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Sample records for bursitis

  1. Bursitis

    Science.gov (United States)

    ... same kinds of movements every day or putting stress on joints increases your risk. Symptoms of bursitis include pain and swelling. Your doctor will diagnose bursitis with a physical exam and tests such as x-rays and MRIs. ...

  2. Bursitis

    Science.gov (United States)

    ... trauma from a direct hit in a contact sport. It's not only sporty types who get bursitis, though. It can sometimes be ... elbow bursitis is one of the most common types of bursitis in teens. ... overhead sports such as swimming, baseball, and tennis. Ankle. Someone ...

  3. Bursitis

    Science.gov (United States)

    ... overweight . It can also be caused by trauma, rheumatoid arthritis , gout , or infection. Sometimes the cause can't be found. Bursitis commonly occurs in the shoulder, knee, elbow, and hip. Other areas that may be affected include the Achilles tendon and the foot.

  4. Knee Bursitis

    Science.gov (United States)

    ... volleyball — can increase your risk of knee bursitis. Runners can develop pain and inflammation in the pes anserine bursa, situated on the inner side of your knee below the joint. Obesity and osteoarthritis. Pes anserine bursitis, affecting the inner ...

  5. Olecranon bursitis.

    Science.gov (United States)

    Reilly, Danielle; Kamineni, Srinath

    2016-01-01

    Bursitis is a common medical condition, and of all the bursae in the body, the olecranon bursa is one of the most frequently affected. Bursitis at this location can be acute or chronic in timing and septic or aseptic. Distinguishing between septic and aseptic bursitis can be difficult, and the current literature is not clear on the optimum length or route of antibiotic treatment for septic cases. The current literature was reviewed to clarify these points. The reported data for olecranon bursitis were compiled from the current literature. The most common physical examination findings were tenderness (88% septic, 36% aseptic), erythema/cellulitis (83% septic, 27% aseptic), warmth (84% septic, 56% aseptic), report of trauma or evidence of a skin lesion (50% septic, 25% aseptic), and fever (38% septic, 0% aseptic). General laboratory data ranges were also summarized. Distinguishing between septic and aseptic olecranon bursitis can be difficult because the physical and laboratory data overlap. Evidence for the optimum length and route of antibiotic treatment for septic cases also differs. In this review we have presented the current data of offending bacteria, frequency of key physical examination findings, ranges of reported laboratory data, and treatment practices so that clinicians might have a better guide for treatment. Copyright © 2016 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  6. [Bursitis iliopectinea].

    Science.gov (United States)

    Koudela, K; Koudelová, J; Koudela, K; Kunesová, M

    2008-10-01

    PURPOSE OF THE STUDY To present clinical and radiographic findings of iliopectineal bursitis and draw attention to some related etiopathogenetic factors. MATERIAL AND METHODS Six patients followed up between 2005 and 2007 were evaluated. They included four women and two men (average age, 58 years; range, 35 to 80 years) who presented with a tender mass in the hip region (four right and two left sides). Each patient underwent an examination involving a clinical check-up, imaging methods (CT, MR, angio-CT) and standard laboratory tests. RESULTS Iliopectineal bursitis clinically manifested as a tender mass in the groin and hip region in five patients; in one it was pulsating. The sixth case was asymptomatic. In three patients iliopectineal bursitis was found in association with steroid therapy and subsequent avascular necrosis of the femoral head and chronic synovitis. It followed tularemia with hip joint involvement in one patient, salmonella arthritis in one, and kidney transplant rejection in one. Also, iliopectineal bursitis was diagnosed in a patient with rheumatoid arthritis treated with steroids, but without femoral head avascular necrosis, and was incidentally found in another patient examined for digestive problems. Of the six cases of swollen bursa detected by the imaging methods used, five were found to communicate with the hip joint cavity, with four being so large that the bursa extended into the retroperitoneum. Two patients underwent excision or resection of the bursa; in addition, one of them had revitalizing graft surgery for femoral head necrosis. The patient with salmonella arthritis had to undergo a Girdlestone procedure. One patient was treated by draining of the bursa and, after inflammation resolved, total hip replacement surgery was carried out during which the iliopectineal bursa was removed. The patient with rheumatoid arthritis was treated by bursa draining and refused further surgical therapy (total hip replacement). DISCUSSION In our group

  7. Ischiogluteal bursitis: an uncommon type of bursitis

    Energy Technology Data Exchange (ETDEWEB)

    Van Mieghem, Isabelle M.; Boets, An; Sciot, Raf; Van Breuseghem, Iwan [Department of Radiology, University Hospitals, Catholic University Leuven, Leuven (Belgium)

    2004-07-01

    Ischiogluteal bursitis is a rare, infrequently recognized soft tissue mass of the buttock region. Of importance is the radiological differential diagnosis with other benign and malignant soft-tissue tumors. We describe the imaging findings of bursitis. (orig.)

  8. Bursitis of the Hip

    Science.gov (United States)

    ... t Want to Eat Home Diseases and Conditions Bursitis of the Hip Condition Bursitis of the Hip Share Print Table of Contents1. ... Prevention5. Treatment6. Everyday Life7. Questions8. Resources What is bursitis of the hip? Bursitis is the painful swelling ...

  9. Retrocalcaneal bursitis (image)

    Science.gov (United States)

    Retrocalcaneal bursitis is an inflammation of the bursa at the back of the heel bone. A bursa is a ... bursa to become irritated and inflamed. Symptoms of bursitis include pain in the heel, especially with walking, ...

  10. Common Superficial Bursitis.

    Science.gov (United States)

    Khodaee, Morteza

    2017-02-15

    Superficial bursitis most often occurs in the olecranon and prepatellar bursae. Less common locations are the superficial infrapatellar and subcutaneous (superficial) calcaneal bursae. Chronic microtrauma (e.g., kneeling on the prepatellar bursa) is the most common cause of superficial bursitis. Other causes include acute trauma/hemorrhage, inflammatory disorders such as gout or rheumatoid arthritis, and infection (septic bursitis). Diagnosis is usually based on clinical presentation, with a particular focus on signs of septic bursitis. Ultrasonography can help distinguish bursitis from cellulitis. Blood testing (white blood cell count, inflammatory markers) and magnetic resonance imaging can help distinguish infectious from noninfectious causes. If infection is suspected, bursal aspiration should be performed and fluid examined using Gram stain, crystal analysis, glucose measurement, blood cell count, and culture. Management depends on the type of bursitis. Acute traumatic/hemorrhagic bursitis is treated conservatively with ice, elevation, rest, and analgesics; aspiration may shorten the duration of symptoms. Chronic microtraumatic bursitis should be treated conservatively, and the underlying cause addressed. Bursal aspiration of microtraumatic bursitis is generally not recommended because of the risk of iatrogenic septic bursitis. Although intrabursal corticosteroid injections are sometimes used to treat microtraumatic bursitis, high-quality evidence demonstrating any benefit is unavailable. Chronic inflammatory bursitis (e.g., gout, rheumatoid arthritis) is treated by addressing the underlying condition, and intrabursal corticosteroid injections are often used. For septic bursitis, antibiotics effective against Staphylococcus aureus are generally the initial treatment, with surgery reserved for bursitis not responsive to antibiotics or for recurrent cases. Outpatient antibiotics may be considered in those who are not acutely ill; patients who are acutely ill

  11. Knee bursitis: a sonographic evaluation

    National Research Council Canada - National Science Library

    Draghi, Ferdinando; Corti, Riccardo; Urciuoli, Luigi; Alessandrino, Francesco; Rotondo, Antonio

    2015-01-01

    ... of experience.Of these patients, 15 (7 men, 8 women) had bursitis, while 143 (76 men, 67 women) had no bursitis. In evaluating knee bursitis, US, when compared to MRI, correctly identified 13 out of 15 cases of bursitis, showing a sensitivity...

  12. Hemorrhagic prepatellar bursitis

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    Donahue, F. [Dept. of Radiology, Musculoskeletal Section, Univ. of Miami/Jackson Memorial Hospital, Miami, FL (United States); Turkel, D. [Dept. of Radiology, Musculoskeletal Section, Univ. of Miami/Jackson Memorial Hospital, Miami, FL (United States); Mnaymneh, W. [Dept. of Orthopedics, Univ. of Miami/Jackson Memorial Hospital, Miami, FL (United States); Ghandur-Mnaymneh, L. [Dept. of Pathology, Univ. of Miami/Jackson Memorial Hospital, Miami, FL (United States)

    1996-04-01

    Simple prepatellar bursitis is easily diagnosed both clinically and by MRI. MRI shows the typical T1 and T2 lengthening of fluid within the bursa. However, because of complex MRI appearance of hemorrhage, chronic hemorrhagic bursitis and the size of the prepatellar mass the clinical and MRI appearance can be very different. (orig.)

  13. Mycobacterium kansasii olecranon bursitis

    National Research Council Canada - National Science Library

    Barham, G. S; Hargreaves, D. G

    2006-01-01

    ...{at}aol.com Received 23 June 2006 Accepted 27 August 2006 A case is reported of a post-traumatic olecranon bursitis caused by Mycobacterium kansasii following an injury sustained in a public swimming pool...

  14. Tendinitis and Bursitis

    Science.gov (United States)

    ... stretching, each day. This preserves movement in the shoulder joint. Tendinitis or bursitis can be painful. Seek medical attention early to prevent joint stiffness and chronic problems that may follow. It also is important to rest the limb or the joint, at least until ...

  15. Mycobacterium kansasii olecranon bursitis.

    Science.gov (United States)

    Barham, G S; Hargreaves, D G

    2006-12-01

    A case is reported of a post-traumatic olecranon bursitis caused by Mycobacterium kansasii following an injury sustained in a public swimming pool. It responded to surgical debridement and combined rifampicin, isoniazid, pyrazinamide and ethambutol antimicrobial therapy. A literature search was performed and a treatment regimen for this uncommon condition is suggested.

  16. Retrocalcaneal bursitis in juvenile chronic arthritis.

    Science.gov (United States)

    Goldenstein-Schainberg, C; Homsi, C; Rodrigues Pereira, R M; Cossermelli, W

    1992-01-01

    Retrocalcaneal bursitis has been described in various adult rheumatic diseases and septic bursitis unrelated to previous bursal disease has been reported in children. The case is reported here of a girl with juvenile chronic arthritis who developed non-septic retrocalcaneal bursitis; the diagnosis was suggested by a combination of clinical and radiographic studies and was confirmed by ultrasonography. Images PMID:1444631

  17. Clinical characteristics and outcomes of septic bursitis.

    Science.gov (United States)

    Lieber, Sarah B; Fowler, Mary Louise; Zhu, Clara; Moore, Andrew; Shmerling, Robert H; Paz, Ziv

    2017-12-01

    Limited data guide practice in evaluation and treatment of septic bursitis. We aimed to characterize clinical characteristics, microbiology, and outcomes of patients with septic bursitis stratified by bursal involvement, presence of trauma, and management type. We conducted a retrospective cohort study of adult patients admitted to a single center from 1998 to 2015 with culture-proven olecranon and patellar septic bursitis. Baseline characteristics, clinical features, microbial profiles, operative interventions, hospitalization lengths, and 60-day readmission rates were determined. Patients were stratified by bursitis site, presence or absence of trauma, and operative or non-operative management. Of 44 cases of septic bursitis, patients with olecranon and patellar bursitis were similar with respect to age, male predominance, and frequency of bursal trauma; patients managed operatively were younger (p = 0.05). Clinical features at presentation and comorbidities were similar despite bursitis site, history of trauma, or management. The most common organism isolated from bursal fluid was Staphylococcus aureus. Patients managed operatively were discharged to rehabilitation less frequently (p = 0.04). This study of septic bursitis is among the largest reported. We were unable to identify presenting clinical features that differentiated patients treated surgically from those treated conservatively. There was no clear relationship between preceding trauma or bursitis site and clinical course, management, or outcomes. Patients with bursitis treated surgically were younger. Additional study is needed to identify patients who would benefit from early surgical intervention for septic bursitis.

  18. Imaging features of iliopsoas bursitis

    Energy Technology Data Exchange (ETDEWEB)

    Wunderbaldinger, P. [Department of Radiology, University of Vienna (Austria); Center of Molecular Imaging Research, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA (United States); Bremer, C. [Department of Radiology, University of Muenster (Germany); Schellenberger, E. [Center of Molecular Imaging Research, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA (United States); Department of Radiology, Martin-Luther University of Halle-Wittenberg, Halle (Germany); Cejna, M.; Turetschek, K.; Kainberger, F. [Department of Radiology, University of Vienna (Austria)

    2002-02-01

    The aim of this study was firstly to describe the spectrum of imaging findings seen in iliopsoas bursitis, and secondly to compare cross-sectional imaging techniques in the demonstration of the extent, size and appearance of the iliopsoas bursitis as referenced by surgery. Imaging studies of 18 patients (13 women, 5 men; mean age 53 years) with surgically proven iliopsoas bursitis were reviewed. All patients received conventional radiographs of the pelvis and hip, US and MR imaging of the hip. The CT was performed in 5 of the 18 patients. Ultrasound, CT and MR all demonstrated enlarged iliopsoas bursae. The bursal wall was thin and well defined in 83% and thickened in 17% of all cases. The two cases with septations on US were not seen by CT and MRI. A communication between the bursa and the hip joint was seen, and surgically verified, in all 18 patients by MR imaging, whereas US and CT failed to demonstrate it in 44 and 40% of the cases, respectively. Hip joint effusion was seen and verified by surgery in 16 patients by MRI, whereas CT (4 of 5) and US (n=12) underestimated the number. The overall size of the bursa corresponded best between MRI and surgery, whereas CT and US tended to underestimate the size. Contrast enhancement of the bursal wall was seen in all cases. The imaging characteristics of iliopsoas bursitis are a well-defined, thin-walled cystic mass with a communication to the hip joint and peripheral contrast enhancement. The most accurate way to assess iliopsoas bursitis is with MR imaging; thus, it should be used for accurate therapy planning and follow-up studies. In order to initially prove an iliopsoas bursitis, US is the most cost-effective, easy-to-perform and fast alternative. (orig.)

  19. MRI-induced retrocalcaneal bursitis

    NARCIS (Netherlands)

    Tol, J. L.; van Dijk, C. N.; Maas, M.

    1999-01-01

    This case report describes a patient with acute retrocalcaneal bursitis, which developed after MRI examination of the ankle. The sagittal T2*-weighted gradient echo sequence revealed an extensive susceptibility artifact in the area surrounding the Achilles tendon near its insertion at the os calcis.

  20. Treatment of olecranon bursitis: a systematic review.

    Science.gov (United States)

    Sayegh, Eli T; Strauch, Robert J

    2014-11-01

    The optimal management of olecranon bursitis is ill-defined. The purposes of this review were to systematically evaluate clinical outcomes for aseptic versus septic bursitis, compare surgical versus nonsurgical management, and examine the roles of corticosteroid injection and aspiration in aseptic bursitis. The English-language literature was searched using PubMed, Cumulative Index to Nursing and Allied Health Literature, Physiotherapy Evidence Database, Allied and Complementary Medicine, and Cochrane Central Register of Controlled Trials. Analyses were performed for clinical resolution and complications after treatment of aseptic and/or septic olecranon bursitis. Twenty-nine studies containing 1278 patients were included. Compared with septic bursitis, aseptic bursitis was associated with a significantly higher overall complication rate (p = 0.0108). Surgical management was less likely to clinically resolve septic or aseptic bursitis (p = 0.0476), and demonstrated higher rates of overall complications (p = 0.0117), persistent drainage (p = 0.0194), and bursal infection (p = 0.0060) than nonsurgical management. Corticosteroid injection for aseptic bursitis was associated with increased overall complications (p = 0.0458) and skin atrophy (p = 0.0261). Aspiration did not increase the risk of bursal infection for aseptic bursitis. Based primarily on level IV evidence, nonsurgical management of olecranon bursitis is significantly more effective and safer than surgical management. The clinical course of aseptic bursitis appears to be more complicated than that of septic bursitis. Corticosteroid injection is associated with significant risks without improving the outcome of aseptic bursitis. Therapeutic IV.

  1. MRI characteristics of olecranon bursitis.

    Science.gov (United States)

    Floemer, Frank; Morrison, William B; Bongartz, Georg; Ledermann, Hans Peter

    2004-07-01

    Our aim was to describe the MRI characteristics of septic and nonseptic olecranon bursitis. MRI contrast-enhanced examinations (n = 19) of 35 patients with olecranon bursitis (septic, n = 14; nonseptic, n = 21) were jointly reviewed by two musculoskeletal radiologists. We evaluated bursa size, extent of marginal lobulation, septation, concomitant elbow joint effusion, soft-tissue edema, rim enhancement, soft-tissue enhancement, degree of fluid complexity, definition of bursa margins, presence of edema, thickening of the triceps tendon, and bone marrow edema. Comparison of septic and nonseptic bursitis yielded the following results: marginal lobulation, 79% (11/14) versus 48% (10/21), p = 0.14; bursa septation, 64% (9/14) versus 57% (12/21), p = 1.0; moderate or marked complexity of bursa fluid, 64% (9/14) versus 29% (6/21), p = 0.15; poorly defined margins, 64% (9/14) versus 67% (14/21), p = 1.0; elbow joint effusion, 86% (12/14) versus 52% (11/21), p = 0.12; moderate to marked soft-tissue edema, 64% (9/14) versus 33% (7/21), p = 0.1; edema of the triceps, 57% (8/14) versus 48% (10/21), p = 0.73; thickening of the triceps, 43% (6/14) versus 14% (3/21), p = 0.21; bone marrow edema, 29% (4/14) versus 5% (1/21), p = 0.13; rim enhancement, 100% (11/11) versus 75% (6/8), p = 0.31; soft-tissue enhancement, 100% (11/11) versus 63% (5/8), p = 0.1. Septic and nonseptic olecranon bursitis present with a considerable overlap of MRI findings without statistically significant differences. Septic olecranon bursitis can be excluded in the absence of bursal and soft-tissue enhancement.

  2. MRI-induced retrocalcaneal bursitis

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    Tol, J.L.; Dijk, C.N. van [Dept. of Orthopaedic Surgery, University of Amsterdam (Netherlands); Maas, M. [Dept. of Radiology, University of Amsterdam (Netherlands)

    1999-10-01

    This case report describes a patient with acute retrocalcaneal bursitis, which developed after MRI examination of the ankle. The sagittal T2*-weighted gradient echo sequence revealed an extensive susceptibility artifact in the area surrounding the Achilles tendon near its insertion at the os calcis. This artifact was caused by postsurgical metallic particles. We postulate that these particles were mechanically stimulated by the magnetic field and induced the inflammatory response. (orig.)

  3. Sarcoidosis presenting as prepatellar bursitis

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    Fujimoto, Hajime; Shimofusa, Ryota [Numazu City Hospital, Department of Radiology, Numazu, Shizuoka (Japan); Shimoyama, Katsuhito; Nagashima, Ryota [Numazu City Hospital, Department of Orthopaedic Surgery, Numazu, Shizuoka (Japan); Eguchi, Masanobu [Numazu City Hospital, Department of Pathology, Numazu, Shizuoka (Japan)

    2006-01-01

    A 61-year-old woman complained of a subcutaneous mass in her right knee. MR images revealed a well-defined subcutaneous mass in the prepatellar region, containing some fluid and foci of short T2. The lesion showed some marginal contrast uptake after an administration of meglumine gadopentetate (Gd-DTPA), consistent with prepatellar bursitis. The pathological specimen, however, revealed subcutaneous sarcoidosis involving the bursa. (orig.)

  4. Exophiala oligosperma causing olecranon bursitis.

    Science.gov (United States)

    Bossler, A D; Richter, S S; Chavez, A J; Vogelgesang, S A; Sutton, D A; Grooters, A M; Rinaldi, M G; de Hoog, G S; Pfaller, M A

    2003-10-01

    A 62-year-old male with a history of Wegener's granulomatosis and immunosuppressive therapy presented with chronic olecranon bursitis. A black velvety mould with brown septate hyphae and tapered annellides was isolated from a left elbow bursa aspirate and was identified as an Exophiala species. Internal transcribed sequence rRNA sequencing showed the isolate to be identical to Exophiala oligosperma. The patient was successfully treated with aspiration and intrabursal amphotericin B.

  5. Four common types of bursitis: diagnosis and management.

    Science.gov (United States)

    Aaron, Daniel L; Patel, Amar; Kayiaros, Stephen; Calfee, Ryan

    2011-06-01

    Bursitis is a common cause of musculoskeletal pain and often prompts orthopaedic consultation. Bursitis must be distinguished from arthritis, fracture, tendinitis, and nerve pathology. Common types of bursitis include prepatellar, olecranon, trochanteric, and retrocalcaneal. Most patients respond to nonsurgical management, including ice, activity modification, and nonsteroidal anti-inflammatory drugs. In cases of septic bursitis, oral antibiotics may be administered. Local corticosteroid injection may be used in the management of prepatellar and olecranon bursitis; however, steroid injection into the retrocalcaneal bursa may adversely affect the biomechanical properties of the Achilles tendon. Surgical intervention may be required for recalcitrant bursitis, such as refractory trochanteric bursitis.

  6. Ultrasonographic evaluation of lschial bursitis

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    Kim, Sung Moon; Shin, Myung Jin; Kim, Kyung Sook; Chang, Jae Suck; Lee, Soo Ho [Asan Medical Center, Ulsan Univ. College of Medicine, Seoul (Korea, Republic of); Ahn, Joong Mo [Samsung Medical Center, Sungkyunkwan Univ. College of Medicine, Seoul (Korea, Republic of); Cho, Kil Ho [Yeungnam Univ. College of Medicine, Kyongsan (Korea, Republic of)

    1999-06-01

    The objective of this study was to evaluate the findings of ultrasonography (US) in patients with ischial bursitis. Our study included 27 patients (mean age 62 years) who underwent US for a painful mass or tenderness in the buttock area. In six of these 27, serous fluid was obtained by needle aspiration, and in five cases, bursal excision permitted histologic confirmation. The other sixteen patients were followed up for one or two months with only NSAID medication; all showed some improvement or remission of symptoms. Using a 5-10 MHz linear array probe, US examination was performed while the patient was lying face down. US images were analyzed with regard to location and size of the lesions, thickness of cyst wall, the presence of internal septa or mural nodules, echogenicity of the cyst wall, fluid content, internal septa, compressibility by a probe, and Doppler signals within the cyst wall. In all 27 patients, ischial bursitis was located superficially to ischial tuberosity. Lesion size(maximum diameter) was 1.5-7(mean 3.8)cm, and the cyst wall was 0.2-0.8cm thick. Internal septa and mural nodules were seen in 12 cases (44%) and 13 cases (48%), respectively. The cyst wall was identifiable in 21 cases (78%), appearing as a single layer with low echogenicity (n=10) or with high echogenicity (n=1); it also appeared as two (n=6) or three (n=4) layers of different echogenicities. When internal septa were present, fluid within the cyst was low echoic in 59% of cases, high echoic in 30%, and of mixed echogenicity (so-called compartmentalization) in 15%. In all cases, the cyst became deformed, when compressed by a probe. In all patients who underwent doppler examination, some vascularity was found within the cyst wall. US helped to detect ischial bursitis; US findings were thin-walled cystic lesion located superficially to ischial tuberosity, with or without internal septa and mural nodules, and easy compressibility.

  7. Traumatic olecranon bursitis. Radiologic observations.

    Science.gov (United States)

    Saini, M; Canoso, J J

    1982-01-01

    The affected elbow of 28 patients with traumatic olecranon bursitis was radiographically compared with the homologous elbow of 28 matched controls. Olecranon spurs, amorphous calcium deposits, or both, were present in 16 patients and 4 controls (p less than 0.01). Air was injected in the bursa in 12 additional patients. Nodules in the bursal floor were noted in 10, and the bursa was partially septated in 8. Olecranon spurs, present in 6 patients, corresponded to the insertion of the triceps tendon. With elbow flexion the bursa flattened and lengthened while the olecranon process glided distally beneath the bursal floor.

  8. Traumatic olecranon bursitis. Radiologic observations

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    Saini, M.; Canoso, J.J. (Radiology and Medical Services, Boston Veterans Administration Medical Center, MA, USA)

    1982-01-01

    The affected elbow of 28 patients with traumatic olecranon bursitis was radiographically compared with the homologous elbow of 28 matched controls. Olecranon spurs, amorphous calcium deposits, or both, were present in 16 patients and 4 controls (p<0.01). Air was injected in the bursa in 12 additional patients. Nodules in the bursal floor were noted in 10, and the bursa was partially septated in 8. Olecranon spurs, present in 6 patients, corresponded to the insertion of the triceps tendon. With elbow flexion the bursa flattened and lengthened while the olecranon process glided distally beneath the bursal floor.

  9. Nasopharyngeal bursitis: from embryology to clinical presentation

    Directory of Open Access Journals (Sweden)

    AE El-Shazly

    2010-10-01

    Full Text Available AE El-Shazly, S Barriat, PP LefebvreDepartment of Otorhinolaryngology and Head and Neck Surgery, Liege University Hospital, Liege, BelgiumAbstract: Nasopharyngeal bursitis is a relatively rare syndrome characterized by a collection of symptoms that multidisciplinary specialists should be aware of. Here we present an audit of cases presenting to a rhinology clinic over a two-year period, as well as an overview of the relevant embryology and different clinical presentations of nasopharyngeal bursitis. For 2008–2009, six patients were diagnosed to have nasopharyngeal bursitis, including four males and two females, of mean age 54 years. Two distinct pathologic types were observed, comprising three patients with classical Tornwaldt’s cyst and three with crust-type bursitis. This audit highlights the importance of recognition of the crust-type of nasopharyngeal bursitis and its anatomic and clinical features. A combined endonasal and transoral endoscopic approach is a minimally invasive procedure and an effective method of treating both types of the disease. Our findings are discussed in relation to the embryology of the disorder, with a clinical emphasis on crust-type nasopharyngeal bursitis.Keywords: nasopharyngeal bursitis, crust type, Tornwaldt’s cyst, endoscopic disruption

  10. Olecranon bursitis: a systematic overview

    Science.gov (United States)

    Hay, Bruce A; Bolt, Alexander M; Hay, Stuart M

    2014-01-01

    Background Olecranon bursitis is a common condition where the bursal cavity, superficial to the olecranon, becomes inflamed. This can occur either with or without infection and has been given pseudonyms relating to the repeated minor trauma from external pressure that often predisposes. As a result of the multiple aetiologies, olecranon bursitis can present to any medical specialty with reasonable frequency and, although many therapies are described, a single, evidence-based and standardized treatment pathway is not well described. Methods We summarize the key points within the literature and subsequently propose an evidence-based treatment pathway. Results Relevant evidence is presented from appropriate publications to add rational to existing decision-making processes, together with personal experience and suggested operative bursectomy techniques from an established upper limb surgeon. The common and significant aetiologies are summarized and, in particular, red flag symptoms are highlighted by way of warning to the unsuspecting investigator. Conclusions The conclusion is provided in diagrammatic form, providing a suggested treatment pathway from history and examination through to operative intervention. PMID:27582935

  11. Olecranon bursitis: a systematic overview.

    Science.gov (United States)

    Blackwell, John R; Hay, Bruce A; Bolt, Alexander M; Hay, Stuart M

    2014-07-01

    Olecranon bursitis is a common condition where the bursal cavity, superficial to the olecranon, becomes inflamed. This can occur either with or without infection and has been given pseudonyms relating to the repeated minor trauma from external pressure that often predisposes. As a result of the multiple aetiologies, olecranon bursitis can present to any medical specialty with reasonable frequency and, although many therapies are described, a single, evidence-based and standardized treatment pathway is not well described. We summarize the key points within the literature and subsequently propose an evidence-based treatment pathway. Relevant evidence is presented from appropriate publications to add rational to existing decision-making processes, together with personal experience and suggested operative bursectomy techniques from an established upper limb surgeon. The common and significant aetiologies are summarized and, in particular, red flag symptoms are highlighted by way of warning to the unsuspecting investigator. The conclusion is provided in diagrammatic form, providing a suggested treatment pathway from history and examination through to operative intervention.

  12. Calcifying Bursitis ischioglutealis: A Case report

    Science.gov (United States)

    Schuh, Alexander; Narayan, Chirag Thonse; Schuh, Ralph; Hönle, Wolfgang

    2011-01-01

    Introduction: The ischiogluteal bursa is an inconstant anatomical finding located between the ischial tuberosity and the gluteus maximus. Ischiogluteal bursitis is a rare disorder. Case Report: We report the case of a 43-year-old female patient with bilateral calcifying ischiogluteal bursitis. The patient had no relevant medical history of systemic illness or major trauma to the buttock. After aspiration of both ischiogluteal bursitis which delievered calcareous deposits and instillation of a mixture of 1cc betamethasone (6 mg) and 4 cc of 1% lidocaine the patient was out of any complaints. Conclusion: Calcifying ischiogluteal bursitis is a rare entity but easily diagnosed on radiographs. Aspiration and local steroid instillation give good relief from symptoms. PMID:27298836

  13. [Concomitant septic and gouty olecranon bursitis].

    Science.gov (United States)

    Abrazhda, D; Andras, L; Van Linthoudt, D

    2007-09-26

    A case of coexistent acute gout and septic olecranon bursitis is presented. Our hypothesis is that asymptomatic monosodium urate crystals, possibly present in the bursa could secondarily been triggered by the infection.

  14. Atypical retroperitoneal extension of iliopsoas bursitis

    Energy Technology Data Exchange (ETDEWEB)

    Coulier, B.; Cloots, V. [Department of Diagnostic Imaging, Cliniques St. Luc, Rue St Luc 8, 5004, Bouge, Namur (Belgium)

    2003-05-01

    We report two rare cases of iliopsoas bursitis extending into the retroperitoneal space. The first lesion contained much gas, mimicking a retroperitoneal abscess, and the second was responsible for atypical inguinal pain. The diagnosis was made by contrast-enhanced CT in both cases and arthrography in the first case. Iliopsoas bursitis in these two patients, it is hypothesized, extended into the retroperitoneum, at least in part, by way of intraneural or perineural structures. (orig.)

  15. MR features of bursitis around the hip

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Kyung Joo; Sung, Mi Sook; Yu, Won Jong; You, Ie Ryung; Yang, Hae Jeom; Lee, Hae Giu; Im, Jung Ik [The Catholic Univ. of Korea Holy Family Hospital, Puchun (Korea, Republic of)

    1998-12-01

    To determine the usefulness of MR imaging for differentiation between infectious and non-infectious bursitis. MR images of 16 patients (18 lesions) in whom bursitis around the hip had been diagnosed were analyzed for homogeneity of the bursa, the presence of septation, the enhancement pattern, and associated findings. Clinical data (symptoms and signs, laboratory data, aspiration of the bursa, and surgical findings) were available for correlation. The location of bursitis was trochanteric (n=3D9), ischiogluteal (n=3D5), iliopsoas (n=3D3), or ischiotrochanteric (n=3D1). Etiologies included infection in seven cases (3 pyogenic; 4 tuberculous) and noninfection in 11 (6 inflammation; 3 hemorrhage; 2 metabolic disease). In seven patients with infectious bursitis, T1-weighted enhanced image revealed thick rim enhancement of the bursa (n=3D7) association with changes in bone marrow signal intensity (n=3D2), bone erosion (n=3D2), and cellulitis (n=3D1). Of 11 cases of noninfectious bursitis, three demonstrated typical signal characteristics of hematoma within the distended bursa. In six of seven patients who underwent contrast-enhancement, thick and thin peripheral enhancement of the bursa was noted. Bone erosion was found in one case of tuberculous bursitis and two of metabolic disease. Internal septation (n=3D4) and internal debris (n=3D3) were found in both infected and noninfected patients. MR imaging plays an important role in the diagnosis of bursitis around the hip. MR findings of thick rim enhancement, associated cellulitis, and changes in bone marrow signal intensity are suggestive of infectious bursitis.=20.

  16. Bursitis

    Science.gov (United States)

    ... Language Publications Portal en espanol Community Outreach Initiative Menu Menu Close Arthritis and Rheumatic Diseases Muscle and ... Media Moderation Policy FOIA Privacy Statement Accessibility Disclaimer Digital Strategy Open Source Data Public Data Listing NIH... ...

  17. Treatment of nonseptic bursitis with endoscopic surgery

    Directory of Open Access Journals (Sweden)

    Azad Yıldırım

    2015-09-01

    Full Text Available Objective: The aim of this study was to show that endoscopic surgery is a simple and acceptable method for various problems associated with wounds, range of motion and that such surgery ensures an early return to work after treatment of nonresponding nonseptic bursitis. Methods: Thirty-two patients with nonseptic bursitis caused by repeated minor trauma that did not respond to medical treatment from 2008 to 2012 were included in this study. Radiographic [anteroposterior and lateral], ultrasound, macro and microscopic analyses of drainage liquid and aerobic and anaerobic cultures were obtained from the patients for the diagnosis. Results: The mean age was 40.8 years. Fifteen patients had prepatellar bursitis, 13 had olecranon bursitis and 4 had ankle bursitis. Two patients had a history of falling on their knee. The other patients had a history of repetitive stimulation .The mean follow up period was 2.6 years [range. 2-5 years] and no medical complications occurred after the endoscopic surgery; such as scarring, loss of sensation and infection. One recurrence in response to medical treatment was observed. Conclusion: Endoscopic bursectomy is a short and acceptable procedure with excellent results in terms of returning to work early and minimal wound related problems. J Clin Exp Invest 2015; 6 (3: 220-223

  18. Scapulothoracic Bursitis in a Patient With Quadriparesis

    Science.gov (United States)

    Seol, Seung Jun; Han, Seung Hoon

    2015-01-01

    Abstract Scapulothoracic bursitis is a rare disease and presents as pain or swelling around the bursa of the scapulothoracic articulation. It has been reported to be related to chronic repetitive mechanical stress of the periscapular tissue, trauma, overuse, and focal muscle weakness. The authors experienced an atypical case of scapulothoracic bursitis with shoulder and periscapular pain after quadriparesis. This case implies that muscular atrophy around the scapula and chest wall from quadriparesis may contribute to the development of scapulothoracic bursitis with shoulder and periscapular pain. In addition, clinician should be alert to it as a possible cause when a patient with quadriparesis complains of shoulder and periscapular pain and consider proper diagnostic options such as ultrasonography or magnetic resonance imaging. PMID:25906107

  19. Acute gouty bursitis: report of 15 cases.

    Science.gov (United States)

    Canoso, J J; Yood, R A

    1979-01-01

    Fifteen cases of acute gouty bursitis were seen among 136 crystal-proved cases of gout. Bursal aspirate yielded yellow or pink fluid in 10, chalky white fluid in 1, and a small amount of bloody fluid in 4. Monosodium urate crystals were present in all. Bursal fluid leucocyte counts averaged 2.9 X 10(9)/1 compared with synovial fluid leucocyte counts that averaged 25.5 X 10(9)/1 in cases of articular gout (P less than 0.05). Gouty, septic, and idiopathic (traumatic) bursitis share clinical features, and detailed bursal fluid analysis is crucial for diagnosis. PMID:496446

  20. Management and outcome of infective prepatellar bursitis.

    Science.gov (United States)

    Wilson-MacDonald, J.

    1987-01-01

    Forty seven cases of prepatellar bursitis are reported. Twenty one patients had sustained a recent injury with a break in the skin which had caused the infection and seventeen patients were employed in jobs which involved kneeling. Oral antibiotics proved to be inadequate treatment in many cases. Splintage and intravenous antibiotics with or without aspiration of the bursa were usually successful in treating the condition, although nine patients required surgical drainage of the bursa. Twelve patients continued to have symptoms months or years after the infection, particularly those with preexisting chronic bursitis, or those who kneeled at work. There was little difference in the results between the different treatment groups. PMID:3447109

  1. Surgical Treatment of Chronic Retrocalcaneal Bursitis

    NARCIS (Netherlands)

    Wiegerinck, Johannes I.; Kok, Aimee C.; van Dijk, C. Niek

    2012-01-01

    Purpose: The purpose of this systematic review was to analyze the results of surgical treatments for chronic retrocalcaneal bursitis (RB). Methods: Medline, CINAHL (Cumulative Index to Nursing and Allied Health Literature), Embase, and the Cochrane Library (1945 to December 2010) were systematically

  2. Tuberculous bicipitoradial bursitis: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Nishida, Jun; Shimamura, Tadashi [Iwate Medical University, Department of Orthopaedic Surgery, School of Medicine, Morioka (Japan); Furumachi, Katsuro [Iwate Medical University, Department of Orthopaedic Surgery, Morioka (Japan); Ehara, Shigeru [Iwate Medical University, Department of Radiology, School of Medicine, Morioka (Japan); Satoh, Takashi [Iwate Medical University, Pathology, Morioka (Japan); Okada, Kyoji [Akita University School of Medicine, Orthopaedics, Akita (Japan)

    2007-05-15

    An 76-year-old man with an indolent soft tissue mass on the volar aspect of the left elbow was referred to our institution with a diagnosis of a soft tissue tumor. He had a history of lung tuberculosis since the age of 30. The mass was adjacent to the biceps brachi tendon. It demonstrated homogeneous low-signal intensity on T1-weighted magnetic resonance (MR) images and heterogeneous relatively high signal intensity with scattered low and high signal intensity areas on T2-weighted MR images. An excision was performed after needle biopsy with presumptive diagnosis of bicipitoradial bursitis. The histological specimen revealed an epithelioid cell granuloma with central necrosis. While the occurrence of tuberculous bicipitoradial bursitis has never been reported, this case demonstrates that it can be considered to be among the causes of a cystic lesion around the elbow joint. (orig.)

  3. Protothecal olecranon bursitis: an unusual algal infection.

    Science.gov (United States)

    Pednekar, Manali; Chandra, Preeti A; Margulis, Yevgeniya; Chandra, Abhinav B; Schiff, Carl

    2011-11-01

    Prototheca is an achlorophyllic alga which rarely causes infections in humans and protothecal olecranon bursitis is remarkably rare. We report a case of a 76-year-old immunocompetent man presenting with pain and swelling of the right elbow secondary to protothecal infection. Initial cultures of the olecranon bursal aspirate revealed no growth; however, repeat aspiration after 2 months grew prototheca species on culture. Prototheca wickerhamii and Prototheca zopfii are the only 2 protothecal species known to cause human infections. Protothecal infection can manifest as skin infections, extremity infections, bursitis and very rarely as systemic infections. Treatment of protothecal infections remains controversial. Amphoterecin B, ketoconazole and fluconazole have been reported to yield a successful outcome. More recently, itraconazole has been found to be curative. Surgical excision of the bursa remains the definitive treatment. Our patient was treated with itraconazole with a favorable response.

  4. Ultrasonographic findings in patients with olecranon bursitis.

    Science.gov (United States)

    Blankstein, A; Ganel, A; Givon, U; Mirovski, Y; Chechick, A

    2006-12-01

    Musculoskeletal ultrasonography (U.S.) is an important imaging technique in the diagnosis of olecranon bursitis, especially for early manifestation. It allows sensitive detection of small fluid collections as well as for differentiation between soft tissue and bone lesions. U.S. examination allows detection of effusions, synovial proliferation, calcifications, loose bodies, rheumatoid nodules, gout tophi and septic processes. To assess the role of ultrasonography in the diagnosis and management of patients with olecranon bursitis. Ultrasound was used in 34 patients with swelling above the olecranon. The opposite asymptomatic side served as a control group. 20 patients demonstrated increased fluid collection in the olecranon bursa. 5 had synovial proliferation, 2 cases showed loose body, 5 patients revealed markedly increased blood flow consistent with inflammation, 2 patients had triceps tendonitis with calcifications. Sonography is an extremely effective tool for the diagnosis of soft tissue lesions in the olecranon area.

  5. Outcome of endoscopic decompression of retrocalcaneal bursitis

    Directory of Open Access Journals (Sweden)

    Vamsi Kondreddi

    2012-01-01

    Full Text Available Background: Posterior heel pain due to retrocalcaneal bursitis, is a disabling condition that responds well to the conventional methods of treatment. Patients who do not respond to conservative treatment may require surgical intervention. This study evaluates the outcome of endoscopic decompression of retrocalcaneal bursitis, with resection of posterosuperior eminence of the calcaneum. Materials and Methods: This present study included 25 heels from 23 consecutive patients with posterior heel pain, who did not respond to conservative treatment and underwent endoscopic decompression of the retrocalcaneal bursae and excision of bony spurs. The functional outcome was evaluated by comparing the pre and postoperative American Orthopedic Foot and Ankle Society (AOFAS scores. The Maryland ankle and foot score was used postoperatively to assess the patient′s satisfaction at the one-year followup. Results: The University of Maryland scores of 25 heels were categorized as the nonparametric categories, and it was observed that 16 patients had an excellent outcome, six good, three fair and there were no poor results. The AOFAS scores averaged 57.92 ± 6.224 points preoperatively and 89.08 ± 5.267 points postoperatively (P < 0.001, at an average followup of 16.4 months. The 12 heels having noninsertional tendinosis on ultrasound had low AOFAS scores compared to 13 heels having retrocalcaneal bursitis alone. At one year followup, correlation for preoperative ultrasound assessment of tendoachilles degeneration versus postoperative Maryland score (Spearman correlation had shown a strong negative correlation. Conclusion: Endoscopic calcaneal resection is highly effective in patients with mild or no degeneration and yields cosmetically better results with fewer complications. Patients with degenerative changes in Achilles tendon had poorer outcomes in terms of subjective satisfaction.

  6. Non-Infectious Ischiogluteal Bursitis: MRI Findings

    Science.gov (United States)

    Lee, Sung Moon; Lee, Young Hwan; Suh, Kyung Jin; Kim, Sung Moon; Shin, Myung Jin; Jang, Han Won

    2004-01-01

    Objective We wished to report on the MRI findings of non-infectious ischiogluteal bursitis. Materials and Methods The MRI findings of 17 confirmed cases of non-infectious ischiogluteal bursitis were analyzed: four out of the 17 cases were confirmed with surgery, and the remaining 13 cases were confirmed with MRI plus the clinical data. Results The enlarged bursae were located deep to the gluteus muscles and postero-inferior to the ischial tuberosity. The superior ends of the bursal sacs abutted to the infero-medial aspect of the ischial tuberosity. The signal intensity within the enlarged bursa on T1-weighted image (WI) was hypo-intense in three cases (3/17, 17.6%), iso-intense in 10 cases (10/17, 58.9%), and hyper-intense in four cases (4/17, 23.5%) in comparison to that of surrounding muscles. The bursal sac appeared homogeneous in 13 patients (13/17, 76.5%) and heterogeneous in the remaining four patients (4/17, 23.5%) on T1-WI. On T2-WI, the bursa was hyper-intense in all cases (17/17, 100%); it was heterogeneous in 10 cases and homogeneous in seven cases. The heterogeneity was variable depending on the degree of the blood-fluid levels and the septae within the bursae. With contrast enhancement, the inner wall of the bursae was smooth (5/17 cases), and irregular (12/17 cases) because of the synovial proliferation and septation. Conclusion Ischiogluteal bursitis can be diagnosed with MRI by its characteristic location and cystic appearance. PMID:15637479

  7. Non-infectious ischiogluteal bursitis: MRI findings

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Kil Ho; Jang, Han Won [Yeungnam University College of Medicine, Daegu (Korea, Republic of); Lee, Sung Moon [Keimyung University College of Medicine, Daegu (Korea, Republic of); Lee, Young Hwan [Daegu Hyosung Catholic University College of Medicine, Daegu (Korea, Republic of); Suh, Kyung Jin [Suh and Joo MR Clinic, Seoul (Korea, Republic of); Kim, Sung Moon; Shin, Myung Jin [University of Ulsan College of Medicine, Seoul (Korea, Republic of)

    2004-12-15

    We wished to report on the MRI findings of non-infectious ischiogluteal bursitis. The MRI findings of 17 confirmed cases of non-infectious ischiogluteal bursitis were analyzed: four out of the 17 cases were confirmed with surgery, and the remaining 13 cases were confirmed with MRI plus the clinical data. The enlarged bursae were located deep to the gluteus muscles and postero-inferior to the ischial tuberosity. The superior ends of the bursal sacs abutted to the infero-medial aspect of the ischial tuberosity. The signal intensity within the enlarged bursa on T1-weighted image (WI) was hypo-intense in three cases (3/17, 17.6%), iso-intense in 10 cases (10/17, 58.9%), and hyper-intense in four cases (4/17, 23.5%) in comparison to that of surrounding muscles. The bursal sac appeared homogeneous in 13 patients (13/17, 76.5%) and heterogeneous in the remaining four patients (4/17, 23.5%) on T1-WI. On T2-WI, the bursa was hyper-intense in all cases (17/17, 100%); it was heterogeneous in 10 cases and homogeneous in seven cases. The heterogeneity was variable depending on the degree of the blood-fluid levels and the septae within the bursae. With contrast enhancement, the inner wall of the bursae was smooth (5/7 cases), and irregular (12/17 cases) because of the synovial proliferation and septation. Ischiogluteal bursitis can be diagnosed with MRI by its characteristic location and cystic appearance.

