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Magnetic resonance imaging of sports-related injuries to the shoulder: impingement and rotator cuff.

MR imaging provides clinically useful information in detecting and characterizing sports-related pathology of the rotator cuff and other shoulder disorders in a non-invasive fashion. Complete and partial tears of the rotator cuff, as well as factors contributing to impingement, can be detected and characterized with MR imaging. The size and location of complete tears of the rotator cuff can be accurately determined with MR imaging.

Athletic Injuries↗

Full-thickness supraspinatus tendon tears with intact superior glenohumeral capsule.

Fourteen of 318 consecutive shoulder arthroscopies performed over 5 years were found to have a complete tear of the supraspinatus tendon with an intact superior glenohumeral joint capsule. All tears were surgically repaired into a bony trough in the greater tuberosity. All of these tears were found in the past 2 years, representing the last 155 arthroscopies performed. This would indicate that there were probably similar lesions that were missed in earlier cases. This represents a significant pitfall injury that may yield a negative arthrogram and may be overlooked in arthroscopic shoulder surgery unless close inspection of the bursal side of the rotator cuff is accomplished.

Arthroscopy↗

Neuro-orthopedic management of shoulder deformity and dysfunction in brain-injured patients: a novel approach.

Shoulder problems are common in patients with traumatic brain injury. Very little has been written about the evaluation and neuro-orthopedic management of these problems. This is largely because there have not been surgical treatments available other than release of contracted, nonfunctional shoulders. Shoulder problems can be classified and evaluated using several different strategies: bony versus soft tissue restrictions; static versus dynamic deformities; traumatic injuries versus impairments secondary to weakness and spasticity; or problems of active function versus problems of passive function. Regardless of the classification system employed a systematic approach to evaluation and treatment is essential. Shoulder impairments can be corrected leading to significant improvement in functional outcomes. In this paper we report on the novel evaluation and surgical management options developed in our program for the most common shoulder problems encountered in patients with traumatic brain injury.

Brain Injuries↗

[Posterosuperior glenoid rim impingement in athletes: the diagnostic value of traditional radiology and magnetic resonance].

First described by Walch in 1991, the posterosuperior glenoid rim impingement syndrome is a major condition in the differential diagnosis of shoulder pain occurring in the athletes engaged in repetitive and loading movements of abduction and extra-rotation of the dominant upper limb. Thirty-eight athletes with these dynamic athletic characteristics, referred for unexplained shoulder pain and with a clinical diagnosis of posterosuperior glenoid rim impingement syndrome, underwent radiography and MR examinations, with excellent final results. Radiography was capable of depicting the abnormal skeletal features of this kind of impingement, thus allowing a preliminary diagnosis to be made. MRI excelled in diagnosing the lesions in the deep surface of the supraspinatus tendon and in the posterior labrum secondary to impingement. The static and the kinematic sequences with the arm in abduction and extrarotation proved to be the best ones to define the physiopathologic phases of impingement. Thus, we conclude that invasive diagnostic procedures are not necessary for the correct and unquestionable diagnosis of posterosuperior glenoid rim impingement syndrome.

Adolescent↗

Impingement in the athlete.

There is no doubt that the understanding of shoulder mechanics and pathology will continue to evolve. It is not appropriate to consider that all patients, especially young athletes, who have shoulder pain have "impingement." Rather, a careful evaluation will result in the correct diagnosis and the institution of the appropriate treatment. A step-by-step assessment and management scheme is necessary for each health care professional dealing with athletes. If surgery is deemed necessary, the correction of the anatomic abnormality with minimal disruption of normal anatomy will be the key to allowing the athlete to return to his or her chosen sport.

Arthroscopy↗

Periarticular soft tissue conditions causing pain in the shoulder.

Pain originating in periarticular soft tissues of the shoulder is a common clinical problem among the aged patients of both sexes, but it has become increasingly frequent in young individuals because of a health-oriented life style. In the past year, a considerable progress has been made in diagnosing these conditions, especially with the aid of magnetic resonance imaging. Our understanding of the pathogenesis of these conditions, however, has advanced very little, and we hope that more efforts will be devoted in the future to elucidate how the periarticular soft tissues of the shoulder react to diverse injuries they are exposed to.

Humans↗

[Degenerative joint and spine diseases].

Degenerative joint and spine diseases account for more than 70% of all complaints and functional impairment in the human locomotor system. An expert assessor has to answer questions referring to loss of capability of earning a living and to the extent of an invalidity. He will often be confronted with questions whether or not the body damage is related to an accident. He therefore has to be familiar with accident mechanisms and typical injury patterns. Particular details of examination and imaging important for fulfilling the assessor's task are given. Special hints will be given referring to evaluation of rotator cuff lesions and spine syndromes.

