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At least 1,063 records · Page 59Linked to original sources
PubMed2001

Late onset rheumatoid arthritis--a clinical and laboratory study.

AIM: To analyze the clinical and laboratory profile of late onset rheumatoid arthritis in comparison with early onset rheumatoid arthritis. METHODS: Fifty patients who satisfied 1988 American College of Rheumatology criteria for rheumatoid arthritis with the disease onset at 60 years or over were studied. Handred cases of early onset rheumatoid arthritis were taken as controls. All of them were followed up for 18 months. RESULTS: Female to male ratio was 1.6:1 in late onset rheumatoid arthritis and 4:1 in early onset group. Shoulder joint involvement was 48% in late onset and 28% in early onset rheumatoid arthritis. Rheumatoid factors was positive in 36% cases in late onset compared to 60% in controls. Most other clinical, laboratory and radiological features were comparable in both the groups. CONCLUSIONS: Late onset rheumatoid arthritis is characterised by a less female preponderance, more shoulder joint involvement and more seronegativity.

Age of Onset↗
PubMed1994

Normal values of isokinetic maximum strength, the strength/velocity curve, and the angle at peak torque of all degrees of freedom in the shoulder.

Many acute and chronic complaints in the shoulder joint are due to a reduced active stabilization capacity. Procedures to measure isokinetic strength are used to objectify the muscle deficits and imbalances of various muscle groups. In this study, standard values and reference ranges were determined for peak torque (PT), strength/velocity curve, and range of motion (ROM) at peak torque in the shoulder in 19 untrained women and 32 men. Differentiation was made by the individual degrees of freedom of the shoulder joint and the various types of work (concentric, isometric, eccentric). Moreover, the influence of height, body weight, and body mass index on isokinetic maximum strength development was investigated. It was found that it is necessary to distinguish between the various movements and types of work in development of peak torque. A decrease in maximum strength is observed in the sequence extension, adduction/flexion, abduction/internal rotation, external rotation. The maximum strength of men was determined to be higher than that in women. ROM shows a wide fluctuation and does not possess high validity. Height, as well as body weight and body mass index have only slight influence on the isokinetic maximum strength in the shoulder of untrained men and women.

Adult↗
PubMed1998

[Standard ultrasound sections of the upper extremity--shoulder and elbow joint].

AIM: The sonographic examination of the shoulder and elbow joint is demonstrated in standardized sectional planes providing a reproducible representation of anatomical structures. METHOD: In ultrasound examination of the shoulder joint the following standardized planes are employed transverse and longitudinal planes in the dorsal, superior/lateral and ventral region. In ultrasound examination of the elbow joint the following standardized planes are employed: a transverse and two longitudinal planes in the ventral region, a transverse and a longitudinal plane in the dorsal region. These standardized sectional planes, performed in a real-time-procedure using a 7.5 MHz linear transducer, as well as the images on the screen, correspond to the guidelines provided by the German Society of Ultrasonography in the Locomotor Apparatus (DEGUM). In cases without pathological findings two standardized planes have to be documented. Otherwise the pathological finding has to be documented in two standardized planes. RESULTS: The introduced examination technique in standardized sectional planes provides an excellent overview of the shoulder and elbow joint with a sufficient evaluation of the periarticular soft tissue and the bony surface. The main advantages in comparison to other diagnostic means (i.e. CT, MRI) lies in the possible dynamic examination which allows excellent imaging especially in rotator cuff lesions. CONCLUSION: Because of the excellent evaluation of the periarticular structures, ultrasound plays a major diagnostic role in shoulder joint diseases. Furthermore this technique provides important information about intra- and periarticular disorders of the elbow joint. The standardized procedures are a useful means of assuring and improving the quality of sonographic examinations of articular and periarticular structures.

Elbow Joint↗
PubMed1984

[Experiences with Weber's subcapital rotation osteotomy in recurrent shoulder dislocation].

In 23 patients suffering from recurrent posttraumatic dislocation of the shoulder joint the derotation of the humeral head was performed as described by Weber. A description of the operative technique is given. As recommended by Weber an angled 1/2-tubular plate with 7 holes was used for stable osteosynthesis 17 times. After movement treatment removal of the osteo-synthesis-material was possible 6 to 8 months later. Because of high absence of recidivity with repair of full mobility and full strength the derotation of the humeral head is a treatment of choice in cases of recurrent posttraumatic dislocation of the shoulder joint.

