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At least 55 records · Page 3Linked to original sources
PubMed1999

The use of combined suprascapular and circumflex (articular branches) nerve blocks in the management of chronic arthritis of the shoulder joint.

Sixteen patients suffering from rheumatoid or osteoarthritis of the shoulder joint were studied. All patients complained of pain and limitation of active movement of the shoulder joint. Combined neural blockade of the suprascapular nerve (SSNB) and articular branches of the circumflex nerve (ACNB) was carried out using 4 mL of 1% prilocaine and 4 mL of 6% aqueous phenol. Following this procedure, the mean value for pain intensity decreased by 69% (VASP 2.7) and for abduction, adduction and flexion increased by 36-67% over a mean time of 13 weeks. Functional external and internal rotation of the shoulder joint also increased after neural blockade. These findings were significant (P < 0.05). Further clinical evaluation of combined SSNB and ACNB in relation to previously reported methods of neural blockade of the shoulder joint is warranted using a randomized, controlled, comparative study. Conventional power calculations (80% power, 5% test) indicate that 17 patients per group would be necessary to detect one standard deviation (about 2 VASP) or 64 per group to detect a change of 0.5 standard deviations.

Aged↗
PubMedDate not supplied

A morphometric analysis of protein gene product 9.5-, substance P-, and calcitonin gene-related peptide immunoreactive innervation in the shoulder joint of the Japanese macaque.

The shoulder capsule and labrum of Japanese macaque monkeys were studied immunohistochemically with the use of antisera against protein gene product 9.5 (PGP 9.5), calcitonin gene-related peptide (CGRP), and substance P (SP) to further characterize the innervation of the supporting structures of the shoulder joint. With PGP 9.5 immunohistochemistry thick nerve fibers (diameter > or = 10 microm) presumed to be proprioceptive based on topographic location were found to be abundant in the posterior half of the capsule. Thinner fibers (diameter <10 microm) presumed to contain nociceptive and autonomic fibers were located in the posterior half of the capsule. Ruffini-like corpuscles were predominantly located in the inferior portion of the capsule. SP and CGRP immunoreactive thin fibers presumed to be nociceptive were abundant in the posterior half of the capsule. Thin fibers that appeared to be nociceptive fibers were found in the marginal portion and the parenchyma of the labrum, although the number was small. The predominant distribution of the Ruffini-like corpuscles in the inferior portion of the capsule suggest an important role of the inferior portion in generation of the proprioceptive output, which should be advantageous in stabilization of the joint in motion. The abundance of nociceptive fibers in the posterior half of the capsule may be responsible for the pathophysiological transmission of pain around the shoulder joint.

Animals↗
PubMed1998

Anatomic and functional aspects of the kinetics of the shoulder joint capsule and the subacromial bursa.

This anatomic study was devoted to the kinetics of the shoulder joint and especially the subacromial region. Following dissection of the shoulder joint capsule and subacromial region of 80 unpreserved shoulder joints, the anatomic relationships of the subacromial space in the neutral position and in continuous abduction (30 degrees, 60 degrees and 90 degrees with fixed scapulae) were examined. These investigations were supplemented by histologic preparations. In the course of our examinations we discovered a gliding mechanism of the subacromial bursa. Moreover, we found a subcoracoid attachment of the shoulder joint capsule and a precoracoid ligamentous connection running between the short head of the biceps brachii m. and the coracoacromial ligament. We termed this the coracoid aponeurosis, which facilitates gliding behaviour of the shoulder joint capsule beneath the coracoid process. In view of this gliding mechanism of the subacromial bursa and the coracoid aponeurosis, discovered in the course of our investigations, we have to reassess the kinetics of the sub-acromial and subcoracoid space. Further, we should reconsider our operative technique in cases of the subacromial or subcoracoid impingement syndrome.

Bursa, Synovial↗
PubMed2001

Topography of corpuscular mechanoreceptors in the shoulder joint region of monodelphis domestica.

