scholarly journals Ultrasonographic Evaluation of the Shoulders and Its Associations with Shoulder Pain, Age, and Swim Training in Masters Swimmers

Medicina ◽  
2020 ◽  
Vol 57 (1) ◽  
pp. 29
Author(s):  
Yuta Suzuki ◽  
Noriaki Maeda ◽  
Junpei Sasadai ◽  
Kazuki Kaneda ◽  
Taizan Shirakawa ◽  
...  

Background and objectives: The long head of the biceps (LHB) and rotator cuff tendinopathy is the major cause of shoulder pain in competitive swimmers. The risk of tendinopathy increases with aging; however, the structural changes of LHB and rotator cuff in populations of masters swimmers have not been well examined. The purpose of this study was to investigate the prevalence of ultrasonographic abnormalities of the shoulders in masters swimmers, and the association of pain, age, and swim training with structural changes in this population. Materials and Methods: A total of 60 subjects participated in this study, with 20 masters swimmers with shoulder pain, 20 asymptomatic masters swimmers, and 20 sex- and age-matched controls. All swimmers completed a self-reported questionnaire for shoulder pain, their history of competition, and training volume. Each subject underwent ultrasonographic examination of both shoulders for pathologic findings in the LHB tendon, rotator cuff (supraspinatus (SSP) and subscapularis (SSC)) tendons, and subacromial bursa (SAB) of both shoulders and had thickness measured. Results: The prevalence of tendinosis (LHB, 48.8%; SSP, 17.5%; SSC, 15.9%), partial tear (SSP, 35.0%), and calcification (SSC, 10.0%) were higher in swimmers than in controls. LHB and SSP tendinosis were associated with shoulder pain. Older age and later start of competition were associated with an increased risk of LHB tendinosis and SSC calcification. Earlier initiation of swimming and longer history of competition were associated with an increased risk of SSP and SSC tendinosis. The thicker SSP tendon significantly increased the risk of tendinosis and partial tear. Conclusions: A high prevalence of structural changes in the rotator cuff and biceps tendons in masters swimmers reflects the effect of shoulder symptoms, aging, and swim training.

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M A Nassef ◽  
A E Allam ◽  
H M N Mohammed

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.


Author(s):  
LN Hazrati

Mild traumatic brain injury (mTBI) or concussion is a very common occurrence in contact sports, and can cause brain damage with long-term symptoms, including depression, aggression, memory loss, and an increased risk of neurodegeneration later in life. Recently, there has been increased attention towards concussion in sport both in research and media, however the nature and pathophysiology of mTBI-induced neurodegeneration remain unknown. The objective of this study is to identify early pathophysiological markers of TBI. This study used a collection of donated postmortem brains with a history of repetitive mTBI in contact sports and non-TBI control brains. Nanostring ncounter’s immune panel was used to evaluate gene expression, and results showed that brains with a history of TBI tended to group with significantly older brains with no history of TBI in regards to their immune profile. Further analysis of this expression panel revealed that genes associated with senescence and secretory phenotype were upregulated in brains with a history of mTBI. Additionally, immunohistochemistry for γ-H2AX (a marker for double stranded DNA breaks) showed that brains with a history of repetitive TBI accumulated a spectrum of DNA damages not present in controls. This damage was widespread and involved mainly glial cells including oligodendrocytes, and astrocytes. The latter showed morphological changes reminiscent of senescence, including soma swelling and beading of processes. Further, these changes were accompanied by translocation of structural nuclear proteins. These changes preceded the appearance of abnormal protein deposition in the brain. Overall, these results suggest that DNA damage and cellular senescence are upstream events in the manifestation of post-mTBI symptoms and pathology, and represent promising opportunities for discovery of biomarkers for early TBI detection and follow-up of progression.LEARNING OBJECTIVESThe presentation will enable the learner to:1.Explore the relationship between trauma and DNA structural changes2.Explore the relationship between trauma and senescence


2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 21168-21168 ◽  
Author(s):  
Y. M. Choi ◽  
S. Shord ◽  
S. Cuellar ◽  
J. Villano