  8. Pes anserine bursitis: incidence in symptomatic knees and clinical presentation

    Energy Technology Data Exchange (ETDEWEB)

    Rennie, W.J. [Royal National Orthopaedic Hospital NHS Trust, Department of Radiology, Stanmore, Middlesex (United Kingdom); Saifuddin, A. [Royal National Orthopaedic Hospital NHS Trust, Department of Radiology, Stanmore, Middlesex (United Kingdom); University College London, Institute of Orthopaedics and Musculoskeletal Sciences (United Kingdom)

    2005-07-01

    To determine the prevalence and associated clinical symptoms of pes anserine bursitis in symptomatic adult knees. A retrospective review was performed of the reports of 509 knee MRI studies obtained from July 1998 to June 2004 on 488 patients presenting to an orthopaedic clinic with knee pain suspected to be due to internal derangement. The MRI studies and case histories of all patients reported to have pes anserine bursitis were reviewed. The management of these patients was also noted. The prevalence of pes anserine bursitis as detected on MRI is 2.5%. The commonest clinical presentation was pain along the medial joint line mimicking a medial meniscal tear. We suggest that an accurate diagnosis of pes anserine bursitis on MRI will help prevent unnecessary arthroscopy and possibly initiate early treatment of the condition. Axial imaging is important in these cases to differentiate the bursa from other medial fluid collections. (orig.)

  9. Association between trochanteric bursitis, osteoarthrosis and total hip arthroplasty,

    Directory of Open Access Journals (Sweden)

    Carlos Roberto Schwartsmann

    2014-06-01

    Full Text Available OBJECTIVE: this was an epidemiological study on trochanteric bursitis at the time of performing total hip arthroplasty.METHODS: sixty-two sequential patients who underwent total hip arthroplasty due to osteoarthrosis, without any previous history of trochanteric bursitis, were evaluated. The bursas were collected and evaluated histologically.RESULTS: there were 35 female patients (56.5% and 27 male patients (43.5%, with a mean age of 65 years (±11. Trochanteric bursitis was conformed histologically in nine patients (14.5%, of whom six were female (66.7% and three were male (33.3%.CONCLUSIONS: 14.5% of the bursas analyzed presented inflammation at the time that the primary total hip arthroplasty due to osteoarthrosis was performed, and the majority of the cases of bursitis were detected in female patients.

  10. Candida glabrata olecranon bursitis treated with bursectomy and intravenous caspofungin.

    Science.gov (United States)

    Skedros, John G; Keenan, Kendra E; Trachtenberg, Joel D

    2013-01-01

    Orthopedic surgeons are becoming more involved in the care of patients with septic arthritis and bursitis caused by yeast species. This case report involves a middle-aged immunocompromised female who developed a Candida glabrata septic olecranon bursitis that developed after she received a corticosteroid injection in the olecranon bursa for presumed aseptic bursitis. Candida (Torulopsis) glabrata is the second most frequently isolated Candida species from the bloodstream in the United States. Increased use of fluconazole and other azole antifungal agents as a prophylactic treatment for recurrent Candida albicans infections in immunocompromised individuals is one reason why there appears to be increased resistance of C. glabrata and other nonalbicans Candida (NAC) species to fluconazole. In this patient, this infection was treated with surgery (bursectomy) and intravenous caspofungin, an echinocandin. This rare infectious etiology coupled with this intravenous antifungal treatment makes this case novel among cases of olecranon bursitis caused by yeasts.

  11. Mycobacterium avium-intracellulare: a rare cause of subacromial bursitis.

    Science.gov (United States)

    Sinha, Raj; Tuckett, John; Hide, Geoff; Dildey, Petra; Karsandas, Alvin

    2015-01-01

    Septic subacromial bursitis is an uncommon disorder with only a few reported cases in the literature. The most common causative organism is Staphylococcus aureus. We report the case of a 61-year-old female with a septic subacromial bursitis where the causative organism was found to be Mycobacterium avium-intracellulare (MAI). The diagnosis was only made following a biopsy, and we use this case to highlight the importance of recognising the need to consider a biopsy and aspiration in atypical situations.

  12. Diagnosis and management of olecranon bursitis.

    Science.gov (United States)

    Del Buono, Angelo; Franceschi, Francesco; Palumbo, Alessio; Denaro, Vincenzo; Maffulli, Nicola

    2012-10-01

    We aim to review the current knowledge on diagnosis, clinical features and main management modalities of olecranon bursitis. We underline that the first treatment line is conservative, including ice, rest, anti-inflammatory and analgesic drugs and, occasionally, bursal fluid aspiration. In unresponsive patients, although open excisional procedures allow to completely remove the pathological bursal tissue, arthroscopy is increasingly being considered as a suitable new modality of management. These minimally invasive procedures, although not free from complications, avoid the wound problems often occurring following open excision. Copyright © 2012 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

  13. Diclofenac Patch for Treatment of Mild to Moderate Tendonitis or Bursitis

    Science.gov (United States)

    2008-08-05

    Rotator Cuff Tendonitis; Bicipital Tendonitis; Subdeltoid Bursitis of the Shoulder; Subacromial Bursitis of the Shoulder; Medial Epicondylitis of the Elbow; Lateral Epicondylitis of the Elbow; DeQuervain's Tenosynovitis of the Wrist

  14. Clinical management of scapulothoracic bursitis and the snapping scapula.

    Science.gov (United States)

    Conduah, Augustine H; Baker, Champ L; Baker, Champ L

    2010-03-01

    Symptomatic scapulothoracic bursitis and crepitus are disorders of the scapulothoracic articulation that are often poorly understood. They can be a source of persistent pain and dysfunction in the active overhead throwing athlete. It is important to distinguish between scapulothoracic bursitis and scapulothoracic crepitus. Scapulothoracic bursitis refers to inflammation of the bursae secondary to trauma or overuse owing to sports activities or work. Scapulothoracic crepitus is defined by a grinding, popping, or thumping sound or sensation secondary to abnormal scapulothoracic motion. This article presents the causes, diagnosis, and management of these shoulder conditions in a manner that is relevant to clinicians, athletic trainers, and physical therapists, and it reviews relevant studies to determine the consensus on nonoperative treatment, as well as open and arthroscopic surgical treatment. The causes of scapulothoracic bursitis and crepitus include direct or indirect trauma, overuse syndromes, glenohumeral joint dysfunction, osseous abnormalities, muscle atrophy or fibrosis, and idiopathic causes. Scapulothoracic bursitis and crepitus remain primarily clinical diagnoses; however, imaging studies or local injections may also be helpful. The initial treatment of scapulothoracic bursitis and scapulothoracic crepitus should be nonoperative. Surgical treatment options include partial scapulectomy or resection of the superomedial angle of the scapula, open bursal resection, and arthroscopic bursectomy. Despite the lack of agreement among orthopaedic surgeons concerning which procedure is best for treating symptomatic scapulothoracic bursitis and crepitus, most reports have demonstrated good to excellent outcomes in a significantly high percentage of patients. Clearly, the best initial approach to these conditions is a nonoperative treatment plan that combines scapular strengthening, postural reeducation, and core strength endurance. The addition of local modalities

  15. Therapy-resistant septic olecranon bursitis due to Mycobacterium gordonae.

    Science.gov (United States)

    Konrads, Christian; Rückl, Kilian; El Tabbakh, Mohammed; Rudert, Maximilian; Kircher, Stefan; Plumhoff, Piet

    2016-01-01

    Septic olecranon bursitis due to atypical mycobacteria is rare. An insidious beginning can delay diagnosis and treatment. Antibacterial therapy recommendations are not well-defined for bursitis caused by atypical mycobacteria. We present a rare case of olecranon bursitis caused by Mycobacterium gordonae, reporting our experiences regarding pathogen identification and antibiotic therapy, which differs from regimes used in common septic bursitis mostly caused by staphylococcus aureus. A 35-year-old male with bursitis olecrani received open bursectomy. Microbiological culture did not reveal bacteria. Due to wound healing complications revision surgery was performed four weeks postoperatively. Finally, Mycobacterium gordonae was identified by PCR and an antibiogram could be developed. A triple antimicrobial combination therapy with Rifampicin, Clarithromycin, and Ethambutol was administered systemically for 12 months. The patient was followed-up for 24 months. After the second operation with pathogen identification and antibiotic combination therapy the wound healed without any additional complications. At last follow-up 24 months after the first surgery with bursectomy and 23 months after revision surgery with debridement, the patient was still pain free with no significant clinical findings or tenderness to touch at the operation site. Elbow range of motion was full. As septic bursitis can be caused by many different and sometimes rare and difficult to identify bacteria, intraoperative probes should be taken and histopathological and microbiological analysis should be conducted, including PCR. In a young man with olecranon bursitis due to Mycobacterium gordonae surgical treatment and an antibiotic combination therapy showed a good clinical outcome after one and two years. © The Authors, published by EDP Sciences, 2016.

  16. Ultrasonographic findings of aspergillus bursitis in a patient with a renal transplantation: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Byeong Seong; Yang, Myeon Jun; Kim, Young Min; Youm, Yoon Seok; Choi, Seong Hoon; Park, Sung Bin; Jeong, Ae Kyung [University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan (Korea, Republic of)

    2008-04-15

    Aspergillus bursitis is an uncommon condition demonstrated as a nonspecific soft tissue mass. To our knowledge, the ultrasonographic findings of aspergillus bursitis in immunocompromised patients have not been previously reported. Here, we report a case of aspergillus bursitis in a renal transplant recipient, accompanied by the associated ultrasonographic findings.

  17. Effect of polydeoxyribonucleotide injection on pes anserine bursitis

    Science.gov (United States)

    Mun, Jong-Uk; Cho, Hyung R.; Bae, Sae M.; Park, Soo K.; Choi, Soo .l; Seo, Mi S.; Lim, Young S.; RN, Soo H. Woo; Kim, Young U.

    2017-01-01

    Abstract Rationale: Pes anserine (PA) bursitis is an inflammatory condition of the medial knee. The PA bursa becomes more painful when infected, damaged, or irritated. Although various treatment options have been attempted to treat PA bursitis, optimal treatments are still debated. This study aims to investigate the effect of polydeoxyribonucleotide (PDRN) injection on reducing pain and inflammation in a patient presenting with PA bursitis. Patient concerns: A 50-year-old female patient was admitted to our pain clinic with symptoms of tenderness and pain over the medial knee. Physical examination revealed the pain to be located over the proximal medial tibia at the insertion of the conjoined tendons of the PA. The knee had lost its range of movement and strength, and resisted knee flexion. Diagnoses: She was diagnosed as having PA bursitis. Interventions: Ultrasound guided PA bursa injection was carried out. Outcomes: Follow-up for the patient was more than eight months. She showed good improvement in PA bursitis without any complications. Lessons: This is the first successful report of successful PDRN injection for PA bursa. PMID:29069005

  18. Endoscopic Olecranon Bursal Resection for Olecranon Bursitis: A Comparative Study for Septic and Aseptic Olecranon Bursitis.

    Science.gov (United States)

    Rhyou, In Hyeok; Park, Kyoung Jun; Kim, Kyung Chul; Lee, Ji-Ho; Kim, Seung Yeon

    2016-06-01

    Open excision of the olecranon bursa has been performed traditionally. However, surgical complications such as wound healing problems and recurrence may occur after the surgery. The purpose of this study was to report on the clinical outcomes of endoscopic olecranon bursal resection performed in both septic and aseptic olecranon bursitis. We retrospectively reviewed 30 patients who underwent endoscopic olecranon bursal resection from June 2007 to January 2012. There were 20 males and 10 females. The ages ranged from 22 to 80 years, with an average age of 57.4 years and the average follow-up was 21.1 months (6-61.5 months). There were 15 cases in the septic group. The treatment outcome was measured according to the following; the rate of recurrence, range of motion, complications associated with surgery, VAS and QuickDASH. There were no complications such as postoperative infection or neurovascular injuries. In the septic group, the VAS and QuickDASH scores were significantly improved from 5.6 to 0.1 and from 28 to 1.3, respectively. In the aseptic group, the VAS and QuickDASH scores were improved from 0.6 to 0.1 and from 25.7 to 0.5, respectively. In all cases, there were no recurrences and no limitations of joint motion until the final follow-up. We were able to obtain excellent outcomes without recurrence by performing endoscopic olecranon bursal resection in both septic and aseptic olecranon bursitis.

  19. Subacromial bursitis following human papilloma virus vaccine misinjection.

    Science.gov (United States)

    Uchida, Soshi; Sakai, Akinori; Nakamura, Toshitaka

    2012-12-17

    A patient presented at our clinic with severe subacromial bursitis, which persisted for several months following a third booster injection with Cervarix™. Chronic subacromial bursitis manifested itself in this patient after what appeared to be the misinjection of vaccine in close proximity to the acromion. This bursitis was resistant to conventional physiotherapy and to corticosteroid therapy, but was responsive to arthroscopic surgery. Since such patients may present to an arthroscopic surgeon only months after receiving a vaccine injection, this etiological link may not be fully appreciated by treating clinicians. Further, the accuracy of injection in the deltoid region also appears under appreciated, and this report highlights the importance of accurate injection to the deltoid region or in certain cases, the value of simply changing the injection site to another larger muscle. Copyright © 2012 Elsevier Ltd. All rights reserved.

  20. Septic Bursitis in an 8-Year-Old Boy

    Directory of Open Access Journals (Sweden)

    Panagiotis Kratimenos

    2014-01-01

    Full Text Available Background. The prepatellar bursa can become inflamed owing to repeated trauma. Prepatellar bursitis is extremely rare in children. Methods. We report the case of an 8-year-old boy who was treated for an erythematous, swollen, and severely painful right knee, fever, inability to bear weight on the leg, and purulent material draining from a puncture wound. We describe the differential diagnosis for tender swollen knee, including infection, gout, rheumatoid arthritis, and osteoarthritis. If untreated, prepatellar bursitis can progress to patellar osteomyelitis. Results. Wound cultures grew Streptococcus pyogenes, with the infection resolving with amoxicillin. Conclusions. A high index of suspicion is necessary in children presenting with prepatellar bursitis to prevent potentially devastating sequelae of infection of the septic joint.

  1. Management of acute bursitis: outcome study of a structured approach.

    Science.gov (United States)

    Stell, I M

    1999-01-01

    In patients with septic bursitis the indications for admission and surgical intervention remain unclear, and practice has varied widely. The effectiveness of a conservative outpatient based approach was assessed by an outcome study in a prospective case series. Consecutive patients attending an emergency department with acute swelling of the olecranon or prepatellar bursa were managed according to a structured approach, subjective and objective outcomes being assessed after two to three days, and subsequently as required until clinical discharge. Long-term outcomes were assessed by telephone follow-up for up to eighteen months. 47 patients were included in the study: 22 had septic bursitis, 15 of the olecranon bursa and 7 of the prepatellar bursa. The mean visual analogue pain scores of those with septic bursitis improved from 4.8 at presentation to 1.7 at first follow-up for olecranon bursitis, and from 3.8 to 2.7 for prepatellar bursitis. Symptoms improved more slowly for patients with non-septic bursitis. No patients were admitted initially, but 2 were admitted (two days each) after the first follow-up appointment. One patient had incision and drainage on the third attendance, and 3 patients developed discharging sinuses, which all healed spontaneously. All patients made a good long-term symptomatic recovery and all could lean on the elbow or kneel by the end of the follow-up period. The management protocol, with specific criteria for admission and surgical intervention, thus produced good results with little need for operation or admission. PMID:10692903

  2. Avascular necrosis of the femoral head presenting as trochanteric bursitis.

    Science.gov (United States)

    Mandell, B F

    1990-01-01

    Five patients are described with avascular necrosis of the femoral head who presented with ipsilateral trochanteric bursitis, in the absence of clearcut hip joint disease. Avascular necrosis was indicated by magnetic resonance imaging. It is suggested that clinical trochanteric bursitis, especially when refractory to local corticosteroid treatment, may be the initial sign of hip disease. In the patient with risk factor(s) for avascular necrosis that diagnosis should be considered and evaluated with appropriate studies, such as magnetic resonance imaging, to prevent weight bearing at an early stage and permit possible surgical decompression in the hope of postponing or obviating the need for total hip replacement. PMID:2241294

  3. Osteomyelitis resulting from chronic filamentous fungus olecranon bursitis.

    Science.gov (United States)

    Llinas, Laura; Olenginski, Thomas P; Bush, David; Gotoff, Robert; Weber, Valerie

    2005-10-01

    We describe a case of Phaeoacremonium olecranon osteomyelitis. The patient, initially felt to have traumatic olecranon bursitis, was found to have an indolent filamentous fungus cultured from the olecranon bursa. In retrospect, x-rays revealed bony erosion, which heightened the index of suspicion for infection in this particular case. Surgical bursal excision was performed and antifungal therapy was administered with clinical resolution. This case emphasizes that aspiration, synovial fluid analysis, and culture of bursal fluid is essential in excluding typical and atypical causes of chronic bursitis.

  4. Subdeltoid/subacromial bursitis associated with influenza vaccination

    OpenAIRE

    Cook, Ian F

    2013-01-01

    A 76-year-old male presented with subacromial/subdeltoid bursitis following influenza vaccine administration into the left deltoid muscle. This shoulder injury related to vaccine administration (SIRVA) could have been prevented by the use of a safe, evidence based protocol for the intramuscular injection of the deltoid muscle.

  5. Celecoxib effectively treats patients with acute shoulder tendinitis/bursitis.

    Science.gov (United States)

    Petri, Michelle; Hufman, Stephen L; Waser, Gregory; Cui, Harry; Snabes, Michael C; Verburg, Kenneth M

    2004-08-01

    Shoulder tendinitis and subacromial bursitis are acute, painful inflammatory musculoskeletal conditions that may recur as a result of overuse. We investigated the efficacy of celecoxib in managing patients with acute shoulder tendinitis/bursitis. In this double blind, placebo controlled, parallel group study, patients with acute onset shoulder tendinitis and/or subacromial bursitis were randomized to receive one of: celecoxib 400 mg followed by 200 mg bid, naproxen 500 mg bid, or placebo bid for 14 days. The primary measure of efficacy was the mean reduction in Maximum Pain Intensity at Rest, measured using a 100 mm visual analog scale, from baseline to Days 7 and 14. Of the 306 patients randomized to treatment, 254 completed the study. On Day 7, the mean reduction from baseline in Maximum Pain Intensity at Rest was significantly greater in the celecoxib group compared with the placebo group (-27.7 +/- 2.75 mm vs -18.4 +/- 2.63 mm, respectively; p subacromial bursitis.

  6. Subdeltoid/subacromial bursitis associated with influenza vaccination.

    Science.gov (United States)

    Cook, Ian F

    2014-01-01

    A 76-year-old male presented with subacromial/subdeltoid bursitis following influenza vaccine administration into the left deltoid muscle. This shoulder injury related to vaccine administration (SIRVA) could have been prevented by the use of a safe, evidence based protocol for the intramuscular injection of the deltoid muscle.

  7. Trochanteric reduction osteotomy as a treatment for refractory trochanteric bursitis

    NARCIS (Netherlands)

    Govaert, L. H. M.; van der Vis, H. M.; Marti, R. K.; Albers, G. H. R.

    2003-01-01

    We describe a new operative procedure for patients with chronic trochanteric bursitis. Between March 1994 and May 2000, a trochanteric reduction osteotomy was performed on ten patients (12 hips). All had received conservative treatment for at least one year. Previous surgical treatment with a

  8. Mineralized fibroma of the tendon sheath presenting as a bursitis

    Energy Technology Data Exchange (ETDEWEB)

    Le Corroller, Thomas; Champsaur, Pierre [Hopital Sainte-Marguerite, Service de Radiologie, Marseille (France); Faculte de Medecine de Marseille, Departement d' Anatomie, Marseille (France); Bouvier-Labit, Corinne [Hopital La Timone, Service d' Anatomopathologie, Marseille (France); Sbihi, Abderrahmane [Clinique Juge, Service de Chirurgie orthopedique, Marseille (France)

    2008-12-15

    We report on the clinical, imaging - including ultrasound, computed tomography, and magnetic resonance imaging - and histological features of a fibroma of the tendon sheath with mineralized chondroid and osseous metaplasia, presenting as a semimembranosus bursitis. The anatomical characteristics of the semimembranosus bursa are demonstrated by dissection in a cadaveric specimen and correlated with the imaging findings in our patient. (orig.)

  9. Tuberculosis of the patella masquerading as prepatellar bursitis

    Science.gov (United States)

    Kulkarni, S

    2013-01-01

    Tuberculosis of bone is an uncommon entity in the Western world. We present a case of tuberculosis of the patella mimicking prepatellar bursitis in an otherwise fit and well woman of Bangladeshi origin. We believe tuberculosis of bone should form a differential diagnosis of the swollen knee in high risk patients. PMID:23317718

  10. Phomopsis bougainvilleicola prepatellar bursitis in a renal transplant recipient

    Science.gov (United States)

    Pre-patellar bursitis is typically a monomicrobial bacterial infection. Rarely is a fungal cause identified. We describe a 61 year-old man who had received a renal transplant 21 months prior to presentation whose synovial fluid and surgical specimens grew Phomopsis bougainvilleicola, a pycnidial coe...

  11. Calcifying supracoracoid bursitis as a cause of chronic shoulder pain.

    Science.gov (United States)

    Mens, J; van der Korst, J K

    1984-01-01

    A case of chronic shoulder pain is reported with marked limitation of both active and passive elevations and a normal range of motion of the glenohumeral joint. X-ray examination demonstrated cloudy calcification in the coracoclavicular region, presumably indicating calcifying supracoracoid bursitis. Images PMID:6497468

  12. Bursectomy, Curettage, and Chemotherapy in Tuberculous Trochanteric Bursitis

    Science.gov (United States)

    Carro-Fernández, José A.; Santos-Sánchez, José A.; Casas Ramos, Paula; Díez-Romero, Luis J.; Izquierdo-García, Francisco M.

    2016-01-01

    We presented three patients with trochanteric tuberculosis and described the clinical and imaging findings of the infection. Histology revealed a necrotizing granulomatous bursitis and microbiology confirmed tuberculosis. All cases were successfully treated with bursectomy and curettage of the trochanteric lesion and antituberculous chemotherapy including isoniazid, pyrazinamide, rifampicin, and ethambutol. PMID:26929807

  13. Preoperative diagnosis of bicipitoradial bursitis: a case report ...

    African Journals Online (AJOL)

    Inflammation of the bicipitoradial bursa is a rare condition and only few reports can be found in literature. Several causes for a cubital bursitis have been suggested in the past. The need to include a malignant lesion in the differential diagnosis has only been mentioned in one of these reports. May main objective in reporting ...

  14. [Current treatment concepts for olecranon and prepatellar bursitis in Austria].

    Science.gov (United States)

    Baumbach, S F; Michel, M; Wyen, H; Buschmann, C T; Kdolsky, R; Kanz, K-G

    2013-04-01

    The limited evidence available on the diagnosis and treatment of olecranon and prepatellar bursitis indicates nationally varying treatment approaches. Therefore the aim of this study was to survey the current treatment concepts of olecranon and prepatellar bursitis in Austria. An online questionnaire comprising of demographic data, questions regarding diagnostics and differentiation between septic bursitis (SB) and non-septic bursitis (NSB) as well as two case reports for therapy appraisal were sent to members of the Austrian Society of Orthopaedics and Orthopaedic Surgery (ÖGO) and the Austrian Society of Traumatology (ÖGU). The overall response rates were 46 % (ÖGU)/12 % (ÖGO). Differentiation between SB and NSB was predominantly based on medical history/clinical presentation (ÖGU: 100 %/ÖGO: 84 %) and blood sampling (ÖGU: 82 %/ÖGO: 77 %). 64/36 % of surveyed members of ÖGO/OGU performed a bursal aspiration. 95/55 % of Austrian ÖGU opinion leaders favoured a surgical treatment approach in cases of SB/NSB. Conversely, ÖGO members rather favoured a conservative treatment approach (28/27 %). Significant differences were found between ÖGO and ÖGU, with the latter favouring a surgical treatment approach in cases of SB and NSB. However, the international literature argues for a conservative treatment approach. Further high quality research is needed to establish an evidence-based treatment approach. Georg Thieme Verlag KG Stuttgart · New York.

  15. Septic olecranon and prepatellar bursitis in hockey players: a report of three cases.

    Science.gov (United States)

    Tuff, Taylor; Chrobak, Karen

    2016-12-01

    Septic bursitis (SB) is an important differential diagnosis in athletes presenting with an acute subcutaneous swelling of the elbow or knee. Prompt recognition is essential to minimize recovery time and prevent the spread of infection. Due to the significant overlap in clinical features, it is often difficult to differentiate SB from non-septic bursitis (NSB) without bursal aspirate analysis. SB is commonly not considered unless the bursitis is accompanied by a local skin lesion or fever. This study describes two cases of septic olecranon bursitis and one case of septic prepatellar bursitis in adult hockey players presenting to a sports medicine clinic. None of the cases presented with an observable skin lesion and only one case developed a fever. It is therefore essential that clinicians maintain a high index of suspicion and monitor for signs of progression when presented with an acute bursitis even in the absence of these features.

  16. Is Ultrasound-Guided Injection More Effective in Chronic Subacromial Bursitis?

    National Research Council Canada - National Science Library

    HSIEH, LIN-FEN; HSU, WEI-CHUN; LIN, YI-JIA; WU, SHIH-HUI; CHANG, KAE-CHWEN; CHANG, HSIAO-LAN

    2013-01-01

    .... Therefore, this study aimed to compare the efficacy of subacromial corticosteroid injection under US guidance with palpation-guided subacromial injection in patients with chronic subacromial bursitis...

  17. Subacromial bursitis related to HIV infection: case report.

    Science.gov (United States)

    Ejnisman, Benno; Figueiredo, Eduardo Antônio de; Terra, Bernardo Barcellos; Lima, Ana Lucia L Munhoz; Uip, David E

    2010-01-01

    Describe a subacromial bursitis at the right shoulder of a 45-year-old male subject. The patient has been living with HIV/AIDS for 22 years. The ultrasonography and the MRI revealed the presence of a pronounced subacromial effusion, with an inflammatory reaction of adjacent tissues. The tumoration was handled firstly with a needle-puncture aspiration, with a thick liquid outflow, followed by an open drainage. Histopathological evaluation showed no evidence of any AIDS defining disease. There was complete remission of the infection after five months thereafter the symptoms had started. After reviewing the scarce literature in the area, no reports of subacromial bursitis in HIV/AIDS patients were found. The authors point out that, although rare, this disease should be considered as differential diagnosis of shoulder diseases in HIV-infected subjects.

  18. Preoperative diagnosis of bicipitoradial bursitis: a case report

    Science.gov (United States)

    Aldhilan, Asim

    2014-01-01

    Inflammation of the bicipitoradial bursa is a rare condition and only few reports can be found in literature. Several causes for a cubital bursitis have been suggested in the past. The need to include a malignant lesion in the differential diagnosis has only been mentioned in one of these reports. May main objective in reporting this case is to make this pathological entity better known. PMID:25018791

  19. A useful procedure in the treatment of chronic olecranon bursitis.

    Science.gov (United States)

    Quayle, J B; Robinson, M P

    1978-05-01

    An operation for chronic olecranon bursitis is described and the results of 11 cases reviewed. It is suggested that a number of patients with this condition have a prominent olecranon process or spur. The technique involves excision of the olecranon process only, the bursa itself is preserved. The overlying skin remains undamaged and this manoeuvre avoids the unpleasant sequelae that may follow its removal. The operation appears to give satisfactory results.

  20. The molecular pathophysiology of subacromial bursitis in rotator cuff disease.

    Science.gov (United States)

    Blaine, Theodore A; Kim, Yang-Soo; Voloshin, Ilya; Chen, Darwin; Murakami, Koko; Chang, Seong-Sil; Winchester, Robert; Lee, Francis Y; O'keefe, Regis J; Bigliani, Louis U

    2005-01-01

    Little information exists on the molecular and biochemical pathophysiology of subacromial bursitis and rotator cuff disease. We investigated the pattern of expression of cytokines (interleukin [IL]-1beta, IL-1, IL-6, tumor necrosis factor [TNF] alpha, small inducible cytokines), metalloproteases, and cyclooxygenases in the subacromial bursa in patients with rotator cuff disease. Subacromial bursa specimens were prepared for molecular and biochemical analysis in patients undergoing shoulder surgery following an institutional review board-approved protocol. Specimens were analyzed for the presence of cytokines, metalloproteases, and cyclooxygenases by use of microarray for gene expression and immunohistocytochemistry. Microarray analysis for gene expression and immunohistochemistry demonstrated that the expression of several cytokine genes (TNF, IL-1alpha, IL-1beta, and IL-6) was increased in patients with subacromial bursitis compared with control specimens. Furthermore, the expression of metalloproteases (MMP-1 and MMP-9) and cyclooxygenases (COX-1 and COX-2) in the bursitis group was found to be increased as compared with controls. Although further investigation is required, these studies suggest that inflammation of the subacromial bursa does occur in patients with rotator cuff disease. These findings support the role of anti-inflammatory agents in the treatment of subacromial impingement and emphasize the importance of subacromial bursectomy to reduce inflammation in rotator cuff disease.

  1. Antecubital Fossa Solitary Osteochondroma with Associated Bicipitoradial Bursitis

    Directory of Open Access Journals (Sweden)

    Colin Ng

    2015-01-01

    Full Text Available Antecubital fossa lesions are uncommon conditions that present to the orthopaedic clinic. Furthermore, the radius bone is an uncommonly reported location for an osteochondroma, especially when presenting with a concurrent reactive bicipitoradial bursitis. Osteochondromas are a type of developmental lesion rather than a true neoplasm. They constitute up to 15% of all bone tumours and up to 50% of benign bone tumours. They may occur as solitary or multiple lesions. Multiple lesions are usually associated with a syndrome known as hereditary multiple exostoses (HME. Malignant transformation is known to occur but is rare. Bicipitoradial bursitis is a condition which can occur as primary or secondary (reactive pathology. In our case, the radius bone osteochondroma caused reactive bicipitoradial bursitis. The differential diagnosis of such antecubital fossa masses is vast but may be narrowed down through a targeted history, stepwise radiological investigations, and histological confirmation. Our aim is to ensure that orthopaedic clinicians keep a wide differential in mind when dealing with antecubital fossa mass lesions.

  2. Iliopsoas bursitis with compression of the common femoral vein resulting in acute lower leg edema

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, Seung Bae; Kwak, Hyo Sung; Han, Young Min; Lee, Sang Yong; Jeong, Yeon Jun [Chonbuk National University Medical School, Chonju (Korea, Republic of)

    2006-08-15

    The clinical manifestations related to iliopsoas bursitis can vary due to compression of the adjacent structure such as the common femoral vein, nerve and bladder. We report here on a rare case of iliopsoas bursitis with compression of the common femoral vein that resulted in acute lower leg edema.

  3. Septic arthritis and bursitis: emergency ultrasound can facilitate diagnosis.

    Science.gov (United States)

    Costantino, Thomas G; Roemer, Benjamin; Leber, Ernest H

    2007-04-01

    This article reports the case of a 52-year-old woman with septic arthritis and bursitis of her shoulder. Due to a minor musculoskeletal injury and lack of fever, the diagnosis was missed on her first Emergency Department visit. Sonographic guidance of the shoulder arthrocentesis led to successful aspiration of the larger fluid collection in the subacromial bursa and allowed the diagnosis and treatment to proceed more rapidly. Septic arthritis is a challenging clinical diagnosis, and when it occurs in more difficult to aspirate joints, the diagnosis can become more challenging still. Ultrasound provides a means for the emergency physician to establish the diagnosis more readily.

  4. Subacromial bursitis with rice bodies : a case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Bong Soo; Joo, Kyung Bin; Park, Dong Woo; Lee, Hak Soo; Oh, Jae Cheon; Lee, Yong Joo; Lee, Won Mi [Hanyang Univ., Seoul (Korea, Republic of). Coll. of Medicine

    1998-04-01

    Multiple rice bodies in joints or bursae are rarely encountered in patients with rheumatoid arthritis. We report the radiologic findings of massive subacromial bursitis with innumerable rice bodies on the right shoulder of a 38-year-old man with rheumatoid arthritis. Subacromial bursography showed markedly distended bursa with multiple nodular filling defects. Precontrast CT scanning revealed well-demarcated hypodense lesion without calcification in subacromio-subdeltoid bursa. Multiple rice bodies showed slightly high signal intensity of T1WI and T2WI, and no enhancement after gadolinium injection. (author). 7 refs., 4 figs.

  5. Surgical treatment and histopathology of different forms of olecranon and presternal bursitis in cattle and buffalo

    Science.gov (United States)

    Fathy, Ahmed

    2006-01-01

    Thirty seven cases of bursitis presented to our Veterinary Teaching Hospital from 2001 to 2005. There were 10 adult female buffalos with olecranon bursitis (one had bilateral bursitis) and 26 calves (7 cattle and 19 buffalos, 16 males and 10 females) with presternal bursitis. There were 10 out of 11 cases of olecranon bursitis and 21 out of 26 cases of presternal bursitis with different forms (cystic, proliferative and fibrous) that were removed surgically. The remaining 6 cases, cystic bursitis (olecranon = 1, presternal = 5), were treated by aspiration of their contents and injection of 4% iodine tincture intrabursally. Only 2 cases recovered, 3 cases progressed to fibrosis and required further surgical treatment 2 to 3 weeks later, and 1 case continued to have a cystic lesion. Histopathological examination of tissue specimens from different forms of bursitis revealed that the acquired bursae were generally lined with synovial-like membrane formed from 2-3 cellular layers that covered the connective tissue capsule. The connective tissue capsule differed from one type to another and consisted of fibrous tissues containing numerous small blood vessels, blood capillaries, lymphatics and nerves. There was also evidence for inflammation within the capsule represented by congestion of blood vessels and the presence of perivascular inflammatory cells, mostly mononuclear. In conclusion, surgical treatment was successful and effective for treatment of olecranon and presternal bursitis particularly for the chronic proliferative and fibrous form in cattle and buffalo. The histological structure of the acquired bursae was relatively similar consisting of a synovial-like membrane and a connective tissue capsule with varying degrees of the inflammatory process. PMID:16871025

  6. Surgical treatment and histopathology of different forms of olecranon and presternal bursitis in cattle and buffalo.

    Science.gov (United States)

    Fathy, Ahmed; Radad, Khaled

    2006-09-01

    Thirty seven cases of bursitis presented to our Veterinary Teaching Hospital from 2001 to 2005. There were 10 adult female buffalos with olecranon bursitis (one had bilateral bursitis) and 26 calves (7 cattle and 19 buffalos, 16 males and 10 females) with presternal bursitis. There were 10 out of 11 cases of olecranon bursitis and 21 out of 26 cases of presternal bursitis with different forms (cystic, proliferative and fibrous) that were removed surgically. The remaining 6 cases, cystic bursitis (olecranon = 1, presternal = 5), were treated by aspiration of their contents and injection of 4% iodine tincture intrabursally. Only 2 cases recovered, 3 cases progressed to fibrosis and required further surgical treatment 2 to 3 weeks later, and 1 case continued to have a cystic lesion. Histopathological examination of tissue specimens from different forms of bursitis revealed that the acquired bursae were generally lined with synovial-like membrane formed from 2-3 cellular layers that covered the connective tissue capsule. The connective tissue capsule differed from one type to another and consisted of fibrous tissues containing numerous small blood vessels, blood capillaries, lymphatics and nerves. There was also evidence for inflammation within the capsule represented by congestion of blood vessels and the presence of perivascular inflammatory cells, mostly mononuclear. In conclusion, surgical treatment was successful and effective for treatment of olecranon and presternal bursitis particularly for the chronic proliferative and fibrous form in cattle and buffalo. The histological structure of the acquired bursae was relatively similar consisting of a synovial-like membrane and a connective tissue capsule with varying degrees of the inflammatory process.

  7. Subcalcaneal Bursitis With Plantar Fasciitis Treated by Arthroscopy

    Science.gov (United States)

    Yamakado, Kotaro

    2013-01-01

    We report the successful arthroscopic treatment of a case of subcalcaneal bursitis with plantar fasciitis. To our knowledge, this is the first report on arthroscopic excision of a subcalcaneal bursa. Right heel pain developed in a 50-year-old woman, without any obvious cause. She reported that the heel pain occurred immediately after waking and that the heel ached when she walked. Magnetic resonance imaging showed an extra-articular, homogeneous, high-intensity lesion in the fat pad adjacent to the calcaneal tubercle on T2-weighted sagittal and coronal images and thickening of the plantar fascia on T2-weighted sagittal images. A diagnosis of a recalcitrant subcalcaneal bursitis with plantar fasciitis was made, and surgery was performed. The arthroscope was placed between the calcaneus and the plantar fascia. With the surgeon viewing from the lateral portal and working from the medial portal, the dorsal surface of the degenerative plantar fascia was debrided and the medial half of the plantar fascia was released, followed by debridement of the subcalcaneal bursal cavity through the incised plantar fascia. Full weight bearing and gait were allowed immediately after the operation. At the latest follow-up, the patient had achieved complete resolution of heel pain without a recurrence of the mass, confirmed by magnetic resonance imaging. PMID:23875139

  8. [Bursitis due to Mycobacterium intracellulare in an immunocompetent patient].

    Science.gov (United States)

    Wastiaux, H; Maillard, H; Bara, C; Catala, S; Steff, M; Célérier, P

    2008-01-01

    Cutaneous infections due to Mycobacterium intracellulare are infrequent. We report a case of bursitis in an immunocompetent patient. A 80-year-old patient with a history of tuberculosis reported swelling of the elbow for six months with effusion due to olecranon bursitis, progressing to an abscess and skin ulceration. Examination of the synovial fluid revealed the presence of M. intracellulare. Histologic investigations showed epithelioid and gigantocellular granulations. Screening for immunodepression was negative. Treatment with clarithromycin and rifabutin proved effective, with partial healing at three months, although hepatic and ocular side effects occurred. While osteomyelitis, arthritis and cutaneous infections due to M. intracellulare have been described in immunocompromised patients, there are very few reported cases concerning immunocompetent individuals, and these suggest the possibility of special individual sensitivity to mycobacterial infections. Genetic mutations of the interleukin-12-interferon-gamma pathway involved in the immune response to mycobacterial infections have been demonstrated. Autoantibodies against interferon-gamma have also been described. Mycobacterium avium-intracellulare is resistant to the classical antibiotics used in tuberculosis. As in pulmonary infections, antibiotics with proven in vivo and in vitro efficacy must be used, taking into account the antibiogram and potential side effects, particularly for combined clarithromycin and rifabutin. This case report emphasizes the benefits of routine mycobacterial investigation of synovial fluid samples.

  9. Recalcitrant Lateral Premalleolar Bursitis of the Ankle Associated with Lateral Ankle Instability

    Directory of Open Access Journals (Sweden)

    Masashi Naito

    2017-01-01

    Full Text Available Lateral premalleolar bursitis of the ankle is a rarely reported disorder in the English literature although it is not uncommon in Asian countries where people commonly sit on their feet. Here, we present the case of a 66-year-old woman with recalcitrant lateral premalleolar bursitis associated with lateral ankle instability which was successfully treated with surgical resection of the bursa and repair of the anterior talofibular ligament. Operative findings revealed a communication between the bursa and articular cavity of the ankle joint via the sheath of the extensor digitorum longus tendon, which was considered to act as a check valve leading to a large and recalcitrant bursitis. This report provides a novel concept about the etiology of recalcitrant lateral premalleolar bursitis of the ankle.

  10. First Report of Nocardia asiatica Olecranon Bursitis in an Immunocompetent Traveler Returning to Austria

    Science.gov (United States)

    Leitner, Eva; Valentin, Thomas; Lanz, Philipp; Flick, Holger; Zollner-Schwetz, Ines; Grisold, Andrea J.; Feierl, Gebhard; Krause, Robert

    2013-01-01

    Nocardia spp. are rarely isolated in extrapulmonary clinical specimens. We describe the first case of olecranon bursitis caused by Nocardia asiatica. The patient, a traveler returning from Thailand, was successfully treated with linezolid. PMID:23637291

  11. The relationship between chondromalacia patella, medial meniscal tear and medial periarticular bursitis in patients with osteoarthritis

    Directory of Open Access Journals (Sweden)

    Resorlu Mustafa

    2017-11-01

    Full Text Available This study investigated the presence of bursitis in the medial compartment of the knee (pes anserine, semimembranosus-tibial collateral ligament, and medial collateral ligament bursa in osteoarthritis, chondromalacia patella and medial meniscal tears.

  12. [Soft-tissue defects following olecranon bursitis. Treatment options for closure].

    Science.gov (United States)

    Damert, H-G; Altmann, S; Schneider, W

    2009-05-01

    Olecranon bursitis has a high prevalence and is commonly treated conservatively. However, in case of bacterial infection and open injuries with chronic courses, surgery is indicated. Despite high surgical standards, soft-tissue defects cannot always be avoided in primary surgery for infectious olecranon bursitis. For complicated courses with persisting defects, standardized closing procedures are available. For maintaining adequate elbow function and avoiding long disease progression, definite closure of the defect should be achieved. Various treatment options exist: VAC therapy and local, island, distant, and free flaps. Between 1996 and 2007, 12 Patients with complicated olecranon bursitis were treated in our institution. Of them, 11 received surgery. In complicated courses of olecranon bursitis with soft-tissue defects, fistulas, or recurrent wound healing disorders, there are several procedures for plastic covering of the elbow.

  13. Olecranon bursitis as initial presentation of gout in asymptomatic normouricemic patients

    National Research Council Canada - National Science Library

    Emad, Yasser; Ragab, Yasser; El Shaarawy, Nashwa; Rasker, Hans J

    2014-01-01

    .... Aim of the work The aim of the current case reports is to describe the clinical and the magnetic resonance imaging features of acute gouty olecranon bursitis as initial presentation of acute gouty attack...

  14. First report of Nocardia asiatica olecranon bursitis in an immunocompetent traveler returning to Austria.

    Science.gov (United States)

    Leitner, Eva; Valentin, Thomas; Hoenigl, Martin; Lanz, Philipp; Flick, Holger; Zollner-Schwetz, Ines; Grisold, Andrea J; Feierl, Gebhard; Krause, Robert

    2013-07-01

    Nocardia spp. are rarely isolated in extrapulmonary clinical specimens. We describe the first case of olecranon bursitis caused by Nocardia asiatica. The patient, a traveler returning from Thailand, was successfully treated with linezolid.

  15. Septic and non-septic olecranon bursitis in the accident and emergency department--an approach to management.

    Science.gov (United States)

    Stell, I M

    1996-09-01

    Olecranon bursitis is relatively common. One third of episodes are septic. Most of the remainder are non-septic, with occasional rheumatological causes. Trauma can cause both septic and non-septic olecranon bursitis. Clinical features are helpful in separating septic from non-septic olecranon bursitis, but there may be local erythema in both. Aspiration should be carried out in all cases, and if the presence of infection is still in doubt, microscopy, Gram staining, and culture of the aspirate will resolve the issue. Septic olecranon bursitis should be treated by aspiration, which may need to be repeated, and a long course of antibiotics. Some cases will need admission, and a few will need surgical treatment. Non-septic olecranon bursitis can be managed with aspiration alone. Non-steroidal anti-inflammatory drugs probably hasten symptomatic improvement. Intrabursal corticosteroids produce a rapid resolution but concern remains over their long term local effects. Recovery from septic olecranon bursitis can take months.

