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At least 1,189 records · Page 66Linked to original sources
PubMed1991

[Examination of the non-injured shoulder].

Modern imaging methods are undeniably very attractive. They should make possible an easy study of the musculotendinous rotator cuff of the shoulder joint, lesions of which are the cause of most painful or stiff shoulder syndromes. However, not all shoulder symptoms are due to rotator cuff lesions. Also, not all methods of imaging are equally suited to showing the different cuff lesions. Further, one cannot consider the treatment of a symptomatic shoulder without having an assessment of the present condition upon which to gauge the functional improvement due to the treatment. Hence clinical examination of the painful shoulder remains essential. This makes it possible (1) to exclude an extra-articular pathology, (2) to choose the method of imaging most suited to showing the suspected lesion, and finally (3) to quantify the functional state of the shoulder.

Arthrography↗
PubMed1991

Neck and shoulder disorders in medical secretaries. Part I. Pain prevalence and risk factors.

420 medical secretaries took part in a cross-sectional study at examining the prevalence of musculoskeletal disorders as well as the relationship between neck and shoulder pain and possible risk factors. Sixty-three percent had experienced neck pain sometime during the previous year and while 15% had suffered almost constant pain 32% had experienced neck pain only occasionally. Shoulder pain during the previous year had been experienced by 62%, 17% had suffered almost constant pain while 29% experienced pain only occasionally. Fifty-one percent had experienced low back pain. Age and length of employment were significantly related to neck and shoulder pain. Furthermore, working with office machines 5 hours or more per day was associated with a significantly increased risk for neck pain (OR 1.7), shoulder pain (OR 1.9) and headache (OR 1.8). Finally, a poorly experienced psychosocial work environment was significantly related to headache, neck, shoulder and low back pain. The results of this study suggest that work with office machines as well as the psychosocial work environment are important factors in neck and shoulder pain.

Academic Medical Centers↗
PubMed1991

[Evaluation of 67Ga accumulation around the shoulder joint--comparison with 99mTc-MDP].

67Ga scintigraphy was performed in 865 patients, and in 1078 examinations. 67Ga accumulation was evaluated retrospectively for asymmetric accumulation in the shoulders. Approximately 50% of patients showed no asymmetric distribution of 67Ga in the shoulders. About 40% of patients showed increased accumulation in the right side and about 10% of patients showed increased accumulation in the left side. A change of 67Ga distribution in the shoulder joints was recognized in about 30% of patients during the follow-up study. Reasons for asymmetric distribution of 67Ga in the shoulders were considered to be due to bone metastasis, changes of local blood flow, edema, irradiation, muscle atrophy after cerebral paralysis, and operation. 67Ga scintigraphy showed a broader range and more prominent accumulation in the soft tissues around the shoulder joint than 99mTc-MDP scintigraphy. The accumulation of 99mTc-MDP was recognized to be in the center of the region of 67Ga accumulation. 99mTc-MDP scintigraphy showed more prominently increased accumulation than 67Ga scintigraphy in patients with osseous lesions. Similar factors appeared to have had an influence on the abnormal accumulation of 67Ga and 99mTc-MDP around the shoulder joint.

Adult↗
PubMedDate not supplied

Paraplegia, syringomyelia tarda and neuropathic arthrosis of the shoulder: a triad.

A casually related triad of syringomyelia tarda, postparaplegia with secondary neuropathic arthrosis of the shoulder has been presented. The development of neuropathic arthrosis of the shoulder has been presented. The development of neuropathic arthrosis of the shoulder in 2 of our paraplegic patients prompted us to look for a correlation and/or a common etiology. Paraplegia secondary to spinal cord injury could be causative or at least an associated factor in a delayed proximal syringomyelia. It is the syringomyelia which can lead to the neuropathic arthrosis in the upper extremity, mainly, in the shoulder. There is an interesting pathological association of paraplegia and syringomyelia with neuropathic arthrosis. Earlier awareness of any neurological changes in the upper extremity of the paraplegic patient could point to recognition of syringomyelic process and portend a tendency toward neuropathic arthrosis of the shoulder. This would require a high index of suspicion, and subsequently a preventative, protective orthopedic approach to minimize the usual functional deformity that occurs when this neuropathy involves the shoulder.

Adult↗
PubMed1979

[Neurologic syndromes affecting the shoulder (author's transl)].

