar brim, 12 (7.59%) had injury of the upper anterior-posterior patellar brim (SLAP). Conclusion. According to the obtained results it could be concluded that there is no a unique injury that leads to shoulder joint instability. It is necessary to point out to the significance of anamnesis and clinical examination in making diagnosis. Arthroscopic diagnostics is indicated in clinically unreliable findings as an additional method for determining operative treatment.

ROLE OF MRI IN DIAGNOSIS OF ROTATOR CUFF TEAR ASSUMING ARTHROSCOPY AS GOLD STANDARD

2019 ◽  
Vol 3 (9) ◽  
Author(s):  
Dr. Chaturbhuj Prasad Swarnkar ◽  
Dr. Shiv Raj Meena
Keyword(s):  
Rotator Cuff ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Shoulder Pain ◽  
Sensitivity And Specificity ◽  
Predictive Value ◽  
Gold Standard ◽  
Shoulder Joint ◽  
Rotator Cuff Tears ◽  
Arthroscopic Findings

Background- Rotator cuff tears are one of the most common causes of shoulder pain for which patients seek treatment. As in our daily work, the shoulder joint is the most frequently used, there is higher chance of having shoulder joint injury. The aim of the study is to compare the efficacy of MRI in diagnosing shoulder pathologies in comparison to arthroscopy, considering arthroscopy as the gold standard. Methods- 30 Patient with suspected rotator cuff injury patients, between 18-80 years of age was included in the study. MRI of the shoulder joint was done followed by shoulder arthroscopy. The data collected was analysed for the significant correlation between MRI of shoulder and arthroscopic findings by kappa statistics. Results- The accuracy of MRI in diagnosis of rotator cuff partial tears, was 90%, while sensitivity and specificity was 100.00%, 78.57% and positive predictive value was 84.21% and negative predictive value was 100.00% and accuracy of MRI in diagnosis of rotator cuff full tears, was 86.67%, while sensitivity and specificity was 63.64%, 100.00%) and positive predictive value was 100.00% and negative predictive value was 82.61% in our study. Conclusion- Our study demonstrates a high sensitivity and specificity for the MRI diagnosis of both partial and full thickness rotator cuff tears and good correlation with arthroscopic findings. Keywords: Rotator cuff, Shoulder pain, Arthroscopy, MRI.

scholarly journals Diagnostic accuracy in rotator cuff tears: clinical tests vs MRI

2019 ◽  
Vol 5 (4) ◽  
pp. 727 ◽  
Author(s):  
Divakar Modipalli ◽  
Atmananda S. Hegde ◽  
Chethan B. Shetty
Keyword(s):  
Rotator Cuff ◽  
Negative Predictive Value ◽  
Clinical Examination ◽  
Predictive Value ◽  
Rotator Cuff Tears ◽  
Clinical Tests ◽  
Predictive Values ◽  
Rotator Cuff Injuries ◽  
Arthroscopic Findings ◽  
Mri Evaluation

<p class="abstract"><strong>Background:</strong> Till date there is a lack of consensus regarding validity of clinical tests in identifying the rotator cuff injuries and also the predictive value of noninvasive investigations done to confirm such shoulder pathology.</p><p class="abstract"><strong>Methods:</strong> We included 48 patients with shoulder complaints in our study who underwent blinded clinical examination and MRI of shoulder, whose findings were compared with arthroscopic findings and were statistically analyzed.<strong></strong></p><p class="abstract"><strong>Results:</strong> In the study group mean age was 47 years and 71% were males. When compared with arthroscopy, clinical examination for supraspinatus had better sensitivity (90) but low specificity and negative predictive value (NPV) (37.5). MRI evaluation of supraspinatus had specificity of 85 and NPV of 60. Infraspinatus had almost similar statistical values. MRI was found to have better specificity (89.5) in comparison with clinical examination (52.6) in subscapularis evaluation along with higher positive (67 vs. 30) and negative predictive value (94 vs. 90).</p><p class="abstract"><strong>Conclusions:</strong> Clinical examination is good in identifying lesion or tear of supraspinatus and subscapularis but may also have false positives, where usage of noninvasive MRI will reduce these false positive in comparison with gold standard arthroscopy. Although clinical examination is very useful for diagnosis of rotator cuff injuries, MRI could be used to improve specificity and predictive values in patients who are planned for surgical management of rotator cuff injury.</p>

