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PubMed1987

The shoulder pain syndrome and soft-tissue abnormalities in patients on long-term haemodialysis.

Fifteen patients on long-term haemodialysis were studied. Twelve patients were symptomatic and ten of these patients had shoulder pain. Eleven patients had associated carpal-tunnel syndrome. A statistically significant correlation was observed between the soft-tissue abnormalities of the hands, carpal-tunnel syndrome and the shoulder pain. Radiological changes were also common and were noted in 14 patients; cysts and erosions were the commonest. The shoulder joint was the most commonly involved joint. No obvious correlation existed with either raised parathormone or calcium levels. The possible role of beta 2-microglobulin and associated amyloidosis in the causation of this syndrome is discussed.

Adult↗
PubMed1987

Joint mobilization principles. Considerations for use in the child with central nervous system dysfunction.

The purpose of this article is to explore the use of mobilization in the treatment of capsular dysfunction of the shoulder joint in children with central nervous system dysfunction. A review of functional anatomy and of normal and abnormal development of the shoulder is presented. Basic mobilization principles and application of joint mobilization techniques to children with long-standing shoulder hypomobility and spasticity are discussed. Research to determine the benefits and risks of mobilization of joints in children with spasticity is recommended.

Central Nervous System Diseases↗
PubMed1983

Double-contrast computed tomography of the glenoid labrum.

Imaging of glenoid labrum pathology is useful to help plan surgical repair of the dislocating shoulder. Eleven patients with suspect labrum damage were imaged with computed tomography (CT) immediately after routine double-contrast shoulder arthrography. Lesions identified included attenuation, tears, and displacement of the labrum as well as stripping and stretching of the anterior shoulder joint capsule. Surgical confirmation of pathology was available in all but one case. CT of the glenoid labrum is easy to perform, low in radiation dose, and accurate.

Adult↗
PubMed1996

Hypertrophic bursopathy of the subacromial-subdeltoid bursa in juvenile rheumatoid arthritis: sonographic appearance.

Hypertrophic bursopathy is a term used to describe the massive synovial proliferation occasionally seen in the bursae of patients with arthritis. Involvement of the subacromial-subdeltoid (SA-SD) bursa in adults in uncommon, and it is still rarer in children. It may simulate synovial proliferation or fluid within the adjacent shoulder joint. Sonography clearly shows the location and nature of the soft-tissue swelling. Two cases of this entity in children with juvenile rheumatoid arthritis are described, one with a uniquely severe sonographic picture.

Arthritis, Juvenile↗
PubMed1982

Pyarthrosis simulating ruptured rotator cuff syndrome.

A 50-year-old black man was admitted with a diagnosis of a ruptured rotator cuff syndrome two weeks after an injury to the right shoulder and treatment by intra-articular steroid injection. At operation pus and necrotic debris were found in the shoulder joint, but the rotator cuff was anatomically intact. Surgical debridement, irrigation, and intravenous antibiotics resulted in good recovery with satisfactory function. The pyarthrosis apparently resulted from the preoperative intra-articular injection.

Acute Disease↗
PubMed1998

Longitudinal changes in selected physical capabilities: muscle strength, flexibility and body size.

OBJECTIVES: first, to record, in a representative sample of older men and women, longitudinal changes in (i) maximal voluntary strength of the handgrip muscles, (ii) maximal range of movement in the shoulder joint and (iii) body weight and skeletal size; second, to explore associations between the changes in muscle strength and both customary physical activity and health outcomes. DESIGN: longitudinal analyses of survivors measured at baseline, and 4-year and 8-year follow-ups. PARTICIPANTS: 350 survivors of a random sample originally aged 65 and over. RESULTS: over 8 years average loss of body weight was slight but significant at about 2 kg (less than 5%). Loss of shoulder range was negligible, while loss of muscle strength was significant at about 40 N (less than 2% per year). Demispan remained stable across all three points of measurement. These mean values concealed substantial variation in the rate of loss of strength, which was twice as fast in the older groups, especially in the women. These losses could not be attributed to worsening health, although this was observed. All the respondents had at least two chronic health problems at the 8-year stage. For the changes in handgrip strength, reduced reported habitual use of the handgrip muscles and increased symptoms of anxiety and depression were significant independent covariates in addition to age and time (all P < 0.0001). CONCLUSION: there are significant independent associations between the loss of muscle strength in old age and both decline in physical activity and increase in depression scores. This is strongly suggestive of causal links and confirms the need to encourage physical activity and control depression in order to maintain strength and function in old age.

Aged↗
PubMed1989

Positive contrast arthrography of the dog's shoulder with meglumine-sodium diatrizoate.