A number of locally defined as well as generalised diseases of the peripheral nervous system is manifested in the shoulderarm region besides lesions of individual nerves through traumas or as a result of pressure. Radicular syndromes are particularly frequent. These are based on prolapsed disks or degenerative changes of the cervical vertebral column. We must differentiate between these syndromes and the often rather unknown neuralgic amytrophy of the shoulder. Our experience has shown that in too many cases, paralysis of the plexus cervico-brachialis is assumed, although this occurs almost exclusively on the basis of traumatic violence, much rarer due to pressure. In such cases, the physician should look for the scalenus syndrome, the costoclavicular syndrome, and the hyperabduction syndrome. As a rule, pain is the most prominent symptom in plexus pareses through new growths, eg Pancoast's tumour. In such cases, a clear distinction must be made against bursitis of the shoulder (periarthritis humeroscapularis), in which there are no neurogenic changes, but only myogenic changes manifested in the electromyogram. If the sudden pain is accompanied by swelling and weakness of the arm, there is every likelihood of the existence of Paget-von Schrötter's syndrome. A remarkably painless deformation of the shoulder joint should also suggest neurogenic arthropathy in syringomyelia. The physician should also consider disturbances of distant origin, for example in the region of the carpal tunnel, with pain radiating to the shoulder in the manner of brachialgia paraesthetica. Finally, any noticeable weakness or muscular atrophy in the shoulder region should suggest a disease of the neuromuscular system, mainly progressive muscular dystrophy or the rare shoulder girdle type of amyotrophic lateral sclerosis.

Arthropathy, Neurogenic↗
PubMed1990

Unconstrained shoulder arthroplasty. A five-year average follow-up study.

A series of 42 total shoulder arthroplasties and four humeral hemiarthroplasties were performed with either the English-McNab or Neer prosthesis. Retrospective follow-up study averaged five years with a three-year minimum. Preoperative diagnoses included rheumatoid arthritis, osteoarthritis, posttraumatic arthritis, rotator cuff arthropathy, avascular necrosis, failed prosthesis, and congenital dislocation. Postoperatively, pain improved in 94% of shoulders, and active range of motion improved an average of 42 degrees in abduction and 47 degrees in forward flexion. Rotator cuff lesions were correlated with poorer postoperative function. Complications developed in four shoulders (9%) and consisted of humeral component protrusions (two shoulders), loosened prosthesis (one shoulder), and unrecognized, preoperative tuberculous infection (one shoulder). Fifteen glenoid components (36%) and six humeral components (13%) developed lucent lines roentgenographically, but only one glenoid component developed migration.

Adult↗
PubMed1990

Evaluation of the prognostic value of positive-contrast shoulder arthrography for bilateral osteochondrosis lesions in dogs.

To investigate whether arthrographic findings had any prognostic value with respect to treatment and outcome of bilateral osteochondrosis, shoulder arthrograms (n = 80) from 40 dogs with bilateral lesions were evaluated. Arthrography was performed, using 1.5 to 4 ml of a 25% solution of meglumine-sodium diatrizoate, with admixture of 0.2 mg of epinephrine. A shoulder with signs of pain and lameness was surgically treated. The contralateral shoulder was treated conservatively, and the final outcome was compared with the arthrographic findings. In 37 dogs, signs of lameness and pain were associated with a loose cartilage flap and, in 3, with a detached cartilage flap. In 2 dogs, admitted with bilateral lameness, a loose cartilage flap was detected in both shoulders. Of 12 dogs with a detectable loose cartilage flap in the contralateral shoulder joint, 6 became lame 2 to 4 months after initial surgical intervention and needed bilateral surgery. In the contralateral joint, development of thick articular cartilage over the subchondral defect or a detached cartilage flap lodged in the caudal pouch of the shoulder joint was a favorable prognostic sign. Such dogs had no signs of lameness on the contralateral side during a follow-up period that ranged from 1 to 7 years.

Animals↗
PubMedDate not supplied

[Rotator syndrome of the shoulder and mobility of the cervical spine].

"Painful shoulder" results from different pathogenetic disorders. There is a coincidence of cervical spine and shoulder syndromes. However, a deficit exists of reproducible proof correlation. In this study the motility of cervical spine in patients with painful shoulder syndromes is biometrically measured and compared with control persons. 41 patients and 94 healthy persons had been investigated. Radiograms of the cervical spine had been taken in spontaneous position, in maximal flexion and extension positions. The radiograms had been digitalized according to the technique of Arlen. In addition, vertebral gliding had been analyzed. There was no difference in spontaneous posture of the cervical spine. In patients the total motility was reduced. Regarding the single segments there was less motility in C4/5, C5/6, and C6/7. The physiologic vertebral gliding was diminished in C2/3 and C5/6. The correlation between reduced motility of cervical spine and shoulder pain can be explained by the following ways: 1. Interactions by posture 2. Disorders of muscular balance by nerve root lesions 3. Disturbance of muscle coordination by reflectoric afferences from cervical or shoulder regions. These results demonstrate the complexity of apparently local disorders of the shoulder.