Arthroscintigraphy in Suspected Rotator Cuff Rupture

1998 ◽  
Vol 37 (08) ◽  
pp. 272-278 ◽  
Author(s):  
S. Gratz ◽  
G. Köster ◽  
T. Behr ◽  
R. Vosshenrich ◽  
E. Grabbe ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Shoulder Joint ◽  
Clinical Signs ◽  
Diagnostic Efficiency ◽  
Rotator Cuff Rupture ◽  
Lower Viscosity ◽  
Rotator Cuff Lesion ◽  
Shoulder Region ◽  
Degenerative Alterations ◽  
Additional Value

Summary Aim: In order to evaluate the diagnostic efficiency of arthroscintigraphy in suspected rotator cuff ruptures this new imaging procedure was performed 20 times in 17 patients with clinical signs of a rotator cuff lesion. The scintigraphic results were compared with sonography (n = 20), contrast arthrography (n = 20) and arthroscopy (n = 10) of the shoulder joint. Methods: After performing a standard bone scintigraphy with intravenous application of 300 MBq 99m-Tc-methylene diphosphonate (MDP) for landmarking of the shoulder region arthroscintigraphy was performed after an intraarticular injection of 99m-Tc microcolloid (ALBURES 400 μCi/5 ml). The application was performed either in direct combination with contrast arthrography (n = 10) or ultrasound conducted mixed with a local anesthetic (n = 10). Findings at arthroscopical surgery (n = 10) were used as the gold standard. Results: In case of complete rotator cuff rupture (n = 5), arthroscintigraphy and radiographic arthrography were identical in 5/5. In one patient with advanced degenerative alterations of the shoulder joint radiographic arthrography incorrectly showed a complete rupture which was not seen by arthroscintigraphy and endoscopy. In 3 patients with incomplete rupture, 2/3 results were consistant. A difference was seen in one patient with a rotator cuff, that has been already revised in the past and that suffered of capsulitis and calcification. Conclusion: Arthroscintigraphy is a sensitive technique for detection of rotator cuff ruptures. Because of the lower viscosity of the active compound, small ruptures can be easily detected, offering additional value over radiographic arthrography and ultrasound, especially for evaluation of incomplete cuff ruptures.

scholarly journals The Relationship between Clinical Tests, Ultrasound Findings and Selected Field-Based Wheelchair Skills Tests in a Cohort of Quadriplegic Wheelchair Rugby Athletes: A Pilot Study

2021 ◽  
Vol 11 (9) ◽  
pp. 4162
Author(s):  
Lucrezia Tognolo ◽  
Alfredo Musumeci ◽  
Andrea Pignataro ◽  
Nicola Petrone ◽  
Michael Benazzato ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Shoulder Joint ◽  
Rating Scale ◽  
Clinical Tests ◽  
Wheelchair Rugby ◽  
Manual Wheelchair ◽  
Shoulder Pathology ◽  
Cord Injury ◽  
Pathologic Findings ◽  
The Relationship

Manual wheelchair use may determine shoulder joint overload and rotator cuff injury. Chronic shoulder pathologies can also influence the propulsion ability of wheelchair athletes with spinal cord injury (SCI) during sport activities. However, the relationship between shoulder pathology and wheelchair performances has never been explored. Therefore, the study aimed to investigate the correlation between shoulder pathologic findings with clinical tests and ultrasonography evaluation and the results of wheelchair performance tests. Nineteen quadriplegic wheelchair rugby players were evaluated to investigate the association between clinical and ultrasound shoulder pathologic findings and their correlation with the performance of field-based selected wheelchair skills tests (WSTs). The outcome measures were the International Wheelchair Rugby Classification Score, dominant and non-dominant Physical Examination Shoulder Score, and dominant and non-dominant Ultrasound Shoulder Pathology Rating Scale (USPRS). The WST was measured at the beginning and at one-year follow-up. A statistically significant correlation was found between the time since SCI and dominant USPRS (p < 0.005). The non-dominant USPRS was strongly related to WST at the beginning (p < 0.005) and the end of the study (p < 0.05). Data suggest that the severity of the non-dominant shoulder pathology detected on the ultrasound is related to lower performance on the WST. Chronic manual wheelchair use could be responsible for dominant SCI shoulder joint and rotator cuff muscle damage, while non-dominant USPRS could be related to performance on the WST.

scholarly journals Evolution of Antennapedia-Class Homeobox Genes

Genetics ◽  
1996 ◽  
Vol 142 (1) ◽  
pp. 295-303 ◽  
Author(s):  
Jianzhi Zhang ◽  
Masatoshi Nei
Keyword(s):  
Gene Expression ◽  
Homeobox Genes ◽  
Amino Acid Sequences ◽  
Gene Arrangement ◽  
Gene Duplications ◽  
Group I ◽  
Group 3 ◽  
Group Ii ◽  
Anterior Posterior

