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At least 883 records · Page 49Linked to original sources
PubMed1980

Lymph drainage of the major joints of the porcine forelimb.

The lymph drainage of the major joints of the porcine forelimb was subjected to a critical examination. Commercial India ink was injected into the left elbow joint and right shoulder joint of an experimental pig. The shoulder joint was approached craniolaterally, the injection site being at the cranial border of the tendon of insertion of the infraspinatus muscle. The elbow joint was approached from the dorsolateral aspect. A suitable site for intra-articular injection into the elbow joint was found to be within an imaginary triangle formed caudal to the lateral epicondyloid crest of the humerus, the ventral border of the lateral head of the M. triceps brachii, and a line just dorsal to the olecranon. The lymph nodes of the neck and shoulder region were carefully exposed and examined for any discoloration due to the ink. The dissection of the lymph vessels and lymph nodes showed that the Lnn, axillares primae costae drained the elbow and shoulder joint after the intra-articular injection of India ink.

Animals↗
PubMed2005

[Developmental changes in the Collis horizontal reaction analyzed using a three-dimensional video motion analysis system. I. Examination of techniques for inducing Collis horizontal reaction].

We used a three-dimensional video motion analysis system to evaluate techniques for inducing the Collis horizontal reaction in 46 infants (total 217 times) from 1-9 months old. Additionally, we examined the safety of different techniques for inducing the Collis horizontal reaction in 20 infants (total 66 times), from 1-3 months old, 40 times by holding the shoulder joint and 26 times by not holding the shoulder joint. Regardless of who performed the examination, the average height that induced the reaction increased from 24.3 to 34.6 cm and the average speed of reaction increased from 28.2 to 43.4 m/s as the age of the infants increased. Additionally, when the Collis horizontal reaction was induced in infants 1-3 months old by holding the shoulder joint of infants, the average fall angle of the head was 7.291 degrees and was not significantly larger than when the reaction was induced by not holding the shoulder joint, which resulted is an average fall angle of the head was 19.302 degrees. However, although the average speed to support the body increased, the fall angle of the head did not increase when the shoulder joint was held. The Collis horizontal reaction is usually not performed in early infancy before head control is acquired, because of the burden to neck caused by the fall of the head and the excess expansion of shoulder joint capsule. However these results suggest that when performing the Collis horizontal reaction in early infancy before head control is acquired, the Collis horizontal reaction can be safely performed by holding the shoulder joint, regardless of the skill of the diagnostician. Therefore, the Collis horizontal reaction is an excellent method to assess infant development, and can be performed at the usual infant health examinations.

Child Development↗
PubMed2005

Evaluation of the passive function of the biceps brachii muscle-tendon unit in limitation of shoulder and elbow joint ranges of motion in horses.

OBJECTIVE: To quantify the passive contribution of the biceps brachii muscle-tendon unit to the limits of elbow joint extension during shoulder joint flexion in horses. SAMPLE POPULATION: Normal right forelimb specimens from 6 Thoroughbred cadavers. PROCEDURE: Specimens included the scapula, humerus, radius-ulna, biceps brachii muscle-tendon unit, and stabilizers of the shoulder and elbow joints. Specimens were mounted to a rigid board by transfixation pins through the humerus and instrumented for mechanical manipulation of the limb and joint angle and load measurements. Flexion and extension limits of shoulder and elbow joint ranges of motion were measured in each joint separately, while the other joint was fixed. Measurements were made before and after transection of the biceps brachii muscle-tendon unit. RESULTS: The biceps brachii muscle-tendon unit limited elbow joint extension when the shoulder joint was fixed in flexion, limited shoulder joint flexion when the elbow joint was fixed in extension, and inhibited shoulder joint extension to a lesser degree when the elbow joint was fixed at midrange angles of 75 degrees to 90 degrees. CONCLUSIONS AND CLINICAL RELEVANCE: Clinical manipulation of the elbow joint into hyperextension during shoulder joint flexion is indicative of biceps brachii injury.

Animals↗
PubMedDate not supplied

Possibility of clinical application of tremor in the upper limb.

