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At least 847 records · Page 47Linked to original sources
PubMed2004

Osteoarthritis of the acromioclavicular joint: a review of anatomy, biomechanics, diagnosis, and treatment.

Shoulder pain is a frequent presenting complaint to physiatrists. Commonly encountered pathogeneses include rotator cuff pathology, bursitis, biceps tendonitis, and labral tears. Because the majority of shoulder pain originates within the subacromial region and the glenohumeral joint, the acromioclavicular, sternoclavicular, and scapulothoracic articulations may be overlooked. Osteoarthritis of the acromioclavicular joint is a common source of shoulder pain that is often neglected by clinicians and researchers. The proper diagnosis of acromioclavicular joint osteoarthritis requires a thorough physical exam, plain-film radiograph, and a diagnostic local anesthetic injection. Current treatment options are rather limited. Initial therapies are similar to that of osteoarthritis in other joints and include oral analgesics or anti-inflammatories and an emphasis on activity modification. Physical therapy, unfortunately, has little to offer, as therapeutic exercise and range of motion play only a minor role. If a diagnostic local anesthetic injection provides relief, there may be a role for corticosteroid injections. It seems that the administration of local corticosteroids into the acromioclavicular joint may provide short-term pain relief. The judicious administration of such injections remains controversial, and most experts agree that steroid injections do not alter the natural progression of the disease. Surgical options, indicated typically after a minimum of 6 mos of unsuccessful conservative treatment consist of open or arthroscopic distal clavicle resection.

Acromioclavicular Joint↗
PubMed1989

Three-dimensional kinematic modelling of the human shoulder complex--Part II: Mathematical modelling and solution via optimization.

In this paper, individual joint sinus cones associated with the sternoclavicular, claviscapular, and glenohumeral joints of the three-dimensional kinematic model introduced in Part I for the human shoulder complex are quantitatively determined. First, mathematical description of the humerus orientation with respect to torso is given in terms of eight joint variables. Since the system is a kinematically redundant one, solution for the joint variables satisfying a prescribed humerus orientation is possible only if additional requirements are imposed; and the "minimum joint motion" criterion is introduced for this purpose. Two methods, namely the Lagrange multipliers and flexible tolerance methods, are formulated and tested for the optimization problem. The statistical in-vivo data base for the circumductory motion of the upper arm is employed to determine a set of joint variables via optimization, which are then utilized to establish the sizes and orientations of the elliptical cones for the individual joint sinuses. The results are discussed and compared with those given on the basis of measurements made on cadaveric specimens.

Biomechanical Phenomena↗
PubMed1995

[Osteoarticular infections caused by Streptococcus agalactiae. Report of 4 cases].

BACKGROUND: Streptococcus agalactiae (group B streptococcus) is a rare etiology of osteoarticular infection in adults. In a literature review (Medline-Embase plus) up until may 1994, we have found only 51 cases. In most patients, diabetes mellitus, liver disease or long-term steroid therapy were documented. METHODS: Four adult patients with osteoarticular infection due to S. agalactiae from two Galician hospitals were studied from January 1988 to October 1994: prepatellar bursitis (one case), septic monoarthritis (2 cases) and psoas abscess associated to cervical spondylodiscitis and oligoarthritis (left sternoclavicular and left hip joints). RESULTS: In the first patient, a young woman with prepatellar bursitis, a previous local trauma was recorded. The second case, a man with septic arthritis of right knee, had degenerative disease of the knees and a prostatic adenocarcinoma. In the third patient, a diabetic woman with septic arthritis of the left shoulder, vulvovaginitis due to Candida albicans was found. The last patient suffered vertebral osteomyelitis of the cervical spine (C3-C4), arthritis of the left sternoclavicular and hip joints and abscess of the ipsilateral psoas. The evolution was favourable in the four cases. CONCLUSIONS: Although uncommon, osteomyelitis and arthritis caused by group B streptococcus should be considered as opportunistic pathogen in adults with debilitating conditions. Early recognition and prompt institution of adequate therapy can help avoid joint destruction and severe complications.

Adult↗
PubMed2006

[Inner amputation of an upper extremity with impaired cerebral perfusion and lethal outcome].

An inner amputation of the upper extremity is understood to be a rupture of the arm's vascular nerve bundle as well as the shoulder's and scapular's stabilizing muscles and fibrous joints without damage to the dermal soft tissue sheath. This injury is a rare and grave incident which mostly occurs within the scope of a high-energy trauma and in cases of polytraumatized patients in combination with additional life-threatening injuries. In the literature this is referred to by the terms scapulothoracic dissociation (SD) and closed forequarter amputation--the entity of SD was first described by Oreck et al. in 1984. Traction of the upper extremity leads to the rupture of the m. pectoralis major, m. pectoralis minor, the musculi rhomboidei, the m. levator scapulae, the m. latissimus dorsi as well as the m. trapezius. Furthermore the traction causes acromioclavicular or sternoclavicular bursting of the joints or a displaced clavicle fracture. Among the more than 50 cases depicted until now, 94% of the patients exhibit a neurological (plexus) and 80% a vascular lesion, thus corresponding to a genuine inner amputation. The prognosis for this injury is consistently poor: 10% of the patients die, in 52% an nonfunctional extremity remains, and in 21% a untimely amputation has to be performed. The observed complication of cerebral hypoperfusion caused by increasing pressure in the neck compartment, which ultimately leads to the death of the patient, has, as far as we know, not yet been specified and emphasizes the gravity and the magnitude as well as the necessity of rapid diagnosis and appropriate therapy of this infrequent injury.