  16. Distinguishing multiple rice body formation in chronic subacromial-subdeltoid bursitis from synovial chondromatosis.

    Science.gov (United States)

    Chen, Albert; Wong, Lun-Yick; Sheu, Chin-Yin; Chen, Be-Fong

    2002-02-01

    Multiple rice body formation is a complication of chronic bursitis. Although it resembles synovial chondromatosis clinically and on imaging, the literature suggests that analysis of radiographic and MR appearances should allow discrimination. We report the imaging findings in a 41-year-old man presenting with rice body formation in chronic subacromial-subdeltoid bursitis. We found that the signal intensity of the rice bodies is helpful in making the diagnosis.

  17. The clinical utility of ultrasonography for rotator cuff disease, shoulder impingement syndrome and subacromial bursitis.

    Science.gov (United States)

    Awerbuch, Mark S

    2008-01-07

    Periarticular shoulder disorders are common in clinical practice, and diagnosis is often difficult. Medicare statistics indicate that between 2001 and 2006 the use of diagnostic shoulder ultrasonography increased significantly. Rotator cuff disease, shoulder impingement syndrome and subacromial bursitis are among the most common diagnoses reported on shoulder ultrasonography. Shoulder ultrasonography is useful in the diagnosis of full thickness tears, but its utility for other rotator cuff disorders, shoulder impingement syndrome and subacromial bursitis is less well established.

  18. Recalcitrant Lateral Premalleolar Bursitis of the Ankle Associated with Lateral Ankle Instability

    OpenAIRE

    Masashi Naito; Takumi Matsumoto; Song Ho Chang; Masachika Ikegami; Jun Hirose; Sakae Tanaka

    2017-01-01

    Lateral premalleolar bursitis of the ankle is a rarely reported disorder in the English literature although it is not uncommon in Asian countries where people commonly sit on their feet. Here, we present the case of a 66-year-old woman with recalcitrant lateral premalleolar bursitis associated with lateral ankle instability which was successfully treated with surgical resection of the bursa and repair of the anterior talofibular ligament. Operative findings revealed a communication between th...

  19. Trochanteric bursitis--a frequent cause of 'hip' pain in rheumatoid arthritis.

    Science.gov (United States)

    Raman, D; Haslock, I

    1982-01-01

    One hundred consecutive patients with rheumatoid arthritis (RA) were examined for the presence of trochanteric bursitis. This condition was found in 15. Ten patients responded to a single local injection of corticosteroid and the remaining 5 to a second injection. Trochanteric bursitis is an underdiagnosed, easily remediable cause of pain in RA. Specific examination for in presence should be a routine in all patients with RA, especially those with hip pain. PMID:7149797

  20. Distinguishing multiple rice body formation in chronic subacromial-subdeltoid bursitis from synovial chondromatosis

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Albert; Wong, Lun-Yick; Sheu, Chin-Yin [Department of Radiology, Mackay Memorial Hospital, Taipei (Taiwan); Chen, Be-Fong [Department of Pathology, Mackay Memorial Hospital, Taipei (Taiwan)

    2002-02-01

    Multiple rice body formation is a complication of chronic bursitis. Although it resembles synovial chondromatosis clinically and on imaging, the literature suggests that analysis of radiographic and MR appearances should allow discrimination. We report the imaging findings in a 41-year-old man presenting with rice body formation in chronic subacromial-subdeltoid bursitis. We found that the signal intensity of the rice bodies is helpful in making the diagnosis. (orig.)

  1. A Rare Form of Brucella Bursitis with Negative Serology: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    F. M. Almajid

    2017-01-01

    Full Text Available Brucellosis is still endemic in certain parts of the world including the Mediterranean, the Middle East, Latin America, and African regions. Osteoarticular manifestations are common presenting features. Brucellosis presenting as prepatellar bursitis has already been reported. We present a case of seronegative olecranon bursitis with positive blood and aspirate cultures. The patient improved remarkably by treatment with streptomycin and doxycycline with no evidence or relapse.

  2. A Rare Form of Brucella Bursitis with Negative Serology: A Case Report and Literature Review.

    Science.gov (United States)

    Almajid, F M

    2017-01-01

    Brucellosis is still endemic in certain parts of the world including the Mediterranean, the Middle East, Latin America, and African regions. Osteoarticular manifestations are common presenting features. Brucellosis presenting as prepatellar bursitis has already been reported. We present a case of seronegative olecranon bursitis with positive blood and aspirate cultures. The patient improved remarkably by treatment with streptomycin and doxycycline with no evidence or relapse.

  3. Olecranon bursitis secondary to Mycobacterium kansasii infection in a patient receiving infliximab for Behcet's disease.

    Science.gov (United States)

    Malkin, Joanne; Shrimpton, Anna; Wiselka, Martin; Barer, Michael R; Duddridge, Michael; Perera, Nelun

    2009-03-01

    We present a case of Mycobacterium kansasii olecranon bursitis in a woman with known immunosuppression secondary to the treatment received for her Behçet's disease. We found only one other case report of olecranon bursitis caused by M. kansasii in the literature, which, unlike our case, presented in an immunocompetent adult following trauma. This case extends the range of opportunistic mycobacterial infections that are associated with anti-tumour necrosis factor therapy.

  4. Efficacy of Treatment of Trochanteric Bursitis: A Systematic Review

    Science.gov (United States)

    Lustenberger, David P; Ng, Vincent Y; Best, Thomas M; Ellis, Thomas J

    2013-01-01

    Objective Trochanteric bursitis (TB) is a self-limiting disorder in the majority of patients and typically responds to conservative measures. However, multiple courses of nonoperative treatment or surgical intervention may be necessary in refractory cases. The purpose of this systematic review was to evaluate the efficacy of the treatment of TB. Data Sources A literature search in the PubMed, MEDLINE, CINAHL, and ISI Web of Knowledge databases was performed for all English language studies up to April 2010. Terms combined in a Boolean search were greater trochanteric pain syndrome, trochanteric bursitis, trochanteric, bursitis, surgery, therapy, drug therapy, physical therapy, rehabilitation, injection, Z-plasty, Z-lengthening, aspiration, bursectomy, bursoscopy, osteotomy, and tendon repair. Study Selection All studies directly involving the treatment of TB were reviewed by 2 authors and selected for further analysis. Expert opinion and review articles were excluded, as well as case series with fewer than 5 patients. Twenty-four articles were identified. According to the system described by Wright et al, 2 studies, each with multiple arms, qualified as level I evidence, 1 as level II, 1 as level III, and the rest as level IV. More than 950 cases were included. Data Extraction The authors extracted data regarding the type of intervention, level of evidence, mean age of patients, patient gender, number of hips in the study, symptom duration before the study, mean number of injections before the study, prior hip surgeries, patient satisfaction, length of follow-up, baseline scores, and follow-up scores for the visual analog scale (VAS) and Harris Hip Scores (HHS). Data Synthesis Symptom resolution and the ability to return to activity ranged from 49% to 100% with corticosteroid injection as the primary treatment modality with and without multimodal conservative therapy. Two comparative studies (levels II and III) found low-energy shock-wave therapy (SWT) to be

  5. Septic and non-septic olecranon bursitis in the accident and emergency department--an approach to management.

    OpenAIRE

    Stell, I M

    1996-01-01

    Olecranon bursitis is relatively common. One third of episodes are septic. Most of the remainder are non-septic, with occasional rheumatological causes. Trauma can cause both septic and non-septic olecranon bursitis. Clinical features are helpful in separating septic from non-septic olecranon bursitis, but there may be local erythema in both. Aspiration should be carried out in all cases, and if the presence of infection is still in doubt, microscopy, Gram staining, and culture of the aspirat...

  6. Huge tumor-like subacromial bursitis associated with rheumatoid arthritis.

    Science.gov (United States)

    Yoneda, M; Wakitani, S; Yamamoto, T

    2001-09-01

    Abstract We report a rare case of a huge subacromial bursitis in rheumatoid arthritis. A solid tumor was initially suspected because it was very large with no apparent local sign of inflammation, and because no fluid retention was observed. We performed radiograms, a plain computed tomogram, a (99)mTc-MDP bone scintigram, a (67)Ga-citrate scintigram, and a digital subtraction arteriogram, which all indicated no evidence of tumor. Finally, a bursogram proved the mass to be a huge enlarged subacromial bursa. Surgical exploration revealed that the bursa contained 450 g of a yellowish, jelly-like substance, which was considered to be a thick collection of fibrin. No recurrence was noted at a follow-up 16 years after surgery.

  7. Bicipitoradial Bursitis: A Review of Clinical Presentation and Treatment

    Directory of Open Access Journals (Sweden)

    Tsz-Lung Choi

    2014-06-01

    Full Text Available The bicipitoradial bursa lies at the insertion of the biceps tendon on the radial tuberosity. It is an unusual site for chronic bursitis and most often results from repetitive mechanical trauma or overuse. Other causes include tuberculosis, immunological complications of rheumatological disease and synovial chondromatosis. Accurate diagnosis requires imaging studies and sometimes histological study. It can be treated conservatively with aspiration and steroid injection. Surgical excision of the bursa is indicated in the case of infection cause, failed conservative treatment with recurrence of the enlarged bursa and pain after aspiration, presence of nerve compression with neurological impairment, mechanical limitation to flexion, and extension of the elbow or biceps tendon degeneration and/or functional impairment.

  8. Paecilomyces lilacinus septic olecranon bursitis in an immunocompetent host.

    Science.gov (United States)

    Schweitzer, Karl M; Richard, Marc J; Leversedge, Fraser J; Ruch, David S

    2012-05-01

    Paecilomyces lilacinus is a filamentous fungus that is a rare cause of infection in immunocompromised human hosts. We present a case of lilacinus septic olecranon bursitis in an otherwise healthy 78-year-old male. This patient's case was complicated by wound breakdown after bursectomy and appropriate anti-fungal treatment, requiring a local soft tissue rearrangement. This case demonstrates the need for appropriate and timely medical and surgical treatment in infections involving lilacinus, which are not isolated solely to systemically immunocompromised and medically-ill patient populations. In cases where the patient is systemically immumocompromised or has been rendered locally immunocompromised, it is essential to obtain a full culture work-up, including fungi.

  9. Spinal epidural abscess: a rare complication of olecranon bursitis.

    Science.gov (United States)

    Evans, Rhys D R; Thaya, Moe; Chew, Ne Siang; Gibbons, Charles E R

    2009-06-30

    Spinal epidural abscess is a rare but potentially fatal condition if left untreated. We report the case of a 67-year old man who presented to the Accident and Emergency department complaining of acute onset of inter-scapular back pain, left leg weakness and loss of sensation in the left foot. On examination he was found to be pyrexial with long tract signs in the left lower leg. In addition he had a left sided olecranon bursitis of three weeks duration. Blood tests revealed raised inflammatory markers and a staphylococcal bacteremia. Magnetic resonance imaging (MRI) confirmed the diagnosis of spinal epidural abscess and he subsequently underwent a three level laminectomy with good resolution of his back pain and neurological symptoms. He has made a complete recovery with a prolonged course of intravenous antibiotics.

  10. The Relationship between Chondromalacia Patella, Medial Meniscal Tear and Medial Periarticular Bursitis in Patients with Osteoarthritis.

    Science.gov (United States)

    Resorlu, Mustafa; Doner, Davut; Karatag, Ozan; Toprak, Canan Akgun

    2017-12-01

    This study investigated the presence of bursitis in the medial compartment of the knee (pes anserine, semimembranosus-tibial collateral ligament, and medial collateral ligament bursa) in osteoarthritis, chondromalacia patella and medial meniscal tears. Radiological findings of 100 patients undergoing magnetic resonance imaging with a preliminary diagnosis of knee pain were retrospectively evaluated by two radiologists. The first radiologist assessed all patients in terms of osteoarthritis, chondromalacia patella and medial meniscal tear. The second radiologist was blinded to these results and assessed the presence of bursitis in all patients. Mild osteoarthritis (grade I and II) was determined in 55 patients and severe osteoarthritis (grade III and IV) in 45 cases. At retropatellar cartilage evaluation, 25 patients were assessed as normal, while 29 patients were diagnosed with mild chondromalacia patella (grade I and II) and 46 with severe chondromalacia patella (grade III and IV). Medial meniscus tear was determined in 51 patients. Severe osteoarthritis and chondromalacia patella were positively correlated with meniscal tear (p chondromalacia patella (p = 0.023 and p = 0.479, respectively). Evaluation of lateral compartment bursae revealed lateral collateral ligament bursitis in 2 patients and iliotibial bursitis in 5 patients. We observed a greater prevalence of bursitis in the medial compartment of the knee in patients with severe osteoarthritis and medial meniscus tear.

  11. Mycobacterium avium intracellulare complex causing olecranon bursitis and prosthetic joint infection in an immunocompromised host

    Directory of Open Access Journals (Sweden)

    Eugene M. Tan

    2016-01-01

    Full Text Available Case: A 73-year-old immunocompromised male presented with recurrent left elbow swelling due to Mycobacterium avium intracellulare complex (MAC olecranon bursitis. 3 years after completing MAC treatment, he underwent right total knee arthroplasty (TKA. 1 year later, he developed TKA pain and swelling and was diagnosed with MAC prosthetic joint infection (PJI. He underwent TKA resection, reimplantation, and 12 months of anti-MAC therapy. This patient is the seventh case report of MAC olecranon bursitis and the third case report of MAC PJI. He is the only report of both MAC olecranon bursitis and PJI occurring in the same patient. Informed consent: This patient was informed and agreed to the publication of this material.

  12. Group B streptococcal meningitis in an adult: A possible complication of olecranon bursitis

    Directory of Open Access Journals (Sweden)

    Manuela Colosimo

    2014-01-01

    Full Text Available Background: We report a man with septic olecranon bursitis who had an early development of meningitis. Case Summary: A 74-year-old man presented to the emergency room with malaise, headache, mental confusion, a fever unsuccessfully treated with oral NSAIDs and ice, and with a 10-day history of pain and swelling in his right elbow. Clinical and laboratory evaluation excluded other causes and microbiological evaluation documented a S. agalactiae infection. Antibiotic treatment induced a rapid improvement, without the development of side effects. Conclusion: This is the first report on olecranon bursitis and concomitant meningitis related to S. agalactiae infection.

  13. Calcific haemorrhagic bursitis anterior to the knee mimicking a soft tissue sarcoma: report of two cases

    Energy Technology Data Exchange (ETDEWEB)

    Stahnke, M.; Davies, A.M. [Department of Radiology, Royal Orthopaedic Hospital, Woodlands, B31 2AP, Northfield, Birmingham (United Kingdom); Mangham, D.C. [Department of Pathology, Royal Orthopaedic Hospital, Woodlands, B31 2AP, Northfield, Birmingham (United Kingdom)

    2004-06-01

    We describe the radiological and pathological findings of two cases of calcific haemorrhagic bursitis, one involving the superficial infrapatellar bursa and the other the prepatellar bursa. It was the presence of dystrophic calcification within the lesion that suggested a mineralizing soft tissue sarcoma such as synovial sarcoma. As the radiographic and MR features of the two conditions can be similar but the appropriate management very different, rare calcifying haemorrhagic bursitis needs to be included in the differential diagnosis of masses adjacent to the knee joint showing calcification. (orig.)

  14. Ischiogluteal bursitis mimicking soft-tissue metastasis from a renal cell carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Voelk, M.; Gmeinwieser, J.; Manke, C.; Strotzer, M. [Department of Radiology, University Hospital, Regensburg (Germany); Hanika, H. [Department of Urology, St. Josef Hospital, Regensburg (Germany)

    1998-09-01

    We report a case of ischiogluteal bursitis mimicking a soft-tissue metastasis from a renal cell carcinoma. A 66-year-old woman suffered from pain over the left buttock 6 months after she was operated on for renal cell carcinoma of the left kidney. CT of the abdomen and pelvis revealed a tumor-like lesion adjacent to the left os ischii, which was suspected to be a soft-tissue metastasis. Percutaneous biopsy revealed no evidence of malignancy, but the histopathological diagnosis of chronic bursitis. (orig.) With 2 figs., 8 refs.

  15. Long-term follow-up of corticosteroid injection for traumatic olecranon bursitis.

    Science.gov (United States)

    Weinstein, P S; Canoso, J J; Wohlgethan, J R

    1984-01-01

    Forty-seven patients with traumatic olecranon bursitis were evaluated after a mean follow-up of 31 months (range 6 to 62 months). Twenty-two patients treated with bursal aspiration had delayed recovery and no complications of therapy. Twenty-five patients treated with intrabursal injection of 20 mg of triamcinolone hexacetonide had rapid recovery, usually within one week, but suffered complications such as infection (3 cases), skin atrophy (5 cases), and chronic local pain (7 cases). Since spontaneous resolution can be expected, a conservative approach is suggested in the treatment of traumatic olecranon bursitis. Images PMID:6696516

  16. Group B streptococcal meningitis in an adult: A possible complication of olecranon bursitis.

    Science.gov (United States)

    Colosimo, Manuela; Corigliano, Antonio; Daprai, Laura; Restelli, Antonella; Torresani, Erminio; Galasso, Olimpio

    2014-04-01

    We report a man with septic olecranon bursitis who had an early development of meningitis. A 74-year-old man presented to the emergency room with malaise, headache, mental confusion, a fever unsuccessfully treated with oral NSAIDs and ice, and with a 10-day history of pain and swelling in his right elbow. Clinical and laboratory evaluation excluded other causes and microbiological evaluation documented a S. agalactiae infection. Antibiotic treatment induced a rapid improvement, without the development of side effects. This is the first report on olecranon bursitis and concomitant meningitis related to S. agalactiae infection.

  17. Olecranon bursitis in patients treated with sunitinib for renal cell carcinoma.

    Science.gov (United States)

    Gregory, Thomas; Mir, Olivier; Medioni, Jacques; Augereau, Bernard; Oudard, Stéphane

    2010-06-01

    Sunitinib is a recently approved tyrosine-kinase inhibitor that targets the vascular endothelial growth factor receptors (VEGFR). We report two cases of patients with metastatic renal cell cancer who developed olecranon bursitis while receiving sunitinib. In both cases other causes of bursitis were excluded and the symptoms resolved after treatment with sunitinib was discontinued. Recurrence of symptoms during subsequent treatment cycles was also observed. This adverse event has not been previously reported for sunitinib and we believe it is directly attributable to the drug. This is an unexpected adverse event, given the mechanism of action of the drug. The pathophysiology of this event remains unexplained, although we describe some hypotheses.

  18. Ultrasound-Guided 50% Ethyl Alcohol Injection for Patients With Malleolar and Olecranon Bursitis: A Prospective Pilot Study

    Science.gov (United States)

    Hong, Ji Seong; Lee, Jin Hyung

    2016-01-01

    Objective To evaluate the feasibility and effect of ultrasound-guided ethyl alcohol injection on malleolar and olecranon synovial proliferative bursitis. Methods Twenty-four patients received ultrasound-guided 50% diluted ethyl alcohol injection at the site of synovial proliferative bursitis after aspiration of the free fluid. Results Swelling and symptoms significantly decreased in 13 of the 24 patients without any complications. Eleven patients had partial improvement in swelling and symptoms. Conclusion Ultrasound-guided alcohol injection could be an alternative therapeutic option before surgery in patients with chronic intractable malleolar and olecranon synovial proliferative bursitis. PMID:27152282

  19. Ultrasound-Guided 50% Ethyl Alcohol Injection for Patients With Malleolar and Olecranon Bursitis: A Prospective Pilot Study.

    Science.gov (United States)

    Hong, Ji Seong; Kim, Hyoung Seop; Lee, Jin Hyung

    2016-04-01

    To evaluate the feasibility and effect of ultrasound-guided ethyl alcohol injection on malleolar and olecranon synovial proliferative bursitis. Twenty-four patients received ultrasound-guided 50% diluted ethyl alcohol injection at the site of synovial proliferative bursitis after aspiration of the free fluid. Swelling and symptoms significantly decreased in 13 of the 24 patients without any complications. Eleven patients had partial improvement in swelling and symptoms. Ultrasound-guided alcohol injection could be an alternative therapeutic option before surgery in patients with chronic intractable malleolar and olecranon synovial proliferative bursitis.

  20. Multiple rice body formation in chronic subacromial/subdeltoid bursitis: MR appearances.

    Science.gov (United States)

    Griffith, J F; Peh, W C; Evans, N S; Smallman, L A; Wong, R W; Thomas, A M

    1996-07-01

    Multiple rice body formation is an unusual complication of chronic bursitis. Clinically and macroscopically, it can resemble synovial osteochondromatosis. Radiographic and MR appearances, however, may allow an accurate pre-operative diagnosis. The imaging features of two middle-aged women with multiple subacromial/subdeltoid bursa rice bodies are described.

  1. Septic subacromial bursitis caused by Mycobacterium kansasii in an immunocompromised host.

    Science.gov (United States)

    Mathew, Stephanie D; Tully, Charla C; Borra, Himabindu; Berven, Michael D; Arroyo, Ramon

    2012-05-01

    Mycobacterium kansasii is a common cause of pulmonary infection as a result of nontuberculous mycobacteria, but is less commonly described as a cause of an orthopedic infection. We present the first case of M. kansasii subacromial septic bursitis in an immunocompromised host. This case demonstrates the diagnostic and treatment challenges associated with orthopedic infections caused by M. kansasii.

  2. The US, CT and MR findings of cubital bursitis: a report of five cases

    Energy Technology Data Exchange (ETDEWEB)

    Liessi, G. [Servizio di Radiologia, Ospedale, I-31033 Castelfranco V.to, Ulss 8 (Tuvalu) (Italy); Cesari, S. [Servizio di Radiologia, Ospedale, I-31033 Castelfranco V.to, Ulss 8 (Tuvalu) (Italy); Spaliviero, B. [Servizio di Radiologia, Ospedale, I-31033 Castelfranco V.to, Ulss 8 (Tuvalu) (Italy); Dell`Antonio, C. [Servizio di Radiologia, Ospedale, I-31033 Castelfranco V.to, Ulss 8 (Tuvalu) (Italy); Avventi, P. [Servizio di Radiologia, Ospedale, I-31033 Castelfranco V.to, Ulss 8 (Tuvalu) (Italy)

    1996-07-01

    Objective. The purpose of the study was to evaluate the appearance of ``cubital bursitis`` on ultrasonography and CT and MR imaging. ``Cubital bursitis`` is a rare pathological condition involving a large swelling of the bicipito-radial or interosseous bursae located at the insertion of the distal biceps tendon on the radial tuberosity. Design and patients. We report on five patients with ``cubital bursitis`` resulting from their work or sporting activities. All patients underwent an ultrasound and MR examination. CT scans were performed on two patients before and after contrast enhancement. Results. Ultrasound studies showed a fusiform anechoic or hypoechoic lesion. CT images showed the lesions but there were some difficulties in determining the exact extent of the bursae. MR imaging showed the enlarged bursae and their fluid content. Four patients each underwent a surgical procedure. Conclusion. Ultrasound and CT were effective in the evaluation of ``cubital bursitis``, but with some diagnostic difficulties. MR imaging is probably the method of choice for determining both the development of the bursae and their fluid content. (orig.)

  3. Appearance of the weight-bearing lateral radiograph in retrocalcaneal bursitis

    NARCIS (Netherlands)

    van Sterkenburg, M.N.; Muller, B.; Maas, M.; Sierevelt, I.N.; van Dijk, C.N.

    2010-01-01

    Background and purpose A retrocalcaneal bursitis is caused by repetitive impingement of the bursa between the Achilles tendon and the posterosuperior calcaneus. The bursa is situated in the posteroinferior corner of Kager's triangle (retrocalcaneal recess), which is a radiolucency with sharp borders

  4. Olecranon bursitis as initial presentation of gout in asymptomatic normouricemic patients

    NARCIS (Netherlands)

    Emad, Yasser; Ragab, Yasser; El Shaarawy, Nashwa; Rasker, Johannes J.

    2014-01-01

    Background Acute bursitis is a less frequent presentation of gout, especially in normouricemic subjects compared to the typical pattern of acute gouty arthritis. Aim of the work The aim of the current case reports is to describe the clinical and the magnetic resonance imaging features of acute gouty

  5. Appearance of the weight-bearing lateral radiograph in retrocalcaneal bursitis

    Science.gov (United States)

    Muller, Bart; Maas, Mario; Sierevelt, Inger N; van Dijk, C Niek

    2010-01-01

    Background and purpose A retrocalcaneal bursitis is caused by repetitive impingement of the bursa between the Achilles tendon and the posterosuperior calcaneus. The bursa is situated in the posteroinferior corner of Kager's triangle (retrocalcaneal recess), which is a radiolucency with sharp borders on the lateral radiograph of the ankle. If there is inflammation, the fluid-filled bursa is less radiolucent, making it difficult to delineate the retrocalcaneal recess. We assessed whether the radiographic appearance of the retrocalcaneal recess on plain digital (filmless) radiographs could be used in the diagnosis of a retrocalcaneal bursitis. Methods Whether or not there was obliteration of the retrocalcaneal recess (yes/no) on 74 digital weight-bearing lateral radiographs of the ankle was independently assessed by 2 observers. The radiographs were from 24 patients (25 heels) with retrocalcaneal bursitis (confirmed on endoscopic calcaneoplasty); the control group consisted of 50 patients (59 heels). Results The sensitivity of the test was 83% for observer 1 and 79% for observer 2. Specificity was 100% and 98%, respectively. The kappa value of the interobserver reliability test was 0.86. For observer 1, intraobserver reliability was 0.96 and for observer 2 it was 0.92. Interpretation On digital weight-bearing lateral radiographs of a retrocalcaneal bursitis, the retrocalcaneal recess has a typical appearance. PMID:20450438

  6. Bilateral subacromial bursitis with macroscopic rice bodies: Ultrasound, CT and MR appearance

    Energy Technology Data Exchange (ETDEWEB)

    Law, T.C.; Chong, S.F.; Lu, P.P. [Kwong Wah Hospital (Hong Kong). Department of Radiology; Mak, K.H. [Kwong Wah Hospital (Hong Kong). Department of Orthopaedics and Traumatology

    1998-05-01

    The radiological findings of ultrasound, CT and MR of a case of bilateral subacromial bursitis with macroscopic rice bodies is described. MRI is the investigation of choice and the intravenous gadolinium-enhanced usefulness was noted. The previous literature is also reviewed. Copyright (1998) Blackwell Science Pty Ltd 5 refs., 1 tab., 4 figs.

  7. [Treatment of traumatic lesions of the bursa olecrani and chronic bursitis olecrani].

    Science.gov (United States)

    Saul, D; Dresing, K

    2017-06-01

    Complete olecranon bursectomy with debridement, protection of veins and nerves. Risk-adapted antibiotic therapy and early functional aftercare. Acute, traumatic laceration of the bursa olecrani, chronic therapy-resistant bursitis olecrani. For traumatic bursa injuries: general contraindications for anesthesia and surgery; chronic bursitis: initially not closable skin defect (plastic surgery required), hemodynamically instable patient (e.g. systemic inflammatory response syndrome [SIRS] or sepsis), pre-existing skin infection. Local anesthesia beyond the lesion, careful debridement, identification and removal of the entire bursa, excision of contaminated skin, lavage, drain insertion (Redon, Easy-flow, Penrose). Wound closure, elastic bandage, and splint. Elastic bandage for 2 days, followed by drain removal. Wound assessment, early functional aftercare without splint, antibiotic therapy in septic bursitis for 2 weeks, PRICE scheme. Removal of stitches after 10-12 days. Over 5 years, 138 cases of traumatic bursa lesion or chronic bursitis olecrani were treated in our clinic, 82 patients underwent surgery. Ten patients were treated with vacuum-assisted closure therapy and consecutive wound healing; fistulae occurred in two patients and in another two dehiscence developed. All of the defects could be closed without flaps.

  8. Pes Anserine Bursitis in Symptomatic Osteoarthritis Patients: A Mesotherapy Treatment Study.

    Science.gov (United States)

    Saggini, Raoul; Di Stefano, Alexandra; Dodaj, Ira; Scarcello, Laura; Bellomo, Rosa Grazia

    2015-08-01

    Pes anserine bursitis strongly affects quality of life in patients with osteoarthritis. Treatment includes nonsteroidal anti-inflammatory drugs (NSAIDs), physiotherapy, and injections of corticosteroid, with highly variable responses; recovery can take 10 days to 36 months. Mesotherapy is a minimally invasive technique consisting of subcutaneous injections of bioactive substances. The goal is to modulate the pharmacokinetics of the injected substance and prolong the effects at a local level. To evaluate the effects of mesotherapy with diclofenac for anserine bursitis associated with knee osteoarthritis. One hundred and seventeen patients with anserine bursitis associated with grade II Kellgren-Lawrence knee osteoarthritis, assessed by clinical, radiographic, and ultrasonographic examination, were evaluated and treated. They were randomly divided into two groups (A, mesotherapy; B, control). Group A completed nine sessions of mesotherapy with sodium diclofenac (25 mg/1 mL; Akis®, IBSA, Lugano, Switzerland), 1 mL for each session, three times per week. Group B received 21 oral administrations of sodium diclofenac (50 mg; Voltaren®, Novartis, Parsippany, NJ), once a day for 3 weeks. Primary outcome measures were pain intensity assessed by visual analogue scale (VAS), along with ability to perform activities of daily living, ability to participate in sports, level of pain, symptoms, and quality of life, as assessed by the Knee injury and Osteoarthritis Outcome Score. These measures were performed before and after the treatment period and at 30 and 90 days' follow up. In both groups pain level decreased significantly after the treatment period. Ultrasonography showed a reduction of the hypoechoic area related to anserine bursitis only in group A. Administration of conventional NSAIDs (diclofenac) by mesotherapy is effective in managing anserine bursitis in knee osteoarthritis in the short term and mid-term. These observations could be of interest for efforts

  9. Risk of bursitis and other injuries and dysfunctions of the shoulder following vaccinations.

    Science.gov (United States)

    Martín Arias, L H; Sanz Fadrique, R; Sáinz Gil, M; Salgueiro-Vazquez, M E

    2017-09-05

    While vaccination injection site adverse reactions are usually mild and transient in nature, several cases of bursitis and other shoulder injuries have been reported in the medical literature. However, these lesions are not included in vaccine label inserts. To identify the characteristics of post-vaccination shoulder injuries and those of patients and involved vaccines, as well as their potential causes, a systematic review of the cases of vaccination-related bursitis and other shoulder injuries reported in the literature and notified to the Spanish Pharmacovigilance System database (FEDRA) have been conducted. We found 45 cases of bursitis and other shoulder injuries that appeared following the vaccine intramuscular injection given into the deltoid muscle (37 from the systematic review of the literature, and 8 from the scrutiny in the Spanish Pharmacovigilance System database, FEDRA). All the patients were adult, 71.1% females, with a mean and median age of 53.6years (range: 22-89). The most frequently involved vaccines were influenza and pneumococcal vaccines, respectively; followed by diphtheria-tetanus-pertussis, diphtheria-tetanus toxoid, human papillomavirus, and hepatitis A vaccines. The most frequent shoulder lesion was bursitis. Most of patients required medical care due to severe local pain and arm mobility restriction. In a majority of cases, symptoms started 48h post vaccination. Subdeltoid or subacromial bursitis and other shoulder lesions may be more common than suspected. Such lesions predominantly affect women. The cause may be related to antigens or adjuvants contained in the vaccines that would trigger an immune or inflammatory response. However, they are more likely to be the consequence of a poor injection technique (site, angle, needle size, and failure to take into account patient's characteristics, i. e., sex, body weight, and physical constitution). Therefore, vaccination-related shoulder injuries would be amenable to prevention. Copyright

  10. Pes Anserine Bursitis in Symptomatic Osteoarthritis Patients: A Mesotherapy Treatment Study

    Science.gov (United States)

    Di Stefano, Alexandra; Dodaj, Ira; Scarcello, Laura; Bellomo, Rosa Grazia

    2015-01-01

    Abstract Background: Pes anserine bursitis strongly affects quality of life in patients with osteoarthritis. Treatment includes nonsteroidal anti-inflammatory drugs (NSAIDs), physiotherapy, and injections of corticosteroid, with highly variable responses; recovery can take 10 days to 36 months. Mesotherapy is a minimally invasive technique consisting of subcutaneous injections of bioactive substances. The goal is to modulate the pharmacokinetics of the injected substance and prolong the effects at a local level. Objective: To evaluate the effects of mesotherapy with diclofenac for anserine bursitis associated with knee osteoarthritis. Methods: One hundred and seventeen patients with anserine bursitis associated with grade II Kellgren-Lawrence knee osteoarthritis, assessed by clinical, radiographic, and ultrasonographic examination, were evaluated and treated. They were randomly divided into two groups (A, mesotherapy; B, control). Group A completed nine sessions of mesotherapy with sodium diclofenac (25 mg/1 mL; Akis®, IBSA, Lugano, Switzerland), 1 mL for each session, three times per week. Group B received 21 oral administrations of sodium diclofenac (50 mg; Voltaren®, Novartis, Parsippany, NJ), once a day for 3 weeks. Primary outcome measures were pain intensity assessed by visual analogue scale (VAS), along with ability to perform activities of daily living, ability to participate in sports, level of pain, symptoms, and quality of life, as assessed by the Knee injury and Osteoarthritis Outcome Score. These measures were performed before and after the treatment period and at 30 and 90 days' follow up. Results: In both groups pain level decreased significantly after the treatment period. Ultrasonography showed a reduction of the hypoechoic area related to anserine bursitis only in group A. Conclusion: Administration of conventional NSAIDs (diclofenac) by mesotherapy is effective in managing anserine bursitis in knee osteoarthritis in the short term and

  11. One- vs 2-Stage Bursectomy for Septic Olecranon and Prepatellar Bursitis: A Prospective Randomized Trial.

    Science.gov (United States)

    Uçkay, Ilker; von Dach, Elodie; Perez, Cédric; Agostinho, Americo; Garnerin, Philippe; Lipsky, Benjamin A; Hoffmeyer, Pierre; Pittet, Didier

    2017-07-01

    To assess the optimal surgical approach and costs for patients hospitalized with septic bursitis. From May 1, 2011, through December 24, 2014, hospitalized patients with septic bursitis at University of Geneva Hospitals were randomized (1:1) to receive 1- vs 2-stage bursectomy. All the patients received postsurgical oral antibiotic drug therapy for 7 days. Of 164 enrolled patients, 130 had bursitis of the elbow and 34 of the patella. The surgical approach used was 1-stage in 79 patients and 2-stage in 85. Overall, there were 22 treatment failures: 8 of 79 patients (10%) in the 1-stage arm and 14 of 85 (16%) in the 2-stage arm (Pearson χ2 test; P=.23). Recurrent infection was caused by the same pathogen in 7 patients (4%) and by a different pathogen in 5 (3%). Outcomes were better in the 1- vs 2-stage arm for wound dehiscence for elbow bursitis (1 of 66 vs 9 of 64; Fisher exact test P=.03), median length of hospital stay (4.5 vs 6.0 days), nurses' workload (605 vs 1055 points), and total costs (Sw₣6881 vs Sw₣11,178; all Pbursitis requiring hospital admission, bursectomy with primary closure, together with antibiotic drug therapy for 7 days, was safe, effective, and resource saving. Using a 2-stage approach may be associated with a higher rate of wound dehiscence for olecranon bursitis than the 1-stage approach. Clinicaltrials.gov Identifier: NCT01406652. Copyright © 2017 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  12. Septic and non-septic olecranon bursitis in the accident and emergency department--an approach to management.

    Science.gov (United States)

    Stell, I M

    1996-01-01

    Olecranon bursitis is relatively common. One third of episodes are septic. Most of the remainder are non-septic, with occasional rheumatological causes. Trauma can cause both septic and non-septic olecranon bursitis. Clinical features are helpful in separating septic from non-septic olecranon bursitis, but there may be local erythema in both. Aspiration should be carried out in all cases, and if the presence of infection is still in doubt, microscopy, Gram staining, and culture of the aspirate will resolve the issue. Septic olecranon bursitis should be treated by aspiration, which may need to be repeated, and a long course of antibiotics. Some cases will need admission, and a few will need surgical treatment. Non-septic olecranon bursitis can be managed with aspiration alone. Non-steroidal anti-inflammatory drugs probably hasten symptomatic improvement. Intrabursal corticosteroids produce a rapid resolution but concern remains over their long term local effects. Recovery from septic olecranon bursitis can take months. PMID:8894865

  13. Carrageenan-induced subacromial bursitis caused changes in the rat's rotator cuff.

    Science.gov (United States)

    Tillander, B; Franzén, L E; Nilsson, E; Norlin, R

    2001-05-01

    This study was designed to investigate the histologic expression of the rat's supra- and infraspinatus tendons in carrageenan-induced subacromial bursitis. Thirty-two rats received subacromial injections with carrageenan (n = 28) or saline (n = 4). The tendons were analysed microscopically after staining with hematoxyline eosin, Van Giesons hematoxyline and immunofluorescent staining of fibronectin and fibrinogen. In the controls (saline x 10) and group A (carrageenan x 5) there were no changes in the tendons. In group B (carrageenan x 10) 3/8 rats showed macrophages between the collagen fibres and an increased staining of fibronectin. In group C (double dosis carrageenan) all rats had signs of fibrocartilaginous metaplasia in the supraspinatus tendon. In eight of these specimens even bony metaplasia was seen. The infraspinatus tendon showed fibrosis but no fibrocartilaginous metaplasia. The results showed that iatrogenic bursitis after carrageenan subacromial injections was associated with marked changes of the supraspinatus tendon.

  14. Olecranon Bursitis Caused by Candida parapsilosis in a Patient with Rheumatoid Arthritis

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    Carla F. Gamarra-Hilburn

    2016-01-01

    Full Text Available Septic bursitis is usually caused by bacterial organisms. However, infectious bursitis caused by fungi is very rare. Herein, we present a 68-year-old woman with long-standing rheumatoid arthritis who developed pain, erythema, and swelling of the right olecranon bursa. Aspiration of the olecranon bursa showed a white blood cell count of 3.1×103/μL (41% neutrophils, 30% lymphocytes, and 29% monocytes. Fluid culture was positive for Candida parapsilosis. She was treated with caspofungin 50 mg intravenously daily for 13 days followed by fluconazole 200 mg orally daily for one week. She responded well to this treatment but had recurrent swelling of the bursa. Bursectomy was recommended but she declined this option. This case, together with other reports, suggests that the awareness of uncommon pathogens, their presentation, and predisposing risk factors are important to establish an early diagnosis and prevent long-term complications.

  15. Septic bursitis: a case report and primer for the emergency clinician.

    Science.gov (United States)

    Wasserman, Adrienne R; Melville, Laura D; Birkhahn, Robert H

    2009-10-01

    We describe the case of a 44-year-old man who presented to the Emergency Department (ED) complaining of pain and swelling over the left elbow of 1-week duration. After olecranon bursal aspiration, synovial fluid analysis yielded an increased white blood cell count (3040 cells/mm(3)) and the presence of bacteria. Culture of the fluid later grew Staphylococcus aureus. The patient was initially treated with oral antibiotics for septic bursitis and returned to the orthopedics clinic for follow-up 2 days later with interval worsening of symptoms. He was subsequently admitted for parenteral antibiotics and surgical wash-out of the affected bursa. This report briefly discusses the clinical history and appropriate diagnostic evaluation for septic olecranon bursitis, as well as the shortcomings of existing treatment guidelines.

  16. Olecranon Bursitis Caused by Candida parapsilosis in a Patient with Rheumatoid Arthritis.

    Science.gov (United States)

    Gamarra-Hilburn, Carla F; Rios, Grissel; Vilá, Luis M

    2016-01-01

    Septic bursitis is usually caused by bacterial organisms. However, infectious bursitis caused by fungi is very rare. Herein, we present a 68-year-old woman with long-standing rheumatoid arthritis who developed pain, erythema, and swelling of the right olecranon bursa. Aspiration of the olecranon bursa showed a white blood cell count of 3.1 × 10(3)/μL (41% neutrophils, 30% lymphocytes, and 29% monocytes). Fluid culture was positive for Candida parapsilosis. She was treated with caspofungin 50 mg intravenously daily for 13 days followed by fluconazole 200 mg orally daily for one week. She responded well to this treatment but had recurrent swelling of the bursa. Bursectomy was recommended but she declined this option. This case, together with other reports, suggests that the awareness of uncommon pathogens, their presentation, and predisposing risk factors are important to establish an early diagnosis and prevent long-term complications.

  17. Bilateral Olecranon Bursitis – A Rare Clinical presentation of Calcium Pyrophosphate Crystal Deposition Disease

    Science.gov (United States)

    Patel, Jignesh; Girishkumar; Mruthyunjaya; Rupakumar, C. S

    2014-01-01

    Introduction: Calcium pyrophosphate crystal deposition disease (CPPD) is the most common form of crystal arthropathy second only to gout. Common clinical presentation is an acute monoarticular arthritis commonly occurring in knee joints. We presented a case of bilateral olecranon bursitis in a calcium pyrophosphate crystal deposition disease. Case Report: A 42-year-old female patient is presented with golf ball sized painless swellings in the posterior aspect of her elbows. Elbow joints were clinically normal except for restriction of terminal flexion. X-ray showed mild erosion at the tip of olecranon. Excision biopsy of the swelling showed positive birefringent calcium pyrophosphate dehydrate crystals on the inner wall of the specimen on polarized light microscopy. Conclusion: Bilateral olecranon bursitis may be part of the extraarticular manifestations of calcium pyrophosphate dihydrate crystal deposition disease with good prognosis following in toto bursa excision. PMID:27298934

  18. Paecilomyces lilacinus olecranon bursitis in an immunocompromised host: case report and review.

    Science.gov (United States)

    Wessolossky, Mireya; Haran, John P; Bagchi, Kaushik

    2008-07-01

    Paecilomyces lilacinus is a little-known mold that causes rare cases of invasive infections in humans regardless of their immune status. We present a unique case in an immunocompromised host with olecranon bursitis because of multidrug-resistant P. lilacinus treated with systemic ketoconazole therapy and surgical debridement. Recognition of this fungus is difficult initially because of its appearance, which can be confused with that of other fungi. Once this organism has been identified, it is recommended that antifungal susceptibility testing be obtained to guide appropriate therapy. Combination of therapeutic modalities requires case-by-case assessment. Surgical debridement and removal of prosthesis may be indicated. Although P. lilacinus can be a laboratory contaminant, in our case, causation was established as the organism grew in repeated cultures, sufficient to confirm a fungal origin for his bursitis.

  19. Bilateral Olecranon Bursitis - A Rare Clinical presentation of Calcium Pyrophosphate Crystal Deposition Disease.

    Science.gov (United States)

    Patel, Jignesh; Girishkumar; Mruthyunjaya; Rupakumar, C S

    2014-01-01

    Calcium pyrophosphate crystal deposition disease (CPPD) is the most common form of crystal arthropathy second only to gout. Common clinical presentation is an acute monoarticular arthritis commonly occurring in knee joints. We presented a case of bilateral olecranon bursitis in a calcium pyrophosphate crystal deposition disease. A 42-year-old female patient is presented with golf ball sized painless swellings in the posterior aspect of her elbows. Elbow joints were clinically normal except for restriction of terminal flexion. X-ray showed mild erosion at the tip of olecranon. Excision biopsy of the swelling showed positive birefringent calcium pyrophosphate dehydrate crystals on the inner wall of the specimen on polarized light microscopy. Bilateral olecranon bursitis may be part of the extraarticular manifestations of calcium pyrophosphate dihydrate crystal deposition disease with good prognosis following in toto bursa excision.