21168 Background: Bevacizumab is an increasingly used anti-cancer treatment with common side effects including hypertension (htn) and proteinuria which occur in approximately 10% and 20% of the patients, respectively. Little is known regarding ethnic variations of bevacizumab induced htn and proteinuria, particularly in African-Americans (AA) who have a high prevalence of htn and susceptibility to kidney disease. Methods: We conducted a retrospective chart review of patients who completed bevacizumab alone or as a chemotherapy regimen at the University of Illinois at Chicago for an 18-month study period. We collected blood pressure (BP) measurements and urinanalyses before starting bevacizumab, during bevacizumab and after stopping bevacizumab, in addition to concurrent medications, past medical history and demographics. Htn and proteinuria were graded by CTC v3.0. Patients with less than two successive doses of bevacizumab or unreliable ethnicity were excluded. Results: 27 subjects were eligible. Eighteen AA (67%) and 9 (33%) non-AA were included. Twenty-two (81%) had colorectal cancer. AA received a median of 10 cycles and non-AA received a median of 6 cycles. Six subjects (22%) developed any grade htn toxicity; maximum grade: grade 2=4 (15%), grade 3=2 (7%). Htn toxicity occurred in 28% AA and 11% non-AA (p=NS). Previous history of hypertension was found in 15 subjects (55%): AA=14 vs. non-AA=1 (p=0.002) and was not correlated with hypertensive toxicity. Twelve subjects (44%) developed any grade proteinuria; maximum grade: grade 1=9 (33%), grade 2=3 (11%). Proteinuria toxicity occurred in 50% AA and 33% non-AA (p=NS). Presence of hypertensive toxicity was associated with increased risk of proteinuria. Clinical benefit (PR, SD) was seen in 15 subjects (55%). Rate of clinical benefit was 67% in AA and 33% in non-AA (p=NS). Clinical benefit did not correlate with hypertensive or proteinuria toxicities. Conclusions: AA were more prone than non-AA to bevacizumab induced hypertension and proteinuria toxicity in this retrospective study. Higher clinical benefit was seen in AA. No significant financial relationships to disclose.


Author(s):  
Ashok Srikar Chowdhary ◽  
Naresh Babu Lakshmipathi Nikhil ◽  
Nidhi Hemendra Chandrakar ◽  
Nidhi Raj Buddaraju

Introduction: Shoulder joint is a highly mobile joint but is prone for rotator cuff injuries and dislocations. It is necessary to accurately diagnose rotator cuff and labral injuries so that appropriate plan of action for treatment can be taken. Magnetic Resonance Imaging (MRI) can be used to diagnose and describe the extent of rotator cuff tendon and labral injuries and any secondary rotator cuff muscle abnormalities. Aim: To study the demographic profile of patients presenting with shoulder pain and instability, identify the various rotator cuff injuries causing shoulder pain, identify the rotator cuff interval lesions causing microinstability, identify the various labral and bony pathologies in instability, describe the MRI features of the rotator cuff, rotator cuff interval, labral and bony injuries. Materials and Methods: This study was a cross-sectional study of patients with symptoms of either shoulder pain or instability who underwent MRI evaluation of the shoulder in the Department of Radiodiagnosis, Rajarajeswari Medical College and Hospital, Bengaluru, Karnataka, India, from July 2018 to December 2020. The study population consisted of 54 patients with either shoulder pain or instability who underwent MRI of shoulder. All the MRI scans of the shoulder in this study were performed using 1.5 Tesla Siemens Magnetom Avanto (Tim 76x18) MR machine using a flex coil. Results: The study population consisted of 54 patients comprising of 38 males and 16 females. The age of the patients ranged from 20-77 years. Majority of the patients were older than 50 years constituting about 33.33% of the total study population. Rotator cuff injury was the commonest cause of pain. Tendinosis was the commonest type of rotator cuff injury followed by partial-thickness and full-thickness tendon tears. The commonest grade of tendinosis was mild or grade 1. Supraspinatus tendon was the most commonly affected tendon followed by subscapularis and infraspinatus tendons. Teres minor tendon was normal in all the cases. Anterior instability was the commonest type of instability with equal prevalence of soft tissue Bankart, bony Bankart and Perthes lesions. Biceps pulley lesions resulted in long head of biceps tendon instability, microinstability and internal impingement. Conclusion: Rotator cuff injuries are the commonest cause of shoulder pain and are seen more frequently after the fifth decade. Shoulder instability is most commonly seen in young male adults. Tendinosis is the commonest type of rotator cuff injury. Supraspinatus tendon is the most commonly injured tendon. Anterior instability is the commonest type of shoulder instability. Biceps pulley lesions result in long head of biceps tendon instability, microinstability and internal impingement. MRI can diagnose interstitial or intrasubstance tendon tears which are not visualised on arthroscopy. MRI description of tendon and labral tears, tendon retraction and muscle atrophy can guide the orthopaedician during arthroscopy and in treatmentplanning.


