Diagnostic and therapeutic value of ultrasonography in the detection of paralabral ganglion cysts with a curved array transducer: A case report

2021 ◽  
pp. 1-6
Author(s):  
Da-Sol Kim ◽  
Nam-Gyu Jo ◽  
Gi-Wook Kim
Keyword(s):  
Case Report ◽  
Rotator Cuff ◽  
Shoulder Pain ◽  
Linear Array ◽  
Ultrasound Guided ◽  
Linear Transducer ◽  
Shoulder Movement ◽  
Array Transducer ◽  
Ganglion Cysts ◽  
Rotator Cuff Lesions

BACKGROUND: Paralabral cysts are a rare cause of shoulder pain. Linear ultrasound transducers are often used for musculoskeletal evaluation and intervention. However, the use of linear transducer is limited when the target structure is located deep and blocked by bony barriers, as is the case of paralabral ganglion cysts. OBJECTIVE: This case report aims to describe a beneficial role of using a convex transducer on the evaluation and ultrasonography-guided intervention of paralabral cysts below the acromion. CASE DESCRIPTION: Two patients visiting the outpatient clinic of Physical Medicine and Rehabilitation complained of severe pain during shoulder movement. Ultrasound scans with linear transducer detected rotator cuff lesions. Shoulder MRIs performed because of persistent pain despite ultrasound-guided bursa injection at the subacromial-subdeltoid bursa using a linear array transducer, confirmed paralabral cysts. Although a linear array transducer could not visualize the lesion but could only perform suprascapular nerve block and intra-articular injection, the use of a convex array transducer improved the visualization of the cystic lesion which we treated using ultrasound-guided aspiration and intra-cystic injection. Visual analog scale and Shoulder Pain and Disability Index were checked to assess the treatment effect of each intervention. The intra-cystic injection with aspiration and intra-articular injection showed minimal to moderate improvement of pain score. CONCLUSION: In pain related to shoulder movement, especially pain that continues despite appropriate treatment for rotator cuff lesions, ultrasound diagnosis of paralabral ganglion cysts using convex transducers will improve the diagnostic value and accuracy of intervention.

Role of Ultrasound-Guided Platelet Rich Plasma Injection in Treatment of Chronic Rotator Cuff Muscles Tendinopathy

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M A Nassef ◽  
A E Allam ◽  
H M N Mohammed
Keyword(s):  
Rotator Cuff ◽  
Range Of Motion ◽  
Shoulder Pain ◽  
Platelet Rich Plasma ◽  
Clinical Manifestations ◽  
Base Line ◽  
Ultrasound Guided ◽  
Plasma Injection ◽  
Effective Treatment Modality ◽  
Rotator Cuff Tendinopathy

Abstract Background shoulder pain is the third most common musculoskeletal complaint. And rotator cuff muscles tendinopathy is one of the most common causes for shoulder pain. Aim of the Work to evaluate the effectiveness of the percutaneous ultrasound guided PRP injection in improving or treating chronic Rotator Cuff muscles tendinopathy. Patients and Methods this study was conducted on 33 patients presented to Police Hospital Nasr City and diagnosed as cases of rotator cuff tendinopathy for more than 6 months and not responding to NSAIDs. Results there is high significant improvement of the ultrasound findings and clinical manifestations of patients as regard pain, range of motion and power comparing to the base line start. According to this study, PRP was found to be more effective on the long term then short term “comparing results after one and five month”. Conclusion ultrasound guided PRP injection is a safe and an effective treatment modality for rotator cuff tendinopathy as evidenced by decreased pain and improved range of motion across the shoulder joint after the application and follow up of the PRP.