  20. Large bursitis formation associated with osteochondroma of the scapula: magnetic resonance imaging findings

    Directory of Open Access Journals (Sweden)

    Elif Karadeli

    2016-03-01

    Full Text Available Osteochondroma is the most common benign bone tumors. 27-year-old man was admitted with complaints of increased swelling of the left shoulder motion. After imaging and histological examination diagnosed osteochondroma. Pain is often connected to the mechanical effect of environmental osteochondroma tissue mass is the result of symptoms. This can result in bursitis. [Cukurova Med J 2016; 41(0.100: 95-97

  1. Rice body formation in bicipito-radial bursitis: ultrasound, CT, and MRI findings

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    Spence, L.D.; Adams, J.; Eustace, S. [Department of Radiology, Boston Medical Center, One Boston Medical Center Place, Boston MA 02118 (United States); Gibbons, D. [Department of Pathology, Boston Medical Center, Boston, Massachusetts (United States); Mason, M.D. [Department of Orthopedics, Boston Medical Center, Boston, Massachusetts (United States)

    1998-01-01

    The bicipito-radial bursa, which lies at the biceps tendon insertion on the radial tuberosity, is a rare site of chronic bursitis. We describe the clinical, radiological, and pathological findings in a case complicated by multiple rice body formation. In so doing, we describe MR appearances that allow discrimination of this entity from both synovial chondromatosis and pigmented villonodular synovitis. (orig.) With 3 figs., 8 refs.

  2. [Treatment of septic olecranon and patellar bursitis by excision and vacuum-assisted closure therapy].

    Science.gov (United States)

    Walter, G; Kemmerer, M; Hoffmann, R

    2013-08-01

    Treatment of septic olecranon and patellar bursitis differs considerably and is currently under discussion. We therefore performed a retrospective study of our patients with septic bursitis in the past 5 years. Between March 2007 and February 2012 we treated 79 patients with septic olecranon (n = 43) and patellar (n = 36) bursitis surgically: 61-males, 18 females, age 51 (range: 11-91) years. Four patients had not been treated before, 25 had suffered recurrences after 1-10 previous procedures, and 9 patients had not improved after conservative therapy. 34 patients presented with traumatic rupture or fistula of their bursae. In all cases we performed a radical bursectomy and vacuum-assisted therapy for 4 to 5 days. In addition, patients received systemic antibiotics. We phoned all patients and were successful in 57 cases (72 %). We questioned these patients for range of movement, limitations at work, pain, sensibility disorder, satisfaction with the result and further surgical procedures. In all cases we took tissue specimens for cultures, in 48 preparations histological examination was performed. Microbiological and histological results are discussed in detail. 40 patients were free of complaints, 15 complained of mild pain, 54 of 57 had unlimited range of motion. Minor discomforts at desk work were reported by 5 of 43 patients, 12 out of 36 patient reported discomfort when performing on their knees. There was no recurrence in the period of investigation. We recommend our treatment concept for septic olecranon and patellar bursitis because patient satisfaction is high and recurrences are reliably avoided. The soft tissue is spared, so that plastic covering procedures are seldom necessary. Georg Thieme Verlag KG Stuttgart · New York.

  3. Ultrasound-guided shoulder injections in the treatment of subacromial bursitis.

    Science.gov (United States)

    Chen, Max J L; Lew, Henry L; Hsu, Tsz-Ching; Tsai, Wen-Chung; Lin, Wei-Ching; Tang, Simon F T; Lee, Ya-Chen; Hsu, Rex C H; Chen, Carl P C

    2006-01-01

    To investigate the treatment effectiveness between ultrasound-guided and blind injection techniques in the treatment of subacromial bursitis. A total of 40 patients with sonographic confirmation of subacromial bursitis were recruited into this study. These patients were divided into blind and ultrasound-guided injection groups. The shoulder abduction range of motion was compared before injections and 1 wk after the completion of injections in both groups. The shoulder abduction range of motion before injection in the blind injection group was 71.03 +/- 12.38 degrees and improved to 100 +/- 18.18 degrees 1 wk after the injection treatments. However, the improvement did not reveal significant statistical differences (P > 0.05). The shoulder abduction range of motion before injection in the ultrasound-guided injection group was 69.05 +/- 14.72 degrees and improved to 139.29 +/- 20.14 degrees 1 wk after the injection treatments (P subacromial bursa. The ultrasound-guided injection technique can result in significant improvement in shoulder abduction range of motion as compared with the blind injection technique in treating patients with subacromial bursitis.

  4. Atypical extraspinal musculoskeletal tuberculosis in immunocompetent patients: Part II, tuberculous myositis, tuberculous bursitis, and tuberculous tenosynovites

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    Abdelwahab, I.F. [Coney Island Hospital, Brooklyn, New York (United States); Bianchi, S. [Clinique et Fondation des Grangettes, Geneva (Switzerland)]. E-mail: stefanobianchi@bluewin.ch; Martinoli, C. [Universita di Genova, Cattedra di Radiologia, DICMI, Genoa (Italy); Klein, M. [Univ. of Alabama School of Medicine, Dept. of Pathology, Birmingham, Alabama (United States); Hermann, G. [Mount Sinai Medical Center, Dept. of Radiology, New York, New York (United States)

    2006-12-15

    Tuberculosis involving the soft tissue from adjacent bone or joint is well recognized. However, primary tuberculous pyomyositis, tuberculous bursitis, and tuberculous tenosynovitis are rare entities constituting 1% of skeletal tuberculosis. Tuberculosis tenosynovitis involves most commonly the tendon sheaths of the hand and wrist, and tuberculous bursitis occurs most commonly around the hip. The greater trochanteric bursa and the greater trochanter are the most frequent sites of tuberculous bursitis. Cases of primary tuberculous pyomyositis and tenosynovitis of the tendons of the ankle and foot are seldom reported in the radiology literature. All imaging modalities - plain radiography, bone scan, computed tomography, and magnetic resonance imaging (MRI) - provide information that is helpful in determining therapy. MRI in particular, with its multiplanar capabilities and superb contrast of soft tissue, can demonstrate the extent of the soft tissue mass and access the adjacent bones and joints. However, MRI has no diagnostic specificity in regard to tuberculosis, and in nonendemic areas, biopsy is strongly recommended. All patients in this review were permanent residents of North America or Western Europe and were immunocompetent. Examples of atypical presentations of the above entities are demonstrated. (author)

  5. Bursite iliopectínea: relato de caso Iliopectineal bursitis: case report

    Directory of Open Access Journals (Sweden)

    Eduardo Amaral Gomes

    2010-10-01

    Full Text Available A bursite iliopectínea, embora não tenha muitos relatos na literatura, apresenta-se clinicamente com sinais e sintomas frequentemente encontrados nos ambulatórios e consultórios. Sua clínica é de dor na parte anterior do quadril que piora à extensão, abdução e rotação interna do mesmo. O diagnóstico é confirmado pelo ultrassom ou ressonância nuclear magnética do quadril. A bursite iliopectínea responde bem ao tratamento conservador com anti-inflamatório não hormonal e repouso. Devido a esta boa evolução, não raro, pode-se tratar uma bursite iliopectínea com sucesso sem se saber o que está tratando.Although there are not many reports in literature, iliopectineal bursitis presents clinically with signs and symptoms frequently found in outpatient services and practice. Its clinical presentation is anterior hip pain that worsens with the extension, abduction and internal rotation of the hip. The diagnosis is confirmed by ultrasound or magnetic nuclear resonance imaging of the hip. The iliopectineal bursitis responds well to conservative treatment with non-hormonal anti-inflammatory drugs and rest. Due to its good evolution, it is not rare to treat iliopectineal bursitis successfully without even knowing what is being treated.

  6. Chronic Open Infective Lateral Malleolus Bursitis Management Using Local Rotational Flap

    Directory of Open Access Journals (Sweden)

    Yong-Beom Lee

    2017-01-01

    Full Text Available Background. Using a sinus tarsi rotational flap is an uncommon approach to treating chronic open infective lateral malleolus bursitis. Methods. We treated eight patients, including six males, using this approach. First, we debrided all the infected tissues and used a negative pressure wound closure system where needed. After acute infection had been controlled, the local rotational flap was used for cases where the wound could not be closed by a simple suture or bone exposure. The rotational flap was detached with a curved skin incision at the sinus tarsi next to the open wound and sutured to the defect, paying careful attention to the superficial peroneal nerve. The donor site was managed with a split-thickness skin graft. Results. The patients’ mean age was 74.1 years. Six patients had a wound after suppurative infection, but two patients had ulcer-type bursitis. Six patients demonstrated full flap healing, but two patients had venous congestion necrosis. Conclusion. A sinus tarsi rotational flap is a useful method to ensure healing and coverage of chronic open lateral malleolus bursitis, especially for small to medium wounds with cavity and bone exposure.

  7. Femoral nerve palsy caused by ileopectineal bursitis after total hip replacement: a case report

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    Bähr Mathias

    2011-05-01

    Full Text Available Abstract Introduction Infectious ileopectineal bursitis is a rare complication after total hip replacement and is associated mainly with rheumatoid arthritis. The main complications are local swelling and pain, but communication of the inflamed bursa with the joint can occur, leading to subsequent cartilage damage and bone destruction. Case presentation We report a case of a 47-year-old Caucasian woman without rheumatoid arthritis who reported pain and palsy in her left leg almost one year after total hip replacement. She was diagnosed with an ileopectineal bursitis after total hip replacement, leading to femoral nerve palsy. The diagnosis was obtained by thorough clinical examination, the results of focused computed tomography and magnetic resonance imaging. Conclusion To the best of our knowledge, this is the first report of non-infectious ileopectineal bursitis in a patient without rheumatoid arthritis as a complication of total hip replacement. This rare case underlines the importance of proper neurologic examination of persistent conditions after orthopedic intervention in otherwise healthy individuals. We believe this case should be useful for a broad spectrum of medical specialties, including orthopedics, neurology, radiology, and general practice.

  8. A case of brucellosis with abscess of the iliacus muscle, olecranon bursitis, and sacroiliitis.

    Science.gov (United States)

    Turan, Hale; Serefhanoglu, Kivanc; Karadeli, Elif; Timurkaynak, Funda; Arslan, Hande

    2009-11-01

    Brucellosis is a systemic infection involving many organs and tissues. The musculoskeletal system is one of the most commonly affected. The disease can present with sacroiliitis, peripheral arthritis, spondylitis, paraspinal abscess, bursitis, and osteomyelitis. A 25-year-old male patient was admitted with fever of 20-day duration, right-sided hip pain, and night sweating. A Brucella standard tube agglutination test was positive at a titer of 1/160. Magnetic resonance imaging (MRI) of the hip joint showed right sacroiliitis and a hyperintense, nodular, lobulated mass within the right iliacus muscle, consistent with abscess. The patient was started on intramuscular streptomycin at a dose of 1 g/day, oral rifampin 600 mg/day, and doxycycline 200 mg/day. On day 20 of treatment, the patient was admitted with swelling and pain over the left elbow for the past week. MRI of the left elbow was performed, which showed fluid edema suggestive of olecranon bursitis. Taking the patient's complaints into consideration, rifampin and doxycycline treatment were maintained for a year. Pain at the hip joint and elbow resolved and MRI findings disappeared. Abscess of the iliacus muscle, which has not been reported before, and the olecranon bursitis that developed during treatment make this case worth presenting.

  9. Tratamiento acupuntural de la bursitis subdeltoidea calcificada en la atención primaria de salud Acupuncture treatment of calcified subdeltoid bursitis in health primary care

    Directory of Open Access Journals (Sweden)

    Orlando Manuel Pérez Rivera

    2009-09-01

    Full Text Available Se presenta el caso de un paciente del sexo masculino, de 43 años de edad, con historia de dolor en el hombro derecho desde hace aproximadamente 3 meses, a raíz de una contusión superficial, el cual recibió tratamiento conservador con reposo y medicamentos, pero no resolvió la sintomatología. Ahora, con diagnóstico de bursitis subdeltoidea calcificada, recibe tratamiento acupuntural en el Departamento de Medicina Natural y Tradicional de la sala de rehabilitación de su área de salud. Se presenta esta variante de tratamiento mediante sus estudios radiológicos.This is the case of a male patient aged 43 with a pain history in right shoulder of approximately 3 months ago caused by a superficial contusion receiving conservative treatment with rest and drugs, without symptoms resolution. For the tine being time diagnosed with calcified subdeltoid bursitis and acupuncture treatment in Natural and Traditional Medicine Service of rehabilitation ward of his health area. This treatment variant is presented by its radiologic studies.

  10. Popliteal cysts and subgastrocnemius bursitis are associated with knee symptoms and structural abnormalities in older adults: a cross-sectional study

    Science.gov (United States)

    2014-01-01

    Introduction The role of popliteal cysts and subgastrocnemius bursitis in knee joint homeostasis is uncertain. The aim of this study is to describe cross-sectional associations between popliteal cysts, subgastrocnemius bursitis, knee symptoms and structural abnormalities in older adults. Methods A cross-sectional sample of 900 randomly-selected subjects (mean age 63 years, 48% female) were studied. Knee pain, stiffness and dysfunction were assessed by self-administered Western Ontario McMaster Osteoarthritis Index (WOMAC) questionnaire. Radiographic knee osteophyte and joint space narrowing (JSN) were recorded. Magnetic resonance imaging (MRI) was utilized to assess popliteal cysts, subgastrocnemius bursitis, cartilage defects and bone marrow lesions (BMLs). Results Popliteal cysts were present in 11.7% and subgastrocnemius bursitis in 12.7% of subjects. Subgastrocnemius bursitis was more common in those with popliteal cyst (36.2% versus 9.7%, P bursitis was associated with increased osteophytes and JSN in the medial tibiofemoral compartment. Both were significantly associated with cartilage defects in all compartments, and with BMLs in the medial tibiofemoral compartment. Furthermore, both popliteal cysts and subgastrocnemius bursitis were significantly associated with increased weight-bearing knee pain but these associations became non-significant after adjustment for cartilage defects and BMLs. Conclusions Popliteal cysts and subgastrocnemius bursitis are associated with increased symptoms as well as radiographic and MRI-detected joint structural abnormalities. Longitudinal data will help resolve if they are a consequence or a cause of knee joint abnormalities. PMID:24581327

  11. MR imaging after rotator cuff repair: full-thickness defects and bursitis-like subacromial abnormalities in asymptomatic subjects.

    Science.gov (United States)

    Zanetti, M; Jost, B; Hodler, J; Gerber, C

    2000-06-01

    To determine the prevalence and extent of residual defects or retears and bursitis-like subacromial abnormalities on MR images after rotator cuff repair in asymptomatic subjects, and to define the clinical relevance of these findings. Fourteen completely asymptomatic patients and 32 patients with residual symptoms were investigated 27-53 months (mean 39 months) after open transosseous reinsertion of the rotator cuff. Coronal T2-weighted turbo spin-echo and turbo STIR or T2-weighted fat-suppressed MR images were obtained. The prevalence and extent of residual defects or retears of the rotator cuff and bursitis-like subacromial abnormalities were determined. Residual defects or retears were detected in three (21%) and bursitis-like abnormalities in 14 (100%) of the 14 asymptomatic patients. Fifteen (47%) residual defects or retears and 31 (97%) bursitis-like abnormalities were diagnosed in the 32 patients with residual symptoms. The size of the residual defects/retears was significantly smaller in the asymptomatic group (mean 8 mm, range 6-11 mm) than in the symptomatic group (mean 32 mm, range 7-50 mm) (t-test, P = 0.001). The extent of the bursitis-like subacromial abnormalities did not significantly differ (t-test, P > 0.05) between asymptomatic (mean 28 x 3 mm) and symptomatic patients (mean 32 x 3 mm). Small residual defects or retears (Subacromial bursitis-like MR abnormalities are almost always seen after rotator cuff repair even in patients without residual complaints. They may persist for several years after rotator cuff repair and appear to be clinically irrelevant.

  12. MR imaging after rotator cuff repair: full-thickness defects and bursitis-like subacromial abnormalities in asymptomatic subjects

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    Zanetti, M.; Hodler, J. [Dept. of Radiology, University Hospital Balgrist, Zurich (Switzerland); Jost, B.; Gerber, C. [Dept. of Orthopedic Surgery, University Hospital Balgrist, Zurich (Switzerland)

    2000-06-01

    Objective. To determine the prevalence and extent of residual defects or retears and bursitis-like subacromial abnormalities on MR images after rotator cuff repair in asymptomatic subjects, and to define the clinical relevance of these findings.Design and patients. Fourteen completely asymptomatic patients and 32 patients with residual symptoms were investigated 27-53 months (mean 39 months) after open transosseous reinsertion of the rotator cuff. Coronal T2-weighted turbo spin-echo and turbo STIR or T2-weighted fat-suppressed MR images were obtained. The prevalence and extent of residual defects or retears of the rotator cuff and bursitis-like subacromial abnormalities were determined.Results. Residual defects or retears were detected in three (21%) and bursitis-like abnormalities in 14 (100%) of the 14 asymptomatic patients. Fifteen (47%) residual defects or retears and 31 (97%) bursitis-like abnormalities were diagnosed in the 32 patients with residual symptoms. The size of the residual defects/retears was significantly smaller in the asymptomatic group (mean 8 mm, range 6-11 mm) than in the symptomatic group (mean 32 mm, range 7-50 mm) (t-test, P=0.001). The extent of the bursitis-like subacromial abnormalities did not significantly differ (t-test, P>0.05) between asymptomatic (mean 28 x 3 mm) and symptomatic patients (mean 32 x 3 mm).Conclusion. Small residual defects or retears (<1 cm) of the rotator cuff are not necessarily associated with clinical symptoms. Subacromial bursitis-like MR abnormalities are almost always seen after rotator cuff repair even in patients without residual complaints. They may persist for several years after rotator cuff repair and appear to be clinically irrelevant. (orig.)

  13. Case Report of Pes Anserine Bursitis patient treated with Bee Venom Acua-Acupuncture Therapy by Using DITI

    Directory of Open Access Journals (Sweden)

    Moon Ja-Young

    2004-02-01

    Full Text Available Objective : The purpose of this study is to report the effect of Bee Venom Acua-Acupuncture Therapy to the patient of Pes Anserine Bursitis by using DITI. Patient & Methods : The patient was 60-year-old woman who complained severe knee pain. She was treated by bee venom acuaacupuncture therapy. To estimate the efficacy of tratment, we used DITI, visual analog scale, knee joint check(ROM. Results : In this case, we treated patient of Pes Anserine Bursitis for 28 days. bee venom acua-acupuncture therapy efficiently relieved patient's pain and improved ROM. DITI and Visual analog scale also showed significantly valuable changes.

  14. Is ultrasound-guided injection more effective in chronic subacromial bursitis?

    Science.gov (United States)

    Hsieh, Lin-Fen; Hsu, Wei-Chun; Lin, Yi-Jia; Wu, Shih-Hui; Chang, Kae-Chwen; Chang, Hsiao-Lan

    2013-12-01

    Although ultrasound (US)-guided subacromial injection has shown increased accuracy in needle placement, whether US-guided injection produces better clinical outcome is still controversial. Therefore, this study aimed to compare the efficacy of subacromial corticosteroid injection under US guidance with palpation-guided subacromial injection in patients with chronic subacromial bursitis. Patients with chronic subacromial bursitis were randomized to a US-guided injection group and a palpation-guided injection group. The subjects in each group were injected with a mixture of 0.5 mL dexamethasone suspension and 3 mL lidocaine into the subacromial bursa. The primary outcome measures were the visual analog scale for pain and active and passive ranges of motion of the affected shoulder. Secondary outcome measures were the Shoulder Pain and Disability Index, the Shoulder Disability Questionnaire, and the 36-item Short-Form Health Survey (SF-36). The primary outcome measures were evaluated before, immediately, 1 wk, and 1 month after the injection; the secondary outcome measures were evaluated before, 1 wk, and 1 month after the injection. Of the 145 subjects screened, 46 in each group completed the study. Significantly greater improvement in passive shoulder abduction and in physical functioning and vitality scores on the SF-36 were observed in the US-guided group. The pre- and postinjection within-group comparison revealed significant improvement in the visual analog scale for pain and range of motion, as well as in the Shoulder Pain and Disability Index, Shoulder Disability Questionnaire, and SF-36 scores, in both groups. The US-guided subacromial injection technique produced significantly greater improvements in passive shoulder abduction and in some items of the SF-36. US is effective in guiding the needle into the subacromial bursa in patients with chronic subacromial bursitis.

  15. Lumbar interspinous bursitis (Baastrup disease) in a symptomatic population: prevalence on magnetic resonance imaging.

    Science.gov (United States)

    Maes, Robbert; Morrison, Willam B; Parker, Laurence; Schweitzer, Mark E; Carrino, John A

    2008-04-01

    Cross-sectional retrospective review of 539 patients with lumbar spine magnetic resonance imaging (MRI). The purpose of this study was to determine the prevalence of lumbar posterior element interspinous bursitis (Baastrup disease) and to measure the association with degenerative disc disease findings, deformities, age, and gender in symptomatic people. Case reports and small case series describing Baastrup disease exist. The prevalence of Baastrup disease on MRI and association with other degenerative-related findings has not been reported. The study group consisted of 539 patients (51% males, 49% females; age range, 7-89 years old) undergoing routine lumbar spine MRI using sagittal T1-weighted, sagittal T2-weighted, and axial T2-weighted pulse sequences. Retrospective consensus review by 2 observers evaluated for the presence of: fluid intervening between consecutive spinous processes (criterion for Baastrup disease), disc degeneration (spondylosis) and contour abnormalities (bulges, herniations), marrow endplate signal alteration (Modic changes), central canal stenosis, lordosis, scoliosis, and displacement (anterolisthesis, retrolisthesis). Statistical analyses were descriptive statistics and determining associations between these MRI findings and Baastrup disease (using chi and Wilcoxon rank sums). Lumbar interspinous bursitis (Baastrup disease) was present in 8.2% (44 of 539) of the study population. There were associations between the presence of Baastrup disease and age (P = 0.001), central canal stenosis (P = 0.0013), disc bulging (P = 0.0341), and anterolisthesis (P = 0.0429). There were not associations between Baastrup disease and disc degeneration, disc herniation, endplate findings, retrolisthesis, scoliosis, lordosis, or gender. Lumbar interspinous bursitis (Baastrup disease) is uncommon but not infrequent in symptomatic patients undergoing lumbar spine MRI. Patients with MRI evident Baastrup disease tend to be older, have central canal stenosis

  16. Prepatellar and olecranon bursitis: literature review and development of a treatment algorithm.

    Science.gov (United States)

    Baumbach, Sebastian F; Lobo, Christopher M; Badyine, Ilias; Mutschler, Wolf; Kanz, Karl-Georg

    2014-03-01

    Olecranon bursitis and prepatellar bursitis are common entities, with a minimum annual incidence of 10/100,000, predominantly affecting male patients (80 %) aged 40-60 years. Approximately 1/3 of cases are septic (SB) and 2/3 of cases are non-septic (NSB), with substantial variations in treatment regimens internationally. The aim of the study was the development of a literature review-based treatment algorithm for prepatellar and olecranon bursitis. Following a systematic review of Pubmed, the Cochrane Library, textbooks of emergency medicine and surgery, and a manual reference search, 52 relevant papers were identified. The initial differentiation between SB and NSB was based on clinical presentation, bursal aspirate, and blood sampling analysis. Physical findings suggesting SB were fever >37.8 °C, prebursal temperature difference greater 2.2 °C, and skin lesions. Relevant findings for bursal aspirate were purulent aspirate, fluid-to-serum glucose ratio 3,000 cells/μl, polymorphonuclear cells >50 %, positive Gram staining, and positive culture. General treatment measures for SB and NSB consist of bursal aspiration, NSAIDs, and PRICE. For patients with confirmed NSB and high athletic or occupational demands, intrabursal steroid injection may be performed. In the case of SB, antibiotic therapy should be initiated. Surgical treatment, i.e., incision, drainage, or bursectomy, should be restricted to severe, refractory, or chronic/recurrent cases. The available evidence did not support the central European concept of immediate bursectomy in cases of SB. A conservative treatment regimen should be pursued, following bursal aspirate-based differentiation between SB and NSB.

  17. Subacromial bursitis with giant rice bodies as initial presentation of rheumatoid arthritis.

    Science.gov (United States)

    Subramaniam, Ramesh; Tan, Justina Wei Lyn; Chau, Cora Yuk Ping; Lee, Keng Thiam

    2012-10-01

    Rice body formation is a nonspecific response to chronic synovial inflammation associated with tuberculous arthritis, rheumatoid arthritis, juvenile rheumatoid arthritis, seronegative inflammatory arthritis, and even osteoarthritis. Such bodies were termed rice bodies because of their close resemblance to grains of polished white rice. We present a case report of a middle-aged woman with right shoulder subacromial/subdeltoid bursitis with giant rice body formation as her initial presentation of rheumatoid arthritis. Her right shoulder symptoms resolved after subacromial and subdeltoid bursectomy and removal of the rice bodies. She subsequently developed inflammatory arthritis of other joints, met the criteria for rheumatoid arthritis, and has been treated medically.

  18. Two Cases of Subacromial Bursitis with Many Loose Bodies as a Cause of Rheumatoid Arthritis

    OpenAIRE

    砂川, 融; 杉村, 功; 堀, 司郎; 村岡, 博; 有田, 淳

    1989-01-01

    Rice bodies caused by T.B. and R.A. in joints are relatively common and reported, but in bursa are rare. We experienced two cases of subacromial bursitis with many rice bodies :one is a 53-year-old female and the other is a 62-year-old male. They were suffering from rheumatoid arthritis for years, and complained of swelling of the shoulder joint, but had no pain and no remarkable limitation of range of motion of the shoulder joint. We resected the bursa containing a lot of rice bodies operati...

  19. Idiopathic or traumatic olecranon bursitis. Clinical features and bursal fluid analysis.

    Science.gov (United States)

    Canoso, J J

    1977-01-01

    Thirty cases of idiopathic olecranon bursitis were studied. Most had previous local trauma. The process was unilateral and often associated with nontender pitting edema in cases of short duration. Ten patients exhibited a bony spur at the olecranon process, and amorphous calcific deposits were seen in 6. The bursal fluid was hemorrhagic with a xanthochromic supernatant, and the mucin clot test was poor or fair. Leukocyte count averaged 878/mm3, predominantly mononuclears. Many cells contained inclusion bodies. Glucose, total protein, and complement (C3) concentration averaged 80, 60, and 60% of the respective serum values.

  20. Compressive Ulnar Neuropathy Caused by Olecranon Bursitis and Concomitant Epidermal Cyst: A Case Report.

    Science.gov (United States)

    Yamazaki, Hiroshi; Shinone, Michitaka; Kato, Hiroyuki

    2017-12-01

    Epidermal cyst is a dermal or subcutaneous epithelial cyst that contains keratin and is lined by true epidermis. Although extremely rare, it can cause pathology including nerve compression syndrome. We report a rare case of ulnar nerve compression in the elbow that was caused by olecranon bursitis and concomitant epidermal cyst in a 67-year-old man. The ulnar nerve was immediately adjacent to the olecranon bursa and was significantly compressed. There was no connection between the tumor and the ulnar nerve. Pain, numbness, and weakness in his ring and little fingers disappeared after resection of the cyst and bursa.

  1. Successful Treatment of Gluteal Pain from Obturator Internus Tendinitis and Bursitis with Ultrasound-Guided Injection.

    Science.gov (United States)

    Chen, Boqing; Rispoli, Leia; Stitik, Todd; Leong, Michelle

    2017-10-01

    This case report describes what the authors believe is the first case of a patient with obturator internus tendinitis and bursitis successfully treated with a corticosteroid injection using a trans-tendinous lateral to medial approach. The patient presented with right gluteal pain not relieved by physical therapy or right hip and ischial bursa corticosteroid injections. Pelvic and lumbar spine MRIs and EMG/NCS findings were unremarkable. Physical examination demonstrated tenderness to palpation at the right middle lower gluteal region. Ultrasound imaging with sonopalpation identified the maximal local tender point as the right obturator internus muscle and/or its underlying bursa. A 22-gauge 3.5-inch needle was inserted in-plane to the transducer and longitudinal to the obturator internus from a lateral to medial direction, an approach previously described in cadavers. The obturator internus tendon sheath and bursa were injected with 2.5 ml of 0.5% lidocaine combined with 10 mg of triamcinolone. The patient reported immediate complete relief of pain with continued relief at 2 and 6 months post-injection. This case report demonstrates an injection of the obturator internus tendon sheath and bursa using a trans-tendinous approach, which may be successful for treatment of patients presenting with persistent gluteal pain from obturator internus tendinitis and bursitis.

  2. Fungal Olecranon Bursitis in an Immunocompetent Patient by Knoxdaviesia dimorphospora sp. nov.: Case Report and Review.

    Science.gov (United States)

    Guevara-Suarez, Marcela; Llaurado, Marta; Pujol, Isabel; Mayayo, Emilio; Martin-Vicente, Adela; Gené, Josepa

    2017-10-09

    Bursitis is a common medical condition that can occur either with or without infection. We present a case of fungal olecranon bursitis in an immunocompetent individual caused by the new species Knoxdaviesia dimorphospora. It is a dematiaceous filamentous fungus characterized by the production of two different conidia: hyaline and cylindrical, which rise up from phialidic conidiogenous cells located in the upper part of differentiated and unbranched conidiophores, and pale brown and ellipsoidal conidia produced by phialidic conidiogenous cells which are born directly on hyphae. In addition to its morphological peculiarities, the novelty of the fungus was confirmed by sequence analysis of the internal transcribed spacer (ITS) regions and D1/D2 domains of the 28S of the nuclear rRNA gene. The fungal infection was confirmed by cytological examination and repeated cultures. The infection was resolved by surgical debridement and drainage, and the patient presented a complete functional recovery 3 months later. The in vitro antifungal susceptibility to this new human opportunist is provided, terbinafine being the drug with the most potent activity.

  3. Popliteal cysts and subgastrocnemius bursitis are associated with knee symptoms and structural abnormalities in older adults: a cross-sectional study.

    Science.gov (United States)

    Cao, Yuelong; Jones, Graeme; Han, Weiyu; Antony, Benny; Wang, Xia; Cicuttini, Flavia; Ding, Changhai

    2014-03-03

    The role of popliteal cysts and subgastrocnemius bursitis in knee joint homeostasis is uncertain. The aim of this study is to describe cross-sectional associations between popliteal cysts, subgastrocnemius bursitis, knee symptoms and structural abnormalities in older adults. A cross-sectional sample of 900 randomly-selected subjects (mean age 63 years, 48% female) were studied. Knee pain, stiffness and dysfunction were assessed by self-administered Western Ontario McMaster Osteoarthritis Index (WOMAC) questionnaire. Radiographic knee osteophyte and joint space narrowing (JSN) were recorded. Magnetic resonance imaging (MRI) was utilized to assess popliteal cysts, subgastrocnemius bursitis, cartilage defects and bone marrow lesions (BMLs). Popliteal cysts were present in 11.7% and subgastrocnemius bursitis in 12.7% of subjects. Subgastrocnemius bursitis was more common in those with popliteal cyst (36.2% versus 9.7%, P weight-bearing knee pain but these associations became non-significant after adjustment for cartilage defects and BMLs. Popliteal cysts and subgastrocnemius bursitis are associated with increased symptoms as well as radiographic and MRI-detected joint structural abnormalities. Longitudinal data will help resolve if they are a consequence or a cause of knee joint abnormalities.

  4. Suture slippage in knotless suture anchors resulting in subacromial-subdeltoid bursitis.

    Science.gov (United States)

    Hayeri, Mohammad Reza; Keefe, Daniel T; Chang, Eric Y

    2016-05-01

    Rotator cuff repair using a suture bridge and knotless suture anchors is a relatively new, but increasingly used technique. The suture bridge technique creates an anatomically similar and more secure rotator cuff repair compared with conventional arthroscopic techniques and the use of knotless anchors eliminates the challenges associated with knot tying during arthroscopic surgery. However, previous in vitro biomechanical tests have shown that the hold of the suture in a knotless suture anchor is far lower than the pullout strength of the anchor from bone. Up until now slippage has been a theoretical concern. We present a prospectively diagnosed case of in vivo suture loosening after rotator cuff repair using a knotless bridge technique resulting in subacromial-subdeltoid bursitis.

  5. Research Regarding some Live Attenuated Vaccines Used in Immunoprophylaxis of the Avian Infectious Bursitis

    Directory of Open Access Journals (Sweden)

    Emil Tirziu

    2010-10-01

    Full Text Available In our research four live attenuated vaccines against avian infectious bursitis (two inland produced and two imported were tested: Biavac, Biaromvac-Pa, Gumboro Vaccine Nobilis 228e and Live Virus Vaccine Tablets Gumboro, M.B. Strain. The research was made in production conditions on 44,400 broiler chickens maintained in industrial system and raised on bedding and in batteries. The broilers were kept in four poultry houses, each of them representing an experimental group. We mention that vaccines were administered only one time. Vaccines efficiency was assessed by immunoenzymatic test. In that purpose, for each poultry house, 20 broilers were isolated and identified by a tibial ring, their immune response being followed between 5 and 42 days of age. Analyzing the results about individual antibodies titer during the experiment, the significant differences were observed both in poultries and phases. The best results were obtained using Live Virus Vaccine Tablets Gumboro, M.B. strain.

  6. Baastrup's Disease, Interspinal Bursitis, and Dorsal Epidural Cysts: Radiologic Evaluation and Impact on Treatment Options.

    Science.gov (United States)

    Hatgis, Jesse; Granville, Michelle; Jacobson, Robert E

    2017-07-09

    Baastrup's disease or "kissing spines syndrome" was first described as a cause of lumbar pain before computerized tomography (CT) and magnetic resonance imaging (MRI) scanning existed. The diagnosis was based on x-ray studies, which showed that the spinous processes, especially in the lower lumbar spine, became approximated to each other and this was a generator of positional back pain. Biomechanically, the interspinous and supraspinous ligaments that are degenerated in Baastrup's disease normally contribute significantly to sagittal alignment. Ligamentous stenosis and anterolisthesis would be the expected pathology with deterioration of these ligaments and were initially described on CT and MRI in patients with symptoms similar to Baastrup's disease as isolated individual case reports. This review will highlight the relationship between the various clinical presentations, biomechanics, and overlap of Baastrup's disease with interspinous bursitis, segmental stenosis, and instability, presenting them as a disease continuum rather than as separate disease processes.

  7. A cluster of septic olecranon bursitis in association with infantry training.

    Science.gov (United States)

    Wasserzug, O; Balicer, R D; Boxman, J; Klement, E; Ambar, R; Zimhony, O

    2011-01-01

    Septic olecranon bursitis (OB) is caused primarily by Staphylococcus aureus (SA) usually in association with occupations involving trauma to the elbows. An outbreak of septic OB was identified in an infantry platoon. The severity of the injury to the skin overlying the elbows was scored and compared to a parallel platoon of the same unit. All soldiers were tested for SA carriage and pulse field gel electrophoresis (PFGE) was performed on available isolates. Nine cases of septic OB were identified only in platoon A. The significant risk factor for septic OB was a moderately or severely injured elbow (RR = 3.86). SA was isolated from the anterior nares and elbows of 29/36 (80.6%) of the soldiers in the unit (platoons A + B); however, this did not account for the difference in morbidity between the two platoons. This is the first report of a cluster of septic OB in association with intense infantry training.

  8. Protothecal bursitis after simultaneous kidney/liver transplantation: a case report and review.

    Science.gov (United States)

    Ramírez, I; Nieto-Ríos, J F; Ocampo-Kohn, C; Aristizábal-Alzate, A; Zuluaga-Valencia, G; Muñoz Maya, O; Pérez, J C

    2016-04-01

    Solid organ transplantation is an accepted therapy for end-stage diseases of the kidneys, liver, heart, and lungs. Unfortunately, transplantation is associated with infectious complications. Here, we present a case report of Prototheca wickerhamii olecranon bursitis and review all of the cases in solid organ transplant (SOT) recipients published in the literature to date. In our patient, the infection resolved with surgical therapy and limited antifungal therapy, and no symptoms have recurred over 24 months of follow-up. A review of the literature suggests that 50% of SOT recipients with Prototheca infection present with disseminated infection, and the overall mortality is 75%. More studies are required to determine the optimal management of protothecosis in this population. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  9. Evaluation of current treatment regimens for prepatellar and olecranon bursitis in Switzerland.

    Science.gov (United States)

    Baumbach, S F; Wyen, H; Perez, C; Kanz, K-G; Uçkay, I

    2013-02-01

    Bursitis is a common entity. However, evidence for the best treatment procedures is lacking, with management concepts varying internationally. We evaluated current treatment regimens for septic (SB) and nonseptic (NSB) prepatellar (PB) and (OB) olecranon bursitis in Switzerland and compared them to the published literature. A voluntary 23-item online survey was distributed amongst all registered Swiss infectiologists and orthopedic surgeons in December 2011. The literature comparison was based on a systematic literature review. Overall response rate was 14 % (n = 117); 11 % (n = 92) were included in the final analysis. The overwhelming majority (91 %) of the respondents differentiated between SB and NSB, with determination predominantly based on clinical presentation (83 %), blood chemistry (75 %), and bursal aspirate (66 %). NSB was predominantly treated conservatively via immobilization (78 %) and anti-inflammatory medication (73 %). For SB, 85 % indicated surgical intervention, with 73 % prescribing concomitant antibiotics. Regarding antibiotic choice, 90 % used an aminopenicillin or its derivatives for a mean of 11 ± 5 days. The literature review revealed 66 relevant publications with an overall level of evidence of 2b, arguing for a conservative treatment approach in cases of SB or NSB. Therapeutic regimens for OB/PB differed considerably within Switzerland. Surgical intervention and antibiotic treatment was the most common therapy for SB, whereas a conservative approach predominated for NSB, which contrasts with the international literature. Clearly, prospective multicenter and multidisciplinary studies are needed to identify an optimal and cost-saving approach to the treatment of these common clinical entities.

  10. Acute Calcific Bursitis After Ultrasound-Guided Percutaneous Barbotage of Rotator Cuff Calcific Tendinopathy: A Case Report.

    Science.gov (United States)

    Kang, Bo-Sung; Lee, Seung Hak; Cho, Yung; Chung, Sun Gun

    2016-08-01

    Ultrasound-guided percutaneous barbotage is an effective treatment for rotator cuff calcific tendinopathy, providing rapid and substantial pain relief. We present the case of a 49-year-old woman with aggravated pain early after ultrasound-guided barbotage of a large calcific deposit in the supraspinatus tendon. Subsequent examination revealed a thick calcification spreading along the subacromial-subdeltoid bursa space, suggesting acute calcific bursitis complicated by barbotage. Additional barbotage alleviated her pain completely. Therefore, a high index of suspicion for acute calcific bursitis is required in patients with unresolved or aggravated pain after barbotage. Repeated barbotage could be effective for this condition. Copyright © 2016 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  11. Outcome of horses undergoing navicular bursotomy for the treatment of contaminated or septic navicular bursitis: 19 cases (2002-2016).

    Science.gov (United States)

    Suarez-Fuentes, D G; Caston, S S; Tatarniuk, D M; Kersh, K D; Ferrero, N R

    2017-08-05

    Contaminated or septic navicular bursitis has been reported to have a guarded prognosis after surgical treatment with navicular bursotomy only. In our experience, the use of navicular bursotomy for the treatment of this disease in combination with systemic and local delivery of antimicrobials can provide a good prognosis, even in horses with chronic disease. To report the outcome of horses undergoing navicular bursotomy for the treatment of contaminated or septic navicular bursitis. Descriptive case series. Navicular bursotomy was performed in combination with systemic and local antimicrobial therapies. Medical records (2002-2016) were reviewed. Follow-up information was obtained from owners or referring veterinarians. Horse outcome was divided into two groups. A successful outcome (Group 1) was assigned to horses that were able to return to the same level of use or performance as before contamination/infection. A satisfactory outcome (Group 2) was assigned to horses that survived but did not return to their previous function or level of performance. All horses survived to hospital discharge. Follow-up was obtained from 4 months to 12.75 years after surgery. Sixteen horses were able to return to their previous level of use (84.2%) and three horses were able to return to a lower level of performance or were pasture sound (15.8%). All 19 owners were satisfied with the outcome. Small sample size and retrospective nature of the study. Follow-up was limited to telephone contact with owners and referring veterinarians, and there is potential for recall bias. Navicular bursotomy in combination with systemic and local antimicrobial therapies is an effective treatment for contaminated or septic navicular bursitis. The success rate in this population makes navicular bursotomy worthy of consideration in cases of contaminated or septic navicular bursitis, especially with chronicity and/or where equipment or expertise for bursoscopy is unavailable. © 2017 EVJ Ltd.

  12. Mycobacterium avium complex olecranon bursitis resolves without antimicrobials or surgical intervention: A case report and review of the literature.

    Science.gov (United States)

    Working, Selene; Tyser, Andrew; Levy, Dana

    2015-01-01

    Nontuberculous mycobacteria are an uncommon cause of septic olecranon bursitis, though cases have increasingly been described in both immunocompromised and immunocompetent hosts. Guidelines recommend a combination of surgical resection and antimicrobials for treatment. This case is the first reported case of nontuberculous mycobacterial olecranon bursitis that resolved without medical or surgical intervention. A 67-year-old female developed a painless, fluctuant swelling of the olecranon bursa following blunt trauma to the elbow. Due to persistent bursal swelling, she underwent three separate therapeutic bursal aspirations, two involving intrabursal steroid injection. After the third aspiration, the bursa became erythematous and severely swollen, and bursal fluid grew Mycobacterium avium complex. Triple-drug antimycobacterial therapy was initiated, but discontinued abruptly due to a rash. Surgery was not performed. The patient was observed off antimicrobials, and gradually clinically improved with a compressive dressing. By 14 months after initial presentation, clinical exam revealed complete resolution of the previously erythematous bursal mass. This is the first reported case of nontuberculous mycobacterial olecranon bursitis managed successfully without surgery or antimicrobials. Musculoskeletal nontuberculous mycobacterial infections are challenging given the lack of clinical data about optimal duration and choice of antimicrobials or the role of surgery. Additionally, the potential toxicity and drug interactions of antimycobacterials are not insignificant and warrant close monitoring if treatment is pursued. This case raises an important clinical question of whether close observation off antimicrobials is appropriate in select cases of immunocompetent patients with localized atypical mycobacterial disease of soft tissue and skeletal structures.

  13. Olecranon Bursitis in a Military Population: Epidemiology and Evidence for Prolonged Morbidity in Combat Recruits.

    Science.gov (United States)

    Schermann, Haggai; Karakis, Isabella; Dolkart, Oleg; Maman, Eran; Kadar, Assaf; Chechik, Ofir

    2017-09-01

    Olecranon bursitis (OB) is a benign but disturbing condition that may adversely affect a military recruit's combat preparedness. This study was designed to assess incidence, risk factors, and associated medical burden of OB in the Israel Defense Forces. This is a retrospective study drawing on medical records of all Israel Defense Forces soldiers diagnosed as having OB between 2005 and 2015. OB was classified as septic and noninfectious. Crude incidence rates and duty-specific incidence rates were calculated. Medical burden was defined by the number of physician visits, referrals to orthopedic specialist consultations, duration of symptoms, and duration of pharmaceutical treatment. Demographic and occupational information (age, sex, height, weight, socioeconomic status, country of origin, type of military service, time of presentation to medical services) was used to identify risk factors for septic bursitis and longer duration of symptoms. Statistical analysis was performed in R statistical software. Risk factors were evaluated using the Chi-square test for categorical variables and Pearson correlation coefficients were used for continuous variables. The study was approved by the Israeli Defense Force IRB. A total of 2,692 soldiers were diagnosed with OB during the study period. The crude annual incidence rate of OB was 29/100,000 person-years (PY). Combat duty had an incidence of 97/100,000 PY, and noncombat duties had an incidence of 12/10,000 PY (p bursitis constituted 24% of all cases, was more frequent in combat soldiers (32%), and on average presented earlier in service than noninfectious OB (13 vs. 17 weeks since recruitment). The mean duration of symptoms was estimated at 17.58 weeks, with a mean of 1.75 physician visits per soldier. About 19% received a specialist referral. Origin from the former USSR was associated with a higher duration of symptoms (p = 0.012). Type of military service was the principal risk factor for OB, as indicated by a higher

  14. Infectious olecranon and patellar bursitis: short-course adjuvant antibiotic therapy is not a risk factor for recurrence in adult hospitalized patients.