Adolescent↗
PubMedDate not supplied

Current concepts in the rehabilitation of the overhead throwing athlete.

The overhead throwing motion is an extremely skillful and intricate movement that is very stressful on the shoulder joint complex. The overhead throwing athlete places extraordinary demands on this complex. Excessively high stresses are applied to the shoulder joint because of the tremendous forces generated by the thrower. The thrower's shoulder must be lax enough to allow excessive external rotation, but stable enough to prevent symptomatic humeral head subluxations, thus requiring a delicate balance between mobility and functional stability. We refer to this as the "thrower's paradox." This balance is frequently compromised, which leads to injury. Numerous types of injuries may occur to the surrounding tissues during overhead throwing. Frequently, injuries can be successfully treated with a well-structured and carefully implemented nonoperative rehabilitation program. The key to successful nonoperative treatment is a thorough clinical examination and accurate diagnosis. Athletes often exhibit numerous adaptive changes that develop from the repetitive microtraumatic stresses observed during overhead throwing. Treatment should focus on the restoration of these adaptations during the rehabilitation program. In this article, the typical musculoskeletal profile of the overhead thrower and various rehabilitation programs for specific injuries are discussed. Rehabilitation follows a structured, multiphase approach with emphasis on controlling inflammation, restoring muscle balance, improving soft tissue flexibility, enhancing proprioception and neuromuscular control, and efficiently returning the athlete to competitive throwing.

Athletic Injuries↗
PubMed1984

[The value of computed tomography in the diagnosis of the rotator cuff tears and bone and soft tissue tumors].

This report consists of 2 parts. Part I: The usefulness of computed tomography (CT) in the diagnosis of rotator cuff tear was assessed. The rotator cuff could not be visualized in detail by CT unless introduction of contrast material into the joint cavity was performed. CT arthrography was performed on 21 cases of rotator cuff tears. The most detailed information was obtained when a relatively low concentration of contrast material (3.25% Angiografin) was filled in the joint cavity, and when the shoulder joint was rotated to the maximum outwards at the side. CT arthrography proved to be the most reliable method for assessing the extent and portion of the rotator cuff tears, so that it demonstrated conclusive evidence of diagnosis and management in 89% of patients studied. Part II: The usefulness of CT in the diagnosis of bone and soft tissue tumors was assessed. CT examination provided unique preoperative information which could imagine a more precise histological characteristics and anatomical localization of the lesion. Contrast enhancement (CE), when used, proved to be helpful in predicting the nature of tumors. The CE by intra-arterial infusion, or intravenous bolus injection of contrast material during the scan was more useful than that by intravenous drip infusion of the material. The information regarding change of tumor size, CT number and CE were appropriate indicators which directly corresponded to responsiveness of the tumor to the chemotherapy and radiotherapy performed. Preoperative ABC classification of the tumor by information regarding its size, location, definition and anatomical relation of tumors to vital structures (neural, vascular, and visceral) was done by using CT. The classification clearly corresponded to the status of patients regarding the treatment required for the patients.

Adolescent↗
PubMedDate not supplied

Relationships between throwing mechanics and shoulder distraction in professional baseball pitchers.

The extreme forces and torques and the high speeds and excessive ranges of motion of baseball pitching place tremendous stress on the soft tissues of the throwing shoulder. Little is known about the relationship between pitching mechanics and shoulder joint stress, especially in professional athletes. The purpose of this study was to quantify joint loads and kinematic parameters of pitching mechanics at the major league level and to study their relationships. Three-dimensional, high-speed video data were collected on 40 professional pitchers during the 1998 Cactus League spring training. A clinically significant distraction force was calculated at the shoulder joint, which reached an average peak value of 947 +/- 162 N (108% +/- 16% body weight). Descriptive statistics and a multiple linear regression analysis were used to relate shoulder distraction to kinematic and kinetic parameters of pitching mechanics. This study was undertaken not only to investigate the peak forces and torques on the shoulder, but also to identify potential areas of intervention that might prevent throwing injuries. Knowledge of joint ranges of motion, angular velocities, and joint-reaction forces can provide a scientific basis for improved preventive and rehabilitative protocols for baseball pitchers.