A procedure to evaluate the function of the glenohumeral joint (i.e., shoulder joint) for persons with shoulder disorders was proposed by analyzing tremor. In order to compare subjects with shoulder disorders to healthy subjects without disorders, characteristics of tremor for the healthy persons under various angles of glenohumeral joint and under the dominant and no-dominant sides of the upper limb were obtained by peak frequency and power spectrum as basic data. As for the persons with rotator cuff injury, the ratio of total powers for the affected side and the healthy side was obtained as the affective side ratio. The ratio showed the characteristic of the persons with the disorder, and discriminated the total power spectra of persons who were healthy and those with disorders.

Adult↗
PubMed2003

The spinoglenoid ligament: an anatomic study.

The spinoglenoid ligament and its anatomic variations are described in 27 shoulders from 15 cadavers. In each shoulder one or two distinct spinoglenoid ligaments originated from the base of the spine of the scapula; they inserted on the neck of the scapula or the shoulder joint capsule. In the 19 shoulders in which only one spinoglenoid ligament was present, it inserted into the neck of the scapula in 14 cases and into the shoulder joint capsule in five instances. In the eight shoulders in which there were two ligaments, one inserted into the neck of the scapula and the other into the shoulder joint capsule. We did not observe any hypertrophic spinoglenoid ligaments that may have compressed the suprascapular nerve.

Cadaver↗
PubMed2006

[Shoulder prostheses].

The design of shoulder prostheses has been developed through four generations which mirror adaptation to our increasing knowledge of the biomechanics of the shoulder joint. Modern shoulder prostheses are adapted to the size, inclination, posterior offset, and retrotorsion of the shoulder. The main reasons for implantation of a shoulder prosthesis are primary osteoarthritis, posttraumatic and rheumatoid arthritis, avascular necrosis, instability arthritis and cuff defect arthropathy. Typical implants are cup prostheses for surface replacement, anatomical stem prostheses, and reverse prostheses. Total prostheses are functionally better as soon as the arthritis involves the glenoid, whereas hemiprostheses should be preferred as long as the glenoid is intact. The stem is mostly cemented, whereas in younger patients with good bone quality a cementless stem may be used. Cemented glenoids may be considered as standard.

Arthritis, Rheumatoid↗
PubMed1992

A note on the anatomy of the supraspinatus muscle.

The muscles and tendons of the rotator cuff of 37 fixed cadaver shoulder joints were dissected. In ten shoulder joints devoid of gross pathological lesions it was found that the supraspinatus muscle was inserted at two points--mainly into the major tubercle and partly into the lesser tubercle of the humerus. In one case of six, an additional insertion clearly occurred in a shoulder joint with rotator cuff tear.

Aged↗
PubMed2004

Shoulder function after accessory nerve-sparing neck dissections.

BACKGROUND: This study was designed to observe the effect of preserving the spinal accessory nerve (SAN) during neck dissection (ND) and adjuvant radiotherapy (ART) after ND on shoulder function. METHODS: Fifty-seven patients with head and neck cancer who had undergone primary tumor resection and various types of NDs were enrolled in this prospective study. Postoperative shoulder joint range of motion was evaluated by goniometry, and muscle strength was measured manually. SAN function was evaluated with electromyography (EMG) with respect to percentage of denervation and presence of neurogenic involvement. Patients were grouped by treatment as follows: radical ND (RND) versus modified radical ND (MRND)/selective ND (SND) and ART versus no ART. RESULTS: Shoulder joint range of motion and shoulder muscle strength were significantly better in the MRND/SND group than in the RND group. However, EMG findings were similar in the RND and MRND/SND groups. When all patients who underwent ND, RND, or MRND/SND were compared with the control group, statistically significant changes in shoulder joint range of motion and shoulder muscle strength were found. Also, denervation and neurogenic involvement of the SAN were significantly higher after all NDs than in the control group. ART did not affect range of motion of the shoulder joint, shoulder muscle strength, or the degree of denervation and neurogenic involvement in any of the ND groups. CONCLUSIONS: ART does not have a negative effect on shoulder function after ND. SAN is always functionally impaired even if we preserve it macroscopically during ND.