    Science.gov (United States)

    Perez, Cédric; Huttner, Angela; Assal, Mathieu; Bernard, Louis; Lew, Daniel; Hoffmeyer, Pierre; Uçkay, Ilker

    2010-05-01

    No evidence-based recommendations exist for the management of infectious bursitis. We examined epidemiology and risk factors for recurrence of septic bursitis. Specifically, we compared outcome in patients receiving bursectomy plus short-course adjuvant antibiotic therapy (7 days). Retrospective study of adult patients with infectious olecranon and patellar bursitis requiring hospitalization at Geneva University Hospital from January 1996 to March 2009. We identified 343 episodes of infectious bursitis (237 olecranon and 106 patellar). Staphylococcus aureus predominated among the 256 cases with an identifiable pathogen (85%). Three hundred and twelve cases (91%) were treated surgically; 142 (41%) with one-stage bursectomy and closure and 146 with two-stage bursectomy. All received antibiotics for a median duration of 13 days with a median intravenous component of 3 days. Cure was achieved in 293 (85%) episodes. Total duration of antibiotic therapy [odds ratio (OR) 0.9; 95% confidence interval (95% CI) 0.8-1.1] showed no association with cure. In multivariate analysis, only immunosuppression was linked to recurrence (OR 5.6; 95% CI 1.9-18.4). Compared with 14 days of antibiotic treatment (OR 0.9; 95% CI 0.1-10.7) was equivalent, as was the intravenous component (OR 1.1; 95% CI 1.0-1.3). In severe infectious bursitis requiring hospitalization, adjuvant antibiotic therapy might be limited to 7 days in non-immunosuppressed patients.

  15. Bone erosion and subacromial bursitis caused by diphtheria-tetanus-poliomyelitis vaccine.

    Science.gov (United States)

    Salmon, J H; Geoffroy, M; Eschard, J P; Ohl, X

    2015-11-17

    Revaxis(®) is a vaccine against diphtheria, tetanus and poliomyelitis (dT-IPV). This vaccine should not be administered by the intradermal or intravenous route. Poor injection techniques and related consequences are rare. We report a case of bursitis associated with reactive glenohumeral effusion complicated by bone erosion occurring after injection of the dT-IPV vaccine. A 26 year old patient was admitted for painful left shoulder causing functional impairment. Control magnetic resonance imaging showed bone oedema on the upper outer part of the humeral head, with a slight cortical irregularity, indicating that the vaccine was injected in contact with the bone at this location, causing erosion. Outcome was favourable after intra-articular corticosteroids. Reports of articular or periarticular injury after vaccination are extremely rare, in view of the substantial number of vaccines administered every year. The potential complications of vaccination are well known to general practitioners but under-reported in the literature. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. Massive subacromial-subdeltoid bursitis with rice bodies secondary to an orthopedic implant.

    Science.gov (United States)

    Urruela, Adriana M; Rapp, Timothy B; Egol, Kenneth A

    2012-09-01

    Both early and late complications following open reduction and internal fixation of proximal humerus fractures have been reported extensively in the literature. Although orthopedic implants are known to cause irritation and inflammation, to our knowledge, this is the first case report to describe a patient with rice bodies secondary to an orthopedic implant. Although the etiology of rice bodies is unclear, histological studies reveal that they are composed of an inner amorphous core surrounded by collagen and fibrin. The differential diagnosis in this case included synovial chondromatosis, infection, and the formation of a malignant tumor. Additional imaging studies, such as magnetic resonance imaging, and more specific tests were necessary to differentiate the rice bodies due to bursitis versus neoplasm, prior to excision. The patient presented 5 years following open reduction and internal fixation of a displaced proximal humerus fracture, with swelling in the area of the previous surgical site. Examination revealed a large, painless tumor-like mass on the anterior aspect of the shoulder. The patient's chief concern was the unpleasant aesthetic of the mass; no pain was reported. Upon excision of the mass, the patient's full, painless range of motion returned.

  17. Prevalence of subacromial-subdeltoid bursitis in shoulder pain: an ultrasonographic study.

    Science.gov (United States)

    Draghi, Ferdinando; Scudeller, Luigia; Draghi, Anna Guja; Bortolotto, Chandra

    2015-06-01

    The presence of the subacromial-subdeltoid (SASD) bursa inflammation has recently been proposed as a primary radiologic factor predicting persistent limitation and pain in operated patients. The aim of the study was to verify the hypothesis that pain, or increased shoulder pain, could be associated with SASD bursitis not only in operated patients but also in general population. A consecutive series of 1940 shoulder ultrasound examinations were performed by our Department over a 5-year period using linear multi-frequency probes. All reports of examination executed for shoulder pain were reviewed. The video clips were independently reviewed by two radiologists: effusion in the SASD bursa and the presence of other pathological conditions were evaluated and confirmed. A total of 1147 shoulder video clips were re-evaluated, and 1587 pathologies were detected; 65.5 % of patients had only one pathology, 30.4 % had two and 4.1 % presented three pathologies. The difference between the group with and without effusion is statistically significant for acromioclavicular joint arthritis, supraspinatus tendon calcific tendinopathy, full-thickness and superficial tear of the supraspinatus, traumas and rheumatoid arthritis with a p value <0.01. Our study shows that the effusion in the SASD bursa is frequently associated with shoulder pain often independently from the underlying pathology; further studies are needed to confirm the statistical significance of this relationship by clarifying possible confounding factors.

  18. Olecranon septic bursitis managed in an ambulatory setting. The Calgary Home Parenteral Therapy Program Study Group.

    Science.gov (United States)

    Laupland, K B; Davies, H D

    2001-08-01

    The epidemiology, outcome and management of olecranon septic bursitis (OSB) have not been described in a large cohort of ambulatory patients. A retrospective study of all 118 cases of OSB presenting over 21 months to all regional Home Parenteral Therapy Program clinics in Calgary (referral base approximately 1 million). The minimum population annual incidence was 10/100,000. The mean (and standard deviation) age was 44 (13) years, and males predominated (88%). One-third of patients had at least one comorbid illness, with preceding injury in 53% of cases. The most common symptoms were pain (87%), redness (77%) and fever or chills (45%). Common signs included erythema (92%), swelling (85%), edema (75%), tenderness (59%), fluctuance (50%), heat (36%) and reduced range of motion (27%). Fever (body temperature of > or =37.8 degrees C) occurred in 20%. Staphylococcus aureus was identified in 88% of culture-proven cases of OBS. The most common antibiotic regimen was sequential intravenous administration of cefazolin (for a median of 4 d) followed by clindamycin orally (for a median of 8 d). Sixty (51%) patients required a drainage procedure and only 1 patient required admission to hospital. OSB is more common than reported and can be treated successfully in ambulatory settings with sequential intravenous therapy followed by oral therapy and drainage in selected cases.

  19. Stromal cell-derived factor 1 (SDF-1, CXCL12) is increased in subacromial bursitis and downregulated by steroid and nonsteroidal anti-inflammatory agents.

    Science.gov (United States)

    Kim, Yang-Soo; Bigliani, Louis U; Fujisawa, Motoyuki; Murakami, Koko; Chang, Seong-Sil; Lee, Hahn-Jun; Lee, Francis Y; Blaine, Theodore A

    2006-08-01

    Several studies have demonstrated that inflammation in the subacromial bursa is an important component in the pathogenesis of impingement syndrome. We have demonstrated in a previous study that many inflammatory cytokines, including stromal cell-derived factor 1 (SDF-1, CXCL12), are increased in the subacromial bursa [Blaine et al. 2005. J Shoulder Elbow Surg 14(Suppl 1):84S-89S]. SDF-1 is a potent chemotactic and angiogenic factor that stimulates recruitment of inflammatory cells. In the current study, we proposed that the resident cells in subacromial bursal tissue produce SDF-1, which can play a role in the inflammatory reponse of bursal tissue, and that this chemokine can be regulated by steroid (dexamethasone) and nonsteroidal anti-inflammatory medications (NSAIDs). Twenty-two subacromial bursa tissues (18 bursitis and 4 normal bursa) were obtained intraoperatively from patients during shoulder surgery and analyzed using the cDNA Array technique in accordance with an IRB approved protocol. cDNA array results were confirmed with real-time reverse transcription-polymerase chain reaction (RT-PCR). Bursal cells (from 4 normal bursa, 3 bursitis) and two normal bone marrow with whole tissue explants were cultured for one passage. Cell culture supernatants were collected and SDF-1 protein was detected with enzyme-linked immunosorbent assay (ELISA). Cultured bursal cells were treated with a COX-2 inhibitor and dexamethasone, and cells was harvested at 1-day and 4-day intervals. SDF-1 expression was evaluated by real-time RT-PCR and ELISA. cDNA Array analysis demonstrated that the gene expression of SDF-1 was increased in patients with subacromial bursitis compared to controls (p bursitis tissue is increased 10-fold over control tissue. While the normal bursal cells produced negligible amounts of SDF-1 protein, cultured cells derived from bursitis lesion released as much SDF-1 protein (235 pg/100,000 cells) as normal bone marrow stromal cells (283 pg/100,000 cells) as

  20. A Randomized Trial Among Compression Plus Nonsteroidal Antiinflammatory Drugs, Aspiration, and Aspiration With Steroid Injection for Nonseptic Olecranon Bursitis.

    Science.gov (United States)

    Kim, Joon Yub; Chung, Seok Won; Kim, Joo Hak; Jung, Jae Hong; Sung, Gwang Young; Oh, Kyung-Soo; Lee, Jong Soo

    2016-03-01

    Olecranon bursitis might be a minor problem in the outpatient clinic but relatively be common to occur. However, there are few well-designed studies comparing approaches to treatment. (1) Which treatment (compression bandaging with nonsteroidal antiinflammatory drugs [NSAIDs], aspiration, or aspiration with steroid injections) is associated with the highest likelihood of resolution of nonseptic olecranon bursitis? (2) Which treatment is associated with earliest resolution of symptoms? (3) What factors are associated with treatment failure by 4 weeks? We enrolled 133 patients from two centers; after applying prespecified exclusions (septic bursitis or concomitant inflammatory arthritis, intraarticular elbow pathology, recent aspiration or steroid injection done elsewhere, and refusal to participate), 90 patients were randomly allocated to receive compression bandaging with NSAIDs (C), aspiration (A), or aspiration with steroid injection (AS) groups (30 patients in each). The groups were similar at baseline in terms of age and gender. Seven patients (four from Group A and three from Group AS) were lost to followup. All patients were followed up weekly for 4 weeks, and the same treatment procedure was repeated if the bursitis recurred with any substantial fluid collection. At 4 weeks, the state of resolution and pain visual analog scale (VAS) were evaluated. Failed resolution was defined as presence of persistent olecranon bursal fluid collection at Week 4 after the initiation of the treatment; on the contrary, if bursal fluid collection was clinically reduced or completely disappeared by the end of Week 4, the treatment was considered successful. We compared the proportion of resolution by Week 4 and the median times to resolution among the treatment groups. In addition, we evaluated whether the resolution affected pain VAS and what factors were associated with the resolution. There were no differences in the proportion of patients whose bursitis resolved by Week 4

  1. Surgery for Retrocalcaneal Bursitis: A Tendon-splitting versus a Lateral Approach

    Science.gov (United States)

    Anderson, John A.; Suero, Eduardo; O’Loughlin, Padhraig F.

    2008-01-01

    For patients with refractory retrocalcaneal bursitis (Haglund’s syndrome), the most effective surgical approach has not been defined. We asked whether patients undergoing the tendon-splitting approach and the lateral approach would have comparably effective relief of pain for both types of calcaneal ostectomies. We retrospectively reviewed 30 patients (31 feet) who underwent the tendon-splitting approach and compared their results with 32 previous patients (35 feet) who had a lateral incision. Minimum followup was 12 months (mean, 16 months; range, 12–23 months) for the tendon-splitting group and 15 months (mean, 51 months; range, 15–109 months) for the lateral group. The mean American Orthopaedic Foot and Ankle Society score improved from 43 points preoperatively to 81 points (range, 8–100 points) postoperatively in the tendon-splitting group and from 54 points to 86 points (range, 55–100 points) in the lateral group. The mean physical component score of the Short Form-36, version 2, at followup was 52 (range, 22–61) in the tendon-splitting group and 49 (range, 34–63) in the lateral group. The median return to normal function was 4.1 months (range, 3–13 months) in the tendon-splitting group and 6.4 months (range, 4–20 months) in the lateral group. Both approaches to calcaneal ostectomy provided symptomatic pain relief. However, patients in the tendon-splitting group returned to normal function quicker than patients in the lateral group. Level of Evidence: Level III, retrospective comparative study. See the Guidelines for Authors for a complete description of levels of evidence. PMID:18465183

  2. Cloxacillin-based therapy in severe septic bursitis: retrospective study of 82 cases.

    Science.gov (United States)

    Martinez-Taboada, Victor Manuel; Cabeza, Rosario; Cacho, Pedro Muñoz; Blanco, Ricardo; Rodriguez-Valverde, Vicente

    2009-12-01

    The purpose of this retrospective study was to describe a tertiary care center experience with different antibiotic strategies that include cloxacillin (C) in patients with severe septic bursitis (SB). A severe SB was considered when the patient needed hospitalization and/or intravenous (i.v.) antibiotics. Patients were treated with bursal aspiration and one of these antibiotic options: C, 2 g/4 h per day i.v. until improvement, and afterwards 1 g/6 h per day v.o. until resolution; (C+G), gentamicin i.v. was added to C for 5 to 7 days (initial dose 240 mg/d); (C+R), rifampicin was added at a dose of 600 mg/d v.o. The study comprised 82 patients with severe SB. The mean delay to diagnosis was 6.1+/-6.9 days, and the most frequent location was the prepatellar bursa. In 67%, the bursal fluid culture yield a positive result, being Staphylococcus aureus the most frequent bacteria isolated (94.4%). At admission, fever and extensive cellulites were more frequent in the C+G group. Patients in the C+G had a longer duration of i.v. antibiotics compared with the C group (p=0.008), although the total duration of antibiotics was not different. There was a tendency in the C+R group to need more surgery. All patients except one had a complete resolution and there were no differences in side effects. In patients with severe SB without extensive cellulites i.v., C alone may be sufficient. In patients with a more severe presentation, C plus gentamicin seems to be an appropriate option in the majority of them.

  3. Epidural cystic masses associated with interspinous bursitis, synovial and discal cysts; Formacoes cisticas epidurais relacionadas a bursite interespinhosa, cisto sinovial e cisto discal

    Energy Technology Data Exchange (ETDEWEB)

    Santos, Frederico Guilherme de Paula Lopes; Souza, Ricardo Andre de; Brotto, Marcos Pama D' Almeida; Suguita, Fabio Massaaki; Amaral, Denise Tokechi; Amaral, Lazaro Luis Faria do [Hospital Beneficencia Portuguesa de Sao Paulo, Sao Paulo, SP (Brazil). MedImagem], e-mail: fgpls@yahoo.com.br

    2009-03-15

    The authors describe some cases of epidural cysts, namely synovial, discal, ligamentum flavum cysts, and cysts secondary to interspinous bursitis, all of these conditions determining radicular, dural sac compression or spinal canal stenosis. Magnetic resonance imaging findings and localization of these entities are described. (author)

  4. Relation Between Subacromial Bursitis on Ultrasonography and Efficacy of Subacromial Corticosteroid Injection in Rotator Cuff Disease: A Prospective Comparison Study.

    Science.gov (United States)

    Lee, Doo-Hyung; Hong, Ji Yeon; Lee, Michael Young; Kwack, Kyu-Sung; Yoon, Seung-Hyun

    2017-05-01

    To evaluate the correlations between subacromial bursitis (bursal thickening and effusion) on ultrasonography and its response to subacromial corticosteroid injection in patients with rotator cuff disease. Prospective, longitudinal comparison study. University-affiliated tertiary care hospital. Patients with rotator cuff disease (N=69) were classified into 3 groups based on ultrasonographic findings; (1) normative bursa group (group 1, n=23): bursa and effusion thickness 2mm and effusion thickness 2mm. A single subacromial injection with 20mg of triamcinolone acetonide. Visual analog scale (VAS) of shoulder pain, Shoulder Disability Questionnaire (SDQ), angles of active shoulder range of motion (flexion, abduction, external rotation, and internal rotation), and bursa and effusion thickness at pre- and posttreatment at week 8. There were no significant differences between the 3 groups in demographic characteristics pretreatment. Groups 2 and 3 showed a significant difference compared with group 1 in changes on the VAS and abduction; group 3 showed a significant difference compared with group 1 in changes of the SDQ, internal rotation, and external rotation; and all groups showed significant differences when compared with each other (groups 1 and 3, 2 and 3, and 1 and 2) in changes of thickness. A patient with ultrasonographic observation of subacromial bursitis, instead of normative bursa, can expect better outcome with subacromial corticosteroid injection. Therefore, we recommend a careful selection of patients using ultrasonography prior to injection. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  5. Effectiveness of ultrasound-guided injections combined with shoulder exercises in the treatment of subacromial adhesive bursitis.

    Science.gov (United States)

    Gasparre, Giuseppe; Fusaro, Isabella; Galletti, Stefano; Volini, Silvia; Benedetti, Maria Grazia

    2012-05-01

    The aim of this study was to evaluate whether the association of exercises for the shoulder with ultrasound-guided injection into the bursa significantly improves the treatment outcome in adhesive bursitis. Two groups of 35 patients, one treated with ultrasound-guided injection (UGI) and the other one with ultrasound-guided injection and home exercise program (UGI-exercise) for 1 month, were assessed for pain and shoulder function before treatment, 1 and 3 months post-treatment. Fourteen patients in UGI group and 23 patients in the UGI-exercises group were completely free of pain after 1 month (p = 0.031). At 3 months' follow-up, patients in the UGI-exercise group showed a significant improvement with respect to the other group (p = 0.005). No differences were found in function assessment. The UGI combined with shoulder exercises in the treatment of subacromial adhesive bursitis is effective to ensure a more frequent complete pain relief in the medium term.

  6. Septic and nonseptic olecranon bursitis. Utility of the surface temperature probe in the early differentiation of septic and nonseptic cases.

    Science.gov (United States)

    Smith, D L; McAfee, J H; Lucas, L M; Kumar, K L; Romney, D M

    1989-07-01

    Forty-six consecutive cases of olecranon bursitis were prospectively analyzed during a 1-year period. Eleven cases were septic; 35 cases were nonseptic. In addition to bursal fluid analysis, the surface temperature over the involved olecranon bursa and the contralateral (control) olecranon process was obtained by using a surface temperature probe. We compared the temperature difference between the involved and control sides in all septic and nonseptic cases. In nonseptic cases, the mean surface temperature difference was 0.7 degree C vs 3.7 degrees C in septic cases. In all septic cases, the temperature difference was 2.2 degrees C or greater (range, 2.2 degrees C to 5.1 degrees C; SD, 1.1). Use of the surface probe temperature difference proved 100% sensitive and 94% specific in discriminating septic from nonseptic cases. It seems to be more helpful than the bursal fluid leukocyte count, the predominant cell type, or Gram's stain in the early differentiation of septic and nonseptic olecranon bursitis.

  7. Baastrup’s Disease, Interspinal Bursitis, and Dorsal Epidural Cysts: Radiologic Evaluation and Impact on Treatment Options

    Science.gov (United States)

    Granville, Michelle; Jacobson, Robert E

    2017-01-01

    Baastrup’s disease or "kissing spines syndrome" was first described as a cause of lumbar pain before computerized tomography (CT) and magnetic resonance imaging (MRI) scanning existed. The diagnosis was based on x-ray studies, which showed that the spinous processes, especially in the lower lumbar spine, became approximated to each other and this was a generator of positional back pain. Biomechanically, the interspinous and supraspinous ligaments that are degenerated in Baastrup's disease normally contribute significantly to sagittal alignment. Ligamentous stenosis and anterolisthesis would be the expected pathology with deterioration of these ligaments and were initially described on CT and MRI in patients with symptoms similar to Baastrup's disease as isolated individual case reports. This review will highlight the relationship between the various clinical presentations, biomechanics, and overlap of Baastrup's disease with interspinous bursitis, segmental stenosis, and instability, presenting them as a disease continuum rather than as separate disease processes. PMID:28929033

  8. Pharmacopuncture and Autohemo-Seperated Regeneration Pharmacopuncture for Acute Traumatic Subdeltoid Bursitis with Patial Tear of Subscapularis Tendon After Bongchuna Treatment - A Case Report -

    Directory of Open Access Journals (Sweden)

    Won-Kyo Oh

    2011-06-01

    Full Text Available This is a case report about effect of soyeom pharmacopuncture, bee venom and autohemo-seperated regeneration pharmacopuncture(ASRP for acute traumatic subdeltoid bursitis with partial tear of subscapularis tendon, which was diagnosed by symptoms and MRI(Magnetic resonance imaging and caused by bongchuna treatment. We evaluated the patient using Visual Analogue Scale(VAS every two or four days and range of movement(ROM, physical examination of shoulder about one per ten days and observed improvement with reexamination by ultrasonography and MRI as well. Pharmacopuncture rapidly reduced pain and improved range of motion and function of shoulder in patients with acute sub-deltoid bursitis even though it was severe symptom. Our result suggest that autohemo-seperated regeneration pharmacopuncture might be effective in regenerating the tear of soft tissue such as subscapularis tendon.

  9. Raynaud's phenomenon and bilateral olecranon bursitis co-existing in a patient with chronic hepatitis B and D treated with pegylated interferon.

    Science.gov (United States)

    Arain, Shafique Rehman; Umer, Tahira Perveen

    2016-06-01

    Pegylated interferon remains the first line treatment for patients with hepatitis D virus and more than one year therapy may be necessary. Interferon a has the most extensive clinical application and is used for the treatment of chronic hepatitis B and D virus as well as HCV infections. The attachment of polyethylene glycol to interferon increases its half-life. Treatment with peg interferon is associated with many troublesome and occasionally with serious or even life-threatening side effects. In this case report, we have described a patient with chronic hepatitis B and D, who developed Raynaud's phenomenon, ischaemic digital necrosis and bilateral olecranon bursitis during Pegylated interferon therapy. The patient underwent a very extensive workup in order to determine the underlying cause of his digital ischaemia and olecranon bursitis, which was finally determined to be secondary to the use of Pegylated interferon.

  10. Effects of kinesiotaping versus non-steroidal anti-inflammatory drugs and physical therapy for treatment of pes anserinus tendino-bursitis: A randomized comparative clinical trial.

    Science.gov (United States)

    Homayouni, Kaynoosh; Foruzi, Shima; Kalhori, Fereshte

    2016-09-01

    Pes anserinus tendino-bursitis is a condition caused by repetitive friction over the bursa or direct trauma to knee joint and it presents with proximal medial tibial pain and swelling. The aim of this study is to determine the effects of kinesiotaping in comparison with naproxen and physical therapy in treatment of pes anserinus tendino-bursitis. In a randomized comparative clinical trial 56 patients with clinical diagnosis of pes anserinus tendino-bursitis were randomly assigned to kinesiotaping and naproxen/physical therapy (28 patients in each group). Kinesiotaping on the tender area in the form of space-correction (lifting) technique was used and repeated for three times with a one-week interval. Another group received naproxen (250mg TID for 10 days) and ten sessions of daily physical therapy. The visual analog scale (VAS) was used for evaluation of pain. The depth of swelling of the area was measured with sonography before and after treatment. Wilcoxon signed ranks test has been used for determining the influence of interventions on pain (VAS) and swelling scores in each group. The ANCOVA (Analysis of covariance) test was applied for comparing the influence of interventions on VAS and swelling scores after adjustment for co-variables. At end of the study, 27 patients remained in the kinesiotaping group and 19 patients in naproxen/physical therapy group. Treatment with kinesiotaping significantly decreased the pain (P=0.0001) and swelling scores (P=0.0001) in comparison with naproxen/physical therapy after adjustment for baseline characteristics. Kinesiotaping was safe without any complications except for a mild local skin irritation in one patient. Kinesiotaping is more effective than naproxen plus physical therapy in reduction of pain and swelling in patients with pes anserinus tendino-bursitis. www.ClinicalTrials.gov identifier is NCT01680263.

  11. Investigating the Effect of Extracorporeal Shock Wave Therapy on Reducing Chronic Pain in Patients with Pes Anserine Bursitis: A Randomized, Clinical- Controlled Trial

    OpenAIRE

    Saeid Khosrawi; Parisa Taheri; Marziyeh Ketabi

    2017-01-01

    Background: Knee pain, is one of the most common causes of patients? referring to physiatric clinics, and several factors, are involved in its creation. One of these factors is pes anserine bursitis (PAB) for which various treatment methods are used. This study aims to investigate the effect of this method on reducing chronic pain in these patients. Materials and Methods: This clinical trial was conducted in 2013- 2014 on patients with PAB referring to academic, physical medicine clinics. The...

  12. Clinical effectiveness of botulinum toxin type B in the treatment of subacromial bursitis or shoulder impingement syndrome.

    Science.gov (United States)

    Lee, Jung Hwan; Lee, Sang-Ho; Song, Sun Hong

    2011-01-01

    Subacromial steroid injections are used as a treatment method in subacromial bursitis (SB) or shoulder impingement syndrome (SIS). However, the steroid effect is relatively restricted to the short-term and repeated injections are frequently required, which contributes to unwanted side effects. As an alternative, botulinum toxin (BT) has recently been used for pain relief. This study aimed to investigate the clinical effectiveness of BT type B and to compare this with the effectiveness of steroids. Sixty-one patients diagnosed with SB or SIS were divided into 2 groups and treated with BT type B (BT group) and trimacinolone injection (TA group) under ultrasound guidance, respectively. Numeric Rating Scale (NRS), active shoulder abduction angle, and the Korean version of the score on the Disability of Arm, Shoulder, and Hand (DASH) were measured before the treatment, and at 1 and 3 months after the treatment. Both groups obtained a significant improvement of NRS, DASH, and active shoulder abduction at 1 and 3 months follow-up. BT group showed significantly better outcomes in terms of reduction of NRS and DASH at 3 months than TA group. BT group showed strong trend toward the larger degree of active shoulder abduction than the TA group at 3 months follow-up, as well. Whereas, no significant difference was found in NRS, DASH, and active shoulder abduction between the 2 groups at 1 month follow-up. BT type B can be a useful strategy and has great potential for replacing steroids as a treatment for SB or SIS.

  13. Current evidence for effectiveness of interventions for cubital tunnel syndrome, radial tunnel syndrome, instability, or bursitis of the elbow: a systematic review.

    Science.gov (United States)

    Rinkel, Willem D; Schreuders, Ton A R; Koes, Bart W; Huisstede, Bionka M A

    2013-12-01

    To provide an evidence-based overview of the effectiveness of interventions for 4 nontraumatic painful disorders sharing the anatomic region of the elbow: cubital tunnel syndrome, radial tunnel syndrome, elbow instability, and olecranon bursitis. The Cochrane Library, PubMed, Embase, PEDro, and CINAHL were searched to identify relevant reviews and randomized clinical trials (RCTs). Two reviewers independently extracted data and assessed the quality of the methodology. A best-evidence synthesis was used to summarize the results. One systematic review and 6 RCTs were included. For the surgical treatment of cubital tunnel syndrome (1 review, 3 RCTs), comparing simple decompression with anterior ulnar nerve transposition, no evidence was found in favor of either one of these. Limited evidence was found in favor of medial epicondylectomy versus anterior transposition and for early postoperative therapy versus immobilization. No evidence was found for the effect of local steroid injection in addition to splinting. No RCTs were found for radial tunnel syndrome. For olecranon bursitis (1 RCT), limited evidence for effectiveness was found for methylprednisolone acetate injection plus naproxen. Concerning elbow instability, including 2 RCTs, one showed that nonsurgical treatment resulted in similar results compared with surgery, whereas the other found limited evidence for the effectiveness in favor of early mobilization versus 3 weeks of immobilization after surgery. In this review no, or at best, limited evidence was found for the effectiveness of nonsurgical and surgical interventions to treat painful cubital tunnel syndrome, radial tunnel syndrome, elbow instability, or olecranon bursitis. Well-designed and well-conducted RCTs are clearly needed in this field.

  14. Rilonacept in the treatment of subacromial bursitis: A randomized, non-inferiority, unblinded study versus triamcinolone acetonide.

    Science.gov (United States)

    Carroll, Matthew B; Motley, Spencer A; Wohlford, Susanna; Ramsey, Bryan C

    2015-12-01

    Subacromial bursitis is caused by inflammation of the bursa that separates the superior surface of the supraspinatus tendon from the overlying coraco-acromial ligament and acromion. While multiple cytokines are implicated, interleukin-1 beta appears to play a prominent role. Rilonacept, an interleukin-1 trap, may be an alternative to corticosteroid injection for the management of this condition. This single center, randomized, non-inferiority, unblinded study recruited 33 subjects over 9 months. Twenty subjects received 160mg intrabursal injection of rilonacept and 13 received a 6mL mixture of lidocaine, bupivacaine, and 80mg triamcinolone acetonide. QuickDASH, subject reported pain, and adverse events were recorded at time of injection, 2 days later, 2 weeks later, and 4 weeks later. Primary outcome was improvement in QuickDASH 4 weeks post-injection. Secondary outcomes were improvement in subject reported pain and occurrence of adverse events at 4 weeks. Both study groups were equally matched for age, gender, ethnicity, and site of bursa injection. Both medications demonstrated a statistically significant improvement in QuickDASH 4 weeks post-injection, but triamcinolone acetonide injection offered greater improvement (P=0.004). Both medications demonstrated improvement in subject reported pain but between group comparison at 4 weeks showed that triamcinolone was superior (P=0.044). No statistically significant differences in adverse events were noted between groups, but subjects who received rilonacept experienced more episodes of diarrhea and headache. While improvement in QuickDASH and pain was noted with a single intrabursal injection of rilonacept at 4 weeks, injection with triamcinolone acetonide was more efficacious. This trial was registered with www.clinicaltrials.gov (NCT01830699). Copyright © 2015 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

  15. Relationship between years in the trade and the development of radiographic knee osteoarthritis and MRI-detected meniscal tears and bursitis in floor layers. A cross-sectional study of a historical cohort

    DEFF Research Database (Denmark)

    Jensen, Lilli Kirkeskov; Rytter, Søren; Marott, Jacob Louis

    2012-01-01

    An increased risk of developing knee disorders including radiographic knee osteoarthritis (OA) have been shown among workers with kneeling working demands. There may also be a dose-related association between duration of employment in occupations with kneeling work and development of radiographic...... knee OA and magnetic resonance imaging (MRI)-detected meniscal tears and bursitis....

  16. Giant Cell Tumor of the Pes Anserine Bursa (Extra-Articular Pigmented Villonodular Bursitis): A Case Report and Review of the Literature

    Science.gov (United States)

    Zhao, Haitao; Maheshwari, Aditya V.; Kumar, Dhruv; Malawer, Martin M.

    2011-01-01

    Pigmented villonodular synovitis (PVNS) is a rare, benign, proliferating disease affecting the synovium of joints, bursae, and tendon sheaths. Involvement of bursa (PVNB, pigmented villonodular bursitis) is the least common, and only few cases of exclusively extra-articular PVNB of the pes anserinus bursa have been reported so far. We report a case of extra-articular pes anserine PVNB along with a review of the literature. The lesion presented as a painful soft tissue mass in the medial part of the proximal leg. A magnetic resonance imaging showed areas of low to intermediate signals in all sequences and the lesion enhanced heterogeneously with contrast. Diagnosis was confirmed by an incisional biopsy, and an intralesional resection was performed. The postoperative course was uneventful, and the patient is free of disease with no functional deficit at 2 years followup. As with other rare lesions, clinical and radiographic findings in addition to histological examination are essential for correct diagnosis. PMID:21687595

  17. Efectividad de la acupuntura y la auriculoterapia en la bursitis de hombro de pacientes atendidos en el policlínico Tula Aguilera

    Directory of Open Access Journals (Sweden)

    Arely Díaz Cifuentes

    2015-02-01

    Full Text Available Se realizó un estudio experimental con el objetivo de comparar la efectividad de la acupuntura y la auriculoterapia en el tratamiento de la bursitis de hombro, en pacientes que fueron atendidos en el policlínico “Tula Aguilera” de Camagüey, durante el periodo de enero a diciembre de 2013. El universo de estudio estuvo integrado por 250 pacientes que asistieron a la consulta de fisiatría, de dicha área de salud, con el diagnóstico de bursitis de hombro, quedando conformada la muestra por 180 pacientes mayores de 30 años. Se excluyeron los pacientes que usaron tratamiento farmacológico una semana antes, con lesiones dermatológicas en los lugares a puncionar, con trastornos de coagulación y/o psiquiátricos. La muestra se dividió en dos grupos de 90 pacientes cada uno, asignados aleatoriamente, el A tratado con acupuntura y el B con auriculoterapia. Predominaron los pacientes de 40 a 49 años, para un 66,1 %. Los síntomas clínicos se redujeron notablemente a los 15 días con la acupuntura y a los 30 con la auriculoterapia. La recuperación del grado de arco articular, tanto para los movimientos de rotación interna como para los de abducción, fue mayor en los pacientes tratados con acupuntura. Los pacientes que tuvieron un tiempo corto de evolución de la enfermedad antes del tratamiento fueron los que tuvieron mejor respuesta al mismo, con un 52,7 %. Los resultados evidencian la mayor efectividad de la acupuntura

  18. Bursitis of the heel

    Science.gov (United States)

    ... heel is swelling of the fluid-filled sac (bursa) at the back of the heel bone. ... A bursa acts as a cushion and lubricant between tendons or muscles sliding over bone. There are bursas around ...

  19. The Morel-Lavallée Lesion as a Rare Differential Diagnosis for Recalcitrant Bursitis of the Knee: Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Ivor S. Vanhegan

    2012-01-01

    Full Text Available A 72 year-old-male was referred to our institution with recalcitrant prepatellar bursitis. The injury was sustained after striking his right knee against a post whilst horse riding 9 months ago. Previous treatments included repeated aspiration and excision of the bursa with elastic compression bandaging. A diagnosis of a Morel-Lavallée internal degloving injury was made, and the lesion was satisfactorily managed by an internal quilting procedure to eliminate the potential dead space. A review of the literature reveals 29 published reports of Morel-Lavallée lesions with sufficient information for inclusion. These came from 14 separate countries with a total of 204 lesions in 195 patients. The most common anatomical location was the greater trochanter/hip (36%, followed by the thigh (24% and the pelvis (19%. Most were managed surgically with evacuation of the haematoma and necrotic tissue followed by debridement, which was often repeated (36%. Conservative treatment with percutaneous aspiration and compression bandaging was the next most common treatment (23%. The knee was the fourth most common region affected (16%, and only 3 other lesions in the literature have been managed with a quilting procedure.

  20. Investigating the Effect of Extracorporeal Shock Wave Therapy on reducing Chronic Pain in Patients with Pes Anserine Bursitis: A Randomized, Clinical- Controlled Trial

    Directory of Open Access Journals (Sweden)

    Saeid Khosrawi

    2017-01-01

    Full Text Available Background: Knee pain, is one of the most common causes of patients' referring to physiatric clinics, and several factors, are involved in its creation. One of these factors is pes anserine bursitis (PAB for which various treatment methods are used. This study aims to investigate the effect of this method on reducing chronic pain in these patients. Materials and Methods: This clinical trial was conducted in 2013- 2014 on patients with PAB referring to academic, physical medicine clinics. The patients with chronic PAB (pain duration more than 3 months, who were refractory to conservative treatments, were randomly divided into two 20-member experimental groups (extracorporeal shock wave therapy [ESWT] and sham ESWT. Pain scores of all patients were measured using the Visual Analog Scale (VAS and McGill Pain Questionnaire (MPQ (total and present pain indexes [TPIs and PPIs] before intervention, immediately after intervention (3rd week, and after 8 weeks. The pain scores were then compared and statistically analyzed. Results: In the ESWT group, the mean patient pain score of the VAS and TPI in MPQ were significantly lower than in the sham ESWT group immediately after intervention (3rd week: P=0.02, P= 0.04 respectively; and 8 weeks after the end of treatment: P=0.01, P= 0.000. Moreover, the PPI in both groups had significantly decreased over time, although in ESWT group this decrement was significantly more than sham ESWT group (P < 0.001. Conclusion: The results showed that ESWT could be effective in reducing the pain and treating PAB.

  1. Investigating the Effect of Extracorporeal Shock Wave Therapy on Reducing Chronic Pain in Patients with Pes Anserine Bursitis: A Randomized, Clinical- Controlled Trial

    Science.gov (United States)

    Khosrawi, Saeid; Taheri, Parisa; Ketabi, Marziyeh

    2017-01-01

    Background: Knee pain, is one of the most common causes of patients’ referring to physiatric clinics, and several factors, are involved in its creation. One of these factors is pes anserine bursitis (PAB) for which various treatment methods are used. This study aims to investigate the effect of this method on reducing chronic pain in these patients. Materials and Methods: This clinical trial was conducted in 2013- 2014 on patients with PAB referring to academic, physical medicine clinics. The patients with chronic PAB (pain duration more than 3 months), who were refractory to conservative treatments, were randomly divided into two 20-member experimental groups (extracorporeal shock wave therapy [ESWT] and sham ESWT). Pain scores of all patients were measured using the Visual Analog Scale (VAS) and McGill Pain Questionnaire (MPQ) (total and present pain indexes [TPIs and PPIs]) before intervention, immediately after intervention (3rd week), and after 8 weeks. The pain scores were then compared and statistically analyzed. Results: In the ESWT group, the mean patient pain score of the VAS and TPI in MPQ were significantly lower than in the sham ESWT group immediately after intervention (3rd week): P =0.02, P = 0.04 respectively; and 8 weeks after the end of treatment: P =0.01, P = 0.000. Moreover, the PPI in both groups had significantly decreased over time, although in ESWT group this decrement was significantly more than sham ESWT group (P < 0.001). Conclusion: The results showed that ESWT could be effective in reducing the pain and treating PAB. PMID:28626745

  2. Brucelose em bovinos com bursite cervical diagnosticada em abatedouro sob inspeção federal Brucelosis in cattle with supraspinous bursitis diagnosed in an abattoir under federal inspection

    Directory of Open Access Journals (Sweden)

    Laerte Pereira de Almeida

    2000-04-01

    Full Text Available Estudo epidemiológico tipo caso-controle realizado em Uberlândia, Minas Gerais (MG, Brasil, pesquisou a ocorrência de brucelose em bovinos com bursite cervical, abatidos no período de agosto de 1993 a julho de 1994. O diagnóstico sorológico de brucelose foi realizado mediante a prova de soroaglutinação rápida em placa. Os casos de bursite foram identificados por técnico do Serviço de Inspeção Federal (SIF, com base em características morfológicas, previamente padronizadas. Para a determinação da "Razão de Odds" e do risco atribuível entre bursite e brucelose, utilizaram-se 30 animais com o quadro e, como controle, 90 bovinos sem a patologia. Dos animais com bursite, 13,3% eram brucélicos, contra 5,6% do grupo controle (P=0,115. Dentre aqueles com brucelose e bursite, as bolsas continham fibrina (40,0% e projeções digitiformes (33,3%; apenas nas bursites dos sorologicamente negativos encontraram-se presença de pus, de nódulos e de líquido viscoso. A "Razão de Odds" encontrada entre brucelose e bursite foi da ordem de 2,61, não sendo demonstrado associação entre bursite cervical e sorologia positiva para brucelose (P>0,05. No âmbito da Saúde Pública e ocupacional, sugere-se a atenção de técnicos e profissionais, visando diminuir o risco de infecção e evitar contaminação de carcaças, equipamentos e instalações.Epidemiological study case-control type carried out in Triângulo abattoir in the city of Uberlândia in the State of Minas Gerais, Brazil, has identified the ocorrence of brucelosis in bovine with supraspinous bursitis, slaughtered from August, 1993 to July, 1994. To diagnose brucelosis "Rapid Agglutination" test was performed on plate with the padronizated antigen count considered positive over 100. The bursas examined were identified by technicians of the Federal Inspection Service based on the presence of ten standardized morphological characteristics. Using the case-control design, 30 animals

  3. Targeted knockout of TNF-α by injection of lentivirus-mediated siRNA into the subacromial bursa for the treatment of subacromial bursitis in rats.

    Science.gov (United States)

    Wang, Yi; Li, Quan; Wei, Xianzhao; Xu, Jie; Chen, Qi; Song, Shuang; Lu, Zhe; Wang, Zimin

    2015-09-01

    Subacromial bursitis (SAB) is the major source of pain in rotator cuff disease. Although multiple investigations have provided support for the role of inflammatory cytokines in SAB, few have focussed on the use these cytokines in the treatment of SAB. The aim of the present study was to observe the therapeutic efficacy of lentivirus‑mediated RNA interference (RNAi) on carrageenan‑induced SAB by injecting lentivirus‑tumor necrosis factor (TNF)‑α‑RNAi expressing TNF‑α small interfering (si)RNA. Using screened siRNA segments, an siRNA was designed. A lentivirus vector expressing siRNA was established and packed as lentivirus particles. A lentivirus that expressed the negative sequence was used as a lentivirus‑negative control (NC). The carrageenan‑induced SAB model was established in 32 male Sprague‑Dawley rats. The modeled rats were randomly assigned to four groups: Lentivirus‑RNAi treatment group, lentivirus‑NC group, SAB group and phosphate‑buffered saline (PBS) blank control group. The lentivirus was injected (1x10(7) transducing units) into the subacromial bursa of the rats in the lentivirus‑RNAi group and lentivirus‑NC group, whereas 100 µl PBS was injected at the same site in the SAB group and the PBS blank control group. At 5 weeks following injection, the animals were sacrificed and venous blood was obtained. The effect of TNF‑α interference and the expression of inflammatory cytokines were determined by reverse transcription‑quantitative polymerase chain reaction, western blotting, hematoxylin and eosin staining, Van Gieson's staining and immunofluorescence. The expression of TNF‑α was decreased in the lentivirus‑TNF‑α‑RNAi group compared with that in the SAB group. Morphological observations revealed that the number of inflammatory cells were reduced and damage to tendon fibers was attenuated in this group, suggesting that the downregulation of the protein expression levels of TNF‑α‑associated nuclear

  4. Formações císticas epidurais relacionadas a bursite interespinhosa, cisto sinovial e cisto discal Epidural cystic masses associated with interspinous bursitis, synovial and discal cysts

    Directory of Open Access Journals (Sweden)

    Frederico Guilherme de Paula Lopes Santos

    2009-04-01

    Full Text Available Os autores apresentam casos de cistos epidurais, dentre eles os cistos sinoviais, discais, do ligamento amarelo e relacionados a bursite interespinhosa, todas essas condições determinando compressão radicular, do saco dural ou estenose do canal vertebral. Descrevem as características de imagem e localização na ressonância magnética nessas diferentes afecções.The authors describe some cases of epidural cysts, namely synovial, discal, ligamentum flavum cysts, and cysts secondary to interspinous bursitis, all of these conditions determining radicular, dural sac compression or spinal canal stenosis. Magnetic resonance imaging findings and localization of these entities are described.

  5. Bilateral Olecranon Tophaceous Gout Bursitis

    Directory of Open Access Journals (Sweden)

    Güzelali Özdemir

    2017-01-01

    Full Text Available In this case, we present a patient with the diagnosis of bilateral olecranon tophaceous gout. After the surgical treatment, there was no limitation of range of motion or wound problem at 6th month control.

  6. Bursitis efter vaccination i skulderregionen

    DEFF Research Database (Denmark)

    Bliddal, Henning; Torp-Pedersen, Søren; Falk-Riecke, Birgit

    2017-01-01

    Shoulder pain may develop after vaccination in the deltoid area due to inadvertent injection of the vaccine into the subdeltoid bursa, which may be located close to the skin. As far as we know, such vaccination reactions occur more frequently than officially registered, and doctors may not be aware...... of the problem. We present two of these cases of a suspected inflammatory reaction in the shoulder bursa after vaccination. Injection of cortisone in the bursa may relieve the reaction to some extent, but chronic shoulder pain may develop....