Different volumes with varying concentrations of meglumine-sodium diatrizoate were injected to study positive contrast shoulder arthrograms in six experimental dogs weighing 23-37 kg. The best delineation of the articular cartilage was obtained following injection of 1.5 ml of a 25% solution (185 mg iodine/joint). To visualize the bicipital tendon sheet and the different pouches of the shoulder joint, 6 ml of a 25% solution (750 mg iodine/joint) should be used. If no definite lesions are previewed, 6 ml of a 19% solution (550 mg iodine/joint) offers an acceptable compromise since with this volume and concentration no pooling of contrast medium overlapping the caudal area of the humeral head was seen. Radiographs should be obtained within 5 minutes after injection of the contrast medium. After that period the delineation of the joint structures is vaguening by absorption of the contrast medium. Repeated contrast examination with meglumine-sodium diatrizoate should be avoided. After four procedures at weekly intervals, the necropsy performed on two dogs showed inflammatory changes of the synovial membrane.

Animals↗
PubMed1975

X-ray enlargement modified for use in experimental animal science.

The primary enlarged x-ray image is produced by a reduction of the focal-film-distance to 80 cm at a given focal size of 0-15 mm. The advantages of this technique as compared to conventional x-ray methods are exemplified with x-ray images from the shoulder joint of a European hamster, a pseudoarthrosis in the foreleg of a beagle, and a renovasography of a rat. The principles of the technique and its significance for investigations using small laboratory animals are discussed.

Animals↗
PubMed1992

[Septic arthritis due to Streptococcus bovis].

A 47-year-old man presented with arthritis of the right shoulder and spondylodiscitis by Streptococcus bovis. This microorganism is a frequent cause of endocarditis and has been associated with gastrointestinal neoplasm, mainly carcinoma of the colon; however up to the present it had not been described as an causal agent of septic arthritis. The studies carried out on the patient permitted the exclusion of the existence of a digestive neoplasm and endocarditis. Despite a prolonged evolution prior to treatment with elevated doses of penicillin G and not requiring surgical drainage, the evolution was good and no destructive lesions were produced in the shoulder joint. Hematogenous infections (in this case septic arthritis) by Streptococcus bovis may present in patients without gastrointestinal diseases or endocarditis, possibly have a low damage to skeletal structures and respond adequately to conventional treatment with penicillin G.

Arthritis, Infectious↗
PubMed1980

Tuberculosis of the subdeltoid bursa. A case report.

The 10th reported case of tuberculosis of the subdeltoid bursa is described. A 45-year-old Caucasian woman presented with a 30-year clinical history of subdeltoid bursitis, with typical physical signs, but with normal X-rays of the shoulder-joint region and lungs. The diagnosis was made by needle aspiration and was later confirmed by bacteriologic and histological examination of the surgical specimen. Following surgery and chemotherapy, the patient has remained free of any active tuberculosis disease for the past five years.

Bursa, Synovial↗
PubMed2005

[MR-guided core biopsy of the shoulder: possibilities and experience with a vertically open 0.5T system].

PURPOSE: The availability of open whole body MRI magnets and MR-compatible instrumentarium were essential conditions for the progression of interventional MRI. The advantages of an MR-guided biopsy at the musculoskeletal system are the visualization of the puncture site of a representative area for tumor histology, the absence of exposure to radiation and the free selection of imaging planes. The purpose of the study was the development of a new technique of a secure MR-guided biopsy of intraosseus lesions in the humeral head. MATERIAL AND METHODS: MR-guided core biopsy of a intraosseus lesion of the humeral head was performed in five male patients on a vertical open, whole body MRI magnet (SIGNA SP/i 0.5T, GE Medical Systems). The technique using interactive MRI and the MR-compatible instrumentarium are described. RESULTS: A secure core biopsy could be obtained from a representative area for tumor histology in all cases. No complications occurred, especially no nerve or vessel lesion, no rotator cuff lesion and no intra-articular contamination of the shoulder joint were observed. CONCLUSION: A new technique is presented to obtain MR-guided core biopsies of intraosseous lesions of the humeral head. Furthermore, clinical indications of this technique are described.

Adult↗
PubMed1997

Magnetic resonance imaging of the coraco-acromial ligament.

The coraco-acromial ligament is important first for the stability of the shoulder joint and second because it can impinge on the rotator cuff. In this study we demonstrate how the coraco-acromial ligament can be shown by magnetic resonance imaging (MRI) in the axial plane as well as in the more conventional coronal and sagittal planes.

Humans↗
PubMed1989

Heterotopic bone formation following total shoulder arthroplasty.

The incidence and location of heterotopic bone formation following total shoulder arthroplasty were evaluated in 58 Neer Mark-II total shoulder replacements. One year after surgery, 45% had developed some ectopic ossification. In six shoulders (10%) the ossifications roentgenographically bridged the glenohumeral and/or the glenoacromial space. There was no correlation between shoulder pain and the development of ossification. Shoulders with grade III heterotopic bone formation had a limited range of active elevation compared with shoulders without or with only a milder lesion. Men and patients with osteoarthritis of the shoulder joint were significantly disposed to the development of heterotopic bone. Heterotopic bone formation following total shoulder arthroplasty is frequent, but disabling heterotopic ossifications seem to be rare.

