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PubMedDate not supplied

Aberrant muscle anterior to the shoulder joint: its clinical relevance.

Thirteen shoulders of 13 cases with aberrant muscle attached to the subscapularis encountered during surgery are described. The distal part of the subscapularis was completely or incompletely covered by aberrant muscle in all cases, and the anterior circumflex vessels were covered in 3 cases. Knowledge concerning these aberrant muscles is indispensable in minimizing confusion concerning surgical anatomy and in achieving adequate exposure of the shoulder during surgery while preserving the anterior circumflex artery, which constitutes the main nutrient vessel of the humeral head.

Female↗
PubMed1984

Arthroscopy of the shoulder joint--a cadaver and clinical study. Part 1: Cadaver study.

An experimental study of shoulder arthroscopy has been carried out over the past two years. Fifty-one cadaveric shoulders were investigated by different types of arthroscope. Dissections were carried out after each arthroscopic examination and the arthroscopic findings were investigated. Three approaches, namely, anterior, posterior and superior were used. The arthroscopic anatomy of the shoulder joint was divided into 5 regions: anterior, superior, central, inferior, and posterior. The posterior approach provides the widest field of view amongst all the approaches and also better orientation. The superior approach could cause damage to the critical area of supraspinatus tendon and its clinical application is not recommended.

Adolescent↗
PubMed2005

Tuberculosis of the shoulder joint.

OBJECTIVES: Skeletal tuberculosis is less common than the pulmonary form. The involvement of the shoulder joint is infrequent. We report our experience treating tuberculosis of the shoulder in 11 patients. METHODS: There were seven men and four women, ranging in age from 19 to 55 years (average 28.09 years). The duration of their complaints at presentation ranged from 3 to 24 months. The most common presentation was pain, which was seen in 10 joints. All of the patients had mild to moderate restriction of motion of the shoulder. On laboratory examination, the erythrocyte sedimentation rate was increased mildly. No patient had an active tuberculosis lesion or history of pulmonary disease. The diagnosis was based on the clinical picture and radiographic features, and was confirmed by open biopsy. The diagnosis was not confirmed by biopsy in one patient, but the family history and clinical and radiological features were highly suggestive of tuberculosis. Surgical debridement was done in two patients and open biopsy in eight patients in order to obtain samples for pathology. Arthrodesis was done in only one patient. In all patients, treatment began with a four-drug regimen for 2 months, followed by a two-drug regimen for 10 months. RESULTS: The mean follow-up period after the end of treatment was 28.72 months (range, 22-52 months). At the time of the last visit, all the lesions had healed without recurrence. Five cases had a painless, mobile shoulder, while three had mildly restricted shoulder motion without pain, and three had residual limitation of motion of the affected shoulder. CONCLUSIONS: Tuberculosis of the shoulder can be difficult to diagnose in the early stages. If not diagnosed early, bony tuberculosis may reduce the quality of life. Therefore, tuberculosis should be suspected in cases of long-standing pain in the shoulder. It is necessary to keep tuberculosis in the differential diagnosis of several osseous pathologies. Arthrodesis should be reserved only for lesions that fail to heal after adequate chemotherapy and rehabilitation.

Adult↗
PubMed1993

Adhesive capsulitis of the shoulder joint: usefulness of dynamic sonography.

We studied the value of dynamic sonography in adhesive capsulitis of the shoulder joint in patients with clinically suspected frozen shoulder. The sonographic criterion of adhesive capsulitis was continuous limitation of the sliding movement of the supraspinatus tendon against the acromion of the scapula. Arthrography was regarded as a gold standard in the diagnosis of adhesive capsulitis against which the sonographic results were compared. Among 23 patients with arthrographically documented adhesive capsulitis, sonographic examination showed limitation of movement of the supraspinatus tendon in 21. This sonographic sign therefore has a sensitivity of 91%, a specificity of 100%, and an accuracy of 92% for detecting adhesive capsulitis, making dynamic sonography a reliable technique for the diagnosis of this condition.

Adult↗
PubMed1988

[Projections in conventional shoulder joint diagnosis].

Numerous projections are described in the literature for plain film radiography of the shoulder joint. A review is given of the indications, advantages and disadvantages of the most common views. The significance of special, additional views is discussed.

Humans↗
PubMed1996

Imaging of bursae around the shoulder joint.

The authors present a review of the anatomy of the major bursae around the shoulder joint and discuss the use of the different imaging modalities which demonstrate their radiologic features. The calcified subacromial-subdeltoid bursa has a characteristic appearance on plain radiographs. When inflamed it can be visualized by ultrasound and magnetic resonance imaging. Calcific bursitis may involve the subcoracoid bursa. This bursa may mimic adhesive capsulitis of the shoulder or complete rotator cuff tear when injected inadvertently during shoulder arthrography. Less well known are three coracoclavicular ligament bursae. These are also subject to calcific bursitis and have a typical radiologic appearance.

Bursa, Synovial↗
PubMed1993

[Magnetic resonance morphologic changes in shoulder joints of world class water polo players].