  7. Bilateral Olecranon Tophaceous Gout Bursitis.

    Science.gov (United States)

    Özdemir, Güzelali; Deveci, Alper; Andıç, Kemal; Erdem Yaşar, Niyazi

    2017-01-01

    In this case, we present a patient with the diagnosis of bilateral olecranon tophaceous gout. After the surgical treatment, there was no limitation of range of motion or wound problem at 6th month control.

  8. Bilateral Olecranon Tophaceous Gout Bursitis

    OpenAIRE

    Güzelali Özdemir; Alper Deveci; Kemal Andıç; Niyazi Erdem Yaşar

    2017-01-01

    In this case, we present a patient with the diagnosis of bilateral olecranon tophaceous gout. After the surgical treatment, there was no limitation of range of motion or wound problem at 6th month control.

  9. Fasciitis necroticans efter artroskopi af præpatellar bursitis

    DEFF Research Database (Denmark)

    Schlesinger, NH; Friis-Møller, Alice; Hvolris, Jesper

    2007-01-01

    Necrotizing fasciitis (NF) is a life-threatening soft tissue infection in superficial and deep fascias. NF is most often caused by mixed aerobic and anaerobic bacteria. The treatment is early and aggressive surgical debridement, antibiotics and hyperbaric oxygen. In this case description, a nearl...

  10. Obturator internus bursitis: a common factor in low back pain.

    Science.gov (United States)

    Swezey, R L

    1993-07-01

    The presence of irritation of the obturator internus bursa (OIB) is identified as a common but thus far overlooked focus of myofascial irritability in association with low back pain. Eighteen of 50 consecutive patients with low back pain (36%) demonstrated the presence of tenderness at the anatomical site of the OIB. OIB was found in 11% of men and 43% of women. Nineteen of the 50 patients had regional myofascial pain; of these, eight (42%) had OIB tenderness. Palpation of the OIB will commonly reveal local tenderness in patients suffering from low back pain. In these patients, conservative treatment of regional myofascial disorders may be made more effective when therapy and/or local steroid injections are appropriately directed to the obturator internus bursa.

  11. Fasciitis necroticans efter artroskopi af præpatellar bursitis

    DEFF Research Database (Denmark)

    Schlesinger, NH; Friis-Møller, Alice; Hvolris, Jesper

    2007-01-01

    Necrotizing fasciitis (NF) is a life-threatening soft tissue infection in superficial and deep fascias. NF is most often caused by mixed aerobic and anaerobic bacteria. The treatment is early and aggressive surgical debridement, antibiotics and hyperbaric oxygen. In this case description, a nearly...... 60-year-old man developed NF after arthroscopic synovectomy of an infected prepatellar bursa. We stress the point that the endoscopic technique itself might be responsible for the spreading of bacteria to the fascias. This is a subject for further investigation Udgivelsesdato: 30. april...

  12. Fasciitis necroticans efter artroskopi af præpatellar bursitis

    DEFF Research Database (Denmark)

    Schlesinger, NH; Friis-Møller, Alice; Hvolris, Jesper

    2007-01-01

    Necrotizing fasciitis (NF) is a life-threatening soft tissue infection in superficial and deep fascias. NF is most often caused by mixed aerobic and anaerobic bacteria. The treatment is early and aggressive surgical debridement, antibiotics and hyperbaric oxygen. In this case description, a nearl...... 60-year-old man developed NF after arthroscopic synovectomy of an infected prepatellar bursa. We stress the point that the endoscopic technique itself might be responsible for the spreading of bacteria to the fascias. This is a subject for further investigation Udgivelsesdato: 30. april...

  13. Bursitis por mercurio tras accidente laboral: a propósito de un caso Bursitis due to Mercury after a work accident: a case report

    Directory of Open Access Journals (Sweden)

    Susana Lastras González

    2010-06-01

    Full Text Available Auxiliar de enfermería de 28 años que acude al Servicio de Urgencias porque refiere dolor y dificultad para la movilización en rodilla derecha, tras accidente laboral, hace dos días. Refiere que se resbaló mientras transportaba 32 termómetros de mercurio, rompiéndose éstos sobre su rodilla, creando una pequeña herida, siendo la puerta de entrada del metal. En la radiografía, se objetiva el cuerpo extraño metálico, correspondiente a mercurio, en bursa rotuliana. Tras el diagnóstico, se realizó la extracción de la bursa, recuperándose la trabajadora totalmente tras la intervención. Con este caso clínico que aportamos, queremos conocer los efectos del mercurio en la salud de las personas expuestas a dicho metal, estudiar los errores acontecidos en este accidente laboral, valorando cuáles hubieran sido las medidas de actuación preventiva adecuadas para evitar la repetición de este tipo de accidentes y, por último, reflexionar acerca de la relación beneficio-riesgo del uso del mercurio en aparatos de medición en el ámbito sanitario.A 28-year-old woman, nursing assistant, who attends to emergency service, referring pain and difficulty mobilizing right knee after a work accident two days ago. She relates that slipped while carrying 32 mercury thermometers, breaking them on her knee, creating a small wound, being the gateway to the metal. In the radiograph, we objective a metallic foreign body, corresponding to mercury, in patellar bursa. After the diagnosis, the bursa was extracted, and the worker recovered completely, after surgery. With this case report we bring, we want to know the health effects of mercury in people exposed to this metal, studying the errors occurred in this accident, assessing measures of preventive action that would have been neccesary to preclude recurrence of this type accidents and, finally, think about the risk-benefit balance the use of mercury in measuring devices in healthcare.

  14. Proliferating Trichilemmal Tumor of the Knee Mimicking Prepatellar Bursitis on Ultrasonogram: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Il Jin; Kim, Tae Eun; Lee, Il Gi; Shin, Hyeon Woong [Daegu Fatima Hospital, Daegu (Korea, Republic of)

    2011-03-15

    Proliferating trichilemmal tumor is a rare benign tumor of skin appendage. It is usually solitary, more common in women after the fourth decade of life, and almost exclusively confined to the scalp and back of the neck. We report herein an unusual case of proliferating trchilemmal tumor which occurred on the knee

  15. Distal fascia lata lengthening: an alternative surgical technique for recalcitrant trochanteric bursitis

    Science.gov (United States)

    Ortega, Javier; García-Rayo, Ramón; Resines, Carlos

    2009-01-01

    This article presents a simple technique for fascia lata lengthening that is less aggressive, can be performed under local anaesthetic with little morbidity and disability, and has excellent results. Eleven patients (13 hips) were enrolled in this study. Mean age was 54.6 years, there was one man and ten women. Outcomes were assessed by using a visual analog pain scale, Harris hip score and Lickert scale (satisfaction). There was a mean follow-up time of 43 months (range 15–84). All patients were scored by the Harris hip scale with a mean improvement from 61 (range 48–77) to 91 (range 76–95) after surgery. The mean visual analogue scale (VAS) score improved from 83 (range 60–99) to 13 (range 0–70). We had 12 of 13 patients reporting a good result. Mean surgical time was 15 min, and only one seroma was reported as a complication. No inpatient management was needed. In conclusion, distal “Z” lengthening of the fascia lata appears to be a good alternative for treatment of this condition. PMID:19214507

  16. Tuberculous trochanteric bursitis, a rare cause of hip pain in an ...

    African Journals Online (AJOL)

    Arun Kumar Agnihotri

    Internet Journal of Medical Update. 2016 January;11(1):22-25. ... was no history of trauma, diabetes mellitus, renal failure and immunosuppressant or corticosteroid use. Constitutional symptoms like fever, weight loss and anorexia were absent. There was no obvious history of contact with tuberculosis. She reported a similar ...

  17. Mycobacterium asiaticum as the probable causative agent in a case of olecranon bursitis.

    Science.gov (United States)

    Dawson, D J; Blacklock, Z M; Ashdown, L R; Böttger, E C

    1995-01-01

    Mycobacterium asiaticum was isolated from fluid aspirated from an olecranon bursa that had become inflamed following a superficial injury. Other possible causes of the inflammation were excluded. No specific antimycobacterial therapy was given. The infection responded to drainage, regular dressing, and immobilization. Our experience suggests that M. asiaticum is a potential cause of infection of the joints and surrounding tissues. PMID:7790435

  18. Tennis elbow

    Science.gov (United States)

    Epitrochlear bursitis; Lateral epicondylitis; Epicondylitis - lateral; Tendonitis - elbow ... Philadelphia, PA: Elsevier; 2017:chap 25. Biundo JJ. Bursitis, tendinitis, and other periarticular disorders and sports medicine. ...

  19. Mycobacterium avium complex olecranon bursitis resolves without antimicrobials or surgical intervention: A case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Selene Working

    2015-01-01

    Conclusion: This case raises an important clinical question of whether close observation off antimicrobials is appropriate in select cases of immunocompetent patients with localized atypical mycobacterial disease of soft tissue and skeletal structures.

  20. Arm Care. Relief and Prevention for Shoulder Tendonitis, Tennis Elbow, Bursitis and Wrist Sprain in Athletics and Other Activities.

    Science.gov (United States)

    Nirschl, Robert P.

    The book provides a practical and meaningful treatment program for athletes involved in sports which injure the arm or shoulder to a high degree, such as tennis, baseball, swimming, raquetball, pole vaulting, javelin throwing, and weight training. The book's chapters present information on: (1) symptoms of injury; (2) the anatomy of injury; (3)…

  1. Joint pain

    Science.gov (United States)

    ... or conditions. It may be linked to arthritis , bursitis , and muscle pain . No matter what causes it, ... Autoimmune diseases such as rheumatoid arthritis and lupus Bursitis Chondromalacia patellae Crystals in the joint: Gout (especially ...

  2. Repetitive Motion Disorders

    Science.gov (United States)

    ... or daily activities. RMDs include carpal tunnel syndrome, bursitis, tendonitis, epicondylitis, ganglion cyst, tenosynovitis, and trigger finger. ... or daily activities. RMDs include carpal tunnel syndrome, bursitis, tendonitis, epicondylitis, ganglion cyst, tenosynovitis, and trigger finger. ...

  3. Knee pain (image)

    Science.gov (United States)

    ... front of the knee can be due to bursitis, arthritis, or softening of the patella cartilage as ... knee. Overall knee pain can be due to bursitis, arthritis, tears in the ligaments, osteoarthritis of the ...

  4. Elbow Pain

    Science.gov (United States)

    ... 5th ed. Philadelphia, Pa.: Saunders Elsevier; 2007:309. Bursitis and tendinitis. National Institute of Arthritis and Musculoskeletal ... Diseases. http://www.niams.nih.gov/health_info/bursitis/. Accessed Feb. 1, 2013. Wilkinson JM (expert opinion). ...

  5. Investigating the effect of extracorporeal shock wave therapy on reducing chronic pain in patients with pes anserine bursitis: A randomized, clinical- controlled trial

    National Research Council Canada - National Science Library

    Khosrawi, Saeid; Taheri, Parisa; Ketabi, Marziyeh

    ... treatments, were randomly divided into two 20-member experimental groups (extracorporeal shock wave therapy [ESWT] and sham ESWT). Pain scores of all patients were measured using the Visual Analog Scale (VAS) and McGill Pain Questionnaire (MPQ) (total and present pain indexes [TPIs and PPIs]) before intervention, immediately after intervention ...

  6. Radiotherapy for treatment of bursitis. Indication, technique, own results, literature survey; Strahlentherapie bei der Periarthropathia humeroscapularis (PHS). Indikation, Technik, eigene Ergebnisse, Literaturuebersicht

    Energy Technology Data Exchange (ETDEWEB)

    Heyd, R. [Staedtische Kliniken Offenbach am Main (Germany). Strahlenklinik]|[Frankfurt Univ. (Germany). Klinik fuer Strahlentherapie und Onkologie; Schopohl, B.; Boettcher, H.D. [Frankfurt Univ. (Germany). Klinik fuer Strahlentherapie und Onkologie

    1998-12-31

    Our own experience covers 41 primarily chronic cases. The patients have been irradiated with a telecobalt device with isocentric opposing fields, receiving 4x1.0 Gy within two weeks; 15 patients (36.6%) received a second radiation treatment (8 Gy), and one patient (2.4%) a third (12 Gy). After a follow-up period of 44 months on the average, the results were: Complete remittence of pain in 44%, abatement of pain in 44%, and no effect in 12%. Improvement of shoulder joint motility was achieved in 78%. The rate of recidivation was as low as 3%. A statistical evaluation of data acquired revealed that the prognosis is worst in case of a long period of pain preceding commencement of radiotherapy, combined with intensive prior therapy. (orig./CB) [Deutsch] In einer eigenen Untersuchung wurden 41 ueberwiegend chronische Faelle mit 4x1,0 Gy in 2 Wochen an einem Telekobaltgeraet mit isozentrischen Gegenfeldern behandelt, 15 (36,6%) erhielten eine 2. Bestrahlungsserie (8 Gy), ein Fall (2,4%) eine Dritte (12 Gy). Nach einem Nachbeobachtungszeitraum von median 44 Monaten fand sich bei 44% eine komplette Schmerzremission, bei 44% eine Linderung und 12% waren ohne einen Einfluss der Behandlung. Eine Verbesserung der Motilitaet des Schultergelenkes wurde bei 78% erreicht. Die Rezidivrate lag bei nur 3%. Nach statistischer Bearbeitung der Daten erwies sich die Kombination einer langen Beschwerdedauer vor Einleitung der Radiotherapie und intensiver Vortherapie als prognostisch unguenstiger (p=0,02). (orig.)

  7. Early diagnosis of bilateral sub-deltoid bursitis using clinic-based ultrasonography in a patient receiving infliximab therapy for ulcerative pouchitis.

    LENUS (Irish Health Repository)

    Veerappan, S G

    2010-12-01

    Infliximab, a monoclonal chimeric antibody to tumour necrosis factor (TNF)α, is a novel therapy used in the management of chronic refractory pouchitis that is unresponsive to conventional medical therapy.

  8. Swollen Knee (Water on the Knee)

    Science.gov (United States)

    ... buildup in and around the knee joint include: Osteoarthritis Rheumatoid arthritis Infection Gout Pseudogout Bursitis Cysts Tumors Risk factors Age. Your likelihood of developing a swollen knee ...

  9. Formações císticas epidurais relacionadas a bursite interespinhosa, cisto sinovial e cisto discal Epidural cystic masses associated with interspinous bursitis, synovial and discal cysts

    OpenAIRE

    Frederico Guilherme de Paula Lopes Santos; Ricardo André de Souza; Marcos Pama D'Almeida Brotto; Fábio Massaaki Suguita; Denise Tokechi Amaral; Lázaro Luís Faria do Amaral

    2009-01-01

    Os autores apresentam casos de cistos epidurais, dentre eles os cistos sinoviais, discais, do ligamento amarelo e relacionados a bursite interespinhosa, todas essas condições determinando compressão radicular, do saco dural ou estenose do canal vertebral. Descrevem as características de imagem e localização na ressonância magnética nessas diferentes afecções.The authors describe some cases of epidural cysts, namely synovial, discal, ligamentum flavum cysts, and cysts secondary to interspinous...

  10. Radiographic Prevalence of Femoroacetabular Impingement in a Young Population with Hip Complaints Is High

    Science.gov (United States)

    2010-01-27

    9 codes associated with hip complaints Diagnosis ICD-9 code Diagnosis ICD-9 code Hip, pelvic pain 719.45 Bursitis buttock, trochanter, hip 726.5...719.6 Nonallopathic lesions, not elsewhere classified 739.5 Other bursitis NOS 727.3 Sprain strain hip thigh NOS 843.9 Iliofemoral ligament sprain

  11. Musculoskeletal and Medical Morbidity Associated with Rigorous Physical Training

    Science.gov (United States)

    1992-08-01

    71881 I 0.2 Tendinitis, rotator cuff (RC) 72610 1 0.2 Subacromial bursitis 72619 1 0.2 Sprain/strain/tear, RC 84040 1 0.2 TABLE 4. Incidence’ of...84509 5 1.0 military investigators, although iliotibial band syn- Tendinitis, ant/post tibialis 72672 5 1.0 Tendinitis/ bursitis , Achilles 72671 4 0.8...91730 3 0.6 SEAL clinic providers with ITBS and other muscu- Tendinitis/ bursitis , peroneal 72679 3 0.6 Sprain/strain, foot, cuboid 84519 2 0.4

  12. The effects of scapulothoracic bursa injections in patients with scapular pain: a pilot study.

    Science.gov (United States)

    Chang, Won Hyuk; Im, Sang Hee; Ryu, Jeong Ah; Lee, Sang Chul; Kim, Ji Sung

    2009-02-01

    To assess the effects of steroid plus hyaluronate injections for scapulothoracic bursitis in patients with scapular pain. Prospective open-label unicenter trial with a 3-month follow-up. University rehabilitation hospital. Twenty-two cases of suspected scapulothoracic bursitis. Injections into scapulothoracic bursa were performed with steroid plus hyaluronate. Injections were administered once a week for 3 weeks. Visual analog scale (VAS), Rubin scale, adverse events, and injection-associated complications. Mean outcome scores at 3-month follow-up visits showed significant improvements versus baseline (mean VAS increased from 7.8 to 2.2) (Pbursa provide an effective means of treating patients with scapulothoracic bursitis.

  13. Protect Your Tendons: Preventing the Pain of Tendinitis

    Science.gov (United States)

    ... steroid injections, or give you a splint or brace. Then gentle exercises can help strengthen the tendon. ... Q&A About Bursitis and Tendinitis Sports Injuries Knee Problems Tendinitis: NIH Health Information NIH Office of ...

  14. Rotator Cuff Injuries

    Science.gov (United States)

    ... cuff are common. They include tendinitis, bursitis, and injuries such as tears. Rotator cuff tendons can become ... cuff depends on age, health, how severe the injury is, and how long you've had the ...

  15. Hip Injuries and Disorders

    Science.gov (United States)

    ... or falling can all sometimes lead to hip injuries. These include Strains Bursitis Dislocations Fractures Certain diseases also lead to hip injuries or problems. Osteoarthritis can cause pain and limited ...

  16. Ketoprofen

    Science.gov (United States)

    ... spondylitis (arthritis that mainly affects the spine), Reiter's syndrome (condition in which many parts of the body including the joints, eyes, genitals, bladder, and digestive system become swollen), shoulder pain caused by bursitis (inflammation of a fluid-filled ...

  17. Ways to Prevent Percussion Overuse Injuries

    Science.gov (United States)

    Fidyk, Steve

    2009-01-01

    It is a proven fact that the repetitive nature of percussion playing can cause carpal tunnel syndrome, bursitis, and tendinitis. This paper offers ways to prevent percussion overuse injuries, particularly by developing a healthy warmup routine.

  18. True bursal pigmented villonodular synovitis

    Energy Technology Data Exchange (ETDEWEB)

    Abdelwahab, Ibrahim Fikry [Department of Radiology, New York Methodist Hospital, Affiliated with New York Hospital-Cornell Medical Center, Brooklyn, NY (United States); Kenan, Samuel [Department of Orthopedics, New York University Medical Center, NY (United States); Steiner, German C. [Department of Pathology, Hospital for Joint Diseases/Orthopedic Institute, New York, NY (United States); Abdul-Quader, Mohammed [Department of Radiology, New York Presbyterian Hospital, Columbia University, New York, NY (United States)

    2002-06-01

    We describe two cases of pigmented villonodular synovitis affecting true bursae. This study was also designed to discuss the term ''pigmented villonodular bursitis'', not confined to true synovial bursae, sometimes creating misunderstanding. (orig.)

  19. Ultrasonography as a prognostic and objective parameter in Achilles tendinopathy:

    DEFF Research Database (Denmark)

    Bakkegaard, Mads; Johannsen, Finn E; Højgaard, Betina

    2015-01-01

    eccentric exercises of the calf muscles and if needed supplemented with corticosteroid injections. The patients were examined clinically and by US (tendon thickness, hyper- and hypoechogenicity, calcification, bursitis, calcaneusspure, tenosynovitis, gray scale and color Doppler focusing on increased flow...

  20. Sindromes Dolorosos Regionales, Columna, Hombro y Rodilla

    Directory of Open Access Journals (Sweden)

    Wolff C. Verónica, Dra.

    2012-07-01

    En la rodilla, los trastornos periarticulares incluyen bursitis y tendinitis de distintas estructuras, y hay que considerar la osteonecrosis dentro del diagnóstico diferencial del dolor de rodilla del adulto mayor.

  1. Integrating Targeted MedlinePlus Health Prescriptions Into Clinic Practice Workflow

    Science.gov (United States)

    2016-09-29

    Allergic Rhinitis; Asthma; Back Pain; Benign Prostatic Hypertrophy; Bursitis; Depression; Anxiety; Diabetes Mellitus; Esophageal Reflux; HIV Infections; Hyperlipidemia; Hypertension; Insomnia; Irritable Bowel Syndrome; Obesity; Osteoporosis (Senile); Shoulder Pain; Sinusitis; Symptomatic Menopause; Urinary Incontinence; Urinary Tract Infection; Vaginitis

  2. Medial epicondylitis - golfer's elbow

    Science.gov (United States)

    ... Saunders; 2009:chap 19. Schmidt MJ, Adams SL. Tendinopathy and bursitis. In: Marx JA, Hockberger RS, Walls ... and Disorders Read more Sports Injuries Read more Tendinitis Read more A.D.A.M., Inc. is ...

  3. What Are Sports Injuries?

    Science.gov (United States)

    ... Osteoporosis Paget’s Disease of Bone Scoliosis Spinal Stenosis Tendinitis Sports Injuries Sports Injuries in Youth: A Guide ... and Strains, Questions and Answers about Bursitis and Tendinitis, Questions and Answers about Last Reviewed: 02/28/ ...

  4. Baker cyst

    Science.gov (United States)

    ... you do not have other types of tumors. Alternative Names ... 26, 2016. Biundo JJ. Bursitis, tendinitis, and other periarticular disorders and sports medicine. In: Goldman L, Schafer AI, eds. Goldman's ...

  5. Tendinitis

    Science.gov (United States)

    ... exercises at a relaxed pace before vigorous activity. Alternative Names Calcific tendinitis; Bicipital tendinitis Images Tendon vs. ligament Tendonitis References Biundo JJ. Bursitis, tendinitis, and other periarticular disorders and sports medicine. In: Goldman L, Schafer AI, eds. Goldman- ...

  6. Tenosynovitis

    Science.gov (United States)

    ... cuts to the hand, wrist, ankle, and foot. Alternative Names Inflammation of the tendon sheath References Biundo JJ. Bursitis, tendinitis, and other periarticular disorders and sports medicine. In: Goldman L, Schafer AI, eds. Goldman- ...

  7. Methicillin-resistant Staphylococcus aureus infection of the subacromial bursa: an unusual complication following subacromial corticosteroid injection (a report of two cases).

    Science.gov (United States)

    Teoh, Kar H; Jones, Sian A; Gurunaidu, Subramaniam; Pritchard, Mark G

    2015-07-01

    Subacromial corticosteroid injections are frequently used for both diagnostic and therapeutic purposes in shoulder pain. Subacromial septic bursitis is a recognized but rare complication. There have been no reports of methicillin-resistant Staphylococcus aureus infections of the subacromial bursa after subacromial injections in the literature. We describe case reports of two patients who presented with subacromial methicillin-resistant Staphylococcus aureus septic bursitis following subacromial corticosteroid injections in the community and highlight the diagnostic and management challenges of this condition.

  8. Methicillin-resistant Staphylococcus aureus infection of the subacromial bursa: an unusual complication following subacromial corticosteroid injection (a report of two cases)

    OpenAIRE

    Teoh, Kar. H.; Jones, Sian A; Gurunaidu, Subramaniam; Pritchard, Mark G.

    2014-01-01

    Subacromial corticosteroid injections are frequently used for both diagnostic and therapeutic purposes in shoulder pain. Subacromial septic bursitis is a recognized but rare complication. There have been no reports of methicillin-resistant Staphylococcus aureus infections of the subacromial bursa after subacromial injections in the literature. We describe case reports of two patients who presented with subacromial methicillin-resistant Staphylococcus aureus septic bursitis following subacromi...

  9. Subdeltoid Bursa Tuberculosis with Rice Body Formation–A Case Report

    Directory of Open Access Journals (Sweden)

    Santosh L. Munde

    2015-01-01

    Full Text Available Tuberculous tenosynovitis and bursitis account for approximately 1%. A 56 years old female presented with swelling in left shoulder, gradually increasing in size with slight restriction in movement since last three months. X-ray revealed no abnormality of humerus head. Histopathological examination showed granulomatous tissue with multiple rice bodies. A positive culture of mycobacterium tuberculosis confirmed the diagnosis of tuberculosis. We here report a case of subdeltoid bursitis with rice body formation and without active bone and joint tuberculosis.

  10. Accuracy of musculoskeletal imaging for the diagnosis of polymyalgia rheumatica: systematic review.

    Science.gov (United States)

    Mackie, Sarah Louise; Koduri, Gouri; Hill, Catherine L; Wakefield, Richard J; Hutchings, Andrew; Loy, Clement; Dasgupta, Bhaskar; Wyatt, Jeremy C

    2015-01-01

    To review the evidence for accuracy of imaging for diagnosis of polymyalgia rheumatica (PMR). Searches included MEDLINE, EMBASE and PubMed. Evaluations of diagnostic accuracy of imaging tests for PMR were eligible, excluding reports with subacromial-subdeltoid bursitis had sensitivity 80% (95% CI 55% to 93%) and specificity 68% (95% CI 60% to 75%), whereas bilateral subacromial-subdeltoid bursitis had sensitivity 66% (95% CI 43% to 87%) and specificity 89% (95% CI 66% to 97%). Sensitivity for ultrasound detection of trochanteric bursitis ranged from 21% to 100%. In four ultrasound studies reporting both subacromial-subdeltoid bursitis and glenohumeral synovitis, detection of subacromial-subdeltoid bursitis was more accurate than that of glenohumeral synovitis (p=0.004). MRI and PET/CT revealed additional areas of inflammation in the spine and pelvis, including focal areas between the vertebrae and anterior to the hip joint, but the number of controls with inflammatory disease was inadequate for precise specificity estimates. Subacromial-subdeltoid bursitis appears to be the most helpful ultrasound feature for PMR diagnosis, but interpretation is limited by study heterogeneity and methodological issues, including variability in blinding and potential bias due to case-control study designs. Recent MRI and PET/CT case-control studies, with blinded readers, yielded promising data requiring validation within a diagnostic cohort study.

  11. Acetabular anteversion is associated with gluteal tendinopathy at MRI.

    Science.gov (United States)

    Moulton, Kyle M; Aly, Abdel-Rahman; Rajasekaran, Sathish; Shepel, Michael; Obaid, Haron

    2015-01-01

    Gluteal tendinopathy and greater trochanteric pain syndrome (GTPS) remain incompletely understood despite their pervasiveness in clinical practice. To date, no study has analyzed the morphometric characteristics of the hip on magnetic resonance imaging (MRI) that may predispose to gluteal tendinopathy. This study aimed to evaluate whether acetabular anteversion (AA), femoral neck anteversion (FNA), and femoral neck-shaft angle (FNSA) are associated with MRI features of gluteal tendinopathy. A total of 203 MRI examinations of the hip met our inclusion and exclusion criteria. A single blinded investigator measured AA, FNA, and FNSA according to validated MRI techniques. Two blinded subspecialty-trained musculoskeletal radiologists then independently evaluated the presence of gluteal tendinosis, trochanteric bursitis, and subgluteal bursitis. Statistical analysis was performed using a one-way analysis of variance (ANOVA; post-hoc Tukey's range test). At MRI, 57 patients had gluteal tendinosis with or without bursitis, 26 had isolated trochanteric bursitis, and 11 had isolated subgluteal bursitis. AA was significantly (p = 0.01) increased in patients with MRI evidence of gluteal tendinosis with or without bursitis [mean: 18.4°, 95 % confidence interval (CI): 17.2°-19.6°] compared with normal controls (mean: 15.7°, 95 % CI: 14.7°-16.8°). Similarly, AA was significantly (p = 0.04) increased in patients with isolated trochanteric bursitis (mean: 18.8°, 95 % CI: 16.2°-21.6°). No association was found between FNA or FNSA and the presence of gluteal tendinopathy. Interobserver agreement for the presence and categorization of gluteal tendinopathy was very good (kappa = 0.859, 95 % CI: 0.815-0.903). Our MRI study suggests that there is an association between increased AA and gluteal tendinopathy, which supports a growing body of evidence implicating abnormal biomechanics in the development of this condition.

  12. Acetabular anteversion is associated with gluteal tendinopathy at MRI

    Energy Technology Data Exchange (ETDEWEB)

    Moulton, Kyle M. [University of Saskatchewan, Department of Medical Imaging, Saskatoon, SK (Canada); Royal University Hospital, Department of Medical Imaging, Saskatoon, SK (Canada); Aly, Abdel-Rahman [University of Saskatchewan, Department of Physical Medicine and Rehabilitation, Saskatoon, SK (Canada); Rajasekaran, Sathish [Health Pointe - Pain, Spine and Sport Medicine, Edmonton, AB (Canada); Shepel, Michael; Obaid, Haron [University of Saskatchewan, Department of Medical Imaging, Saskatoon, SK (Canada)

    2015-01-15

    Gluteal tendinopathy and greater trochanteric pain syndrome (GTPS) remain incompletely understood despite their pervasiveness in clinical practice. To date, no study has analyzed the morphometric characteristics of the hip on magnetic resonance imaging (MRI) that may predispose to gluteal tendinopathy. This study aimed to evaluate whether acetabular anteversion (AA), femoral neck anteversion (FNA), and femoral neck-shaft angle (FNSA) are associated with MRI features of gluteal tendinopathy. A total of 203 MRI examinations of the hip met our inclusion and exclusion criteria. A single blinded investigator measured AA, FNA, and FNSA according to validated MRI techniques. Two blinded subspecialty-trained musculoskeletal radiologists then independently evaluated the presence of gluteal tendinosis, trochanteric bursitis, and subgluteal bursitis. Statistical analysis was performed using a one-way analysis of variance (ANOVA; post-hoc Tukey's range test). At MRI, 57 patients had gluteal tendinosis with or without bursitis, 26 had isolated trochanteric bursitis, and 11 had isolated subgluteal bursitis. AA was significantly (p = 0.01) increased in patients with MRI evidence of gluteal tendinosis with or without bursitis [mean: 18.4 , 95 % confidence interval (CI): 17.2 -19.6 ] compared with normal controls (mean: 15.7 , 95 % CI: 14.7 -16.8 ). Similarly, AA was significantly (p = 0.04) increased in patients with isolated trochanteric bursitis (mean: 18.8 , 95 % CI: 16.2 -21.6 ). No association was found between FNA or FNSA and the presence of gluteal tendinopathy. Interobserver agreement for the presence and categorization of gluteal tendinopathy was very good (kappa = 0.859, 95 % CI: 0.815-0.903). Our MRI study suggests that there is an association between increased AA and gluteal tendinopathy, which supports a growing body of evidence implicating abnormal biomechanics in the development of this condition. (orig.)

  13. Factors associated with regional rheumatic pain disorders in a population of Puerto Ricans with diabetes mellitus

    Science.gov (United States)

    Font, Yvonne M.; Castro-Santana, Lesliane E.; Nieves-Plaza, Mariely; Maldonado, Mirna; Mayor, Ángel M.

    2015-01-01

    The aim of the study was to determine the prevalence and factors associated with bursitis/tendonitis disorders in Puerto Ricans with diabetes mellitus (DM). A cross-sectional study was performed in 202 adult Puerto Ricans (100 DM patients and 102 non-diabetic subjects). For each participant, a complete medical history and a musculoskeletal exam were systematically performed. Socio-demographic parameters, health-related behaviors, comorbidities, and pharmacotherapy were determined for all subjects. For DM patients, disease duration, glycemic control, and DM long-term complications were also examined. Multivariate logistic regression analyses were used to determine the factors associated with bursitis/tendonitis disorders. The mean (SD) age for DM patients and non-diabetic controls were 53.3 (12.9) and 50.0 (13.1) years; 64.0 and 64.7 % of DM patients and controls were females, respectively. Overall, the prevalence of bursitis/tendonitis was higher in DM patients than among non-diabetics (59.0 % vs. 29.4 %, pbursitis/tendonitis as compared to non-diabetics. Specifically, DM patients had a higher frequency of flexor tenosynovitis, De Quervain’s tenosynovitis, lateral epicondylitis, medial epicondylitis, trochanteric bursitis, and anserine bursitis than non-diabetic subjects (pbursitis/tendonitis were more likely to be female [OR (95 % CI) 4.55 (1.42, 14.55)] and have peripheral vascular disease [OR (95 % CI) 8.48 (1.71, 41.93)]. In conclusion, bursitis/tendonitis disorders were common in this population of Hispanics with DM. Among DM patients, bursitis/tendonitis disorders were more frequent in women and those with long-term complications such as peripheral vascular disease. PMID:24522480

  14. The prevalence of periarticular lesions detected on magnetic resonance imaging in middle-aged and elderly persons: a cross-sectional study.

    Science.gov (United States)

    Kim, In Je; Kim, Dong Hyun; Song, Yeoung Wook; Guermazi, Ali; Crema, Michel D; Hunter, David J; Seo, Young-Il; Kim, Hyun Ah

    2016-04-26

    Previous studies showed that among persons with radiographic knee OA, periarticular lesions were significantly more common among participants with knee pain than those without. However, data were derived mostly from persons with knee OA, and there were few normal participants without knee OA in the data analyses. The objectives of this study were to investigate the prevalence of periarticular lesions detected by magnetic resonance imaging (MRI), and to examine their prevalence according to the presence of knee pain and radiographic knee osteoarthritis (OA) in community residents in Korea. Demographic and knee pain data were obtained by questionnaire from 358 participants of the population-based Hallym Aging Study who were recruited irrespective of the presence of knee OA or pain. Radiographic evaluations consisted of weight-bearing knee anteroposterior radiographs and 1.5-T MRI scans. Periarticular lesions included prepatellar or anserine bursitis, Baker's cyst, and tibiofibular cyst. The prevalence of each lesion in subjects with knee OA or knee pain compared to those without was examined by a chi-square test. The mean age of the subjects was 72 years and 50.6% were female. Radiographic knee OA was present in 34.5%. The most prevalent peri-articular lesion was Baker's cyst (27.9%), followed by tibiofibular cyst (9.5%). Anserine bursitis and tibulofibular cyst were more common in subjects with knee OA (17.5% vs 2.2% for anserine bursitis, 15.8% vs 6.1% for tibiofibular cyst in subjects with and without OA, respectively), while Baker's cyst and anserine bursitis were more common in subjects with knee pain (36.3% vs 21.8% for Baker's cyst, 14.4% vs 2.5% for anserine bursitis in subjects with and without knee pain, respectively). Periarticular lesions on MRI of the knee are common in middle-aged and elderly persons. Anserine bursitis and Baker's cysts are more common in subjects with knee pain compared to those without.

  15. Endoscopic resection of the inflamed bicipitoradial bursa extended around the radial neck.

    Science.gov (United States)

    Lui, Tun Hing

    2013-05-22

    The bicipitoradial bursa lies at the insertion of the biceps tendon on the radial tuberosity. It is an unusual site for chronic bursitis and most often, results from repetitive mechanical trauma or overuse. Other causes include tuberculosis, immunological complications of the rheumatological disease, for example, psoriatic arthropathy, rheumatoid arthritis and synovial chondromatosis. Unlike ganglion cyst arising from the elbow joint, resection of the bursa through the elbow arthroscopy is not possible as the bursa is not communicated with the joint. We reported a patient with rheumatoid arthritis presenting with bicipitoradial bursitis extended around the radial neck which was successfully resected endoscopically.

  16. Rhabdomyolysis in DOMS

    Energy Technology Data Exchange (ETDEWEB)

    Martinez Carsi, C. [Hospital 9 d' Octubre, Valencia (Spain). Serveis de Medicina Nuclear; Ruiz Hernandez, G. [Hospital Clinic Universitari, Valencia (Spain). Serveis de Medicina Nuclear; Sanchez Marchori, C.; Munoz Moliner, J. [Hospital 9 d' Octubre, Valencia (Spain). Serveis de Traumatologia

    1999-07-01

    A 26-year-old man with a previous history of external twin bursitis was remitted to our Department for a bone scintigraphy. Before the study, the patient performed an elevated number of intense sprints. Bone scintigraphy showed a bilaterally increased activity in both anterior rectum muscles suggesting rhabdomyolysis. Biochemical studies and MRT confirmed the diagnosis. (orig.) [German] Ein 26jaehriger Mann mit vorausgehender M.-gastrocnemius-Bursitis wurde zur Skelettszintigraphie in unsere Abteilung ueberwiesen. Vor der Untersuchung fuehrte der Patient mehrere Kurzstreckensprints durch. Die Skelettszintigraphie ergab eine erhoehte Aktivitaet in beiden Mm. recti femoris, die auf eine Rhabdomyolyse hinweist. Biochemische Untersuchungen und MRT bestaetigten die Diagnose. (orig.)

  17. “Liquid elbows” due to afatinib administration

    Directory of Open Access Journals (Sweden)

    Paul Zarogoulidis

    2017-01-01

    Full Text Available Non-small cell lung cancer adenocarcinoma in the past decade has targeted therapies as the cornerstone for therapy. In specific patients with epidermal growth factor receptor mutation have three different therapy approaches with the tyrosine kinase inhibitors: erlotinib, gefitinib and afatinib. Nowadays we can use tyrosine kinase inhibitors as second line treatment for squamous cell carcinoma. We present a case with a patient with squamous cell carcinoma receiving afatinib tyrosine kinase inhibitor who presented elbow bursitis or olecranon bursitis in both elbows.

  18. Imaging of bursae around the shoulder joint

    Energy Technology Data Exchange (ETDEWEB)

    Bureau, N.J. [Department of Radiology, Hotel-Dieu de Montreal Hospital, Montreal, Quebec (Canada); Dussault, R.G. [Department of Radiology, Health Sciences Center, University of Virginia, Charlottesville, Virginia (United States); Keats, T.E. [Department of Radiology, Health Sciences Center, University of Virginia, Charlottesville, Virginia (United States)

    1996-08-01

    The authors present a review of the anatomy of the major bursae around the shoulder joint and discuss the use of the different imaging modalities which demonstrate their radiologic features. The calcified subacromial-subdeltoid bursa has a characteristic appearance on plain radiographs. When inflamed it can be visualized by ultrasound and magnetic resonance imaging. Calcific bursitis may involve the subcoracoid bursa. This bursa may mimic adhesive capsulitis of the shoulder or complete rotator cuff tear when injected inadvertently during shoulder arthrography. Less well known are three coracoclavicular ligament bursae. These are also subject to calcific bursitis and have a typical radiologic appearance. (orig.). With 6 figs.

  19. Short-Term Outcome of Combined Corticosteriod and Local ...

    African Journals Online (AJOL)

    Erah

    treatment consists of physical therapy, rest and oral anti-inflammatory drugs2. Some other conditions causing painful shoulder are subacromial bursitis, degeneration of acromioclavicular joint, tendonitis, adhesive capsulitis, impingement syndrome and rotator cuff tears. Lack of appropriate examination and inadequate.

  20. An analysis of the diagnostic accuracy of the Hawkins and Neer subacromial impingement signs.

    Science.gov (United States)

    MacDonald, P B; Clark, P; Sutherland, K

    2000-01-01

    The purpose of this study was to assess the diagnostic accuracy of the Neer and Hawkins impingement signs for the diagnosis of subacromial bursitis or rotator cuff pathosis. Eighty-five consecutive patients undergoing shoulder arthroscopy by a single surgeon were documented prospectively for the positive and negative clinical and arthroscopic pathologic findings. The Neer sign was found to have a sensitivity of 75% for the appearance suggestive of subacromial bursitis; this compared with 92% for the Hawkins sign. For rotator cuff tearing, the sensitivity of the Neer sign was 85% and the sensitivity of the Hawkins sign was 88%. Specificity and positive predictive values for the two tests were low, being not much higher than pretest probability. The two tests had a high negative predictive value (96% for bursitis, 90% for rotator cuff tearing) when they were combined. The results are compared with those reported in the literature. We conclude that the Neer and Hawkins signs are sensitive for appearances suggestive of subacromial bursitis and rotator cuff partial or complete tearing with a high negative predictive value. However, they lack specificity in comparison with arthroscopic findings.

  1. Infectious bursal disease outbreak in 19-week old commercial ...

    African Journals Online (AJOL)

    Necropsy revealed a markedly enlarged, oedematous and haemorrhagic bursa. Histopathologic findings including lympho-cytolysis and oedema were characteristic of an acute bursitis and a positive agar-gel precipitation test were used to confirm the diagnosis of Infectious bursal disease. Keywords: Agar gel precipitation, ...

  2. MR Imaging Features of Obturator Internus Bursa of the Hip

    Science.gov (United States)

    Lee, Sun Wha; Kim, Jong Oh

    2008-01-01

    The authors report two cases with distension of the obturator internus bursa identified on MR images, and describe the location and characteristic features of obturator internus bursitis; the "boomerang"-shaped fluid distension between the obturator internus tendon and the posterior grooved surface of the ischium. PMID:18682677

  3. Case report

    African Journals Online (AJOL)

    abp

    2014-01-21

    Jan 21, 2014 ... Abstract. Inflammation of the bicipitoradial bursa is a rare condition and only few reports can be found in literature. Several causes for a cubital bursitis have been suggested in the past. The need to include a malignant lesion in the differential diagnosis has only been mentioned in one of these reports.

  4. Tubercular tenosynovitis of extensor tendons of foot--a rare ...

    African Journals Online (AJOL)

    Tuberculosis of soft tissues as a result of spread from adjacent bone or joint is a well recognized entity. However isolated tuberculous pyomyositis, bursitis and tenosynovitis are rare, constituting about 1% of skeletal tuberculosis. Tubercular tenosynovitis commonly involves tendon sheaths of wrist and hand. Cases of ...

  5. Comparison of the Therapeutic Efficacy of Double-Modality Therapy ...

    African Journals Online (AJOL)

    olayemitoyin

    Committee (JUTH/DCS/ADM/127/XXVI/1800). Procedure. On completion of history, careful clinical and radiographic examination the sixty (60) subjects whose injuries were classified as follows :– rotator cuff syndrome (n=15), ankle sprain (n=8), knee sprain (n=4), patellar bursitis (n=5), low back pain. (n=12), muscle strain ...

  6. Author Details

    African Journals Online (AJOL)

    Abstract PDF · Vol 11, No 1 (2016) - Articles Case Reoprt: Isolated fracture of pisiform: case report of a rare injury of wrist. Abstract PDF · Vol 11, No 1 (2016) - Articles Case Report: Tuberculous trochanteric bursitis, a rare cause of hip pain in an immunocompetent patient: A case report. Abstract PDF. ISSN: 1694-0423.

  7. Prototecosis Informe de tres casos

    Directory of Open Access Journals (Sweden)

    Miguel Guzmán

    1983-12-01

    Full Text Available Se presentan tres casos clínicos de prototecosis vistos y estudiados en el lnstituto Nacional de Salud. Uno corresponde a la forma tegumentaria y los otros dos a formas de bursitis del olécranon. Se discuten los aspectos biológicos, clínicos y de laboratorio de esta rara entidad causada por algas.

  8. The appearance of the pre-Achilles fat pad after endoscopic calcaneoplasty

    NARCIS (Netherlands)

    Wiegerinck, Johannes I.; Zwiers, Ruben; van Sterkenburg, Maayke N.; Maas, Mario M.; van Dijk, C. Niek

    2015-01-01

    To evaluate whether the imaging features of the retrocalcaneal recess normalize on a conventional radiograph after surgery for retrocalcaneal bursitis and evaluate whether it can be reused if complaints reoccur. Patients who underwent an endoscopic calcaneoplasty at least 2 years before were

  9. Power Doppler ultrasonography of painful Achilles tendons and entheses in patients with and without spondyloarthropathy-a comparison with clinical examination and contrast-enhanced MRI

    DEFF Research Database (Denmark)

    Wiell, Charlotte; Szkudlarek, Marcin; Hasselquist, Maria

    2013-01-01

    /or enthesis due to sports-related causes and 10 CTRLs were examined at the Achilles tendons and entheses with US, MRI and clinical assessment. Intratendinous changes, entheseal changes, bursitis and peritendonitis were assessed. An US interobserver substudy was performed in nine persons. US findings showed...