Accessory Nerve↗
PubMed2006

Efficacy of arthroscopic synovectomy for the effect attenuation cases of infliximab in rheumatoid arthritis.

To investigate whether arthroscopic synovectomy is effective for nonresponders to infliximab, anti-tumor necrosis factor-alpha antibody, for the treatment of rheumatoid arthritis (RA), we assessed seven patients including ten arthroscopic synovectomies in knee joint, in shoulder joint, and in ankle joints. We compared C-reactive protein (CRP) and DAS28 (ESR) before and after surgery at 6 and 50 weeks. After arthroscopic synovectomy, we continued the infliximab treatment with methotrexate in a routine manner. We detected synovium proliferation with vascular increase in patellofemoral joint and around the meniscus and femoral and tibial side of the anterior cruciate ligament in the knee joints. We also found synovial proliferation in rotator interval in the glenohumeral joint and fatty changing in subacromial bursa in the shoulder. In the ankle joint, we found synovial proliferation with white meniscoid between tibiofibular joint to develop impingement. Serum CRP was improved from 3.45+/-0.4 to 1.12+/-0.2 at 6 weeks to 1.22+/-0.4 at 50 weeks after arthroscopic synovectomy. There is no severe side effect of arthroscopic synovectomy during infliximab treatment; however, one patient had slight rash that was improved. DAS28 was improved from 5.58+/-0.23 to 3.87+/-0.47 at 6 weeks to 2.58+/-1.49 at 50 weeks after arthroscopic synovectomy. It is possible that arthroscopic synovectomy can be one of the effective methods to continue with the infliximab treatment when its efficacy decreased or in the nonresponders of infliximab for RA patients.

Aged↗
PubMed2006

[Prosthesis replacement of proximal humerus after resection of malignant tumor].

OBJECTIVE: To study the operative effect and complication of the prosthesis replacement of the proximal humerus with malignant tumor. METHODS: From October 1998 to August 2003, the prosthesis replacement was performed to treat the proximal femur with malignant tumor in 4 patients, including 2 patients with osteosarcoma (Enneking staging, I A) and 2 patients with giant cell tumor of the bone (II A, II B). By the International Society of Limb Salvage (ISOLS) criterion, the 2 cases of osteosarcoma were preoperatively scored as 4 and 5 points, and 2 cases of giant cell tumor of the bone were scored as 9 and 11 points. The patients' psychological conditions as well as their limb pain, shape, locality, activity, and function were also observed. RESULTS: The follow-up for 24-58 months (mean, 44 months) showed that there was no local recurrence or infection in all the patients except one patient who had the loosening of the screws for the fixation 17 months after operation and had no treatment. After operation, all the patients had a better postoperative extention angle from 22 degrees to 41 degrees (mean, 25 degrees), bending angle from 29 degrees to 80 degrees (mean, 35 degrees), abduction angle from 5 degrees to 28 degrees, and circumgyrate angle from 15 degrees to 22 degrees in their shoulder joints. However, the shoulder joint function was still unstable to some extent and the joints had a decreased strength. By the criterion formulated by the ISOLS, the postoperative score for assessing the 2 patients with osteosarcoma was increased by 16 points when compared with the preoperative score; the score for the 2 patients with giant cell tumor of the bone was increased by 9.5 points. CONCLUSION: The prosthesis replacement to treat the malignant tumor of the proximal humerus is the good method of choice and has a good therapeutic result; however, there are more complications and so the method should be cautiously employed in the clinical practice.

Adult↗
PubMed2004

[Conservative treatment and rehabilitation of shoulder problems].