Adult↗
PubMed1989

Impingement problems in the athlete.

In summary, there is a delicate balance between the mobility and the stability of the shoulder joint. The young athlete involved in overhand sports is at risk for injury, and must be clinically evaluated and treated differently from the rest of the population. Shoulder impingement and instability are a continuum of abnormalities, beginning with instability and progressing to subluxation, impingement, and, finally, rotator cuff tear. Thus, it is crucial to deal with the core of the problem, (that is, the instability) before dealing with the impingement. A kinesiologic repair is desirable. If that fails, or if there is anatomic damage, an anatomic repair is done. The anterior capsular labral reconstruction is a surgical procedure designed with biomechanical and kinesiologic principles in mind. A rehabilitation program is initiated immediately after surgery. The rehabilitation program is just as important as the surgery.

Adult↗
PubMed1989

[Etiology of sub-acromial impingement syndrome--a biomechanical study].

Eight fresh shoulder specimen were dissected and the functional relationship of the rotator cuff tendons to the acromion was demonstrated through various arcs of shoulder motion. The scapula was fixed and the arm was elevated, rotated, and abducted by pulling the muscle tendon according to EMG activities. Using FUJI compression films the subacromial compression of the rotator cuff was measured. Different forms of acromion were tested. While moving the shoulder with normal relationship of deltoid to rotator cuff, there is no -or at least less than 0.1 mPa compression of the rotator cuff in the subacromial space. Weakness of the rotator cuff results in a moderate compression of 0.6 mPa. In type III acromion there was significant increase up to 1.0 mPa between the acromion and the rotator cuff. This study suggests, that a mechanical subacromial compression only occurs in shoulder joints with a Bigliani acromion type III and/or in joints with a imbalance of the deltoid/rotator cuff relation. Thus an acromioplasty should be primarily undertaken only if the pathology affects the acromion. If there is a muscle imbalance, we recommend a special rehabilitation program in order to strengthen the cuff-muscles the first place.

Acromion↗
PubMed2000

Lateral glenohumeral ligament rupture in three dogs.

Three adult large breed dogs were evaluated for chronic forelimb lameness. Clinical examination localised pain to the area of the shoulder joint. Traditional imaging methods, including radiography, arthrography and ultrasonography, were unrewarding. Arthroscopy performed via a lateral portal demonstrated complete tears of the proximal part of the lateral glenohumeral ligament in all cases. Two of the three cases responded to treatment with intra-articular methylprednisolone and rest with a resolution of the lameness, while the third failed to improve. Surgical intervention in this third case involved lateral capsulorraphy, and re-examination at five weeks postoperatively showed the dog to be without lameness. Tearing of the lateral glenohumeral ligament should be considered in the differential diagnosis of shoulder lameness. Surgical stabilisation should be considered in cases refractory to conservative treatment.

Animals↗
PubMed2005

Septic arthritis as a late complication of carcinoma of the breast.

OBJECTIVES: To see if a past history of radiation therapy is a risk factor for septic arthritis. METHODS: We retrospectively searched our records of 282 patients with septic arthritis and found 10 cases of septic arthritis post-radiotherapy, all in females. We analysed our group, correlating them with the literature. We also compared our patients with a group of septic arthritis patients without radiation therapy. RESULTS: Nine had had radiation therapy for carcinoma of the breast. The shoulder joint was involved in six and the sternoclavicular joint in three. The tenth patient had had brachytherapy and radiation for carcinoma of the cervix and presented with septic arthritis of the hip. The mean age of the patients was 69 yr (49-82 yr). The mean time elapsed since radiation was 16 yr (3-34 yr). Twenty-three cases of shoulder septic arthritis in patients without past radiation therapy were selected for comparison. The five patients with past radiation therapy had fever less often and a longer time lapse before diagnosis. They required longer antibiotherapy. However, this prevented neither bone destruction nor relapse. CONCLUSIONS: In our study, a past history of radiation therapy was observed in 6/50 infections of the shoulder, 3/5 infections of the sternoclavicular joint, 6/23 cases of septic arthritis of the shoulder and all cases of septic arthritis of the sternoclavicular joint for females. Radiation therapy seems to be a risk factor for septic arthritis. Diagnosis would be aided by a greater awareness of the clinical and radiological features of this septic arthritis.

Aged↗
PubMed1985

Recurrent dislocation of the shoulder. The Alvik modification of the Eden-Hybinette operation.

We re-examined 31 patients treated with Alvik's modification of the Eden-Hybbinette operation for recurrent anterior dislocation of the shoulder joint after 5 (2-14) years. Two patients had been re-operated because of instability. Muscular strength and joint motion were only insignificantly affected. Only one patient did not rate the results as good. The rate of recurrences was comparable to other methods, but the frequency of reoperations was low, as no complications occurred from fixation of the bone block.

Adolescent↗