Adult↗
PubMed1997

[Application of artificial humeral head in the treatment of tumor of upper end of humerus].

In order to restore the function of shoulder joint in patient with tumor of upper end of humerus, artificial humeral head replacement was performed. The materials included resinene, nylon-6 and large molecular polyethylene from 1978 to 1993, 14 patients were treated. The tumors involved in this group were giant cell tumor, synviosarcoma, bone cyst, osteochondroma, osteoblastoma, osteofibrosarcoma, osteosarcoma, chondrosarcoma, parosteosarcoma and malignant giant cell tumor. After resection of the tumor, the artificial prosthesis was implanted with bone cement. After 1 to 16 years follow-up, functions of the shoulder joint were reserved in 86% of the patients.

Adult↗
PubMed2002

Shoulder movements during quadrupedal locomotion in arboreal primates.

The kinematics of scapula and shoulder joint movements were analyzed in three species of arboreal quadrupedal primates using cineradiography. Our findings indicate that scapular movement is highly important for forelimb movement in primates with this ancestral mode of locomotion. Retroversion of the scapula (syn. caudal rotation or extension) during the stance phase contributes more than 40% to the stride length of the forelimb. Lateral forelimb excursions, a general feature for arboreal primates, are based on complex three-dimensional scapular movements guided by the clavicle. Humeral abduction is achieved by scapular abduction and transversal rotation of the scapula about its longitudinal axis, and is therefore strikingly different from humeral abduction in humans. At the same time, the movements of the shoulder joint are limited to flexion and extension only.

Animals↗
PubMed1981

Anti-inflammatory drugs in periarthritis of the shoulder: a double-blind, between-patient study of naproxen versus indomethacin.

Fifty-nine patients were entered into a double-blind, parallel comparison of the efficacy and side-effects of naproxen sodium (825 mg daily) and indomethacin (100 mg daily) in the treatment of periarthritis of the shoulder joint. Assessments were made on entry to the study, at two weeks, and at the end of four weeks when objective and subjective recordings of mobility, loss of function, pain and the presence of absence of side-effects were noted. The two treatment groups were found to be matched for age, sex and duration of disease, and an assessment at the start of the study differed only in respect of the degree of active medial rotation of the shoulder joint and pain. There was an overall improvement from the time of admission to the study in both the naproxen sodium and the indomethacin treatment groups but there was no significant difference between the efficacy of the two groups. One patient from the naproxen sodium group and three patients from the indomethacin group withdrew from the trial because of side-effects which in each case involved the gastro-intestinal tract.

Clinical Trials as Topic↗
PubMed2005

Three-dimensional morphological analysis of humeral heads: a study in cadavers.

BACKGROUND: Anatomy of the humeral head may be of importance for the kinematics of the shoulder joint. We therefore evaluated the three-dimensional morphology of humeral heads. MATERIAL AND METHODS: We performed three-dimensional morphological analysis of the articular surfaces of 14 humeral heads in the proximal humeri of 7 cadavers. The articular surface was divided into 9 portions, which were in turn equally divided into 3 sections by an angle in supero-inferior and antero-posterior directions. Each portion of the articular surface was fitted to a sphere, and we calculated the radius of the curvature of each portion. RESULTS: The mean radius of the superior portion was significantly greater than that of the central portion, and the mean radii of the anterior and posterior portions were significantly less than that of the central portion. INTERPRETATION: Our findings lead us to believe that the morphology of the humeral head is of importance for the kinematics of the shoulder joint.

Biomechanical Phenomena↗
PubMed1988

[Sonographic evaluation of the rotator cuff following reconstruction of complete ruptures].

This is a report on the results of a clinical and sonographical re-examination of 66 shoulder joints after reconstruction of complete rotator cuff tears. One-third of the patients were asymptomatic, in more than half of them pre-operatively existing complaints had improved, and in 15% no improvement was seen. Clinical findings were without abnormalities in half of the patients. In as many patients indications were found of a still existing rotator cuff syndrome. Sonographically, in 49 out of 66 cases the continuity of the rotator cuff was maintained. In 17 cases indications of tears were found. Remarkable features were, in rotator cuffs with maintained tendon continuity, in 50% of the shoulder joints a thinning out of the tendon and/or echogenic patterns. Tears in the non-operated opposite side were found in 7 cases and thinning out and/or enhanced echogenicity in 12 cases.