The shoulder joint has an important influence on arm- and hand function. Therefore, activities of daily living, working and leisure time can be negatively influenced by diseases of the shoulder joint. Problems of the shoulder joint can be induced by muscular dysbalance and poor body posture. There is a strong relationship between shoulder function and body posture. Conservative treatment and rehabilitation of the shoulder joint aims at improving the local dysfunction of the shoulder joint as well as at improving function and social participation. Antiinflammatory and pain medication, exercise, occupational, electro-, ultrasound and shock wave therapy, massage, thermotherapy and pulsed electromagnetic fields are used as conservative treatments. Exercise therapy aims at improving muscular performance, joint mobility and body posture. Occupational therapy aims at improving functional movements for daily living and work. Electrotherapy is primarily used to relieve pain. Shock wave and ultrasound therapy proved to be an effective treatment for patients with calcific tendinitis. The subacromial impingement syndrome can be effectively treated by conservative therapy.

Biomechanical Phenomena↗
PubMed2005

Effect of fore-aft seat position on shoulder demands during wheelchair propulsion: part 1. A kinetic analysis.

BACKGROUND/OBJECTIVE: The highly repetitive and weight-bearing nature of wheelchair (WC) propulsion has been associated with shoulder pain among persons with spinal cord injury (SCI). Manipulation of WC seat position is believed to reduce the overall demand of WC propulsion. The objective of this investigation was to document the effect of fore-aft seat position on shoulder joint kinetics. METHODS: Thirteen men with complete motor paraplegia propelled a test WC in 2 fore-aft seat positions during free, fast, and graded conditions. The seat-anterior position aligned the glenohumeral joint with the wheel axle and the seat-posterior position moved the glenohumeral joint 8 cm posteriorly. The right wheel of the test chair was instrumented to measure forces applied to the pushrim. An inverse dynamics algorithm was applied to calculate shoulder joint forces, external moments, and powers. RESULTS: For all test conditions, the superior component of the shoulder joint resultant force was significantly lower in the seat-posterior position. During graded propulsion, the posterior component of the shoulder joint force was significantly higher with the seat posterior. Peak shoulder joint moments and power were similar during free and fast propulsion. During graded propulsion, the seat-posterior position displayed increased internal rotation moment, decreased sagittal plane power absorption, and increased transverse plane power generation. CONCLUSIONS: This investigation provides objective support that a posterior seat position reduces the superior component of the shoulder joint resultant force. Consequently, this intervention potentially diminishes the risk for impingement of subacromial structures.

Acceleration↗
PubMedDate not supplied

Heterotopic ossification after primary shoulder arthroplasty.

We have assessed the incidence of heterotopic ossification (HO) after primary shoulder joint replacement in 126 shoulders; 58 patients had hemiarthroplasty, and 68 had total shoulder joint replacement. HO developed to a minor extent in 15% of patients (19/126). There was no statistical difference between hemiarthroplasty or total shoulder replacement or between male and female patients. Patients with cuff tear arthropathy were the only group with an increased risk (36.4% [4/11]) of having HO develop. In patients with osteoarthritis, fractures, or rheumatoid arthritis, HO occurred in less than 14.5% (15/115). Nonsteroidal anti-inflammatory drugs (NSAIDs) did not appear to have any effect on HO as in hip replacement, as HO developed in 15.15% of patients having NSAIDs postoperatively and in 15.05% of patients without NSAIDs. Prophylaxis of HO with NSAIDs seems only to be indicated in patients with cuff tear arthropathy.

Adult↗
PubMed2003

[Rheumatoid arthritis in patients aged above 75 years old at onset].

Elderly onset rheumatoid arthritis (RA) is difficult to diagnose definitively when the patients note their first symptoms of arthritis above the age of 75 years old. In this report, we reviewed the clinical features of elderly onset RA and its diagnosis. The subjects included 4 females, aged 78, 83, 84 and 93 years, respectively. The onsets were abrupt in 2 cases and more slowly arriving in the other 2. Shoulder joints and wrist joints were involved in all cases. Knee joints, finger joints and foot joints were involved in 3 cases and the elbow was involved in one case. Anti-RA treatment quickly attenuated the acute and severe arthritis and brought down the high CRP level associated with vivid inflammatory activity of RA. The RAPA value was very high in all but one of the cases. Severe destructive findings in radiography was undetectable in the major joints (e.g. shoulder, hip and knee joints). Radiographic findings in wrist and finger joints were also very difficult to differentiate from arthrosis and osteoporosis. On the other hand, RA involvement in the cervical spine was certain in the radiographs; 1 case had anterior atlantoaxial subluxation and 2 cases had subaxial intervertebral erosion. Pathological radiographic findings in the cervical spine are useful for the diagnosis of elderly onset RA.