UNLABELLED: In a prospective study we examined the dominant shoulder of 11 athletes from the 1992 German Olympic water polo team. Their mean age was 25.4 +/- 3.5 years. Water polo had been practised generally for 14.1 +/- 4.3 years and professionally for 11.6 +/- 3.9 years. The weekly training amounted to between 12.5 and 19.5 hours. All athletes were submitted to standardised clinical, sonographical and MRI tests. In 5 cases we found anamnestic and/or clinical indications of rotator cuff pathology. In all 5 cases the supraspinatus tendon was affected, and in three cases both the supra- and the infraspinatus tendon were involved. Sonographically, no specific pathology except a thickened rotator cuff was seen. Remarkable changes were revealed by magnetic resonance imaging. In 8 cases changes were present in the insertion of the rotator cuff at the humeral head. The subacromial bursa was not pathologic. The tendon of the long head of the biceps was pathologically changed in 9 cases. In 7 athletes a so-called biceps halo and in two an osteophyte in the area of the bicipital groove was visible. In all of the 11 dominant shoulder joints massive hypertrophy of the articular capsule and pathologic changes of the anterior glenoid labrum existed. Occult osseous lesions were detected in 5 athletes, and osseous lesions of the humeral head in 8 athletes. In all athletes we could document degenerative changes at the acromioclavicular joints such as effusion in 7 cases, arthritis in two cases, and evident synovitis in two cases. CLINICAL RELEVANCE: Many of the changes detected by MRI were not symptomatic.(ABSTRACT TRUNCATED AT 250 WORDS)

Acromioclavicular Joint↗
PubMed1997

Mennen plate in hip and shoulder joint replacement.

Sixteen patients complicated by femoral fracture and aseptic loosening with severe bone loss and two patients complicated by humeral fracture after hip and shoulder joint replacement, respectively, were collected from the Carmel and Ichilov teaching hospitals. All patients underwent internal fixation with the Mennen plate or in conjunction with revision joint replacement, either for internal fixation or for bone graft support. The results were satisfactory in fifteen patients with respect to functional activity, pain, and the radiographic evaluation. In three patients who underwent their fourth revision, the results were unsatisfactory but were better than their preoperative status. Our conclusion is that Mennen plate fixation provides a sufficient and easy internal fixation technique for a fracture around or below the un-dislodged stem of hip and shoulder in joint replacement. In an unstable femoral fracture or in a case of aseptic loosenings with marked bone loss, we recommend Mennen plate fixation in conjunction with long stem revision total hip replacement and bone graft.

Aged↗
PubMed2002

A simplified technique for diagnostic and surgical arthroscopy of the shoulder joint in the dog.

A modified technique is presented for surgical and diagnostic arthroscopy of the shoulder joint in the dog. The technique involves access to the joint through two points only; one was created in place of the drainage needle-cannula, which was replaced with a portal, while the second was located more caudally compared with previous techniques. Using a changing guide rod system the two portals are completely interchangeable in order to perform easier arthroscopic surgery either in the cranial or caudal aspect of the joint. The presence of only one portal caudal to the lateral collateral ligament allows more freedom of movement and avoids interference between the arthroscope and the instruments. The modified procedure was performed on 33 joints affected by osteochondritis dissecans or tenoligament diseases and facilitated straightforward diagnostic examinations, and simple and rapid surgical procedures.

Animals↗
PubMed1986

Shoulder joint load and muscular activity during lifting.

The aim of this study was to investigate load on shoulder joint and muscles in healthy adults during four different ways of lifting a moderate burden (12.8 kg) from floor to table level. The methods used were surface electrode EMG with linear envelope, and calculation of loading moments of force using a static biomechanical model. The shoulder load at the beginning of the lift was lowest for the straight knee lift. The peak load occurred in the late phase of all lifts. On completion of the lift, load and activation were considerably lower when the subject was allowed to step forward before putting the box down. The most activated shoulder muscles were the anterior and lateral parts of the deltoid, and the serratus anterior. Around 80% of the shoulder load moment was caused by the weight of the burden. Some 75% of maximum shoulder strength was required for lifting the burden.

Adult↗
PubMed2005

Intra-articular fibroma of tendon sheath of the shoulder joint: synovial fibroma.

The case of a 30-year-old woman with multiple loose bodies in the shoulder joint is presented. The patient complained of discomfort of her right shoulder. Conventional radiographs failed to reveal any abnormality of the shoulder. On MRI numerous loose bodies were detected that resembled synovial chondromatosis. Histologically, the loose bodies were composed of a benign fibroblastic lesion with diagnostic features of fibroma of tendon sheath, each surfaced by synoviocytes. The clinicopathologic features of intra-articular fibroma of tendon sheath are reviewed. We propose using the term "synovial fibroma" for tumors with histopathologic features of fibroma of tendon sheath arising in the synovium of joints.

Adult↗
PubMed1983

Arthroscopy of the shoulder joint (technique).