2016 ◽  
pp. 3-23
Author(s):  
Stefano Gumina ◽  
Daniele Passaretti ◽  
Vittorio Candela

2019 ◽  
Author(s):  
Andrea Ruberti ◽  
Mario Ronga ◽  
Leonardo Callegari

Abstract Background: Rotator cuff structural changes are common in overhead throwing athletes, such as baseball, javelin, swimming, volleyball, by increasing the risk of shoulder pain and injury. The structural alterations in elite waterpolo players are not well known. In elite waterpolo athletes there are structural alterations of rotato cuff tendons due to overuse of the dominant shoulder compared to the non-dominant, like in oth er overhead disciplines, identifiable by ultrasound (US). Methods: Asymptomatic elite men waterpolo players were selected. All athletes were evaluated with standardized scales of shoulder pain and function (Oxford Shoulder Score, Constant Shoulder Score) and provided data of training, injury and shoulder pain history. Each athlete underwent clinical evaluation of shoulders followed by US of rotator cuff, biceps and bursas. Results : 23 athletes met the inclusion criteria, mean age 24.2±3.3. 14 athletes (60.9%) presented higher degeneration grade at the dominant supraspinatus compared to the contralateral, always in the same area in outfield pla yers: anterior, lateral, pre-insertional. In 22/23 (95.6%) the biceps tendon was damaged: 20/23 athletes (87%) bilaterally, 2/23 (8.7%) at the only dominant limb. The site was always at the bicipital groove in its insertion on the humerus. Power Doppler (PD) evidenced neovascularization in only 5/23 (21.7%) players at supraspinatus: 4 bilaterally, 1 only at the non-dominant. No statistical correlation was found between tendon degeneration and age, career years. Conclusion: Outfield waterpolo players have peculiar changes in supraspinatus at preinsertional level, as seen in other overhead throwing athletes. We found changes also in biceps, bilaterally, like in shoulders of elite swimmers. We suppose that these changes are predictive of shoulder pain and injury.


2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
P Brainin ◽  
G H Mohr ◽  
D Modin ◽  
B Claggett ◽  
O M Silvestre ◽  
...  

Abstract Background Malaria is a parasitic mosquito-borne infection which affects more than 219 million people worldwide each year. Recent studies have hypothesized that malaria may contribute to functional and structural changes in the myocardium, which can lead to cardiovascular disease. We therefore investigated the risk of heart failure (HF) and other cardiovascular events in individuals with a prior history of malaria infection. Methods Danish nationwide registries were used to identify patients with a history of malaria infection between January 1994 and January 2017. Patients with ischemic heart disease or HF at baseline were excluded. The population was sex and age matched with the general population in a ratio of 1:10. Information on cardiovascular risk factors and medication were assessed at time of the malaria diagnosis. Cox proportional hazards models, and a propensity score-matched model, were used to assess the risk of HF, myocardial infarction (MI) and cardiovascular death (CVD). Results A total of 3,570 malaria cases were identified (40% had plasmodium falciparum). The median age was 32 years and 57% were male. During a median follow-up time of 11 years [interquartile range 5, 17], 52 cases experienced incident HF (1.5%), 30 MI (0.9%) and 58 suffered from CVD (1.6%). In unadjusted survival analyses, malaria cases had a significantly increased risk of HF (HR 1.34 95% CI 1.01–1.79, P=0.046) but not MI (HR 0.72 95% CI 0.51–1.03, P=0.073) or CVD (HR 1.14 95% CI 0.87–1.49, P=0.34). In multivariable models adjusted for hypertension, diabetes, chronic kidney disease, vascular disease and concomitant pharmacotherapy (lipid lowering/antianginal/diuretics/betablocker), the association with HF remained significant (HR 1.40 95% CI 1.05–1.87, P=0.023). A propensity score-matched model based on 7,152 individuals (1:1 of cases and controls) also yielded a significant association with HF (HR 1.59 95% CI 1.03–2.46, P=0.036). Forest plot: Malaria and CV events Conclusion Our data indicate that individuals with a prior history of a malaria infection may have an increased risk of incident HF but not MI or CVD. This suggests that malaria, on a hypothesis-generating basis, may affect long-term cardiac function.