Adult↗
PubMed1988

[Diseases of the shoulder joint from the orthopedic viewpoint].

The cardinal symptom in all shoulder disorders is shoulder pain. We have to differentiate between genuine shoulder pain originating from the glenohumeral joint and its periarticular structures and referred pain originating at a site distant from the shoulder joint, e.g., the cervical spine or the internal organs. The differential diagnosis of genuine shoulder pain is discussed. The options open to the radiologist for reaching a correct diagnosis in different sorts of shoulder pain are shown.

Arthritis↗
PubMed1987

Measurement of fetal shoulder width with computed tomography in diabetic women.

We conducted a feasibility study of the use of computed tomography (CT) to measure the width of the fetal shoulders and to predict large birth weight in infants of diabetic mothers. Computed tomography pelvimetry using low-dose digital radiographs was performed before delivery at term in 22 diabetic women. Shoulder width was estimated by direct electronic measurement on a single axial section through the shoulders of the fetus, and by orthopedic calipers within 48 hours of birth. Shoulder width by CT was 11.4-16.5 cm, and correlated significantly with postnatal measurements (r = 0.66, P = .01). Shoulder width by CT also correlated well with birth weight (r = 0.84, P less than .01), and measured more than 14 cm in all seven infants with birth weights more than 4200 g. Using 14 cm as a positive test and birth weight 4200 g as an abnormal result, the predictive value of a positive test was 78% and the predictive value of a negative test was 100%. This technique deserves further evaluation in assessing the risk of shoulder dystocia in potentially macrosomic infants.

Birth Weight↗
PubMed1986

Excessive retroversion of the glenoid cavity. A cause of non-traumatic posterior instability of the shoulder.

Seventeen shoulders in ten adolescents were evaluated for non-traumatic posterior instability. Each patient had significant disability in throwing a ball, swimming, arm-blocking in football, and bench-pressing weights. Each patient had excessive retroversion of the glenoid. Five shoulders had a posterior opening-wedge osteotomy of the scapular neck to correct the excessive retroversion of the glenoid cavity. Acromial bone was used as graft material in the first four shoulders. Three shoulders lost some correction but only one required revision, which was done using cortical iliac bone as a graft and screw fixation. This technique was used primarily in the fifth shoulder. Excessive retroversion of the glenoid cavity is a developmental deformity and is considered the primary etiology of posterior instability of the shoulder. The posterior opening-wedge osteotomy of the scapular neck corrects the defect and the instability.

Acromion↗
PubMed1986

Painful shoulder in hemiplegic patients: a study of the suprascapular nerve.

The etiology of painful shoulder in hemiplegic patients has not been fully explained. Since it has been shown that a suprascapular nerve lesion can be associated with "frozen shoulder," we have investigated the possibility that a similar lesion may exist in the painful contracted shoulder of hemiplegic patients. Thirty hemiplegic men with shoulder pain were examined and latencies determined for the suprascapular nerve from the supraclavicular fossa to the supra- and infraspinatus muscles on both sides. Routine EMG was also done for the same muscles. Patients' ages ranged from 45 to 85 (means 67 years) and the duration of hemiplegia from 1 month to 13 years (means 30.9 months). Mean latencies of the noninvolved side were 3.2 +/- 0.5 (SD) and 4.2 +/- 0.7 ms to the supraspinatus and the infraspinatus muscles, respectively. Three patients had latencies greater by two SD on the hemiplegic side than on the noninvolved side. Suprascapular nerve block did not relieve the shoulder pain completely in these patients. Excluding these three, mean latencies on the hemiplegic side were 3.1 +/- 0.4 ms to the supraspinatus muscle and 4.1 +/- 0.6 ms to the infraspinatus muscle. It is concluded that a lesion of the suprascapular nerve is not responsible for the painful contracted shoulder of the hemiplegic patient although such a lesion may exist incidentally.

Aged↗
PubMed1985

Cervical spine and the shoulder.

Cervical spine pathosis and pain can be referred to the shoulder and can actually result in a frozen shoulder or a tendinitis pattern. Concomitant cervical spine pathosis can coexist with primary shoulder pathosis and can present a diagnostic and therapeutic dilemma. Conservative programs usually require an aggressive attack on the cervical spine, often with therapy to the shoulder. Surgical considerations rely on diagnostic acumen to sort out accurately where the predominant problem exists. The usual scenario of shoulder pain referred from the cervical spine involves an appropriate history, physical examination, selective subacromial injection, appropriate roentgenograms of the cervical spine and shoulder and finally a cervical discogram to document the level of the disorder followed occasionally by an anterior cervical fusion.

Adult↗
PubMed1985

Shoulder impingement syndrome in athletes treated by an anterior acromioplasty.