Antennapedia (Antp)-class homeobox genes are involved in the determination of pattern formation along the anterior-posterior axis of the animal embryo. A phylogenetic analysis of Antp-class homeodomains of the nematode, Drosophila, amphioxus, mouse, and human indicates that the 13 cognate group genes of this gene family can be divided into two major groups, i.e., groups I and II. Group I genes can further be divided into subgroups A (cognate groups 1–2), B (cognate group 3), and C (cognate groups 4–8), and group II genes can be divided into subgroups D (cognate groups 9–10) and E (cognate groups 11–13), though this classification is somewhat ambiguous. Evolutionary distances among different amino acid sequences suggest that the divergence between group I and group II genes occurred ∼1000 million years (MY) ago, and the five different subgroups were formed by ∼600 MY ago, probably before the divergence of Pseudocoelomates (e.g., nematodes) and Coelomates (e.g., insects and chordates). Our results show that the genes that are phylogenetically close are also closely located in the chromosome, suggesting that the colinearity between the gene expression and gene arrangement was generated by successive tandem gene duplications and that the gene arrangement has been maintained by some sort of selection.

scholarly journals SLAP Tears

2021 ◽  
Vol 1 (3) ◽  
pp. 263502542110007
Author(s):  
Steven B. Cohen ◽  
John R. Matthews
Keyword(s):  
Rotator Cuff ◽  
Shoulder Arthroscopy ◽  
Biceps Tendon ◽  
Full Range ◽  
Contralateral Side ◽  
Highly Active ◽  
Slap Repair ◽  
Biceps Tenotomy ◽  
Labral Tears ◽  
Anterior Posterior

Background: Superior labral tears are frequently encountered during shoulder arthroscopy. Outcomes following superior labral anterior-posterior (SLAP) repairs in young athletes have been well documented. Superior labral repairs in older patient population continue to remain controversial due to concerns of postoperative complications including persistent preoperative symptoms, pain, stiffness, and higher rates of revision surgery. Indications: We present a case of a highly active 38-year-old woman who failed 1½ years of nonoperative management of a type IIB SLAP tear with extension to the posterior labrum. Her symptoms continued to limit her hobbies and work. Technique: A knotless single-anchor SLAP repair was performed along with debridement of the posterior frayed labrum. No biceps tenotomy or tenodesis was performed after full evaluation of the tendon failed to demonstrate evidence of synovitis, tendinopathy, or tear. The patient also did not have any concomitant shoulder pathology, including a rotator cuff tear or chondral lesion. Results: At 6 months, the patient had regained full range of motion similar to the contralateral side. She had returned to her normal activities and sports, including tennis. Discussion/Conclusion: Successful outcomes following SLAP repairs in patients over 35 years can be achieved, but treatment should be individualized with particular attention to concomitant pathology involving the rotator cuff, chondral surface, or biceps tendon which may require tenodesis or tenotomy.

scholarly journals The Association Between the Rotator Cuff Status and the Severity and Recovery of Weakness in the Shoulder Abductor Strength in a Case of Proximal Type Cervical Spondylotic Amyotrophy

2020 ◽  
pp. 219256822098044
Author(s):  
Sho Ishiwata ◽  
Yoichi Iizuka ◽  
Hitoshi Shitara ◽  
Tokue Mieda ◽  
Eiji Takasawa ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Biceps Brachii ◽  
Case Series ◽  
Manual Muscle Test ◽  
Cuff Tear ◽  
Cervical Spondylotic Amyotrophy ◽  
Case Series Study ◽  
Shoulder Abductor ◽  
Series Study

Study Design: Case series study. Objective: We aimed to clarify the prevalence of rotator cuff tear (RCT), and the association between RCT and the severity and prognosis in patients with proximal type cervical spondylotic amyotrophy (CSA). Methods: We retrospectively analyzed 35 proximal type CSA patients who were treated conservatively. The following data was collected: age, rotator cuff status on MRI, manual muscle test (MMT) score of shoulder abductor and biceps brachii muscles both at the first visit and final follow-up. We investigated the prevalence of RCT and the association between the rotator cuff status, and the severity and recovery of upper extremity weakness in patients with proximal type CSA. Results: Of the 35 patients, 21 had an RCT on MRI, indicating that the prevalence of RCT in patients with proximal type CSA was 60%. An age-adjusted analysis showed that the presence of RCT was significantly associated with the MMT score of the shoulder abductor muscles both at the first visit and at the final follow-up. The presence of RCT was significantly associated with the recovery of the shoulder abductor muscles. The size of the RCT was negatively correlated with the MMT score of the shoulder abductor muscles at the final follow-up. The size of the RCT was independently correlated with the change of the MMT score of the shoulder abductor muscles. Conclusion: RCT was detected in >50% in patients with proximal type CSA, and the presence and severity of RCT can be used as prognostic factors for proximal type CSA patients who are treated conservatively.

scholarly journals Is it the coracobrachialis superior muscle, or is it an unidentified rare variant of coracobrachialis muscle?