Adult↗
PubMed1996

Amyloidosis of the shoulder in patients on chronic hemodialysis: sonographic findings.

OBJECTIVE: The purpose of this study was to determine the sonographic findings of amyloidosis in shoulders of patients on chronic hemodialysis. SUBJECTS AND METHODS: Sonograms were obtained for 19 shoulders of 11 patients on chronic hemodialysis with clinical findings suggestive of amyloidosis. Five patients had biopsy-proven amyloidosis, and one patient had positive shoulder joint fluid aspirate. The thicknesses of the following structures were measured: the rotator cuff, the subacromial-subdeltoid bursa, and the long head of the biceps tendon and its synovial sheath. The presence of intra- or periarticular masses or nodules, hyperechoic areas, bony erosions, and calcifications was specifically assessed. Shoulder sonograms from dialysis patients were compared with normal sonograms obtained for 20 asymptomatic shoulders of patients without renal disease. RESULTS: The mean rotator cuff thickness in the patients with amyloidosis was significantly greater than that in the normal group (p < .0001). Ten shoulders of six patients with amyloidosis but none of the control subjects had a rotator cuff thickness greater than 7 mm. The synovial sheath of the long head of the biceps tendon was thickened in 10 shoulders of patients with amyloidosis and in one normal shoulder. The subacromial-subdeltoid bursa was thickened in seven shoulders of patients with amyloidosis but not in any shoulders in the control group. Eight shoulder sonograms from dialysis patients showed intra- or periarticular nodules. CONCLUSION: Sonographic findings associated with amyloidosis of the shoulder include thickening of the rotator cuff, the synovial sheath of the long head of the biceps tendon, and the subacromial-subdeltoid bursa and the presence of nodules within or around the joint. Shoulder sonography may be useful as a noninvasive technique for the diagnosis of dialysis-related amyloidosis in the proper clinical setting.

Adult↗
PubMed1995

Differences in distribution of myofiber types between the supraspinatus and infraspinatus muscles of sheep.

BACKGROUND: The m. supraspinatus stabilizes the shoulder joint to bear the body weight, and the m. infraspinatus assists in extension and flexion of the joint in sheep. Postural muscles have many SO myofibers, whereas locomotory muscles have numerous fast-twitch myofibers. In sheep the distribution of myofiber types within the two muscles, necessary for a better understanding of postural function, remains to be clarified. METHODS: Muscle samples were removed from the whole transverse sections of the dorsal, middle, and ventral compartments of the m. supraspinatus and m. infraspinatus of sheep. Myofibers were classified into FG, FOG, SO-1, and SO-2 myofibers by histochemical methods. RESULTS: The distribution of SO myofibers changed more greatly in the m. supraspinatus (15.0-99.1%) than in the m. infraspinatus (24.5-62.3%). SO myofibers were concentrated markedly in the caudal and deep regions near the spine and fossa of the scapula in the m. supraspinatus and distributed more in the medial part than in the lateral part in the m. infraspinatus. Such changes were caused by increases in percentage of SO-2 myofibers and not SO-1 myofibers. The craniolateral regions of the m. supraspinatus and the caudolateral regions of the m. infraspinatus had many fast-twitch (FOG plus FG) myofibers suited for rapid extension and flexion of the shoulder joint. CONCLUSIONS: The m. supraspinatus has the compartmentalized, deep, and caudal regions occupied by SO myofibers, which seem to be specialized for maintenance of the joint extension. The medial region of the m. infraspinatus may assist in the joint stabilization.

Animals↗
PubMed1995

[Clarification of the concept humeroscapular periarthritis].

Shoulder pain may be due to various reasons. It is primarily produced by changes in the periarticular structures of the shoulder joint. The term "periarthritis humeroscapularis" (PHS), often used at diagnosis, is unsuitable however because it prevents differentiation of the various clinical pictures related to the anatomical structures. Among the anatomical structures concerned, above all the rotator cuff and here especially the suprasinatus muscle must be mentioned. Also the long biceps tendon and the shoulder joint capsule are, according to Welfling, locations of painful processes, not to forget the subacromial bursa. The pathology responsible for the clinical symptoms and signs is primarily produced by degenerative changes. They lead to tendopathy, as well as to tendon rupture, and also seem to be of importance in connection with calcifying tendopathy. Capsule shrinkage in shoulder stiffness can also be influenced by neighboring degenerative processes. This also applies to isolated bursitis. Today thorough clinical and radiological clarification makes a differentiated diagnosis possible so that the vague term "periarthritis humeroscapularis" can be dropped.

