shoulder pathologies
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2021 ◽  
pp. 261-266
Author(s):  
Pedro Ferreira Pereira ◽  
José Fernandes ◽  
António Sousa ◽  
Manuel Gutierres

Enchondromas are common benign bone tumors. They are often found incidentally and usually do not require any treatment other than clinical surveillance. Signs of lesion progression or nontolerable pain are criteria for surgical resection. We present a case of a 44-year-old woman with long-lasting shoulder pain, diagnosed with enchondroma. Imaging studies showed an enchondroma near the great tuberosity. Shoulder arthroscopy made it possible to diagnose and treat an SLAP lesion as well as to resect by curettage and shaving through the subacromial lateral portal. One year after surgery, the patient had significant pain relief and improved shoulder function. Shoulder arthroscopy seems to be a safe and suitable technique for resection of small-sized humeral enchondromas, with the advantage of allowing to treat other possible concomitant shoulder pathologies.


2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Susann Minkwitz ◽  
Kathi Thiele ◽  
Aysha Schmock ◽  
Nicole Bormann ◽  
Thanh Huyen Nguyen ◽  
...  

Abstract Background The role of the subacromial bursa in the development or healing of shoulder pathologies is unclear. Due to this limited knowledge, we aimed to understand specific reactions of the subacromial bursa according to rotator cuff (RC) pathologies compared to non-tendon defects of the shoulder. We hypothesized that the tissue composition and inflammatory status of the bursa are likely to vary between shoulder pathologies depending on the presence and the extent of RC lesion. Method Bursa samples from patients with either 1) shoulder instability with intact RC (healthy bursa, control), 2) osteochondral pathology with intact RC, 3) partial supraspinatus (SSP) tendon tear, or 4) full-thickness SSP tear were investigated histologically and on gene expression level. Result Bursae from SSP tears differed from non-tendon pathologies by exhibiting increased chondral metaplasia and TGFβ1 expression. MMP1 was not expressed in healthy bursa controls, but strongly increased with full-thickness SSP tears. Additionally, the expression of the inflammatory mediators IL1β, IL6, and COX2 increased with the extent of SSP tear as shown by correlation analysis. In contrast, increased angiogenesis and nerve fibers as well as significantly upregulated IL6 and COX2 expression were features of bursae from patients with osteochondral pathology. Using immunohistochemistry, CD45+ leukocytes were observed in all examined groups, which were identified in particular as CD68+ monocytes/macrophages. Conclusion In summary, besides the strong increase in MMP1 expression with SSP tear, molecular changes were minor between the investigated groups. However, expression of pro-inflammatory cytokines correlated with the severity of the SSP tear. Most pronounced tissue alterations occurred for the osteochondral pathology and full-thickness SSP tear group, which demonstrates that the bursal reaction is not exclusively dependent on the occurrence of an SSP tear rather than longstanding degenerative changes. The present bursa characterization contributes to the understanding of specific tissue alterations related to RC tears or non-tendon shoulder pathologies. This pilot study provides the basis for future studies elucidating the role of the subacromial bursa in the development or healing of shoulder pathologies.


2021 ◽  
Vol 25 (05) ◽  
pp. 652-660
Author(s):  
James Francis Griffith

AbstractMagnetic resonance imaging of the shoulder is a commonly performed investigation. This article discusses the common shoulder pathologies encountered, emphasizes the key features to report, and provides examples of terminology used to describe these pathologies.


2021 ◽  
Author(s):  
Zeitler Cornelia ◽  
Irene Steiner ◽  
Breuer Robert ◽  
Rainer Fiala ◽  
Rolf Michael Krifter