The topography and structure of corpuscular mechanoreceptors in the shoulder joint capsule and periarticular connective tissue of a small laboratory marsupial (monodelphis domestica) were studied using light and electron microscopy. This animal is known to use its upper extremities for a wide range of activities like climbing and manipulating food. Thus, the shoulder joint of this animal species has a similar wide range of movement as the human shoulder joint, but is small enough for serial sectioning in its entirety. Silver stained serial paraffin sections were examined under the light microscope and the distribution of the different types of mechanoreceptors was reconstructed using three-dimensional image processing. In addition, selected mechanoreceptors were studied electron microscopically. Approximately 100 small lamellated corpuscles were found in the dense connective tissue of the joint capsule close to the insertion on the scapula and in the thickening of the joint capsule close to the glenoid labrum. Ruffini corpuscles were found in much smaller numbers in the moderately dense connective tissue of the axillary region. Only very few Vater-Pacinian corpuscles were seen in the soft periarticular connective tissue. The large number and localization of mechanoreceptor corpuscles in the shoulder joint capsule especially close to the glenoid labrum suggests, that these specialized nerve endings are likely to play an important role in control of joint movement. They can induce protective reflexes during extreme movements in the shoulder joint preventing shoulder luxation by increasing the tone of muscles pressing the humerus head into the glenoid cavity.

Animals↗
PubMed1983

Comparative study of the properties of the shoulder joint capsule with those of other joint capsules.

To compare the collagen structure of the shoulder joint with that of other joints, the collagen of shoulder, elbow, and hip joints was examined electron microscopically, electrophoretically, and by its response to mechanical stress. Collagen Types I, III, and V were common to joint capsules. Electron microscopy of shoulder and elbow joint capsules did not identify any structural difference. When subjected to a mechanical force, the shoulder joint showed a greater capacity to stretch than the elbow joint, and greater force was required to break the shoulder joint than the elbow joint.

Adult↗
PubMed1981

Osteochondrosis of the shoulder joint of the horse.

Osteochondrosis of the shoulder joint in the horse was diagnosed radiographically in 54 shoulders of 38 horses. Clinical signs were those of an intermittent lameness characterized as a swinging leg shoulder lameness with pain elicited by extension, flexion or abduction of the limb. Diagnosis of shoulder lameness was supported by blocking the shoulder joint with local anesthetics. Radiographic changes consisted of: (1) alteration in the contour of the humeral head and glenoid cavity, (2) periarticular osteophyte formation, (3) sclerosis of the subchondral bone, and (4) bone cyst formation. The primary bony lesion in the shoulder of the horse is similar to that described in the dog, pig, bull, turkey and broiler chicken. Secondary joint disease is a prominent finding with osteochondrosis of the shoulder in the horse. A follow-up study of 17 horses indicated that many of the affected horses had been sold and were being used for pleasure riding and breeding purposes. Those horses still in use usually had less severe radiographic changes at the time of diagnosis.

Animals↗
PubMedDate not supplied

[Osteochondrosis dissecans of concave joint surfaces: roof of shoulder joint, tibial plateau, distal tibia].

Typically an osteochondrosis dissecans occurs in the region of a convex articular surface, the most frequently localisation observed being the medial femoral condyle. Only few cases of an osteochondrosis dissecans in concave articular surfaces have been reported; these involved the tibial plateau, the distal tibia and the proximal surface of the navicular bone. Two more cases with an osteochondrosis dissecans in the proximal and distal tibial epiphysis are reported and additionally a hitherto unreported localisation in the glenoid fossa of the scapula. True osteochondrosis must be differentiated from ossification variants.

Adolescent↗
PubMed1978

Swelling of the upper extremity, function and muscle strength of shoulder joint following mastectomy combined with radiotherapy.