Aged↗
PubMed1993

Treatment of cysts of the acromioclavicular joint with shoulder hemiarthroplasty.

A chronic cyst overlying the acromioclavicular joint was managed in four patients, between July 1988 and September 1991. All patients had had previous unsuccessful aspiration and excision of the cyst with recurrence. Each cyst was associated with a chronic, massive defect of the rotator cuff; superior migration of the humeral head; and degenerative osteoarthrosis of the glenohumeral joint. All patients had complained of pain and limitation of motion (mean forward elevation, 95 degrees; mean external rotation, 20 degrees; and mean internal rotation, to the spinous process of the second lumbar vertebra). All procedures consisted of a large-humeral-head hemiarthroplasty, with no operative treatment directed at the cyst or the acromioclavicular joint. At an average of twenty-seven months (range, fifteen to thirty-six months) after the operation, the patients were all pain-free and had not had a recurrence of the cyst. The average postoperative range of motion was 130 degrees of forward elevation, 30 degrees of external rotation, and internal rotation to the spinous process of the first lumbar vertebra.

Acromioclavicular Joint↗
PubMed1991

[Sources of error in sonographic diagnosis of the rotator cuff].

Sonography of the shoulder joint has developed into an established examination technique in the diagnosis of periarticular lesions of the shoulder. Sonographic diagnosis of the rotator cuff in particular contains a multitude of possible errors, which are gone into by this study by means of 149 clinically, radiologically and sonographically examined shoulder patients with an average age of 50.5 years. Besides errors made by wrong examination technique such of the transducer as incorrect adjustment of the equipment, insufficient contact of the transducer with the skin and unsuitable choice of the examination plane, there are sources of errors in the interpretation of the sonogram caused by lack of knowledge about physically caused artifacts and sonoanatomical qualities of the shoulder joint. Calcification inside the rotator cuff and the so-called "sonographic inhomogeneity of the rotator cuff" are numbered among the sources of error particular to the shoulder joint. Most errors in sonographic diagnosis of the rotator cuff can be avoided by careful examination of both shoulder joints with an exactly tuned ultrasound device, taking into account the sonoanatomical and ultrasonic qualities. Radiological examination of the affected shoulder joint cannot be replaced by ultrasound.

Diagnostic Errors↗
PubMed1993

[Ultrasound in inflammatory rheumatic joint diseases].

Inflammatory changes of the shoulder joint could be detected at a very early stage, when the clinical and radiological examinations were unremarkable. In 50% of the cases a rupture of the rotator cuff could be demonstrated. Only 10% of the shoulder joints had normal sonographic findings, whereas 50% were normal on clinical or radiological examination. Synovitis and effusion of the hand can be diagnosed very well by clinical examination, and can be documented in ultrasound. The sonographic diagnostic accuracy in tendon ruptures of the hand is lower than accuracy of the clinical examination. New technical developments may yield better results. Inflammatory changes of the hip joint are very difficult to diagnose by clinical examination. Synovitis, effusion and changes of the capsule can be better detected by ultrasound. Sonography of the hip joint has become part of our routine diagnostic programme, especially because early changes of the joint do not present clear symptoms.

Arthritis, Rheumatoid↗
PubMed1999

[Locked dorsal shoulder dislocation and contralateral ventral shoulder dislocation fracture. A rare combination].

The posterior luxation of the shoulder joint is a rarely reported and often not recognized lesion in the clinical workday. The authors present the first case of a posterior luxation of the shoulder joint in combination with an contralateral anterior shoulder joint fracture dislocation. In that case the authors stress the importance of an exact clinical and radiology diagnostic and the right way to reduce a posterior luxation of the shoulder joint. Finally they draw the readers attention to operative steps to prevent a reluxation of the shoulder joint.

Adult↗