Shoulder pain caused by a impingement syndrome commonly affects an athlete's performance. Thirty-five shoulders in 33 athletes had an impingement syndrome treated by an anterior acromioplasty after failure of conservative treatment. Thirty-one of 35 shoulders (89%) were subjectively judged improved by the patients from their preoperative status. The moderate and severe pain was reduced from 97% of the shoulders preoperation to 20% postoperation. The pain at rest and with activities of daily living was reduced from 71% of the shoulders preoperation to 9% postoperation. However, only 15 of 35 operated shoulders (43%) allowed return to the same preinjury level of competitive athletics, and only four of 18 athletes involved in pitching and throwing returned to their former preinjury status. This operation is satisfactory for pain relief but does not allow an athlete to return to his former competitive status. A prolonged rehabilitation program may improve the results.

Acromion↗
PubMed1985

Shoulder arthrodesis for the treatment of brachial plexus palsy.

In 14 adult patients with brachial plexus injuries, shoulder arthrodesis was completed in a position of 30 degrees abduction, 30 degrees flexion, and 30 degrees internal rotation. Abduction was measured by the position of the arm in relation to the side of the body with the scapula in the anatomic position. Internal fixation was used in each case. Six patients had had Steindler procedures. Three patients with complete paralysis were treated by above-elbow amputation. All shoulders fused. Mean follow-up time was 32 months. All patients noted that shoulder fusion had improved the function of their extremities. Minimum shoulder motion was 60 degrees abduction and 50 degrees flexion. Three procedures failed because of continued pain that was not relieved by surgery. One patient with an elbow flexion contracture disliked the combination of shoulder and elbow flexion. Seven patients required plate removal. Only one of the three patients who had had above-elbow amputation became a good prosthetic user. Shoulder arthrodesis is a reliable procedure that improves function in adult patients with brachial plexus palsy.

Adult↗
PubMed1984

[Traumatic shoulder dislocation. Late functional results with reference to the frequency of redislocation].

This study reports on the after-examination of 86 out of 107 patients with primary shoulder dislocation. Of greatest interest was the question which period of immobilisation would yield the best results. The most frequent type of dislocation was the subcoracoid position in 62% of all cases. In 44% the dislocations were associated with fractures especially of the greater tuberosity. The greatest number of dislocations occurred between 61 and 80 years of age (= 42%). The second highest number was found between 21 and 40 years of age (= 29%). In 47% of all cases the shoulder was immobilised for a week, in 40% between one and two weeks and in 13% for more than two weeks. The incidence of recurrence was 15% (13 patients). In 8 cases (= 9%) a recurrent dislocation of the shoulder resulted, whereas in 5 cases (= 6%) only one relapse occurred due to a repeated intense trauma. The function of the injured shoulder is most significantly impaired and rendered worse by the factors: higher age (greater than 41 years) and associated fractures. The duration of immobilisation itself has neither a significant influence on posttraumatic function of the shoulder nor on the incidence of recurrence. Therefore, an uncomplicated dislocation of the shoulder should be immobilised for a short period only. However, in cases of associated fractures, immobilisation will be necessary for a longer time.

Adolescent↗
PubMed1980

[Functional anatomy of shoulder-arm pain (author's transl)].

The treatment of pains felt in the shoulder-arm region depends on the pathogenesis of the individual case. For this reason the functional anatomical conditions which can cause pain in various diseases are first described. This is followed by a presentation of the pathophysiological mechanisms of the causation of pain. The shoulder girdle is a functional skeletal motor unit which includes joints and muscles of the arm, neck and trunk. Disturbances of one structural element of the shoulder girdle are reflected as muscular distortion of the entire shoulder girdle and possibly also of the neighboring parts of the body communicating with the shoulder girdle. Shoulder-arm pain can arise in principle from two different sources: stimulation of pain receptors (receptor pain, physiological excitation of pain) and by functional disturbance of pain conducting and pain producing neuronal structures.

Humans↗
PubMed1983

Load moment, muscle strength and level of muscular activity during internal rotation training of the shoulder.

Existing studies of shoulder joint loading, muscle strength and muscular activity do not, from the point of view of clinical application, adequately cover these factors, knowledge of which is important for the design of optimal exercises for training shoulder impairments. In the present study, exercises using a weight-and-pulley device have been analysed in order to map the resistance moments of force in relation to the muscular strength capacity of shoulder internal rotators , and to map the activation of these muscles in response to the resistance from the device. The relationships established in the study provide a basis for optimising various types of shoulder training exercises. For example, an angle of 40 degrees between frontal plane and shoulder-pulley line has been found to give the best adaptation of resistance to strength. The study also demonstrates the possibility of using a pulley apparatus for shoulder inward rotator muscle training.

Adult↗