Swelling of the arm, mobility of the shoulder joint and muscle strength were examined in 76 patients with breast cancer 4.5 to 14 years (mean 8 years) after primary therapy. Marked arm swelling was found on the operated side in 31% of the patients operated by radical mastectomy and in 18% of those having undergone total mastectomy. The swelling was more marked in the upper arm than in the forearm. Patients irradiated postoperatively with a megavoltage technique showed more often and more oedema than those treated with a kilovoltage technique. Obese patients had more swelling than patients of normal weight. Of the various movements of the shoulder joint, abduction, adduction, flexion, extension, horizontal extension and internal rotation were significantly reduced on the operated side in comparison with the non-operated side, but the differences were not great. Neither swelling of the arm nor the patient's weight had any effect on the function of the shoulder joint, as expressed in terms of abduction. Of the muscle groups in the shoulder joint adductors, flexors and extensors were significantly weaker on the operated than on the non-operated side. The muscle strength of the operated side averaged 25% weaker than that of the control side. Swelling of the arm did not reduce the muscle strength of the shoulder joint.

Adult↗
PubMed1995

Sympathetic and sensory innervation of the rat shoulder joint: a WGA-HRP tracing and CGRP immunohistochemical study.

The innervation of the shoulder joint of the rat was investigated. Nerve origin was assessed by injection of a neuronal tracer (WGA-HRP) into the shoulder joint cavity and calcitonin gene-related peptide (CGRP), which is known to be present in some sensory neurons, was detected immunohistochemically with an anti-CGRP antibody. In the ipsilateral sympathetic and dorsal root ganglia, 133-312 and 12-55 nerve cell bodies were respectively labeled by injection of the tracer. In the sympathetic ganglia, 83% of all labeled cells were found in the stellate ganglion and 17% in the superior cervical ganglion. In the dorsal root ganglia, 75% of the labeled cells were found in C4 and the neighboring ganglia (C4-C5), while the rest were observed in C6-8 and T3. This suggested that the origin of sensory innervation for the shoulder joint was mainly in the mid-cervical cord. CGRP-immunoreactive fibers were found in the synovial capsule of the shoulder joint. These fibers were fine and resembled type 4 axons as classified by Brodal, i.e., nerve related to pain sensation. These findings indicate that sensory nerves from the mid-cervical cord and sympathetic nerves from the cervical ganglion are distributed to the shoulder joint. It is possible that these nerves are related to symptoms such as pain in patients with "frozen" shoulder or other diseases.

Animals↗
PubMed2004

Recovery of shoulder joint function after humeral shaft fracture: a comparative study between antegrade intramedullary nailing and plate fixation.

INTRODUCTION: Antegrade intramedullary (IM) nailing of humeral shaft fractures is reported to cause shoulder joint impairment. This retrospective study compared shoulder joint symptoms, range of motion (ROM), and isometric strength after antegrade IM nailing and dynamic compression (DC) plating of humeral shaft fractures. MATERIALS AND METHODS: We compared 29 patients with DC plating and 44 with antegrade IM nailing of their humeral shaft fractures. Shoulder pain, L'Insalata and Constant scores, shoulder joint ROM and isometric shoulder strengths were measured after mean follow-up of 6.2 (1-15) years (DC plating) and 5.5 (2-10) years (IM nailing). RESULTS: Patients had nonsignificantly more shoulder pain after IM nailing than after DC plating. Shoulder scores and isometric strength measurements showed no difference between the groups. Flexion was significantly better after DC plating, but none of the other ROM parameters differed between the groups. The shoulder scores and all ROM and strength parameters of the injured side were significantly lower than on the uninjured side in both groups. CONCLUSIONS: Shoulder joint ROM and strength does not recover to normal after humeral shaft fracture. Antegrade IM nailing if performed properly is not responsible for shoulder joint impairment.

Adolescent↗
PubMed2005

Arthroscopic study of the shoulder joint in fetuses.