Rotator Cuff Lesions: A Case Report

2011 ◽  
Vol 7 (1) ◽  
pp. 56 ◽  
Author(s):  
N. Khurana ◽  
S. S. Hanspal ◽  
G. Singh
Keyword(s):  
Case Report ◽  
Rotator Cuff ◽  
Rotator Cuff Lesions

scholarly journals Acute Symptoms on Rotator Cuff Calcific Tendinitis is Effectively Relieved by Ultrasound Guided Percutaneous Needle Lavage Procedure: a Case Report

2019 ◽  
Vol 7 (11_suppl6) ◽  
pp. 2325967119S0048
Author(s):  
Tommy Mandagi ◽  
Nyoman Aditya Sindunata ◽  
Prettysia Suvarly ◽  
John Butarbutar
Keyword(s):  
Rotator Cuff ◽  
Shoulder Pain ◽  
Acute Pain ◽  
Corticosteroid Injection ◽  
Calcific Tendinitis ◽  
Left Shoulder ◽  
Ultrasound Guided ◽  
Good Outcome ◽  
Limited Range Of Motion ◽  
Infraspinatus Tendon

Introduction: Rotator cuff calcific tendinitis (RCCT) frequently manifests as acute shoulder pain during the acute resorptive phase. Pain typically worse at night and limited range of motion (ROM) with muscle spasm. Several treatment options have been proposed. In this case, a single needle ultrasound-guided percutaneous lavage (UGPL) combined with corticosteroid subdeltoid bursa injection (SDBI) with a good outcome. Case Presentation: A Female, 59 years old, presents with left RCCT acute pain (VAS 7/10) for 2 days and limited painful shoulder ROM. Inflammation and local tenderness found on the left shoulder, ultrasonography shows calcification in the left infraspinatus tendon with sub-deltoid bursa fluid. Patient in sitting position, ultrasound probe placed at long axis of infraspinatus tendon. Using a 23G needle 5 ml syringe, 1% lidocaine infiltrated until the needle penetrates the calcification site. Then a small amount of normal saline (NaCl) with lidocaine injected in a pulsating manner, observed until chalky matter backflows, mixed with NaCl in the syringe. Repeat this procedure until chalky backflow is minimal. Finally, 10 ml of Triamcinolone Acetonide 40 mg mixed with 2 ml lidocaine 2% SDBI using the same needle. Dramatic shoulder pain relieve (VAS 2/10) is immediately achieved after the procedure. One week follow up, the patient is pain-free and regains full ROM of her left shoulder. Discussion: Several methods are proposed for the treatment of acute RCCT, including corticosteroid injection and arthroscopy debridement. UPGL is an attractive option because it is minimally invasive, can be performed in-office setting, and pain relief is obtained immediately by decompressing and removing inflamed calcified sites. Conclusion: The treatment in acute pain RCCT using UGPL combined with corticosteroid SDBI provides a good outcome.

Ultrasound-Guided Treatments for the Painful Shoulder

2021 ◽  
Vol 17 ◽  
Author(s):  
Nicolas Papalexis ◽  
Federico Ponti ◽  
Raffaella Rinaldi ◽  
Giuliano Peta ◽  
Riccardo Bruno ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Image Guidance ◽  
Ultrasound Guidance ◽  
Wide Spectrum ◽  
Biceps Tendon ◽  
Common Condition ◽  
Ultrasound Guided ◽  
Painful Shoulder ◽  
Pathological Conditions ◽  
Rotator Cuff Lesions

: Shoulder pain is an extremely common condition. The painful shoulder may be the result of a wide spectrum of underlying pathological conditions, including calcific tendinopathy of the rotator cuff, subacromial-subdeltoid bursitis, acromioclavicular or glenohumeral arthritis, tenosynovitis of the long biceps tendon, rotator cuff lesions, and many other less common conditions. Ultrasound imaging is an effective tool for the diagnosis and also for the image guidance of treatment of the majority of these conditions. Several ultrasound-guided procedures are effective for pain relief, such as percutaneous irrigation, intra-bursal or intra-articular drugs injection, fluid aspiration, neural block. This review article aims to summarize and discuss the most common treatment possibilities with ultrasound guidance for the painful shoulder.