Adult↗

Imaging of sports injuries of the upper extremity in children.

Competitive athletics in school-aged children has become the norm rather than the exception. The increased repetitive stresses placed on the upper extremity in a wide variety of sports result in a host of injuries unique to the skeletally immature athlete. This article focuses on a discussion of the more common upper extremity injuries encountered in the child athlete and the role of radiography and MRI in diagnosis and management.

Acute Disease↗

Overuse injuries of the upper extremity in baseball.

The shoulder and elbow are prone to many overuse injuries in baseball. Injury to the muscles or ligaments leads to pain and loss of effectiveness in competition. Although many of these disorders respond to conservative management, surgery is sometimes necessary to provide pain relief and restore function. Unfortunately, overuse injuries that require surgery still are career-threatening injuries. Correct diagnosis and treatment increase the probability of a throwing athlete returning to competition.

Arm Injuries↗

[Tennis shoulder].

Explore the source record for details and available documents.

Athletic Injuries↗

[Instability and impingement of the shoulder of the high performance athlete in overhead stress].

The present prospective study was performed on 89 competitive sportsmen (league players of handball, basketball, volleyball and water polo). The evaluation was based on information obtained from a review of training methods, a standardised anamnestic, physical and sonographic examination directed at pain, function, flexibility and all signs of impingement and instability of the shoulder counted in a score. The incidence of shoulder pain, which handicapped during training and play within the last 6 months was for water polo 60%, handball 40%, volleyball 25% and basketball 3.5%. Analysing these problems we found severe problems predominantly in handball, fewer in water polo or volleyball. According to data obtained from sports with throwing activity we found a high incidence of shoulder disorders. Using basketball players as a control group with less throwing activity our results would suggest that this mechanism seems to be the most important. The high incidence of severe disorders in handball players is additionally caused by traumatic injuries. Ultrasonography shows predominantly incomplete tears of the deep surface of the supraspinatus tendon near to the insertion with exception of the basketball players. Only in 5 shoulders (2.8%) we found the coincidence of clear signs of instability and subacromial pathology. The term "instability impingement" has not proved to be very helpful and has turned out to be far too diffuse to establish a diagnosis.

Acromioclavicular Joint↗

Complications of shoulder dislocation.

Dislocations of the shoulder are the most common joint dislocations seen in the emergency department, and complications of shoulder dislocations are more frequent than is generally believed. It is vital that emergency physicians have current knowledge of complications associated with shoulder dislocations because of their important role in recognition and prevention. Delayed recognition of complications can have an impact on the long-term outcome of patients. Prompt recognition and follow-up are essential. Most references address reduction methods rather than recognition of specific complications. Emergency physicians have few opportunities to update their knowledge of complications of shoulder dislocations. This article briefly reviews mechanisms of shoulder dislocation and discusses complications in light of the mechanisms of injury.

Biomechanical Phenomena↗

[Isolated traumatic rupture of the subscapular muscle tendon as an adolescent injury].

INTRODUCTION: Until now no case of a traumatic tear of the subascapularis muscle in children was described in the German speaking literature. Using the example of 2 cases of a 12 and 14 year boys youth history, clinic, diagnostics and therapy will be presented. METHODS: The accident happened in extension and external rotation of the arm without dislocation. Beside the complete tear of the SCP-tendon in one case an accompanying expanded humeral flake fracture at the minor tuberosity was found. Under protection of the epiphysis line the refixation was performed using suture anchors. RESULTS: The post-operative control after 12 months showed a complete tendon healing, no arthritis or delayed bony ingrowth with return to full activity. CONCLUSION: Isolated traumatic SCP-tears can be occur also in young patients. As major consequence, it is necessary to perform a thorough clinical examination with additional apparative diagnostics (Sonography, MRI). This way, this rare but important lesion can be detected early and lead to adequate surgery without any delay.

Adolescent↗

Upper extremity injuries in youth sports.

This article provides an overview of common upper extremity injuries in youth sports, including injuries to the shoulder, elbow, and wrist. Pain in the shoulder and elbow is common among youngsters who participate in throwing sports, raquet sports, and swimming, while wrist pain is common among young gymnasts. Acute trauma to the shoulder and elbow can occur in almost any sporting activity. This article provides descriptions of common injuries and guidelines for treatment.

Adolescent↗

Rotator interval tear: a case report.

Rotator cuff tear is one of the most common shoulder disorders. Most of the tears involve the critical area of the supraspinatus tendon. The rotator interval tear is extremely rare. Tear in this area is important due to its relationship with shoulder instability, different clinical symptom and different management. Recently we have uneventually treated a case with rotator interval tear after a violent throwing injury. The purpose of the paper is to emphasize the clinical differences of this unusual tear.

Humans↗