Abstract Background: High injury rates are to be expected in combat sports. Although case reports and epidemiological studies have documented shoulder injuries in boxers, numbers differ and there is currently no systematic review reporting injury prevalence. Purpose: The aim of this study was to offer an analysis of existing studies documenting shoulder injuries in boxing. Additionally, we wanted to evaluate, if chronic shoulder pathologies seen in former boxers, originate from acute injuries or result from chronic overuse syndromes.Study Design: Systematic ReviewMethods: We performed a systematic database research according to the PRISMA guidelines on PubMed, Scopus and Google Scholar for the keywords “boxing”, “injury” and “shoulder” or their respective synonyms. Any epidemiological cohort- and cross-sectional studies on boxing, that documented shoulder injuries and were published in German or English language up to January 2020, were included. Statistical analysis including individual and overall proportion with 95% Clopper-Pearson confidence intervals was performed to determine shoulder injury rates for amateur and professional cohorts separately.Results: Methodological quality was assessed using the STROBE statement and a modified Downs&Black's checklist. 13 studies were included, 10 of which met the criteria for statistical analyses. The heterogeneity in study design and cohort characteristics did not allow for detailed quantitative analysis. Overall, shoulder injuries occurred almost twice as often in amateur athletes than in professionals (overall proportion [95% CI]: amateur athletes: 9% [6%; 12%], professionals: 4% [2%; 8%]).Conclusion: No study investigating the long-term effects of boxing on shoulder pathologies was identified. Although specific information on injury type is mostly missing, the few studies addressing it report shoulder dislocations, strains, tendonitis, or chronic impingement syndromes. Unlike head trauma, shoulder injuries do not necessarily lead to cessation of fight, therefore at the ringside gross underreporting of shoulder pathologies must be taken into consideration.


2021 ◽  
Vol 162 (15) ◽  
pp. 587-594
Author(s):  
Dominik Norbert Kovács ◽  
Márton Moldoványi ◽  
Veronika Varga ◽  
Márta Hock ◽  
Eleonóra Leidecker

Összefoglaló. Bevezetés: A megváltozott statikus és/vagy dinamikus lapockapozíciót, azaz a scapuladyskinesist gyakran vonják párhuzamba a vállelváltozásokkal. Mindemellett a lapocka kinematikai eltérései nagy számban jelen lehetnek tünetmentes egyéneknél is, melegágyat biztosítva a későbbi vállelváltozások kialakulásának. Célkitűzés: Munkánk fő célja az volt, hogy felhívja a figyelmet ezen problémakör fontosságára, valamint hogy megvizsgálja a scapuladyskinesis előfordulásának gyakoriságát és körülményeit az átlagpopulációban. Módszer: Mintánk 70 főből állt (átlagéletkor: 22,17 ± 1,77 év). 67%-uk férfi, míg 33%-uk nő volt. A scapuladyskinesis fennállását McClure-féle ’Scapular Dyskinesis Test’-tel vizsgáltuk. A résztvevők vállfájdalmának intenzitását vizuális analóg skála segítségével, habituális testtartásukat fotogrammetriás módszerrel, főbb lapockastabilizáló izmaik izomerejét pedig Kendall-féle manuális izomerőtesztekkel mértük fel. Mindemellett felvettük antropometriai adataikat, valamint megkérdeztük, hogy milyen gyakran végeznek sporttevékenységet. Eredmények: A résztvevők 53%-ánál találtunk valamilyen fokú scapuladyskinesist. A habituális testtartást vizsgáló fotogrammetriás felmérés eredményei és a scapuladyskinesist mérő McClure-féle teszt eredményei között szignifikáns összefüggést találtunk (p = 0,01). A sportolási gyakoriság és a scapuladyskinesis előfordulása között jelentős összefüggést tapasztaltunk (p = 0,01). A fájdalom erőssége és a scapuladyskinesis előfordulása között szignifikáns volt az összefüggés (p = 0,03). A scapuladyskinesist mérő McClure-féle teszt és az azonos oldali felső végtagon izomerő-csökkenést mutató tesztek eredményei között szintén szignifikáns összefüggést tapasztaltunk (p = 0,01). Következtetés: Az elit sportolók mellett az átlagos populációban is jelentős mértékben jelen lehetnek a lapocka kinematikai eltérései. Mindez jelentős összefüggésben állhat az adott személy életmódjával és egészségmagatartásával, valamint kiemelt szerepet játszhat a krónikus vállfájdalom kialakulásában. Orv Hetil. 2021; 162(15): 587–594. Summary. Introduction: The altered static and/or dynamic scapular position, i. e., scapular dyskinesis, is often paralleled with shoulder pathologies. However, shoulder kinematic abnormalities may also be present in large numbers in asymptomatic individuals. Objective: The main goal of our work was to draw attention to the importance of scapular dyskinesis in shoulder pathologies. Method: The final sample consisted of 70 people (average age: 22.17 ± 1.77 years), 67% of them was male and 33% female. The presence of scapular dyskinesis was assessed by McClure’s Scapular Dyskinesis Test. Visual analog scale was used to examine the shoulder pain of the participants, photogrammetric method was used to document their habitual posture. Kendall’s manual muscle testing methods were used to determine the muscle strength of the individual muscles of the shoulder girdle; we also recorded their anthropometric data and asked them about their sporting habits. Results: In 53% of the participants, some degree of scapular dyskinesis was found. We observed significant correlation between the sporting habits and scapular dyskinesis (p = 0.01). Significant correlation was observed between the posture and scapular dyskinesis (p = 0.01). Between the strength of pain and the dyskinesis, we found a significant correlation (p = 0.03). There was a significant correlation between the results of the McClure’s test and the tests showing muscle strength loss around the scapula (p = 0.01). Conclusion: In addition to elite athletes, scapular dyskinesis may also be significantly present in the average population and can play a key role in the development of shoulder pain. Orv Hetil. 2021; 162(15): 587–594.