scholarly journals Use of injectable collagen in partial-thickness tears of the supraspinatus tendon: a case report

2020 ◽  
Vol 2020 (11) ◽  
Author(s):  
Bruno Corrado ◽  
Ilenia Bonini ◽  
Vincenzo Alessio Chirico ◽  
Nicola Rosano ◽  
Pietro Gisonni
Keyword(s):  
Case Report ◽  
Rotator Cuff ◽  
Functional Limitation ◽  
Supraspinatus Tendon ◽  
Rotator Cuff Tears ◽  
Future Research ◽  
Type I ◽  
Ultrasound Guided ◽  
Partial Thickness ◽  
Porcine Collagen

ABSTRACT Management of partial-thickness rotator cuff tears is actually controversial. We treated a patient with a partial-thickness tear of the supraspinatus tendon by a series of four type I porcine collagen ultrasound-guided injections, at weekly intervals. At the same time the patient underwent physical therapy, consisting of motor re-education and proprioceptive exercises. The patient was assessed before the treatment and up to 18 months after the last injection by the Constant–Murley score, the Disability of Arm, Shoulder and Hand questionnaire and ultrasonography. Shoulder pain and functional limitation progressively improved and they almost completely disappeared at the last follow-up. Ultrasonography showed a gradual healing of the partial-thickness tear and a regeneration of the tendon structure. This is the first study on ultrasound-guided injections of type I porcine collagen for the treatment of partial-thickness rotator cuff tears. Future research should confirm the excellent result achieved in this case report.

scholarly journals Quantitative Ultrasonographic Analysis of Changes of the Suprascapular Nerve in the Aging Population With Shoulder Pain

2021 ◽  
Vol 9 ◽  
Author(s):  
Wei-Ting Wu ◽  
Lan-Rong Chen ◽  
Hsiang-Chi Chang ◽  
Ke-Vin Chang ◽  
Levent Özçakar
Keyword(s):  
Rotator Cuff ◽  
Older People ◽  
Brachial Plexus ◽  
Shoulder Pain ◽  
Supraspinatus Tendon ◽  
Suprascapular Nerve ◽  
Control Group ◽  
Full Thickness ◽  
Cross Sectional ◽  
Rotator Cuff Lesions

BackgroundOlder people are vulnerable to painful shoulder syndromes, the majority of which are derived from degenerative rotator cuff pathologies. The suprascapular nerve (SSN) is closely related to the rotator cuff complex, and its role in shoulder pain has recently been highlighted. This study aimed to explore the differences in SSN among older people with and without shoulder pain, and to investigate the potential factors influencing the nerve size using ultrasound (US) imaging.MethodsParticipants aged ≥60 years were enrolled in the study. A systematic and bilateral US examination of the rotator cuff tendons was performed. The SSN was examined from its origin in the brachial plexus to the spinoglenoid notch of the infraspinatus fossa. The association between the nerve’s cross-sectional area (CSA) and rotator cuff lesions was analyzed using the generalized estimation equation.ResultsAmong the 94 participants, 45 (with bilaterally asymptomatic shoulders) were classified into the control group, whereas 49 (with at least one-sided shoulder pain) were classified into the group with shoulder pain. The average CSAs of the SSN at the level of the brachial plexus, supraspinatus fossa, and infraspinatus fossa were comparable between the patients in the control group and those with shoulder pain. There was a higher prevalence of rotator cuff lesions and enlarged distal SSNs in the painful shoulders than in the asymptomatic shoulders of patients with unilateral involvement. A full-thickness tear of the supraspinatus tendon was associated with swelling of the SSN in the supraspinatus fossa (β coefficient = 4.068 mm2, p < 0.001).ConclusionIn the older population, full-thickness tears of the supraspinatus tendon are independently associated with enlargement of the distal SSN. In cases with large rotator cuff tendon tears with poor response to conservative treatments, possible SSN entrapment should be considered and managed accordingly.

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