2021 ◽  
Author(s):  
Łukasz Olewnik ◽  
Nicol Zielinska ◽  
Łukasz Gołek ◽  
Paloma Aragonés ◽  
Jose Ramon Sanudo
Keyword(s):  
Case Report ◽  
Rare Variant ◽  
Shoulder Joint ◽  
Biceps Brachii ◽  
Coracoid Process ◽  
Biceps Brachii Muscle ◽  
Shoulder Region

AbstractThe coracobrachialis muscle (CBM) originates from the apex of the coracoid process, in common with the short head of the biceps brachii muscle, and from the intermuscular septum. The CBM demonstrates variability in both the proximal and distal attachment, with some extremely rare varieties, such as the coracobrachialis superior, coracobrachialis longus and coracocapsularis muscle. This case report describes an extremely rare variant of the coracobrachialis superior muscle, or a very rare variant of the CBM. Our findings highlight the importance of muscle variants in the shoulder region, especially the coracoid region, and are significant for radiologists, anatomists, physiotherapists and surgeons specializing in the shoulder joint.

Lesions of the Biceps Tendon Diagnosis and Classification

1999 ◽  
Vol 12 (04) ◽  
pp. 188-195 ◽  
Author(s):  
J. F. Bardet
Keyword(s):  
Shoulder Joint ◽  
Biceps Brachii ◽  
Shoulder Arthroscopy ◽  
Case Reports ◽  
Biceps Tendon ◽  
Adhesive Capsulitis ◽  
Clinical Signs ◽  
Joint Disease ◽  
Response To Treatment ◽  
Biceps Tendon Rupture

SummaryThis paper presents the clinical signs, radiographic and arthroscopic findings in 23 dogs and a cat having a lesion of the biceps tendon. Several conditions were recognized: partial or complete rupture; avulsion of the biceps tendon from the supraglenoid tubercle, tendinitis, mid-substance tear, bipartite tendon, dislocations and tenosynovitis of the bicipital tendon. Osteoarthritis of the shoulder joint was seen in 84% of the cases and osteophytosis of the bicipital groove was recognized in 38%. Biceps tendon rupture was associated with shoulder joint instability 76% of the time. Shoulder arthroscopy is a very reliable diagnostic method allowing direct visualization of intra-articular pathologies.In man, the tendon of the biceps brachii is the proverbial stepchild of the shoulder. It has been blamed for numerous painful conditions of the shoulder from arthritis to adhesive capsulitis. Kessell described the tendon as “somewhat of a maverick, easy to inculpate but difficult to condemn (1). Its function has been often misunderstood. It has been tenodesed, translocated, pulled through drill holes in the humeral head, and debrided with an arthroscope, oftentimes with marginal results”. Lippmann likened the biceps tendon to the appendix: “An unimportant vestigial structure unless something goes wrong with it” (2). Neer II has stressed the fact that 95 to 98 per cent of patients with a diagnosis of biceps tendinitis have, in reality, a primary diagnosis of impingement syndrome with secondary involvement of the biceps tendon (3). He has condemned routine biceps tenodesis.The veterinary literature on the biceps tendon in dogs is sparse (4-8). Tenosynovitis of the biceps tendon is “a common cause of forelimb lameness in medium and large breed dogs” (7). “Definitive diagnosis of bicipital tenosynovitis is often not possible, and the diagnosis is backed into by eliminating other causes of lameness. Proof of the diagnosis often depends on response to treatment” (7). There are not any reviews of cases of rupture of the tendon of the biceps brachii muscle except for anecdotal case reports (7). Arthrography has been described as diagnostic of rupture (10, 11). Calcifying tendinopathy of the biceps tendon was seen on radiographic views of the scapulohumeral joint in four dogs (9). Twodimensional real-time ultrasonography was found helpful in the diagnosis of strain of the infraspinatus muscle in a dog (12).This paper reviews the pertinent anatomy, explains the function of the biceps tendon, and presents a review of current concepts on the diagnosis of lesions of the biceps tendon.The author presents the clinical signs, radiographic and arthroscopic finding of the disorders of the biceps tendon seen in 25 shoulders. All biceps tendon lesions may be classified in one of the six subtypes. Partial or complete tears are the most frequent pathology. Degenerative joint disease is seen in 84% of the shoulders.

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