  10. Achilles Pain.

    Science.gov (United States)

    Connors, G. Patrick

    Five ailments which can cause pain in the achilles tendon area are: (1) muscular strain, involving the stretching or tearing of muscle or tendon fibers; (2) a contusion, inflammation or infection called tenosynovitis; (3) tendonitis, the inflammation of the tendon; (4) calcaneal bursitis, the inflammation of the bursa between the achilles tendon…

  11. Subacromial impingement syndrome

    NARCIS (Netherlands)

    Umer, M.; Qadir, I.; Azam, M.

    2012-01-01

    Subacromial impingement syndrome (SAIS) represents a spectrum of pathology ranging from subacromial bursitis to rotator cuff tendinopathy and full-thickness rotator cuff tears. The relationship between subacromial impingement and rotator cuff disease in the etiology of rotator cuff injury is a

  12. The Achilles heel of adults and children

    NARCIS (Netherlands)

    Wiegerinck, J.I.

    2014-01-01

    This thesis focuses on the imaging and treatment of the Achilles heel of adults and children. The figurative and literal Achilles heel consists of a number of pathologies: ankle impingement, Achilles tendinopathy, retrocalcaneal bursitis and calcaneal apophysitis. Research as well as diagnosis and

  13. Cervical Spondylitis and Epidural Abscess Caused by Brucellosis: a Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Reşorlu Hatice

    2016-12-01

    Full Text Available Brucellosis is a zoonotic disease widely seen in endemic regions and that can lead to systemic involvement. The musculoskeletal system is frequently affected, and the disease can exhibit clinical involvements such as arthritis, spondylitis, spondylodiscitis, osteomyelitis, tenosynovitis and bursitis. Spondylitis and spondylodiscitis, common complications of brucellosis, predominantly affect the lumbar and thoracic vertebrae.

  14. MR Imaging Features of Obturator Internus Bursa of the Hip

    OpenAIRE

    Hwang, Ji Young; Lee, Sun Wha; Kim, Jong Oh

    2008-01-01

    The authors report two cases with distension of the obturator internus bursa identified on MR images, and describe the location and characteristic features of obturator internus bursitis; the "boomerang"-shaped fluid distension between the obturator internus tendon and the posterior grooved surface of the ischium.

  15. MR Imaging Features of Obturator Internus Bursa of the Hip

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, Ji Young; Lee, Sun Wha; Kim, Jong Oh [School of Medicine, Ewha Womans University, Seoul (Korea, Republic of)

    2008-08-15

    The authors report two cases with distension of the obturator internus bursa identified on MR images, and describe the location and characteristic features of obturator internus bursitis; the 'boomerang'-shaped fluid distension between the obturator internus tendon and the posterior grooved surface of the ischium

  16. MR imaging features of obturator internus bursa of the hip.

    Science.gov (United States)

    Hwang, Ji Young; Lee, Sun Wha; Kim, Jong Oh

    2008-01-01

    The authors report two cases with distension of the obturator internus bursa identified on MR images, and describe the location and characteristic features of obturator internus bursitis; the "boomerang"-shaped fluid distension between the obturator internus tendon and the posterior grooved surface of the ischium.

  17. Symptomatic knee disorders in floor layers and graphic designers. A cross-sectional study

    DEFF Research Database (Denmark)

    Jensen, Lilli Kirkeskov; Rytter, Søren; Bonde, Jens Peter

    2012-01-01

    Previous studies have described an increased risk of developing tibio-femoral osteoarthritis (TF OA), meniscal tears and bursitis among those with a trade as floor layers. The purpose of this study was to analyse symptomatic knee disorders among floor layers that were highly exposed to kneeling w...... work tasks compared to graphic designers without knee-demanding work tasks....

  18. triceps tendon avulsion

    African Journals Online (AJOL)

    GB

    2014-01-01

    Jan 1, 2014 ... examination seeking a palpable gap, and search for a 'flake' fracture on lateral radiographs will help make the diagnosis of triceps avulsion. ... head fracture, olecranon bursitis and fractures around the elbow joint (7). Likewise, swelling ... functional recovery after a period of active strengthening exercise.

  19. Ultrasonography of the Rotator Cuff

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Yong Cheol [Samsung Medica Center, Sungkyunkwan University College of Medicine, Seoul (Korea, Republic of)

    2006-09-15

    The ultrasonography (US) is an important modality in evaluating shoulder disease. It is accurate in diagnosing the various shoulder diseases including tendinosis, calcific tendinitis, and subacromial bursitis as well as rotator cuff tears. This article presents a pictorial review of US anatomy of the shoulder, the technical aspects of shoulder US, major types of shoulder pathology, and interventional procedure under US guidance

  20. Excessive progression in weekly running distance and risk of running-related injuries

    DEFF Research Database (Denmark)

    Nielsen, Rasmus Østergaard; Parner, Erik Thorlund; Nohr, Ellen Aagaard

    2014-01-01

    trochanteric bursitis, injury to the tensor fascia latae, and patellar tendinopathy) existed in those who progressed their weekly running distance by more than 30% compared with those who progressed less than 10% (hazard ratio = 1.59; 95% confidence interval: 0.96, 2.66; P = .07). Conclusion Novice runners who...

  1. Radiotherapy in degenerative-dystrophic and inflammatory diseases of the osteoarticular system

    Energy Technology Data Exchange (ETDEWEB)

    Pereslegin, I.A.; Zolotkov, A.G.; Alejnikov, G.E. (Vtoroj Moskovskij Gosudarstvennyj Meditsinskij Inst. (USSR))

    1984-07-01

    Analysis of a 3-6 year follow-up of 565 patients with deforming arthrosis, spondylosis, osteochondrosis, spondylarthrosis and calcareous bursitis indicates the efficacy of the proposed standardized complex of topometric and roentgenotherapeutic methods. Medical and social rehabilitation was achieved in most of the patients. The quantitative assessment of the therapeutic results makes it possible to interpret them objectively and unambiguously.

  2. 21 CFR 522.960c - Flumethasone solution.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Flumethasone solution. 522.960c Section 522.960c... Flumethasone solution. (a) Specifications. Each milliliter of sterile aqueous solution contains 0.5 milligram... inflammation, where permanent structural changes do not exist, e.g., bursitis, carpitis, osselets, and myositis...

  3. MRI of the Achilles tendon: A comprehensive review of the anatomy, biomechanics, and imaging of overuse tendinopathies

    Energy Technology Data Exchange (ETDEWEB)

    Pierre-Jerome, Claude; Moncayo, Valeria; Terk, Michael R. (Dept. of Radiology, Emory Univ. Orthopedics and Spine Center, Atlanta, GA (United States)), e-mail: cpierr3@emory.edu

    2010-05-15

    The Achilles tendon is the largest tendon in the body; it plays an important role in the biomechanics of the lower extremity. It can withstand great forces, especially during sporting exercises and pivoting. The pathologies related to the Achilles tendon are diverse and many carry undesirable consequences. We retrospectively analyzed the images of patients who underwent examinations of the ankle/foot region to review the anatomy of the Achilles tendon and its surroundings and to search for pathologies consistent with overuse injuries. The anatomy of the tendon is described from origin to insertion. The imaging characteristics of the Achilles tendon including pitfalls are reviewed. We also describe the Achilles overuse injuries: paratenonitis, tendinosis, tendon tear, atypical tear, tendon re-tear, retrocalcaneal bursitis, retro-Achilles bursitis, Haglund's deformity, and tendon calcification. We present other entities like tendon ossification and failed transplanted Achilles tendon, with emphasis on MRI

  4. Imaging of the Bursae

    Science.gov (United States)

    Hirji, Zameer; Hunjun, Jaspal S; Choudur, Hema N

    2011-01-01

    When assessing joints with various imaging modalities, it is important to focus on the extraarticular soft tissues that may clinically mimic joint pathology. One such extraarticular structure is the bursa. Bursitis can clinically be misdiagnosed as joint-, tendon- or muscle-related pain. Pathological processes are often a result of inflammation that is secondary to excessive local friction, infection, arthritides or direct trauma. It is therefore important to understand the anatomy and pathology of the common bursae in the appendicular skeleton. The purpose of this pictorial essay is to characterize the clinically relevant bursae in the appendicular skeleton using diagrams and corresponding multimodality images, focusing on normal anatomy and common pathological processes that affect them. The aim is to familiarize radiologists with the radiological features of bursitis. PMID:21966619

  5. Anserina Bursitis—A Treatable Cause of Knee Pain in Patients with Degenerative Arthritis

    Science.gov (United States)

    Brookler, Morton I.; Mongan, Edward S.

    1973-01-01

    The anserina bursa is located on the medial surface of the tibia deep to the tendons of the sartorius, gracilis, and semimembranosus muscles and superficial to the insertion of the tibial collateral ligament. Knee pain, a palpable swelling of the bursa, and tenderness over the medial anterior aspect of the tibia just below the knee are the hallmarks of anserina bursitis. In a three-year period, 24 patients with anserina bursitis were seen in a rheumatology clinic. All but one were women, 18 were obese, and only four were under 50 years old. Knee x-ray studies showed degenerative arthritis in 20 of the 24 patients. In ten, varus knee deformities were present, while three had valgus deformities. Ultrasound or local steroid injections gave dramatic relief in all but one patient. PMID:4731586

  6. Features of Onset and Clinical Course of Reactive Arthritis in Children

    Directory of Open Access Journals (Sweden)

    I.S. Lebets

    2013-09-01

    Results. Reactive arthritis of chlamydial etiology is characterized by lesion of large and medium-sized joints of the lower limbs, which is often accompanied by short-term morning stiffness and rapid onset of transient hypomyatrophy. Reiter’s disease may develop rarely. Mycoplasma-induced reactive arthritis is characterized by debut with arthritis of knee, ankle, wrist and small joints of the hand, the development of bursitis and hypomyatrophy. Feature of Ureaplasma arthritis is the formation of bursitis in the heel and tendinitis. Reactive arthritis associated with elevated titers to antistreptolysin O differs with polymorphism of articular syndrome manifestations and, to some extent, of similarity with juvenile rheumatoid arthritis. Unspecified reactive arthritis has a number of the general features with others reactive arthritis and it is characterized by rather benign clinical course, long preservation of joints function and low laboratory activity. Relapse rate of reactive arthritis increases with an increase of duration of illness.

  7. Swelling of olecranon bursa in uremic patients receiving hemodialysis.

    Science.gov (United States)

    Handa, S. P.; Khaliq, S. U.

    1978-01-01

    Three patients with chronic renal failure who received therapy with hemodialysis through arteriovenous fistulas in the forearm had fluctuating swelling over the elbow on the same side as the fistula used for the dialysis. The clinical findings in each case were compatible with olecranon bursitis with effusion. The aspirate obtained from the swellings contained lymphocytes, polymorphonuclear leukocytes and histiocytes, a finding similar to that in cases of uremic pericardial and pleural effusion. Biopsy of the bursa in one case showed hyalinized collagenous tissue with infiltration by histiocytes and lymphocytes, reflecting underlying chronic inflammation. Uremia was believed to be the causative factor. Bursitis with effusion is considered to be one of the clinical aspects of uremic polyserositis. Images FIG. 1 FIG. 2 PMID:638913

  8. The Epidemiology of Physical Training Injuries in U.S. Army Infantry Trainees: Methodology, Population, and Risk Factors

    Science.gov (United States)

    1988-11-01

    photographs were taken of the legs, with anatomical landmarks highlighted with markers. Four plane photographs (medial, plantar , anterior, and posterior...Taunton JE, Clement DB, McNicol K. Plantar fasciitis in runners. Can J Appl Sport Sci 7 (March)41-44 1982. 34. Williams AF. Personality and other...Type Frequency Achilles Tendinitis 3 Ankle Sprain 19 Bursitis 2 Fascitiis 7 Fracture 2 Other Sprain 3 Overuse Knee Injury 18 Pain Not Otherwise

  9. The ''hot'' patella

    Energy Technology Data Exchange (ETDEWEB)

    Kipper, M.S.; Alazraki, N.P.; Feiglin, D.H.

    1982-01-01

    Increased patellar uptake on bone scans is seen quite commonly but the possible or probable etiologies of this finding have not been previously well described. A review of 100 consecutive bone scans showed that the incidence of bilateral ''hot'' patellae is 15%. Identified etiologies include osteoarthritic degenerative disease (35%), fracture, possible metastatic disease, bursitis, Paget's disease, and osteomyelitis. The value of careful history, physical examination, and radiographs is stressed.

  10. Minor rheumatology: Nonsystemic rheumatic disease of juxta-articular soft tissues of the upper extremity. Part 1

    OpenAIRE

    A. E. Karateev; D. E. Karateev; E. S. Orlova; Yu. A. Ermakova

    2015-01-01

    Rheumatic diseases of juxta-articular soft tissues (RDJAST) (tendinitis, tenosynovitis, bursitis, etc.) are one of the most common causes of disability and one the most common reasons for seeking medical advice. To manage patients with RDJAST is an important part of practising rheumatologists’ work. But unfortunately, the issues of diagnosis and therapy of this pathology have been relatively rarely discussed on the pages of Russian medical journals and at the scientific congresses and confere...

  11. Subacromial impingement syndrome

    OpenAIRE

    Masood Umer; Irfan Qadir; Mohsin Azam

    2012-01-01

    Subacromial impingement syndrome (SAIS) represents a spectrum of pathology ranging from subacromial bursitis to rotator cuff tendinopathy and full-thickness rotator cuff tears. The relationship between subacromial impingement and rotator cuff disease in the etiology of rotator cuff injury is a matter of debate. However, the etiology is multi-factorial, and it has been attributed to both extrinsic and intrinsic mechanisms. Management includes physical therapy, injections, and, for some patient...

  12. Arthroscopic Treatment of a Case with Concomitant Subacromial and Subdeltoid Synovial Chondromatosis and Labrum Tear

    OpenAIRE

    Nevres Hurriyet Aydogan; Onur Kocadal; Ahmet Ozmeric; Cem Nuri Aktekin

    2013-01-01

    Synovial chondromatosis is a disease that seldomly seen in shoulder joint and is related to benign synovial proliferation and synchronous chondral tissue formation within the joint cavity. Patients suffer from progressive restriction of range of motion and shoulder pain. Extra-articular involvement is an extremely rare condition. Degenerative osteoarthritis, joint subluxation, and bursitis are common complications in untreated patients. Open or arthroscopic surgery is suitable while there is ...

  13. Subacromial Impingement Syndrome Caused by a Voluminous Subdeltoid Lipoma

    OpenAIRE

    Jean-Christophe Murray; Stéphane Pelet

    2014-01-01

    Subacromial impingement syndrome is a clinical diagnosis encompassing a spectrum of possible etiologies, including subacromial bursitis, rotator cuff tendinopathy, and partial- to full-thickness rotator cuff tears. This report presents an unusual case of subdeltoid lipoma causing extrinsic compression and subacromial impingement syndrome. The patient, a 60-year-old man, presented to our institution with a few years' history of nontraumatic, posteriorly localized throbbing pain in his right sh...

  14. Interleukin-1β stimulates stromal-derived factor-1α expression in human subacromial bursa.

    Science.gov (United States)

    Blaine, Theodore A; Cote, Mindy A; Proto, Al; Mulcahey, Mary; Lee, Francis Y; Bigliani, Louis U

    2011-11-01

    Chemokines produced by synoviocytes of the subacromial bursa are up-regulated in subacromial bursitis and rotator cuff disease. We hypothesized that SDF-1α production in bursal synoviocytes may be induced by local cytokines such as interleukin IL-1β and IL-6. Subacromial bursa specimens were obtained from patients undergoing shoulder surgery. Bursal specimens were stained with anti-human antibodies to IL-1, IL-6, and SDF-1α by immunohistochemistry and compared to normal and rheumatoid controls. Bursal cells were also isolated from specimens and cultured. Early passaged cells were then treated with cytokines (IL-1β and IL-6) and SDF-1α expression was measured by ELISA and RT-PCR. SDF-1α, IL-1β, and IL-6 were expressed at high levels in bursitis specimens from human subacromial bursa compared to normal controls. In cultured bursal synoviocytes, there was a dose-dependent increase in SDF-1α production in the supernatants of cells treated with IL-1β. SDF-1α mRNA expression was also increased in bursal cells treated with IL-1β. IL-6 caused a minimal but not statistically significant increase in SDF-1α expression. SDF-1α, IL-1β, and IL-6 are expressed in the inflamed human subacromial bursal tissues in patients with subacromial bursitis. In cultured bursal synoviocytes, SDF-1α gene expression and protein production are stimulated by IL-1β. IL-1β produced by bursal syvoviocytes and inflammatory cells in the human subacromial bursa is an important signal in the inflammatory response that occurs in subacromial bursitis and rotator cuff disease. Copyright © 2011 Orthopaedic Research Society.

  15. Greater trochanter pain syndrome: A descriptive MR imaging study

    Energy Technology Data Exchange (ETDEWEB)

    Klontzas, Michail E., E-mail: miklontzas@gmail.com; Karantanas, Apostolos H., E-mail: akarantanas@gmail.com

    2014-10-15

    Objective: Greater trochanter pain syndrome (GTPS) is a diverse clinical entity caused by a variety of underlying conditions. We sought to explore the impact of (1) hip morphology, namely the center-edge angle (CEa) and femoral neck-shaft (NSa) angle, (2) hip abductor tendon degeneration, (3) the dimensions of peritrochanteric edema and (4) bursitis, on the presence of GTPS, using MR imaging. Materials and methods: The presence of pain was prospectively assessed blindly by the senior author. CEa and NSa were blindly measured in 174 hip MR examinations, after completion of the clinical evaluation by another evaluator. The existence and dimensions of T2 hyperintensity of the peritrochanteric soft tissues, the existence and dimensions of bursae, as well as degeneration and tearing of gluteus tendons were also recorded. Results: Out of 174 examinations, 91 displayed peritrochanteric edema (group A) and 34 bursitis, all with peritrochanteric edema (group B). A number of 78 patients from both A and B groups, showed gluteus medius tendon degeneration and one tendon tear. CEa of groups A and B were 6° higher than those of normals (group C, P = 0.0038). The mean age of normals was 16.6 years less than in group A and 19.8 years less than in group B (P < 0.0001). Bursitis was associated with pain with a negative predictive value of 97% (P = 0.0003). Conclusion: Acetabular morphology is associated with GTPS and the absence of bursitis was proved to be clinically relevant. Peritrochanteric edema alone was not associated with local pain.

  16. Non-neoplastic conditions presenting as soft-tissue tumours

    Energy Technology Data Exchange (ETDEWEB)

    Crundwell, N. [Royal National Orthopaedic Hospital, Stanmore, Middlesex (United Kingdom); O' Donnell, P. [Royal National Orthopaedic Hospital, Stanmore, Middlesex (United Kingdom); Saifuddin, A. [Royal National Orthopaedic Hospital, Stanmore, Middlesex (United Kingdom)]. E-mail: asif.saifuddin@rnoh.nhs.uk

    2007-01-15

    Review of referrals to our unit over the last 7 years showed that of approximately 750 cases referred as soft-tissue tumours, 132 were subsequently diagnosed as non-neoplastic lesions. The imaging characteristics of these lesions are presented to differentiate them from neoplasms. The most common diagnoses were myositis ossificans, ganglion cyst, abscess/infection, bursitis and synovitis. The imaging features of other rarer conditions will also be discussed.

  17. Calcaneal tendon: imaging findings; Tendao calcaneo: avaliacao por imagem

    Energy Technology Data Exchange (ETDEWEB)

    Montandon, Cristiano; Fonseca, Cristiano Rezio; Montandon Junior, Marcelo Eustaquio [Colegio Brasileiro de Radiologia e Diagnostico por Imagem, Sao Paulo, SP (Brazil)]. E-mail: crismontandon@hotmail.com; Lobo, Leonardo Valadares; Ribeiro, Flavia Aparecida de Souza; Teixeira, Kim-Ir-Sen Santos [Goias Univ., Goiania, GO (Brazil). Hospital de Clinicas. Dept. de Diagnostico por Imagem e Anatomia Patologica

    2003-12-01

    We reviewed the radiological and clinical features of 23 patients with calcaneal tendon diseases, who were submitted to ultrasound or magnetic resonance imaging. The objective of this study was to characterize the lesions for a precise diagnosis of calcaneal tendon injuries. A wide range of calcaneal tendon diseases include degenerative lesions, inflammation of the peritendinous tissue such as peritendinitis and bursitis, and rupture. Imaging methods are essential in the diagnosis, treatment and follow-up of calcaneal tendon diseases. (author)

  18. Fluid collections and juxta-articular cystic lesions of the shoulder: spectrum of MRI findings

    Energy Technology Data Exchange (ETDEWEB)

    Mellado, J.M.; Salvado, E.; Camins, A.; Ramos, A.; Sauri, A. [Institut de Diagnostic per la Imatge, Hospital Joan XXIII, Tarragona (Spain); Merino, X. [Institut de Diagnostic per la Imatge, Hospital Vall' Ebron, Barcelona (Spain); Calmet, J. [Orthopaedic Surgery, Hospital Joan XXIII, Carrer Doctor Mallafre Guasch, Tarragona (Spain)

    2002-03-01

    The MR imaging features of fluid collections and juxta-articular cystic lesions of the shoulder are discussed, with special focus on those related to subacromial impingement and rotator cuff tears. Other more unusual fluid collections and cystic lesions are described, including rice-bodies bursitis, idiopathic synovial osteochondromatosis, dialysis-related amyloid arthropathy, hemophilic arthropathy, infectious conditions, non-infectious inflammatory arthritis, and paralabral cysts. (orig.)

  19. Musculoskeletal infections: ultrasound appearances

    Energy Technology Data Exchange (ETDEWEB)

    Chau, C.L.F. [Department of Radiology, North District Hospital, NTEC, Fanling, NT, Hong Kong (China)]. E-mail: c8681@yahoo.com; Griffith, J.F. [Department of Diagnostic Radiology and Organ Imaging, Prince of Wales Hospital, NTEC, Shatin, NT, Hong Kong (China)

    2005-02-01

    Musculoskeletal infections are commonly encountered in clinical practice. This review will discuss the ultrasound appearances of a variety of musculoskeletal infections such as cellulitis, infective tenosynovitis, pyomyositis, soft-tissue abscesses, septic arthritis, acute and chronic osteomyelitis, and post-operative infection. The peculiar sonographic features of less common musculoskeletal infections, such as necrotizing fasciitis, and rice body formation in atypical mycobacterial tenosynovitis, and bursitis will also be presented.

  20. Ultrasonographic and clinical study of post-stroke painful hemiplegic shoulder

    OpenAIRE

    Mohamed, Rania E.; Amin, Mohamed A.; Aboelsafa, Ashraf A.

    2014-01-01

    Aim of the work: To describe the structural abnormalities of the painful hemiplegic shoulder (PHS) by ultrasound (U/S) and their relationship with some clinical variables. Materials and methods: Eighty consecutive patients with post-stroke PHS were subjected to both clinical assessment and ultrasonographic examination of both shoulders. Ultrasonographic imaging data were classified into five grades. Results: The biceps tendon sheath effusion (51.25%) and the SA–SD bursitis (43.75%) were...

  1. Ultrasound-guided interventional procedures around the shoulder

    OpenAIRE

    Messina, Carmelo; Banfi, Giuseppe; Orlandi, Davide; Lacelli, Francesca; Serafini, Giovanni; Mauri, Giovanni; Secchi, Francesco; Silvestri, Enzo; Sconfienza, Luca Maria

    2015-01-01

    Ultrasound is an established modality for shoulder evaluation, being accurate, low cost and radiation free. Different pathological conditions can be diagnosed using ultrasound and can be treated using ultrasound guidance, such as degenerative, traumatic or inflammatory diseases. Subacromial–subdeltoid bursitis is the most common finding on ultrasound evaluation for painful shoulder. Therapeutic injections of corticosteroids are helpful to reduce inflammation and pain. Calcific tendinopathy of...

  2. MedlinePlus Health Prescriptions: Developing a Pragmatic Approach for Clinic Use

    Science.gov (United States)

    2016-09-29

    Acne Vulgaris; Allergic Rhinitis; Anxiety; Asthma; Back Pain; Prostatic Hyperplasia; Bursitis; Chronic Obstructive Pulmonary Disease; Cough; Coronary Artery Disease; Depression; Diabetes Mellitus; Diarrhea; Gastroesophageal Reflux; Fibromyalgia; Headache; HIV Infections; Hypothyroidism; Hyperlipidemia; Hypertension; Influenza; Sleep Initiation and Maintenance Disorders; Irritable Bowel Syndrome; Migraine Disorders; Obesity; Obstructive Sleep Apnea; Osteoarthritis; Senile Osteoporosis; Shoulder Pain; Sinusitis; Smoking Cessation; Tobacco Use Cessation; Menopause; Urinary Incontinence; Urinary Tract Infection; Vaginitis; Vertigo

  3. Comparison the percentage of detection of periarthritis in patients with rheumatoid arthritis using clinical examination or ultrasound methods

    Directory of Open Access Journals (Sweden)

    Hadi Karimzadeh

    2016-01-01

    Full Text Available Background: This study aimed to compare the percentage of detection of periarthritis in patients with rheumatoid arthritis using clinical examination and ultrasound methods. Materials and Methods: This study is a cross-sectional study which was conducted in Al-Zahra Hospital (Isfahan, Iran during 2014–2015. In our study, ninety patients were selected based on the American College of Rheumatology 2010 criteria. All patients were examined by a rheumatologist to find the existence of effusion, and the data were filled in the checklist. The ultrasonography for detecting effusion in periarticular structures was done by an expert radiologist with two methods, including high-resolution ultrasonography and power Doppler. The percentage of effusion existence found by physical examination was compared by sonography, and the Chi-square and t-tests were used for data analysis. Results: The percentage of effusion found in areas with physical examination by rheumatologist was lower than the frequency distribution of effusions found by sonography (8.3% VS 14.2% (P < 0.001. In sonography, rotator cuff tendonitis is the most common periarthritis. Other findings in sonography were biceps tendinitis (10 cases, wrist tendonitis (13 cases, olecranon bursitis (9 cases, golfers elbow (4 cases, tennis elbow (4 cases, trochanteric bursitis (6 cases, anserine bursitis (6 cases, prepatellar bursitis (11 cases, and ankle tendonitis (7 cases. Tenderness on physical examination was found in 15% of the cases, and the evidence of periarthritis was found in 21/7% through sonography (P < 0.001 and 34% through Doppler sonography (P < 0.001. Conclusion: The percentage of periarthritis detection by ultrasonography and power Doppler sonography was higher than clinical examination. Hence, the ultrasonography is more accurate than physical examination.

  4. Complications following resection of the olecranon bursa.

    Science.gov (United States)

    Degreef, Ilse; De Smet, Luc

    2006-08-01

    We retrospectively reviewed 37 cases of resection of the olecranon bursa and noted wound healing problems in 10 (27%) and recurrence in 8 (22%). A lateral arm flap was necessary in one patient. Conservative treatment remains the treatment of choice for olecranon bursitis. Differentiation between septic and non-septic cases is challenging. The risk of wound healing problems and recurrence should be taken into account when planning surgical resection.

  5. MR imaging features of foot involvement in patients with psoriasis

    Energy Technology Data Exchange (ETDEWEB)

    Erdem, C. Zuhal [Department of Radiology, Zonguldak Karaelmas University, School of Medicine, Zonguldak (Turkey)], E-mail: sunarerdem@yahoo.com; Tekin, Nilgun Solak [Department of Dermatology, Zonguldak Karaelmas University, School of Medicine, Zonguldak (Turkey); Sarikaya, Selda [Department of Physical Therapy and Rehabilitation, Zonguldak Karaelmas University, School of Medicine, Zonguldak (Turkey); Erdem, L. Oktay; Gulec, Sezen [Department of Radiology, Zonguldak Karaelmas University, School of Medicine, Zonguldak (Turkey)

    2008-09-15

    Objective: To determine alterations of the soft tissues, tendons, cartilage, joint spaces, and bones of the foot using magnetic resonance (MR) imaging in patients with psoriasis. Materials and methods: Clinical and MR examination of the foot was performed in 26 consecutive patients (52 ft) with psoriasis. As a control group, 10 healthy volunteers (20 ft) were also studied. Joint effusion/synovitis, retrocalcaneal bursitis, retroachilles bursitis, Achilles tendonitis, soft-tissue edema, para-articular enthesophytes, bone marrow edema, sinus tarsi syndrome, enthesopathy at the Achilles attachment and at the plantar fascia attachment, plantar fasciitis, tenosynovitis, subchondral cysts, and bone erosions, joint space narrowing, subchondral signal changes, osteolysis, luxation, and sub-luxation were examined. Results: Clinical signs and symptoms (pain and swelling) due to foot involvement were present in none of the patients while frequency of involvement was 92% (24/26) by MR imaging. The most common MR imaging findings were Achilles tendonitis (acute and peritendinitis) (57%), retrocalcaneal bursitis (50%), joint effusion/synovitis (46%), soft-tissue edema (46%), and para-articular enthesophytes (38%). The most commonly involved anatomical region was the hindfoot (73%). Conclusion: Our data showed that the incidence of foot involvement was very high in asymptomatic patients with psoriasis on MR imaging. Further MR studies are needed to confirm these data. We conclude that MR imaging may be of importance especially in early diagnosis and treatment of inflammatory changes in the foot.

  6. Musculoskeletal ultrasound imaging of the plantar forefoot in patients with rheumatoid arthritis: inter-observer agreement between a podiatrist and a radiologist

    Directory of Open Access Journals (Sweden)

    Bowen Catherine J

    2008-07-01

    Full Text Available Abstract Background The use of musculoskeletal ultrasound (MSUS in the diagnosis and management of foot and ankle musculoskeletal pathology is increasing. Due to the wide use of MSUS and the depth and breadth of training required new proposals advocate tailored learning of the technique to discrete fields of practice. The aims of the study were to evaluate the inter-observer agreement between a MSUS radiologist and a podiatrist, who had completed basic skills training in MSUS, in the MSUS assessment of the forefoot of patients with Rheumatoid Arthritis. Methods A consecutive sample of thirty-two patients with rheumatoid arthritis was assessed for presence of synovitis, erosions and bursitis within the forefoot using MSUS. All MSUS assessments were performed independently on the same day by a podiatrist and one of two Consultant Radiologists experienced in MSUS. Results Moderate agreement on image acquisition and interpretation was achieved for bursitis (kappa 0.522; p Conclusion This study demonstrated good inter-observer agreement between a podiatrist and radiologist on MSUS assessment of the forefoot, particularly for bursitis and erosions, in patients with rheumatoid arthritis. There is scope to further evaluate and consider the role of podiatrists in the MSUS imaging of the foot following appropriate training and also in the development of reliable protocols for MSUS assessment of the foot.

  7. BURSITIS—OFTEN AN INEXACT DIAGNOSIS

    Science.gov (United States)

    Carpenter, Donald P.

    1958-01-01

    The word bursitis is like arthritis in that it must be modified by another before it has meaning precise enough for useful medical description and communication. It is used loosely and generally to describe a number of clinical and pathological entities, among which are true primary bursitis, cystic degenerations, calcareous deposits in ligaments and tendons, and so-called “chronic sprains” where a calcified deposit cannot be demonstrated. It is possible to differentiate between these four entities in the light of present-day knowledge and to make a more accurate statement of diagnosis. Bursitis is often a symptom... not a primary disease and hence not a proper diagnosis. Calcareous deposits in ligaments and tendons with evident inflammatory reaction have been described in many locations. No area seems to be immune but the rotator cuff and supraspinatus tendon of the shoulder show the greatest incidence. The term inflammatory tendinitis appears to be a reasonably useful one for describing the clinical manifestations of the disease. For further accuracy it can be modified by saying that it is with calcification or without calcification as the case may be. There might be serious consequences from confusing the pain radiation of inflammatory tendinitis (with or without calcification) around the trochanteric region of the hip with true sciatic neuritis arising from a herniated intervertebral disk. PMID:13500222

  8. Accuracy of diagnostic ultrasound in patients with suspected subacromial disorders: a systematic review and meta-analysis.

    Science.gov (United States)

    Ottenheijm, Ramon P; Jansen, Mariëtte J; Staal, J Bart; van den Bruel, Ann; Weijers, René E; de Bie, Rob A; Dinant, Geert-Jan

    2010-10-01

    To determine the diagnostic accuracy of ultrasound for detecting subacromial disorders in patients presenting in primary and secondary care settings. Medline and Embase were searched on June 9, 2010. In addition, the reference list of 1 systematic review and all included articles were searched to identify relevant studies. Two reviewers independently selected the articles evaluating the accuracy of ultrasound for detecting subacromial disorders from the title and abstracts retrieved by the literature search. Selection criteria were ultrasound frequency greater than or equal to 7.5MHz as index test, surgery, magnetic resonance imaging and/or radiography as reference standards, and subacromial disorders as target conditions. Two reviewers independently extracted the data on study characteristics and results to construct 2 by 2 tables and performed a methodologic quality assessment. Twenty-three studies were included: 22 reported on full-thickness rotator cuff tears, 15 on partial-thickness tears, 3 on subacromial bursitis, 2 on tendinopathy, and 2 on calcifying tendonitis, respectively. For full-thickness tears, pooled sensitivity of ultrasound was .95 (95% confidence interval, .90-.97), and specificity .96 (.93-.98). For partial-thickness tears, pooled sensitivity was .72 (.58-.83), and specificity .93 (.89-.96). Statistical pooling was not possible for the other disorders. For subacromial bursitis, sensitivity ranged from .79 to .81, and specificity from .94 to .98. For tendinopathy, sensitivity ranged from .67 to .93, specificity from .88 to 1.00. Sensitivity for calcifying tendonitis was 1.00 in both studies, with specificity ranging from .85 to .98. We strongly recommend ultrasound in patients for whom conservative treatment fails, to rule in or out full-thickness tears, to rule in partial-thickness tears, and to a lesser extent to diagnose tendinopathy, subacromial bursitis, and calcifying tendonitis. These results can help physicians tailor treatment

  9. Preoperative conventional magnetic resonance images versus magnetic resonance arthrography of subacromial impingement syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Ahn, Sang Hyuk; Park, Jung Hwan; Moon, Tae Yong [Pusan National Univ. Yangsan Hospital, Yangsan (Korea, Republic of); Lee, In Sook; Lee, Seung Jun [Pusan National Univ. Hospital, Busan (Korea, Republic of)

    2012-09-15

    To evaluate the usefulness of conventional magnetic resonance images (MRI) for arthroscopic surgery in subacromial impingement syndrome of the shoulder, as an alternative to MR arthrography with additional T2 fat saturation images (MRA). The preoperative MRI of 77 patients (45 females, 32 males) (52 right, 25 left) and MRA of 34 patients (14 females, 20 males) (24 right, 10 left) with subsequent arthroscopic confirmation of subacromial impingement syndrome were reviewed retrospectively. The lesions requiring arthroscopic surgery were 95 subacromial spurs, 101 subacromial bursitis, and 51 full-thickness and 44 partial thickness tears of the supraspinatus among 111 cases for both studies. A two by two table was constructed in order to calculate the sensitivity and specificity of both studies against arthroscopic outcomes. Also we analyzed the false positive and false negative cases of the full-thickness tears individually. The detection rates of subacromial spur and bursitis and full and partial thickness tears of the supraspinatus were 91%, 94%, 77%, and 65% in MRI and 93%, 100%, 83%, and 77% in MRA respectively. Their specificities were 33%, 33%, 90%, and 76% in MRI and 50%, 75%, 100%, and 71% in MRA respectively. Eleven false negative cases in regards to MRI resulted in Ellman's grade 3 partial thickness tear (72.7%), mild bursitis (63.6%), greater tuberosity erosion (45.5%), and negative fluid signal of the glenohumeral joint (81.8%). Three false positive cases on the MRI were induced from errors with lower window depth and width on the imagings. Two false negative cases on MRA were induced from the adhesion between Ellman's grade 3 rim rent tear and the glenohumeral joint cavity. Conventional MR images could be used to decide the arthroscopic surgery in subacromial impingement syndrome, as an alternative to MR arthrography with additional T2 fat saturation images.

  10. Ultrasonographic findings of Achilles tendon and plantar fascia in patients with calcium pyrophosphate deposition disease.

    Science.gov (United States)

    Ellabban, Abdou S; Kamel, Shereen R; Abo Omar, Hanaa A S; El-Sherif, Ashraf M H; Abdel-Magied, Rasha A

    2012-04-01

    The aims of the study were to detect the frequency of involvement of the Achilles tendon and plantar fascia in patients with calcium pyrophosphate deposition disease (CPPD) by high-frequency gray-scale ultrasonography (US) and power Doppler sonography (PDS) and to correlate these findings with demographic and clinical data. Two groups of patients were enrolled: group I (38 patients with CPPD) and group II (22 patients with knee OA). US/PDS examination of the heels was performed to both groups. In the CPPD group, US/PDS examination of the Achilles tendon revealed: calcification in 57.9%, enthesophytosis in 57.9%, enthesopathy in 23.7%, vascular sign in 21%, bursitis in 13.2%, and cortical bone irregularity in 10.5%. US/PDS examination of plantar fascia in the CPPD group revealed: calcification in 15.8%, cortical bone irregularity in 78.9%, enthesophytosis in 60.5%, and planter fasciitis in 42.1%. In patients with CPPD, age was significantly correlated with enthesophytosis and deep retrocalcaneal bursitis (p = 0.01 and p = 0.04, respectively). Heel tenderness and posterior talalgia were significantly correlated with Achilles tendon enthesopathy, vascular sign, and deep retrocalcaneal bursitis (p = 0.0001 for each). Inferior talalgia was significantly correlated with plantar fasciitis (p = 0.0001). The sensitivity of ultrasonography for detection of calcifications in Achilles tendon and plantar fascia was 57.9% and 15.8%, respectively, and the specificity was 100% for both. To conclude, ultrasonographic Achilles tendon and plantar fascia calcifications are frequent findings in patients with CPPD. These calcifications have a high specificity and can be used as a useful indirect sign of CPPD.

  11. Ultrasound assessment of new onset bilateral painful shoulder in patients with polymyalgia rheumatica and rheumatoid arthritis.

    Science.gov (United States)

    Ruta, Santiago; Rosa, Javier; Navarta, David A; Saucedo, Carla; Catoggio, Luis J; Monaco, Ricardo García; Soriano, Enrique R

    2012-09-01

    The aim of our study was to investigate by ultrasound (US) the anatomical structures affected during a new episode of bilateral painful shoulder in patients with polymyalgia rheumatica (PMR) and rheumatoid arthritis (RA) and to compare the findings between these two conditions. PMR and RA patients complaining of new onset bilateral painful shoulder were included. Subjects without any known rheumatic condition with a new onset unilateral painful shoulder were assessed as a control group. US evaluation includes the depiction subacromial-subdeltoid (SAD) bursitis, long head biceps (LHB) tenosynovitis and/or gleno-humeral (GH) synovitis. Thirty patients with PMR, 30 with RA, and 60 controls were included for a total of 60 shoulders per group. Unilateral SAD bursitis and LHB tenosynovitis were significantly more frequent in patients with PMR when compared to those with RA (p < 0.0001 and p < 0.01, respectively) and controls (p < 0.001 and p < 0.01, respectively). Unilateral GH synovitis was more common in RA than in PMR and controls (p < 0.05 and p < 0.01, respectively). Bilateral SAD bursitis was significantly more frequent in patients with PMR than in those with RA (p < 0.01) as was bilateral LHB tenosynovitis (p < 0.01). No significant differences were found in bilateral GH synovitis. US-detected periarticular inflammatory involvement more frequently in PMR both unilaterally and bilaterally and intra-articular inflammatory involvement was commonly in RA but only unilaterally.

  12. Prevalence and pattern of gluteus medius and minimus tendon pathology and muscle atrophy in older individuals using MRI

    Energy Technology Data Exchange (ETDEWEB)

    Chi, Andrew S. [University of Pennsylvania, Department of Radiology, Philadelphia, PA (United States); Long, Suzanne S.; Zoga, Adam C.; Read, Paul J.; Deely, Diane M.; Parker, Laurence; Morrison, William B. [Thomas Jefferson University Hospital, Department of Radiology, Philadelphia, PA (United States)

    2015-12-15

    To evaluate gluteus medius and minimus tendon pathology and muscle atrophy in older individuals using MRI. A retrospective MRI study of 185 individuals was performed. The inclusion criterion was age ≥50. Exclusion criteria were hip surgery, fracture, infection, tumor, or inadequate image quality. Greater trochanteric bursitis was graded none, mild, moderate, or severe. Gluteus medius, gluteus minimus, and iliopsoas tendinopathy was graded normal, tendinosis, low-grade partial tear, high-grade partial tear, or full thickness tear. Gluteus medius, gluteus minimus, tensor fascia lata, and iliopsoas muscle atrophy was scored using a standard scale. Insertion site of tendinopathy and location of muscle atrophy were assessed. Descriptive and statistical analysis was performed. There was increasing greater trochanteric bursitis and gluteus medius and minimus tendinopathy and atrophy with advancing age with moderate to strong positive associations (p < 0.0001) for age and tendinopathy, age and atrophy, bursitis and tendinopathy, and tendinopathy and atrophy for the gluteus medius and minimus. There is a weak positive association (p < 0.0001) for age and tensor fascia lata atrophy, and no statistically significant association between age and tendinopathy or between age and atrophy for the iliopsoas. Fisher's exact tests were statistically significant (p < 0.0001) for insertion site of tendon pathology and location of muscle atrophy for the gluteus medius. Gluteus medius and minimus tendon pathology and muscle atrophy increase with advancing age with progression of tendinosis to low-grade tendon tears to high-grade tendon tears. There is an associated progression in atrophy of these muscles, which may be important in fall-related hip fractures. (orig.)

  13. 2010 Aerospace Medical Certification Statistical Handbook

    Science.gov (United States)

    2012-02-01

    8,443 New Mexico 36 605 96 1,038 174 1,898 306 3,541 New York 268 4,312 208 2,979 589 7,849 1,065 15,140 North Carolina 200 3,868 135 2,602 433...1.70 Other general heart pathology (abnormal ECG, open heart surgery, etc.). Wolff- Parkinson -White syndrome, ablation, AV block, right bundle...toes, foot, or leg, diseases (synovitis, arthritis, bursitis, osteomyelitis, neoplasms, polymyaglia rheumatica, etc.), rheumatoid arthritis, unstable

  14. La radioterapia en las enfermedades no malignas del aparato locomotor

    OpenAIRE

    Algara López, Manuel Ignacio; Marín, M.; Valls, A.

    1999-01-01

    Los autores hacen una revisión de las indicaciones y resultados obtenidos mediante la radioterapia en enfermedades del aparato locomotor, excluyendo las enfermedades proliferativas malignas. En el ámbito de los procesos inflamatorios siguen existiendo dudas a su eficacia en el tratamiento de bursitis y tendinitis, por el contrario, tanto en el tratamiento sistémico inmunosupresor de la artritis reumatoide como en la formación heterotópica de hueso, su utilidad está probada. En el campo de los...

  15. Subacromial impingement syndrome.

    Science.gov (United States)

    Umer, Masood; Qadir, Irfan; Azam, Mohsin

    2012-05-09

    Subacromial impingement syndrome (SAIS) represents a spectrum of pathology ranging from subacromial bursitis to rotator cuff tendinopathy and full-thickness rotator cuff tears. The relationship between subacromial impingement and rotator cuff disease in the etiology of rotator cuff injury is a matter of debate. However, the etiology is multi-factorial, and it has been attributed to both extrinsic and intrinsic mechanisms. Management includes physical therapy, injections, and, for some patients, surgery. No high-quality randomized controlled trials are available so far to provide possible evidence for differences in outcome of different treatment strategies. There remains a need for high-quality clinical research on the diagnosis and treatment of SAIS.