Adult↗
PubMedDate not supplied

S-C joint disruption in an infant.

An anterosuperior sternoclavicular disruption in a 7 month old female was caused by trauma. Good results were observed by concervative managment.

Female↗
PubMedDate not supplied

Posterior sternoclavicular inveterate dislocation.

The authors report a case of posterior inveterate sternoclavicular dislocation, which came to their observation after tangential resection of the clavicle. They discuss the surgical technique of reduction and stabilization and clinical results. CT scan was the method most-suited to evaluate dislocation of the clavicle.

Adult↗
PubMed2001

Comparison of autopsy, X-ray, and M.R.I. findings following a low speed impact to the shoulder.

The objectives of the study was to generate data useful to engineers improving crash test dummies and to physicians in anticipating low speed lateral impact injuries to the shoulder. Constant impact mass, distance and variable speeds were used to generate impact forces. Twelve unembalmed human cadavers were studied within 48 hours of death. Pre-test and Post-test physical, X-Ray, and Magnetic Resonance examinations were completed. X-Ray best identified bone injury, Magnetic Resonance intratendinous and intramuscular pathology and autopsy joint instability. Low speed (3.5-7.0 m/sec) impacts under these testing conditions frequently produce soft tissue and bone injuries. Sternoclavicular and acromioclavicular joint instabilities were found in 83% of the cadavers. The most frequent bone fractures were in the distal clavicle of 42% and labral or rotator cuff tears in 13% of the cadavers.

Accidents, Traffic↗
PubMed1999

Right sternoclavicular dislocation after traumatic delivery: a case report.

Sternoclavicular (SC) dislocation is an injury that is very rare in the newborn. Thus far there have been no reports describing this in neonates after a traumatic birth injury. This condition can be difficult to differentiate from epiphyseal separation, which occurs more often in older children. For successful treatment, early diagnosis is essential. Timely surgical reposition and fixation with following immobilization is recommended in instances of complete (SC) dislocation. We report a trauma-induced case of SC dislocation in a neonate successfully managed by polydioxanon cord fixation.

Birth Injuries↗
PubMed1981

[Technique of the alloplastic ligament substitution with carbon fibres (author's transl)].

Chronic instabilities or remaining luxations of joints are not acceptable for an active human being. The desired result is often not achieved by surgical methods applying most different autologous and homologous materials. This is why our working group has been trying for several years to develop a more promising method using an alloplastic material in the form of carbon ligaments. Numerous mechanical, biological, biomechanical, and histological examinations showed that the implantation of woven carbon ligaments in man could be accepted. During the most recent years, we have effected 150 ligament grafts with this material and, in course of time, we have been able to modify and to ameliorate the operation techniques. Today we may state that the described operation methods using ligaments of carbon fibres in the sternoclavicular, acromioclavicular, knee and ankle joint can bring about favorable results with regard to their function and stability. Further improvements can probably be achieved by a careful examination of the results obtained hitherto which will possibly include another refinement of the operation technique. A definite evaluation of this method, however, will only be possible within several years, when clinical check-up examinations will be made.

Acromioclavicular Joint↗
PubMed1986

Bone imaging of sternocostoclavicular hyperostosis in palmoplantar pustulosis.

Sternocostoclavicular hyperostosis is a rare syndrome that is characterized by hyperostosis and soft tissue ossification between the clavicles and the anterior part of the upper ribs. This syndrome frequently is found in the case of palmoplantar pustulosis (PPP), especially in Japan. There have been few published reports, however, of Tc-99m MDP bone imaging findings in PPP. Eleven patients with PPP who were suspected to have sternocostoclavicular hyperostosis were studied with Tc-99m MDP whole body bone imaging. Bone images were abnormal in 11 patients. Abnormal radionuclide concentrations were observed in the sternoclavicular, sternocostal, and manubriosternal joints, in the ribs, and in the sternum. Whole body imaging revealed radionuclide accumulations unexpectedly in other bones such as the vertebrae, femur, tibia, or sacroiliac joints in five of 11 cases. Radiographs were available in nine patients. Three chest radiographs were negative, and six showed various degrees of hyperostosis or sclerotic changes in sternoclavicular, sternocostal, or manubriosternal joints, or in the sternum or anterior upper ribs. These bone lesions usually were more prominent and more easily recognized with bone scintigraphy. Bone scintigraphy should be used as a routine procedure in patients with PPP who are suspected to have sternocostoclavicular hyperostosis.

Adult↗
PubMed1990

Anterior chest wall involvement in patients with pustulosis palmoplantaris.

With the aim of determining the frequency and radiographic features of anterior chest wall involvement in patients with pustulosis palmoplantaris, a questionnaire was sent to 107 patients. Ninety-three patients returned the questionnaire, five of whom were excluded from further analysis due to the appearance of psoriatic lesions. Twenty-five (28%) of the remaining 88 patients reported pain and/or swelling of joints or bones in the anterior chest wall. All were examined radiographically, using tomography, and a group of 20 patients without anterior chest wall complaints were examined similarly. Sixteen of the patients with, but none of the patients without, complaints were found to have arthro-osteitis of the anterior chest wall, consisting of diffuse sclerosis of the manubrium sterni in one patient, localized sclerosis in seven patients, and sequelae of arthritis of the sternoclavicular, upper sternocostal and/or manubriosternal joint in eight patients.

Adult↗