PURPOSE: The purpose of this study was to macroscopically examine the fetal shoulder joint using arthroscopy. We attempted to identify and describe the specific characteristics of the fetal shoulder joint, how it evolves during the last few weeks of intrauterine development, and any possible variations with regard to the adult shoulder. TYPE OF STUDY: Observational anatomic case series. METHODS: We used 20 frozen fetuses with a gestational age of 24 to 40 +/- 2 weeks, obtained from spontaneous abortions. Examination was performed with standard arthroscopic surgical equipment, using a 2.7-mm optical lens. Whenever possible, we tried to use the standard arthroscopic portals. Images were obtained for comparison with the adult shoulder. RESULTS: The arthroscopic images of the fetal glenohumeral joint are similar to those of an adult shoulder, with the only differences being those related to the stage of development. In this study we observed no so-called bare spot in the glenoid cavity such as has been described in treatises on the adult shoulder joint. The arthroscopic images of the anterosuperior region of the fetal joint show more highly defined structures than in the adult shoulder, especially the coracohumeral and glenohumeral ligaments. CONCLUSIONS: To our knowledge, this is the first arthroscopic study to target the fetal shoulder joint. The results indicate minimal differences when compared with the adult shoulder joint; for some structures, particularly in the anterosuperior region, the anatomy observed was easier to discern than what is observed in adult shoulder arthroscopy. CLINICAL RELEVANCE: Our study obtained clear images of virgin shoulder joints that had never been subjected to deterioration from wear or other distorting forces. The clarity of these images is useful for locating and identifying structures in the adult shoulder.

Arthroscopy↗
PubMed2002

Shoulder joint capsule distension (hydroplasty): a case series of patients with "frozen shoulders" treated in a primary care office.

"Frozen shoulder," most often caused by adhesive capsulitis, is frequently treated with intra-articular steroid injections, physical therapy, and surgical manipulation under anesthesia. These therapies provide limited benefits. Hydraulic distension of the shoulder joint capsule (hydroplasty) has potential to provide rapid relief of pain and immediate improvement of shoulder function for patients with adhesive capsulitis. We performed 21 hydroplasty procedures on 16 patients over a 4-year period. Ninety-four percent (17/18) of the procedures improved patient's measured mobility immediately after the procedure. Fifty-three percent (10/19) of the procedures produced immediate, short term, and sustained improvement in comfort and function. No significant complications of the procedure were detected. Our series suggests that the hydroplasty procedure should be further evalutated.

Adult↗
PubMedDate not supplied

[MRI as a diagnostic technique in examination of the shoulder joint].

The paper presents the results of examination of 95 patients with shoulder joint abnormality to define the capacities of MR imaging in the evaluation of the anatomic structures of this joint. It details the MR anatomic features of the shoulder joint. Some conditions should be adhered to while performing MRI of the joint, namely: to obtain high-quality images by correctly choosing pulse sequences and scanning planes and to know the anatomic variants of the structure of the shoulder joint.

Humans↗
PubMed2001

Shoulder joint movement of the non-throwing arm during baseball pitch--comparison between skilled and unskilled pitchers.

The shoulder of a non-throwing arm during a baseball pitch must be in a constant position while the shoulder of the throwing arm moves in a nearly circular path around it. However, it has not been investigated whether a skilled pitch requires less shoulder-joint movement. It was hypothesized that pitchers with less shoulder movement of the non-throwing arm can be considered to have higher skill and to attain higher initial ball velocity. Nine baseball pitchers were used as subjects. The coach classified them into a skilled and an unskilled group. The pitching motions were recorded using two high-speed cameras. The time series of three-dimensional landmark coordinates of the shoulder joint of the non-throwing arm during the baseball pitch were calculated using the direct linear transformation method. The shoulder-joint movement (SJM) index, which expresses the movement (displacement) of the shoulder joint of the non-throwing arm quantitatively, was proposed to compare the SJM at different skill levels and investigate the relationship between SJM and initial ball velocity. The SJM of the skilled pitchers was smaller than that of the unskilled pitchers, and the smaller value of the SJM led to faster initial ball velocity. The data suggest that the less SJM of the non-throwing arm is required to attain a skilled pitch and higher initial ball velocity.

Adult↗