2021 ◽  
Author(s):  
Zachariah J. Henderson ◽  
Sarah Bohunicky ◽  
Josee A. Rochon ◽  
Mark Dacanay ◽  
Trisha D. Scribbans

Abstract Context: Manual muscle tests (MMTs) are often used when assessing shoulder pathologies. For the trapezius, individual MMTs are used to selectively test the upper (UTR), middle (MTR), and lower (LTR) trapezius regions. It is assumed that MMTs for each region preferentially recruit the corresponding muscle fibres and produce a “maximal” contraction; however, it is unknown if this is true. Objective: To determine if maximum voluntary isometric contractions (MVICs) for the upper (UT-MVIC), middle (MT-MVIC), and lower (LT-MVIC) trapezius, adapted from the Kendall MMTs, recruit the corresponding trapezius regions. Design: Cross-Over. Setting: Laboratory. Participants: 20 young, healthy individuals. Intervention: Participants performed three repetitions of each MVIC. High density surface electromyography was collected from the UTR, MTR, and LTR. Main Outcome Measures: Root mean square (excitation) of the UTR, MTR, and LTR. Statistical Analysis: Three, one-way repeated measures ANOVAs. Results: UTR excitation: There was a significant increase in UTR excitation during the LT-MVIC compared to the UT-MVIC (p = .016), and MT-MVIC (p < .001). MTR excitation: There was a significant increase in MTR excitation during the MT-MVIC compared to the UT-MVIC (p = .001), and a significant increase in MTR excitation during the LT-MVIC compared to the UT-MVIC (p < .001). There was also a significant increase in MTR excitation during the LT-MVIC compared to the MT-MVIC (p < .001). LTR excitation: There was a significant increase in LTR excitation during the MT-MVIC (p < .001) and LT-MVIC (p < .001) compared to the UT-MVIC. Conclusions: The UT-MVIC and MT-MVIC do not necessarily recruit the corresponding trapezius regions more than the other MVICs. Rather, the LT-MVIC appears to produce the greatest excitation in all trapezius regions. Additional research is needed; however, clinicians should be aware that maximal contractions may not always recruit the desired musculature when forming a clinical interpretation.


2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Fatih Özden ◽  
Nazan Tuğay ◽  
Özgür Nadiye Karaman ◽  
Cem Yalın Kilinç ◽  
Baki Umut Tuğay

Abstract Background The pain, fear of movement, and disability are interrelated parameters that may adversely affect the individual in terms of medical and social aspects. This relationship has not been well studied in shoulder pathologies. We carried out a single-center cross-sectional study in the Orthopaedics and Traumatology Clinic. The aim of the study was to investigate the relationship between pain, function range of motion (ROM), and fear of movement in patients with shoulder pain. Results The mean age of the participants was 53.7 ± 11.2 years. Symptom duration was 11.65 ± 23.39 months. Most of the subjects (66.7%) had impingement syndrome. There was a weak to moderate negative correlation between both visual analog scale (VAS) and Oxford Shoulder Score (OSS) with flexion, abduction, external rotation ROM values (r1 = − 0.293, r2 = − 0.348, r3 = − 0.330, p < 0.001). In addition, there was a weak negative correlation between Tampa Kinesiophobia Score (TKS) and ROM values of abduction, internal rotation, and external rotation (r1 = − 0.273, r2 = − 0.207, r3 = − 0.250, p < 0.05). Pain was weakly and positively correlated with OSS (r = 0.209, p < 0.05). Conclusions According to our results, shoulder pain was associated with functionality, but fear of movement was not associated with shoulder pain or functionality. ROM was associated with both pain, functionality, and fear of movement.


Author(s):  
Ursina Arnet ◽  
Wiebe H. de Vries ◽  
Inge Eriks-Hoogland ◽  
Christian Wisianowsky ◽  
Lucas H. V. van der Woude ◽  
...  

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