2019 ◽  
Vol 02 (01) ◽  
pp. 09-17
Author(s):  
Claudia Juan Vigar ◽  
Francesc Medina-Mirapeix

Introduction CrossFit is a sport that is on the rise and has a known injury rate thanks to studies that have affirmed that the shoulder is the area that suffers the most damage. To date, no objective tool has been used to evaluate this. The aim of the present study was to determine the frequency of structural sonographic alterations in CrossFit athletes and its relationship with accumulated hours of practice and/or competition in the sport and shoulder pain. Material and Methods A cross-sectional descriptive study was conducted with sonographic assessments performed on 208 shoulders of 104 participants at official CrossFit gyms in Barcelona, between April and May 2017. The participants were requested to complete a specific questionnaire on CrossFit sports practice that included demographic data, the existence of pain, data on training routines, and clinical history. Ultrasound (US) examinations were made on the supraspinatus tendons (SST), on the long head of the biceps (LHB), and on the acromioclavicular (AC) joint. Results The presence of focal hypoechoic areas (FHAs) in the LHB (48.1%) and in the SST (60.6%) were the most common alterations in this sample, whereas, at the level of the AC joint, the most common disorder was the presence of cortical defects (30.3%). Shoulder pain was present in 37.5% of the participants. The probability of experiencing pain increased when the athletes accumulated > 1,000 hours of training (odds ratio [OR] = 2.0). In these athletes, the probability of presenting a focal hypoechoic area (FHA) decreased in the LHB (OR = 0.3), and the width of the SST increased a mean of 0.5 mm (p < 0.01). In athletes who participated in competitions, the sonographic pattern also presented an increased width of the SST and LHB tendons; however, this was not related with an increased probability of experiencing pain. Conclusions The sonographic pattern of the shoulder of CrossFit athletes presented structural changes in the SST and LHB tendons when subjects accumulated > 1,000 hours of training or when they participated in competitions. It is essential to relate the sonographic findings with the clinical findings of a patient to define whether these findings are, indeed, pathological. The probability of experiencing pain in the shoulder doubles when > 1,000 hours of CrossFit training are accumulated. This finding bears no relation with competing.


2020 ◽  
Vol 23 (3) ◽  
pp. 125-130
Author(s):  
Do-Young Kim ◽  
Jung-Taek Hwang ◽  
Sang-Soo Lee ◽  
Jun-Hyuck Lee ◽  
Min-Soo Cho

Background: To determine the prevalence of rotator cuff diseases in a population older than 40 years in or nearby Chuncheon city, Republic of Korea.Methods: Sixty shoulders of 30 people older than 40 years who participated in a health lecture were examined for free by an orthopedic surgeon. Visual analog scale of pain and American Shoulder and Elbow Surgeons scores were assigned, and routine physical examination was performed. Ultrasonography was performed on the shoulder. Results: On ultrasonographic examination, there were one shoulder with full thickness rotator cuff tear, 20 of 60 (33%) with partial thickness rotator cuff tear, five of 60 (8%) with calcific tendinitis, one of 60 (2%) with tear of the long head of the biceps, and five of 50 (8%) with tendinitis of the long head of the biceps. Participants older than 60 years showed significantly high proportions of lesion of the long head of the biceps and rotator cuff diseases (P=0.019 and P=0.015, respectively). Participants who performed physical labor had high proportions of rotator cuff tear and rotator cuff disease (P=0.001 and P<0.001, respectively). Conclusions: Rotator cuff diseases showed a high prevalence in elderly persons and resulted in a decrease in shoulder function.


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