Diagnosis, Differential↗
PubMed2006

[Upper limb pain and limited mobility in the patients after stroke].

Pain in the paretic upper limb is a common complaint in the post-stroke patients. It usually affects shoulder joint and, less frequently, wrist and hand. Pain is usually accompanied by limited mobility of the shoulder and sometimes by swelling of the hand and wrist. The aetiology of these complaints remains unclear. The objective of the study was to evaluate the incidence of pain, limited mobility, swelling and other signs that appear in the paretic limb within the first year after stroke. Forty-five stroke patients treated in the Department of Neurology in 2000 who answered the questionnaire concerning type, localization and intensity of the complaints from paretic upper limb were included. Twenty-six patients (58%) had a painful shoulder, wrist or hand. These complaints concerned women more frequently than men (71% vs. 46%, consecutively), younger patients aged below 55, and those who initially had more severe paresis. Symptoms and signs appeared within first month after stroke in majority of patients, and 70% of patients considered these symptoms very disturbing, significantly deteriorating the dexterity of the paretic limb. Thirty five percent of patients complained of limited mobility in the shoulder joint, 18% had incomplete mobility of fingers in the paretic limb. Twenty two percent of patients had swollen wrist and hand, and 24% had a discoloration and trophic changes of the skin in the paretic hand. Cold intolerance by means of freezing sensation in the affected limb was experienced by 58% of patients. Three patients had complaints both in shoulder and hand, with accompanied swelling, trophic changes and vasomotor disturbances in the hand, what fulfilled criteria for the diagnosis of shoulder-hand syndrome. The results of the study show that upper limb pain and limited mobility are common complications of the stroke. Usually underestimated by family doctors these symptoms and signs cause a significant discomfort for the patients and delay the recovery of the paretic limb.

Activities of Daily Living↗
PubMed2005

Corticosteroid injections for painful shoulders.

The painful shoulder is a common clinical entity with a broad array of possible causes. A caregiver for an affected patient needs to determine the aetiology for the pain, often relying primarily on the history and physical examination and supplemented with laboratory testing and imaging when needed. However, initial treatment decisions are often made before ordering these tests in situations not involving trauma. Most conditions affecting the shoulder are treated with conservative measures such as rest, physical therapy and analgesics. When such measures fail, local corticosteroid injections can be a valuable tool to help achieve symptom relief for a wide range of the most common conditions affecting the shoulder joint. This review aims to help the clinician distinguish among the commonly encountered causes of shoulder pain and guide therapy when the use of local corticosteroid injections is considered.

Arthritis↗
PubMed2005

Potential ecotoxic effects of polychlorinated biphenyls on Xenopus laevis.

We examined potential ecotoxic effects of polychlorinated biphenyl (PCB)3, PCB5, Aroclor 1254, and Aroclor 1242 on Xenopus laevis. Tadpoles were exposed to PCBs from stage 46/47 (system of Nieuwkoop and Faber) to the completion of metamorphosis. We demonstrated, to our knowledge for the first time, forelimb malformations caused by PCBs (malformation rate, > 70%). The malformed forelimbs were fixed in the adduction-backward rotation position and could not move. Therefore, malformed male frogs were destined to have no offspring, because they could not grasp the females with their forelimbs to mate. Alcian blue-alizarin red double-staining indicated that the forelimb malformation resulted from the shoulder abnormality. Compared with the normal shoulder joint, the proximal humerus with the humerus inter-rotated 90 degrees in the abnormal shoulder joint. Moreover, testes from more than a third of male frogs with exposed to PCBs exhibited feminization to different degrees at gross morphology and histology, with fewer or abnormal spermatogonia and oocytes. Gonadal abnormalities would lead directly to reproductive dysfunction and population decline. These results suggest that PCBs have potentially ecotoxic effects on amphibian populations. We infer that PCBs could play roles in amphibian malformations and population declines, at least at sites that are polluted heavily with PCBs.

Animals↗