The results are reported of using different telescopes and different approaches in arthroscopy of the shoulder joint. This joint is particularly suitable for arthroscopic investigation and its use will no doubt increase considerably in the near future because of its considerable potential as an aid to diagnosis and treatment.

Arthroscopy↗
PubMed1989

[NMR tomography of the shoulder joint: clinical experiences with the saturation pulse technic].

High zoom factors for MRT of the shoulder joint can lead to disturbing artifacts. The use of special saturation coils can improve longitudinal magnetisation of the central image, making it possible to produce artifact-free images of the shoulder with high resolution. Two normals and 20 patients with the rotator cuff syndrome, as well as other inflammatory and neoplastic processes, have been examined. The findings have been correlated with those of arthrography, arthro-sonography, bone scintigraphy, CT and simple radiographic examination. The MRT findings were compared with the other imaging techniques and the results are discussed. MRT proved superior to other techniques, particularly in the elucidation of soft tissue abnormalities in the rotator cuff syndrome.

Adolescent↗
PubMed2004

Proprioception of the shoulder joint after surgical repair for Instability: a long-term follow-up study.

BACKGROUND: Proprioceptive capabilities play an important role in stability of the shoulder joint. HYPOTHESIS: Decreased proprioceptive capabilities can improve by surgical repair of shoulder instability. STUDY DESIGN: Prospective long-term study. METHODS: The proprioceptive capabilities of 14 patients with recurrent anterior shoulder instability were examined preoperative and with a minimum follow-up of 5 years postoperative using the angle reproduction test. The patients' data were compared to a healthy control group. RESULTS: The joint position sense improved significantly in abduction, flexion, and rotation (P <.05). The preoperative difference from the target joint position was 9.3 degrees (SD, 4.6 degrees ) for the summarized positions in abduction, 9.1 degrees (SD, 4.5 degrees ) in flexion, and 10.1 degrees (SD, 5.1 degrees ) in rotation. Postoperatively, it improved to 5.6 degrees (SD, 2.9 degrees ) in abduction, 5.6 degrees (SD, 2.7 degrees ) in flexion, and 5.0 degrees (SD, 1.8 degrees ) in rotation. The joint position sense of the uninvolved contralateral shoulder improved too. CONCLUSIONS: Five years after surgical repair for shoulder instability, the joint position sense improved significantly, to a level of normal, healthy shoulders.

Adolescent↗
PubMed1956

The shoulder joint; observations on comparative anatomy, physiology and treatment.

In a visual study of human and simian function of the shoulder joint, manifest superiority of the latter was noted. Comparative anatomical studies tend to confirm these observations and indicate that many common affections of the shoulder in humans may stem from incomplete evolutionary adaptation. Certain anatomical clues may lead to improvements in conservative and surgical treatment.A regimen of conservative and operative treatment developed over a period of many years has been found to be clinically effective for the relief of chronic refractory shoulder pain. These techniques differ at many points from present practices of a majority of physicians who deal with diseases of the shoulder.

Anatomy, Comparative↗
PubMed1996

Long-term follow-up of bypasses to the brachial artery across the shoulder joint.

BACKGROUND: Most atherosclerotic lesions in the subclavian artery are successfully treated with carotid to subclavian bypass. The need to bypass to the brachial artery (BA) is rare. We reviewed our experience with this bypass. METHODS: Over a 10-year period, we have performed 13 bypasses to the BA originating from an artery proximal to the shoulder joint. In this retrospective study, the demographic and clinical risk factors were evaluated. Long-term results were analyzed. RESULTS: Thirteen operations were performed in 10 patients, aged 47 to 80 years. The operations were carried out for acute severe ischemia in 1 limb, effort discomfort in 9, and rest pain in 3 limbs. Donor arteries were axillary (7), carotid (4), and subclavian (2). All bypasses were to the BA proximal to the elbow joints. Life-table analysis showed 100% patency in the first 3 years and 88% at 7 years. There were 2 deaths in follow-up. Average preoperative brachial to brachial index was 0.59 and postoperative index was 1.1. In patients with bilateral occlusions, mean preoperative brachial artery pressure was 62 mm Hg, which improved to 142 mm Hg postoperatively. There were no neurological complications and no 30-day mortality. CONCLUSIONS: Bypass across the shoulder joint to the BA using expanded polytetrafluoroethylene (ePTFE) or vein is a safe operation with excellent long-term patency. The carotid artery can be used as a donor vessel without complications. Hypertension and female gender appear to be risk factors for extensive disease in proximal upper extremity arteries.

Aged↗
PubMed1990

[Sonographic diagnosis of Hill-Sachs lesions in unstable shoulder joints].

In a prospective study we evaluated the use of diagnostic ultrasound for Hill-Sachs lesions in unstable shoulder joints of 71 patients. The arthroscopic control of the sonographic findings showed a high sensitivity of 100%, a specificity of 89%, an accuracy of 95%, a positive predictive value of 93%, and a negative predictive value of 100%. With these results ultrasound seems to be more reliable than x-ray in the diagnosis of Hill-Sachs lesions.

Adolescent↗