  16. Case report: Lower extremity sparganosis in a bursa.

    Science.gov (United States)

    Ha, Kee-Yong; Oh, In-Soo

    2011-07-01

    Sparganosis is a rare parasitic infection caused by the plerocercoid tapeworm larva of the genus Spirometra. We report the case of a 67-year-old man with a mass over the anteromedial surface of the proximal extremity of the tibia. We surgically excised a bursa containing Spirometra larvae. Sparganosis is a rare parasitic infection. We found no cases of lower extremity sparganosis combined with bursitis reported in the literature. Sparganosis should be considered in the differential diagnosis of soft tissue tumors, especially among patients who frequently have consumed mountain water or raw snakes or frogs.

  17. Longitudinal assessment of cyst-like lesions of the knee and their relation to radiographic osteoarthritis and MRI-detected effusion and synovitis in patients with knee pain

    Science.gov (United States)

    2010-01-01

    Introduction The purpose of the present study was to determine the prevalence of cystic lesions and cyst-like bursitides in subjects with frequent knee pain and to assess their relation to radiographic osteoarthritis (OA) severity; to describe bilaterality and size fluctuation of the lesions over 6 months; and to assess relations between the prevalence of synovium-lined lesions communicating with the joint capsule and severity of magnetic resonance imaging (MRI)-detected effusion and synovitis. Methods One hundred and sixty-three subjects (total 319 knees) aged 35 to 65 with chronic, frequent knee pain were included. Imaging with 3 Tesla MRI was performed at baseline and 6-month follow-up with the same protocols as those used in the Osteoarthritis Initiative. Severity of radiographic OA was assessed using the Kellgren-Lawrence grade (0 to 4). Severity of effusion and synovitis was graded 0 to 3 based on the Whole Organ Magnetic Resonance Imaging Score system. The associations of cysts and cyst-like bursitides and severity of radiographic OA, MRI-detected effusion and synovitis were analyzed using logistic regression controlling for clustering by person. The Wilcoxon signed-rank test was used to determine whether there was a significant change in the size of lesions between baseline and follow-up. Results At least one lesion (any type) was present in 222 (70%) knees. The most prevalent lesions were popliteal cysts (40%, 128/319), followed by subgastrocnemius bursitis (15%, 49/319) and proximal tibiofibular joint cysts (8%, 26/319). Bilateral lesions were seen in 49% of the subjects. Only popliteal cysts and subgastrocnemius bursitis showed a significant change in size (P bursitis was associated with increasing severity of effusion (P = 0.0072) and synovitis (P = 0.0033). Conclusions None of the cyst-like lesions analyzed seems to be a marker of radiographic OA severity in knees with chronic frequent pain. Subgastrocnemius bursitis may be used as a marker of effusion

  18. Imaging of the hip in patients with rheumatic disorders

    Energy Technology Data Exchange (ETDEWEB)

    Boutry, Nathalie [Department of Musculoskeletal Radiology, Roger Salengro Hospital, Centre Hospitalier Universitaire de Lille (France)]. E-mail: nboutry@chru-lille.fr; Khalil, Chadi [Department of Musculoskeletal Radiology, Roger Salengro Hospital, Centre Hospitalier Universitaire de Lille (France); Jaspart, Matthieu [Department of Musculoskeletal Radiology, Roger Salengro Hospital, Centre Hospitalier Universitaire de Lille (France); Department of Anatomy, Faculty of Medicine, Centre Hospitalier Universitaire de Lille (France); Marie-Helene, Vieillard [Department of Rheumatology, Roger Salengro Hospital, Centre Hospitalier Universitaire de Lille (France); Demondion, Xavier [Department of Musculoskeletal Radiology, Roger Salengro Hospital, Centre Hospitalier Universitaire de Lille (France); Department of Anatomy, Faculty of Medicine, Centre Hospitalier Universitaire de Lille (France); Cotten, Anne [Department of Musculoskeletal Radiology, Roger Salengro Hospital, Centre Hospitalier Universitaire de Lille (France)

    2007-07-15

    Hip joint abnormalities are commonly encountered in patients with rheumatic disorders. Although conventional radiography remains the mainstay for diagnosis of joint damage and subsequent follow-up, magnetic resonance imaging and, to a lesser extent, ultrasound have afforded the ability to detect early signs of articular involvement (i.e., synovitis and bone erosions), and to assess disease activity in treated patients. In more advanced stages of rheumatic disorders, magnetic resonance imaging and ultrasound are both useful in assessing paraarticular involvement (i.e., bursitis and synovial cysts)

  19. Radiographic changes in the os calcis in rheumatoid arthritis; Radiographische Veraenderungen am Fersenbein im Rahmen der chronischen Polyarthritis

    Energy Technology Data Exchange (ETDEWEB)

    Lakits, A. [Krankenhaus Lainz (Austria). Zentralroentgeninstitut; Haller, J. [Hanusch-Krankenhaus, Vienna (Austria). Roentgenabteilung; Steiner, E. [Vienna Univ. (Austria). Klinik fuer Roentgendiagnostik; Stenzel, I. [Krankenhaus Lainz (Austria). Zentralroentgeninstitut; Schneider, B. [Vienna Univ. (Austria). Inst. fuer Medizinische Statistik und Dokumentation; Czembirek, H. [Krankenhaus Lainz (Austria). Zentralroentgeninstitut; Smolen, J. [Krankenhaus Lainz (Austria). 2. Medizinische Abt. (Rheumatologie)

    1994-02-01

    Plain films of the calcanea of 768 patients with confirmed rheumatoid arthritis were examined retrospectively with reference to inflammatory rheumatic changes. 42 patients (5.5%) showed an erosion of the posterior upper calcaneal margin related to an Achilles bursitis. In three patients there were additional plantar erosions. The Achilles bursitis was bilateral in 50% of cases, particularly in patients in stages 2 and 3 according to Steinbrocker. In the majority of bilateral cases (62%) the size or shape of the lesions was asymmetrical. Our observations indicate that involvement of the os calcis is not uncommon in rheumatoid arthritis; routine examination of this bone would appear to be indicated even in patients without symptoms. Since the defect is unilateral in half the patients, unilateral occurrence of an erosive lesion cannot be regarded as a criterion for a bacterial-inflammatory bursitis. Contrary to the symmetrical involvement of joints in the hands in rheumatoid arthritis, defects in the calcanea are often unilateral or asymmetrical. (orig.) [Deutsch] Die Nativroentgenaufnahmen des Fersenbeins von 768 Patienten mit gesicherter chronischer Polyarthritis wurden retrospektiv hinsichtlich des Auftretens entzuendlich-rheumatischer Veraenderungen beurteilt. 42 Patienten (5,5%) zeigten eine Erosion der hinteren oberen Fersenbeinkante im Sinne eines Achillobursitisdefektes. Bei drei Patienten gelangte zusaetzlich eine plantare Erosion zur Darstellung. Der Achillobursitisdefekt war in 50% der Faelle beidseitig ausgebildet, wobei das bilaterale Auftreten bei Patienten in den Stadien II und III nach Steinbrocker ueberwog. Bei bilateralem Befall waren die Laesionen allerdings in der Mehrzahl der Faelle (62%) hinsichtlich Groesse und/oder Form asymmetrisch ausgebildet. Unsere Beobachtungen belegen, dass eine Fersenbeinbeteiligung im Rahmen der chronischen Polyarthritis nicht selten auftritt, weshalb routinemaessig Roentgenaufnahmen des Fersenbeins bei Patienten mit

  20. MRI and US of gluteal tendinopathy in greater trochanteric pain syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Kong, Andrew; Van der Vliet, Andrew [Regional Imaging Border, Albury, NSW (Australia); Zadow, Steven [Dr Jones and Partners Medical Imaging, Adelaide, SA (Australia)

    2007-07-15

    Greater trochanteric pain syndrome is commonly due to gluteus minimus or medius injury rather than trochanteric bursitis. Gluteal tendinopathy most frequently occurs in late-middle aged females. In this pictorial review the pertinent MRI and US anatomy of the gluteal tendon insertions on the greater trochanter and the adjacent bursae are reviewed. The direct (peritendinitis, tendinosis, partial and complete tear) and indirect (bursal fluid, bony changes and fatty atrophy) MRI signs of gluteal tendon injury are illustrated. The key sonographic findings of gluteal tendinopathy are also discussed. (orig.)

  1. The painful heel. Comparative study in rheumatoid arthritis, ankylosing spondylitis, Reiter's syndrome, and generalized osteoarthrosis.

    Science.gov (United States)

    Gerster, J C; Vischer, T L; Bennani, A; Fallet, G H

    1977-08-01

    This study presents the frequency of severe and mild talalgias in unselected, consecutive patients with rheumatoid arthritis, ankylosing spondylitis, Reiter's syndrome, and generalized osteoarthosis. Achilles tendinitis and plantar fasciitis caused a severe talalgia and they were observed mainly in males with Reiter's syndrome or ankylosing spondylitis. On the other hand, sub-Achilles bursitis more frequently affected women with rheumatoid arthritis and rarely gave rise to severe talalgias. The simple calcaneal spur was associated with generalized osteoarthrosis and its frequency increased with age. This condition was not related to talalgias. Finally, clinical and radiological involvement of the subtalar and midtarsal joints were observed mainly in rheumatoid arthritis and occasionally caused apes valgoplanus.

  2. Miscellaneous conditions of tendons, tendon sheaths, and ligaments.

    Science.gov (United States)

    Dyson, S J; Dik, K J

    1995-08-01

    The use of diagnostic ultrasonography has greatly enhances our ability to diagnose injuries of tendons and tendon sheaths that were previously either unrecognized or poorly understood. For may of these injuries, there is currently only a small amount of follow-up data. This article considers injuries of the deep digital flexor tendon and its accessory ligament, the carpal tunnel syndrome soft tissue swellings on the dorsal aspect of the carpus, intertubercular (bicipital) bursitis and bicipital tendinitis, injuries of the gastrocnemius tendon, common calcaneal tendinitis, rupture of peroneus (fibularis tertius) and ligaments injuries of the back.

  3. Impact of radiation therapy for benign diseases; Role de la radiotherapie dans les affections benignes

    Energy Technology Data Exchange (ETDEWEB)

    Kantor, G. [Institut National de la Sante et de la Recherche Medicale (INSERM), Fondation Bergonie, 33 - Bordeaux (France); Van Houtte, P.; Beauvois, S.; Roelandts, M. [Institut Bordet, Brussels (Belgium)

    1997-12-31

    Radiation therapy of benign diseases represent a wide panel of indications. Some indications are clearly identified as treatment of arteriovenous malformations (AVM), hyperthyroid ophthalmopathy, postoperative heterotopic bone formations or keloid scars. Some indications are under evaluation as complications induced by neo-vessels of age-related macular degeneration or coronary restenosis after angioplasty. Some indications remain controversial with poor evidence of efficiency as treatment of bursitis, tendinitis or Dupuytren`s disease. Some indications are now obsolete such as warts, or contra-indicated as treatment of infant and children. (authors)

  4. Autologous implant of bone marrow mononuclear stem-cells as treatment for equine bicipital tendonitis: case report Implante autólogo de células mononucleares de médula ósea como tratamiento de tendinitis bicipital equina: reporte de caso clínico

    OpenAIRE

    BC Menarim; GA Fortini; PS Álvarez; J Gómez; CD Jarrín; A Ramírez; JS Galecio

    2012-01-01

    Bicipital bursitis in the horse, the inflammation of the bicipital tendon and its surrounding bursa, has been reported to represent a low percentage of lameness cause. However, it is the main cause of lameness associated to the shoulder region and it has been under diagnosed. Due to high recurrence in different types of tendon injuries, treatments aiming to re-establish tendon functionality have been a focus of research. The aim of this study is to report the implant of a bone marrow mononucl...

  5. Subacromial impingement syndrome

    Directory of Open Access Journals (Sweden)

    Masood Umer

    2012-05-01

    Full Text Available Subacromial impingement syndrome (SAIS represents a spectrum of pathology ranging from subacromial bursitis to rotator cuff tendinopathy and full-thickness rotator cuff tears. The relationship between subacromial impingement and rotator cuff disease in the etiology of rotator cuff injury is a matter of debate. However the etiology is multi-factorial, and has been attributed to both extrinsic and intrinsic mechanisms. Management includes physical therapy, injections, and, for some patients, surgery. No high-quality RCTs are available so far to provide possible evidence for differences in outcome of different treatment strategies. There remains a need for high-quality clinical research on the diagnosis and treatment of SAIS.

  6. Disseminated protothecosis.

    Science.gov (United States)

    Mathew, Leni G; Pulimood, Susanne; Thomas, Meera; Acharya, Mary A; Raj, Promila Mohan; Mathews, Mary S

    2010-02-01

    Here is presented, a rare case of disseminated protothecosis in a 10-year-old boy with combined immunodeficiency, hitherto unreported from India. Even though it is difficult to diagnose clinically, observation of the sporangiospores within the sporangium in culture gives the accurate laboratory identification of Prototheca spp. In this patient, failure to eradicate the infection with amphotericin B and recurrence with olecranon bursitis along with skin lesions and splenomegaly was observed. Disseminated protothecosis in a child with combined immunodeficiency and failure to eradicate the infection with amphotericin B is reported.

  7. Olecranon extrabursal endoscopic bursectomy.

    Science.gov (United States)

    Tu, Chen G; McGuire, Duncan T; Morse, Levi P; Bain, Gregory I

    2013-09-01

    Olecranon bursitis is a common clinical problem. It is often managed conservatively because of the high rates of wound complications with the conventional open surgical technique. Conventional olecranon bursoscopy utilizes an arthroscope and an arthroscopic shaver, removing the bursa from inside-out. We describe an extrabursal endoscopic technique where the bursa is not entered but excised in its entirety under endoscopic vision. A satisfactory view is obtained with less morbidity than the open method, while still avoiding a wound over the sensitive point of the olecranon.

  8. Lesión de "tennis leg" asociada a rotura parcial del tendón de Aquiles

    OpenAIRE

    Rodas Font, Gil; Bove, Toni; Martinez, Xavier; Pedret Carballido, Carles; Dalmau, Antoni

    2010-01-01

    La rotura de la porción distal del músculo gemelo interno también es conocida como la lesión de "tennis leg". Es frecuente que esta patología esté asociada a la rotura del músculo sóleo o la del músculo plantar delgado, así como la trombosis venosa profunda. Presentamos el caso de un jugador profesional de baloncesto con antecedentes de tendinopatía aquílea y bursitis retrocalcánea que presenta un "tennis-leg" asociado a una rotura parcial del tendón de Aquiles.

  9. High-resolution ultrasound of rotator cuff and biceps reflection pulley in non-elite junior tennis players: anatomical study.

    Science.gov (United States)

    Tagliafico, Alberto; Cadoni, Angela; Bignotti, Bianca; Martinoli, Carlo

    2014-07-18

    Tennis is believed to be potentially harmful for the shoulder, therefore the purpose of this study is to evaluate the anatomy of the rotator cuff and the coraco-humeral ligament (CHL) in a-symptomatic non-elite junior tennis players with high-resolution ultrasound (US). From August 2009 to September 2010 n = 90 a-symptomatic non-elite junior tennis players (mean age ± standard deviation: 15 ± 3) and a control group of age- and sex- matched subjects were included. Shoulder assessment with a customized standardized protocol was performed. Body mass index, dominant arm, years of practice, weekly hours of training, racket weight, grip (Eastern, Western and semi-Western), kind of strings were recorded. Abnormalities were found at ultrasound in 14/90 (15%) players. Two players had supraspinatus tendinosis, two had subacromial impingement and ten had subacromial bursitis. CHL thickness resulted comparable in the dominant and non-dominant arms (11.3 ± 4.4 mm vs. 13 ± 4.2, p > 0.05). Multivariate analysis demonstrated that no association was present among CHL thickness and the variables evaluated. In the control group, abnormalities were found at ultrasound in 6/60 (10%) subjects (sub-acromial bursitis). No statistically significant differences between players and control group were found (p = 0.71). In a-symptomatic non-elite junior tennis players only minor shoulder abnormalities were found.

  10. Subacromial corticosteroid injection for poststroke shoulder pain: an exploratory prospective case series.

    Science.gov (United States)

    Chae, John; Jedlicka, Lynn

    2009-03-01

    To assess the effectiveness of subacromial corticosteroid injections for poststroke shoulder pain. Exploratory, prospective case series. Ambulatory setting, university-affiliated hospital. Stroke survivors (N=10) with pain in the hemiparetic shoulder. Consecutive stroke survivors with evidence of supraspinatus impingement, supraspinatus tendonitis, or subacromial bursitis received subacromial corticosteroid injections. The primary outcome measure was the Brief Pain Inventory (BPI) question 12 (BPI 12), which assesses "worst pain" in the previous 7 days. Secondary measures included BPI question 15, which assesses present pain and BPI question 23 (BPI 23), which assesses pain interference with 7 daily activities. Outcomes were assessed at baseline, weekly for the first 4 weeks and then at 8 and 12 weeks postinjection. Repeated measure analysis of variance revealed significant within group time effect for BPI 12 (F=7.7, PSubacromial corticosteroid injection is associated with significant reduction in poststroke shoulder pain in patients with evidence of supraspinatus impingement, supraspinatus tendonitis, or subacromial bursitis. However, there is a gradual loss of effect with time. Controlled trials are needed to show a cause and effect relationship.

  11. Assessment of the Postoperative Appearance of the Rotator Cuff Tendon Using Serial Sonography After Arthroscopic Repair of a Rotator Cuff Tear.

    Science.gov (United States)

    Yoo, Hye Jin; Choi, Ja-Young; Hong, Sung Hwan; Kang, Yusuhn; Park, Jina; Kim, Sae Hoon; Kang, Heung Sik

    2015-07-01

    The purpose of this study was to evaluate serial changes in sonographic findings of a rotator cuff tendon after rotator cuff repair. Sixty-five arthroscopically repaired rotator cuff tears (43 full-thickness tears and 22 partial-thickness tears) were retrospectively included in this study. Serial sonographic examinations were performed at 5 weeks, 3 months, and 6 months after surgery. The sonographic findings of the repaired tendon were assessed for a recurrent tear, tendon thickness, morphologic tendon characteristics, vascularity, and bursitis at each time point. Four recurrent tears occurred within 3 months of surgery. The postoperative tendon thickness decreased from 5 weeks to 6 months after surgery (P = .001). There were significant changes in the morphologic tendon characteristics, including the echo texture, fibrillar pattern, and surface irregularity of the repaired tendon, from 5 weeks to 6 months after surgery (P subacromial-subdeltoid bursitis and the vascularity of the repaired tendon decreased postoperatively over time. Serial sonography after arthroscopic rotator cuff repair was useful for monitoring the postoperative changes in a repaired tendon. The morphologic appearance of the repaired tendon and peritendinous soft tissue changes improved over time and nearly normalized within 6 months of surgery. © 2015 by the American Institute of Ultrasound in Medicine.

  12. Static and Dynamic Shoulder Imaging to Predict Initial Effectiveness and Recurrence After Ultrasound-Guided Subacromial Corticosteroid Injections.

    Science.gov (United States)

    Chang, Ke-Vin; Wu, Wei-Ting; Han, Der-Sheng; Özçakar, Levent

    2017-10-01

    To explore factors contributing to initial effectiveness and recurrence after ultrasound (US)-guided subacromial corticosteroid injections by assessing clinical measurements and static and dynamic shoulder US images. Retrospective cohort study. Rehabilitation outpatient clinic. Adults with shoulder pain referred for injection therapy (N=164). US-guided subacromial corticosteroid injection. The association of initial effectiveness (defined as >50% decrease in any of the 3 pain subdomains after the first injection) and recurrent shoulder pain that required repeated intervention with record-based clinical measurements and static/dynamic shoulder US. This study included 164 patients, 106 of whom were responsive to a first injection. Among the 106 participants, 42 received a second injection because of recurrent shoulder pain. By using the multivariate logistic regression analysis, initial effectiveness was positively associated with right handedness, grade 2 subacromial impingement during the dynamic US examination, and bicipital groove tenderness. However, these patients had a negative association with subdeltoid bursitis, grade 3 subacromial impingement, and shoulder stiffness. Subdeltoid bursitis and a positive painful arc test were predictors of recurrent shoulder pain that necessitated a repeated injection in the Cox proportional hazards model. The initial effectiveness and recurrence after US-guided subacromial corticosteroid injection were associated with certain clinical measurements and static and dynamic shoulder US, which should be carefully evaluated (and can be used) to guide the best treatment outcomes. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  13. Adhesive capsulitis: a review.

    Science.gov (United States)

    Ewald, Anthony

    2011-02-15

    Adhesive capsulitis is a common, yet poorly understood, condition causing pain and loss of range of motion in the shoulder. It can occur in isolation or concomitantly with other shoulder conditions (e.g., rotator cuff tendinopathy, bursitis) or diabetes mellitus. It is often self-limited, but can persist for years and may never fully resolve. The diagnosis is usually clinical, although imaging can help rule out other conditions. The differential diagnosis includes acromioclavicular arthropathy, autoimmune disease (e.g., systemic lupus erythematosus, rheumatoid arthritis), biceps tendinopathy, glenohumeral osteoarthritis, neoplasm, rotator cuff tendinopathy or tear (with or without impingement), and subacromial and subdeltoid bursitis. Several treatment options are commonly used, but few have high-level evidence to support them. Because the condition is often self-limited, observation and reassurance may be considered; however, this may not be acceptable to many patients because of the painful and debilitating nature of the condition. Nonsurgical treatments include analgesics (e.g., acetaminophen, nonsteroidal anti-inflammatory drugs), oral prednisone, and intra-articular corticosteroid injections. Home exercise regimens and physical therapy are often prescribed. Surgical treatments include manipulation of the joint under anesthesia and capsular release.

  14. Sonography of the bicipitoradial bursa: A short pictorial essay.

    Science.gov (United States)

    Draghi, F; Gregoli, B; Sileo, C

    2012-02-01

    Serous bursae consist of a synovial membrane enveloping a film of liquid. They are located at interfaces between moving structures where friction must be reduced. The bicipitoradial bursa lies between the distal tendon of the biceps brachii, which it surrounds, and the radial tuberosity. It is a relatively large bursa, with dimensions ranging from 2.4 to 3.9 cm. It sometimes presents septation. It does not communicate with the joint cavity, but it may communicate with the interosseous bursa of the elbow. Regardless of its cause, bicipitoradial bursitis presents as a mass in the cubital fossa and/or with neurological symptoms (sensorial and/or motorial) caused by compression of the radial nerve. On ultrasonography, the inflamed bursa is visualized as an anechoic formation surrounding the distal biceps tendon. In addition to its role in diagnosing the bursitis, sonography can provide information about radial nerve injury (in the presence of macroscopic damage), and it can also be used for guidance during intrabursal injections.

  15. Sonography of the bicipitoradial bursa

    Science.gov (United States)

    Draghi, F.; Gregoli, B.; Sileo, C.

    2012-01-01

    Serous bursae consist of a synovial membrane enveloping a film of liquid. They are located at interfaces between moving structures where friction must be reduced. The bicipitoradial bursa lies between the distal tendon of the biceps brachii, which it surrounds, and the radial tuberosity. It is a relatively large bursa, with dimensions ranging from 2.4 to 3.9 cm. It sometimes presents septation. It does not communicate with the joint cavity, but it may communicate with the interosseous bursa of the elbow. Regardless of its cause, bicipitoradial bursitis presents as a mass in the cubital fossa and/or with neurological symptoms (sensorial and/or motorial) caused by compression of the radial nerve. On ultrasonography, the inflamed bursa is visualized as an anechoic formation surrounding the distal biceps tendon. In addition to its role in diagnosing the bursitis, sonography can provide information about radial nerve injury (in the presence of macroscopic damage), and it can also be used for guidance during intrabursal injections. PMID:23396577

  16. Involvement of the inconstant bursa of the fifth metatarsophalangeal joint in psoriatic arthritis: a clinical and ultrasonographic study.

    Science.gov (United States)

    Ciancio, Giovanni; Volpinari, Stefania; Fotinidi, Maria; Furini, Federica; Farina, Ilaria; Bortoluzzi, Alessandra; Ferracin, Manuela; Bandinelli, Francesca; Orzincolo, Carlo; Trotta, Francesco; Govoni, Marcello

    2014-01-01

    To evaluate the involvement of the bursa located next to the head of the 5th metatarsal bone in patients with psoriatic arthritis (PsA) in comparison with the other seronegative spondyloarthritis (SpA). All patients with PsA seen during a period of 24 months were enrolled. The control group included healthy subjects and patients with the other SpA. All subjects underwent clinical and ultrasound (US) examination of the lateral surface of the 5th metatarsal. 150 PsA patients (88 M; 62 F), 172 SpA (107 M; 65 F), and 95 healthy controls (58 M; 37 F) were evaluated. Based on clinical and US evaluation, bursitis was diagnosed in 17/150 (11.3%) PsA patients but in none of the SpA (P bursa of the 5th metatarsophalangeal joint appears to be involved in PsA more frequently than by chance. If confirmed by other studies, this finding could be considered as a distinctive clinical sign of PsA, useful for differential diagnosis with the other SpA. In asymptomatic patients, US proved to be more sensitive in the detection of bursitis.

  17. Minor rheumatology: Nonsystemic rheumatic disease of juxta-articular soft tissues of the pelvis and lower extremity: Diagnosis and treatment. Part 3

    Directory of Open Access Journals (Sweden)

    A. E. Karateev

    2015-01-01

    Full Text Available Pain associated with rheumatic diseases of juxta-articular soft tissues (RDJAST of the pelvis and lower extremity is a frequent reason for seeking advice from general practitioners and rheumatologists. However, the true cause of painful sensations is often overlooked by a physician and the patient is long and frequently treated unsuccessfully for lumbago, coxarthrosis, or gonarthrosis.The complexities of topical diagnosis are largely associated with the fact that instrumental methods virtually always determine these or those degenerative changes in the lumbar spine and hip joint (HJ, which formally supports the presence of nonspecific low back pain and coxarthrosis. Differential diagnosis can be made between these conditions if their clinical features are considered, by discriminating symptoms, such as pains in the back or buttock, and those located predominantly in the hip and groin area.The most known forms of RDJAST of the pelvis and HJ may include trochanteritis, hip abductor and adductor syndromes, iliopectineal bursitis, and ischial tuberosity bursitis.This review briefly describes the major forms of RDJAST of the mentioned area, their clinical manifestations, and topical diagnostic techniques. It also considers main therapeutic approaches: the administration of nonsteroidal antiinflammatory drugs, local injections of glucocorticoids and plateletrich plasma, and physiotherapy.

  18. Artroscopia da articulação escapulotorácica: relato de casos Arthroscopy of the scapulothoracic joint: case reports

    Directory of Open Access Journals (Sweden)

    Carlos Vicente Andreoli

    2009-01-01

    Full Text Available A artroscopia escapulotorácica é um procedimento que apresenta indicações restritas, para ressecção de corpos livres, tumores benignos, bursites e escápulas em ressalto. Os autores relatam quatro casos de artroscopia da articulação escapulotorácica; no primeiro caso, foi realizada apenas a visualização do tumor benigno (osteocondroma; no segundo caso, a ressecção artroscópica de um osteocondroma; no terceiro caso, a bursectomia artroscópica devido à bursite escapulotorácica; e no quarto caso, bursectomia e escapulectomia súpero-medial parcial artroscópica devido à escápula em ressalto.Scapulothoracic arthroscopy is a procedure presenting restricted indications, for resecting free bodies, benign tumors, bursitis, and snaping scapula. The authors report four cases of scapulothoracic joint arthroscopy; in the first case, only a benign tumor (osteochondroma could be visualized; in the second case, arthroscopic resection of an osteochondroma was found; in the third case, arthroscopic bursectomy due to scapulothoracic bursitis, and; in the fourth case, bursectomy and partial superomedial arthroscopic scapulectomy due to snaping scapula.

  19. Intramuscular myxoid lipoma in the proximal forearm presenting as an olecranon mass with superficial radial nerve palsy: a case report

    Directory of Open Access Journals (Sweden)

    Hildebrand Kevin A

    2011-07-01

    Full Text Available Abstract Background Extremity lipomas may occur in any location, including the proximal forearm. We describe a case of a patient with an intramuscular lipoma presenting as an unusual posterior elbow mass. Case presentation We discuss the case of a 57-year-old Caucasian man who presented with a tender, posterior elbow mass initially diagnosed as chronic olecranon bursitis. A minor sensory disturbance in the distribution of the superficial radial nerve was initially thought to be unrelated, but was likely caused by mass effect from the lipoma. No pre-operative advanced imaging was obtained because the diagnosis was felt to have already been made. At the time of surgery, a fatty mass originating in the volar forearm muscles was found to have breached the dorsal forearm fascia and displaced the olecranon bursa. Tissue diagnosis was made by histopathology as a myxoid lipoma with no aggressive features. Post-operative recovery was uneventful. Conclusion We present a case of an unusual elbow mass presenting with symptoms consistent with chronic olecranon bursitis, a relatively common condition. The only unexplained pre-operative finding was the non-specific finding of a transient superficial radial nerve deficit. We remind clinicians to be cautious when diagnosing soft tissue masses in the extremities when unexplained physical findings are present.

  20. MRI findings of prepatellar Morel-Lavallee effusions

    Energy Technology Data Exchange (ETDEWEB)

    Borrero, Camilo G.; Maxwell, Norman; Kavanagh, Eoin [University of Pittsburgh Medical Center, Department of Radiology, Pittsburgh, PA (United States)

    2008-05-15

    To describe MR imaging characteristics and treatment options for prepatellar closed degloving injuries or Morel-Lavallee effusions. Imaging features are discussed that may aid in the distinguishing of this entity from 'housemaid's knee' or prepatellar bursitis. MR images of four young wrestlers were reviewed by two attending radiologists and one fellow, and correlative clinical data were collected using the electronic medical database. MR images in all cases showed a unilocular, T2 hyperintense prepatellar collection extending beyond the normal boundaries of the prepatellar bursa. No necrotic fat or blood products were identified in the collections. Surgical pathology proving the absence of synovial tissue was available for one case, and differentiation of the collection from the adjacent bursa was confirmed visually by the surgeon in a second case. Although prepatellar hemorrhagic bursitis and Morel-Lavallee effusions share many imaging features, making a specific diagnosis in most cases is not necessary, as treatment is often similar for both entities. (orig.)

  1. Percutaneous Fascia Release for Treating Chronic Recurrent Gluteal Myofascial Pain—A Pilot Study of a New Technique

    Directory of Open Access Journals (Sweden)

    Hsin-Shui Chen

    2015-01-01

    Full Text Available Objective To investigate the therapeutic effectiveness of percutaneous fascia release to treat chronic recurrent gluteal myofascial pain related to recurrent tendonitis or bursitis at the attachment sites. Methods Five patients (three males, two females; aged 48.6 ± 8.9 years with myofascial trigger points in the gluteus medius muscle were treated. Outcome measures, including pain intensity, pressure pain threshold, and the relative strength of hip abduction, were assessed before, immediately after, and six months after the treatment. The data measured before and after treatment (different times on visual analog scale, pressure pain threshold, and relative hip abduction strength were analyzed by Wilcoxon signed-rank test and paired t -test, respectively, for the comparisons between time points. Results Reduction in pain intensity and increase in the pressure pain threshold and the relative hip abduction strength were found in all five patients after treatment when compared with those of before treatment ( P 0.05. Conclusions Percutaneous fascia release of gluteal muscle insertion sites can be used to treat chronic gluteal pain related to subtrochanteric bursitis to avoid recurrence, if other treatment cannot control the recurrence, although this was demonstrated only on a small sample size without control and blind assessment in the pilot study.

  2. Iatrogenic Cushing's syndrome after triamcinolone plus ritonavir-boosted atazanavir.

    Science.gov (United States)

    Jakeman, Bernadette; Conklin, Jessica; Bouchonville, Matthew; Thornton, Karla

    2015-01-01

    To describe a case of iatrogenic Cushing's syndrome (ICS) following a triamcinolone injection for subscapular bursitis in an HIV-positive patient receiving an antiretroviral regimen that included ritonavir boosted-atazanavir. University outpatient HIV clinic. A 60-year-old HIV-positive man on a ritonavir-boosted, atazanavir-containing antiretroviral regimen was diagnosed with subscapular bursitis. The patient received two intrabursal injections with 1% lidocaine plus triamcinolone 20 mg. Four weeks after the injections, the patient experienced symptoms of Cushing's syndrome with a pronounced drop in his CD4+ T-cell count, requiring treatment of oral candidiasis and prophylaxis for opportunistic infections. The interaction between ritonavir and oral corticosteroids, resulting in ICS, has been established. This case adds to the literature as one of the few cases illustrating that interaction can also occur between ritonavir and intrabursal administration of corticosteroids. This case further supports concerns regarding use of corticosteroids in HIV-infected patients who are treated with ritonavir-containing antiretroviral regimens.

  3. Injectable Corticosteroids: Take Precautions and Use Caution.

    Science.gov (United States)

    Freire, Véronique; Bureau, Nathalie J

    2016-11-01

    Corticosteroids are routinely injected into soft tissues, tendon sheaths, bursae, and joints. These anti-inflammatory agents have different potency and solubility, and solubility is inversely correlated with the duration of action. Corticosteroids carry a low risk of complications but commonly cause systemic and local adverse effects. The use of intra-articular corticosteroid injections in the treatment of inflammatory arthritis and osteoarthritis is well established. Evidence also supports the use of injectable corticosteroids in the treatment of inflammatory tenosynovitis and bursitis associated with rheumatic diseases, trigger finger and de Quervain disease, and carpal tunnel syndrome. The role of corticosteroid injections in the management of rotator cuff disease remains unclear. Strong scientific evidence indicates that corticosteroid injections for lateral epicondylosis worsen the long-term outcomes of patients. This review article discusses the considerations related to the use of corticosteroid injections in the management of nonspinal musculoskeletal conditions. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  4. Caracterización de patologías del hombro relacionadas con el origen y prestaciones asistenciales y económicas en una EPS, Bogotá, 2012 a 2014

    OpenAIRE

    Villa Rodriguez, Marilyn Esther

    2016-01-01

    Introducción: Las patologías del hombro suelen ser una de las causas de mayor solicitud de consulta en el ámbito laboral, con generación de incapacidad y pérdidas económicas, tanto para el afectado como para la empresa e incluso, la Entidad Promotora de Salud responsable de la atención y tratamiento. Entre las patologías de hombro más frecuentes se hallan el síndrome del manguito rotador, bursitis del hombro, síndrome de abducción dolorosa del hombro, tendinitis del bíceps, traumatismos del t...

  5. The Morel-Lavallée lesion: pathophysiology, clinical presentation, imaging features, and treatment options.

    Science.gov (United States)

    Bonilla-Yoon, Iris; Masih, Sulabha; Patel, Dakshesh B; White, Eric A; Levine, Benjamin D; Chow, Kira; Gottsegen, Christopher J; Matcuk, George R

    2014-02-01

    Morel-Lavallée lesions are posttraumatic hemolymphatic collections related to shearing injury and disruption of interfascial planes between subcutaneous soft tissue and muscle. We review the pathophysiology of Morel-Lavallée lesions, clinical presentation, and potential sites of involvement. Magnetic resonance imaging (MRI) is the modality of choice for characterization. We present the MRI classification and highlight the key imaging features that distinguish the different types, focusing on the three most common: seroma, subacute hematoma, and chronic organizing hematoma. Potential mimics of Morel-Lavallée lesions, such as soft tissue sarcoma and hemorrhagic prepatellar bursitis, are compared and contrasted. Treatment options and a management algorithm are also briefly discussed.

  6. Morel-Lavallee Lesions-Review of Pathophysiology, Clinical Findings, Imaging Findings and Management.

    Science.gov (United States)

    Diviti, Sreelatha; Gupta, Nishant; Hooda, Kusum; Sharma, Komal; Lo, Lawrence

    2017-04-01

    Morel-Lavallee lesion is a post-traumatic soft tissue degloving injury. This is commonly associated with sports injury caused by a shearing force resulting in separation of the hypodermis from the deeper fascia. Most common at the greater trochanter, these injuries also occur at flank, buttock, lumbar spine, scapula and the knee. Separation of the tissue planes result in a complex serosanguinous fluid collection with areas of fat within it. The imaging appearance is variable and non specific, potentially mimicking simple soft tissue haematoma, superficial bursitis or necrotic soft tissue neoplasms. If not treated in the acute or early sub acute settings, these collections are at risk for superinfection, overlying tissue necrosis and continued expansion. In this review article, we discuss the clinical presentation, pathophysiology, imaging features and differential diagnostic considerations of Morel-Lavallee lesions. Role of imaging in guiding prompt and appropriate treatment has also been discussed.

  7. Morel-Lavallée Injuries: A Multimodality Approach to Imaging Characteristics.

    Science.gov (United States)

    Spain, James A; Rheinboldt, Matthew; Parrish, David; Rinker, Eric

    2017-02-01

    Morel-Lavallée lesions are relatively rare closed degloving injuries caused by a shearing force resulting in separation of the dermis and the hypodermis from the subjacent deeper fascia. Although most commonly encountered lateral to the greater trochanter, these injuries may occur throughout the body in a variety of locations. Separation of the hypodermal tissue planes results in a complex serosanguinous fluid collection with areas of internal fat necrosis. The imaging appearance is variable and nonspecific, potentially mimicking superficial hemorrhagic bursitis, or cystic or necrotic primary soft tissue neoplasms. If not treated in the acute or early subacute setting, these collections are at risk of superinfection, overlying tissue necrosis, and continued expansion. In this article, we will review the pathophysiology, cross-sectional imaging features, and differential diagnostic considerations of Morel-Lavallée lesions as well as discuss management and treatment options. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  8. Arthroscopic treatment of a case with concomitant subacromial and subdeltoid synovial chondromatosis and labrum tear.

    Science.gov (United States)

    Aydogan, Nevres Hurriyet; Kocadal, Onur; Ozmeric, Ahmet; Aktekin, Cem Nuri

    2013-01-01

    Synovial chondromatosis is a disease that seldomly seen in shoulder joint and is related to benign synovial proliferation and synchronous chondral tissue formation within the joint cavity. Patients suffer from progressive restriction of range of motion and shoulder pain. Extra-articular involvement is an extremely rare condition. Degenerative osteoarthritis, joint subluxation, and bursitis are common complications in untreated patients. Open or arthroscopic surgery is suitable while there is no consensus related to superiority of different approaches. We presented an arthroscopic treatment of a male patient, 48 years old with labrum tear and synovial chondromatosis localized in subacromial and subdeltoid region. Advantages of arthroscopic surgery in the presence of intra- and extra-articular combined pathologies are also discussed.

  9. Current Concepts in the Diagnosis and Treatment of Shoulder Impingement

    Science.gov (United States)

    Singh, Bijayendra; Bakti, Nik; Gulihar, Abhinav

    2017-01-01

    Subacromial impingement syndrome (SIS) is a very common cause of shoulder pain in the young adults. It can cause debilitating pain, dysfunction, and affects the activities of daily living. It represents a spectrum of pathology ranging from bursitis to rotator cuff tendinopathy which can ultimately lead to degenerative tear of the rotator cuff. Various theories and concepts have been described and it is still a matter of debate. However, most published studies suggest that both extrinsic and intrinsic factors have a role in the development of SIS. The management is controversial as both nonoperative and operative treatments have shown to provide good results. This article aims to provide a comprehensive current concepts review of the pathogenesis, etiologies, clinical diagnosis, appropriate use of investigations, and discussion on the management of SIS. PMID:28966374

  10. Migration of calcium deposits into subacromial-subdeltoid bursa and into humeral head as a rare complication of calcifying tendinitis: sonography and imaging.

    Science.gov (United States)

    Della Valle, Valeria; Bassi, Emilio Maria; Calliada, Fabrizio

    2015-09-01

    Calcifying tendinitis of the shoulder is a common condition characterized by the deposition of calcium, predominantly hydroxyapatite crystals, in the rotator cuff. A rare complication of this condition is the migration of calcium deposits from tendons, usually the supraspinatus, into the subacromial-subdeltoid bursa or into the humeral greater tuberosity. These complications are responsible for intense acute shoulder pain and functional disability. Patient anamnesis and clinical symptoms must be considered to make the diagnosis, but imaging, particularly sonography, is often necessary, showing a typical presentation related to the locations of calcium deposits. We present sonographic and other imaging features of subacromial-subdeltoid bursitis and humeral osteitis related to the migration of calcium.

  11. Haglund's syndrome. Two case reports.

    Science.gov (United States)

    Jiménez Martín, Florencio; Alonso Valdazo, María Dolores; Díaz Peña, Gara; Fernández Leroy, Julia; Hernández Herrero, David; Díaz García, Fermín

    Haglund's syndrome produces posterior impingement of the heel, which is caused by a posterosuperior calcaneal exostosis, known as Haglund's deformity, associated with Achilles tendinitis and retrocalcaneal bursitis. Its pathogenesis is unknown. We report two cases that were diagnosed clinically and confirmed radiographically. One patient was treated conservatively and the other underwent surgery. The diagnosis is based on clinical signs and radiological images, using the measurement of the parallel pitch lines, in a lateral radiograph of the ankle. Initial treatment is usually conservative and includes anti-inflammatory or analgesic agents, physiotherapy and low-heeled, open-heeled shoes. If conservative treatment does not relieve the pain, surgery may be necessary. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  12. Patella tendon rupture after arthroscopic resection of the prepatellar bursa--a case report.

    Science.gov (United States)

    Epstein, David M; Capeci, Craig M; Rokito, Andrew S

    2010-01-01

    The use of arthroscopic techniques for excision of the pre-patellar bursa has become more common in recent years for the treatment of prepatellar bursitis. The current literature includes several case series that report few complications with this technique. We report the case of a 73-year-old male who sustained a low-energy patella tendon rupture 2 months after arthroscopic resection of the prepatellar bursa. We hypothesize that during arthroscopic excision of the prepatellar bursa there was an iatrogenic injury to the patellar tendon, which contributed to the subsequent rupture. Surgical repair was successfully performed using an open technique with a 1-year follow-up. To our knowledge, this is the first case report of patella tendon rupture following arthroscopic excision of the prepatellar bursa.

  13. Bursa formation with scapular osteochondroma in hereditary multiple exostosis.

    Science.gov (United States)

    Ceberut, Kadri; Korkmaz, Murat; Ergin, Ismail; Müslehiddinoglu, Ahmet

    2013-07-01

    Osteochondroma is the most common benign bone tumour present multiple hereditary exostosis (HME). Scapular osteochondroma associated with pain and bursitis is rarely reported in literature. Here, we describe a 49-year-old male with the diagnosis of HME who was admitted to the Department of Thoracic Surgery with a painful and rapidly enlarging mass behind the left scapula. Computed tomography and magnetic resonance imaging indicated a large bursa formation associated with chest wall mass. Pre-operatively, the mass was diagnosed as osteochondroma and resected. Pathological findings confirmed that mass was a large bursa formation due to scapular osteochondroma without any evidence of malignancy. Osteochondroma should be considered in differential diagnosis of chest wall tumours located at this specific site. We discuss this rare complication of HME and emphasize the importance of early diagnosis and differentiation from malignant transformation of osteochondroma.

  14. El En Dehors en la danza clásica: mecanismos de producción de lesionesg

    Directory of Open Access Journals (Sweden)

    Sebastián G. Lozano

    2010-04-01

    Full Text Available El en dehors es la posición base del ballet clásico. Consiste en mantener las caderas y extremidades inferiores en rotación externa. Se pretende que los pies lleguen a formar 180º ente sí. Cuando la movilidad articular y flexibilidad muscular es menor que la requerida, se suele compensar forzando la posición presionando con los pies el suelo, llegando a provocar una rotación externa de la tibia sobre el fémur. Esto suele desencadenar desalineaciones femoropatelares, subluxación rotuliana, tendinitis tibial, hiperextensión de rodillas e hiperlordosis lumbar.Pero a pesar de que su ejecución técnica sea correcta, también puede originar algias por sobresolicitación ,tales como artritis a nivel coxofemoral, bursitis glútea y tendinitis de los músculos aductores entre otros.

  15. The distal semimembranosus complex: normal MR anatomy, variants, biomechanics and pathology.

    Science.gov (United States)

    Beltran, Javier; Matityahu, Amir; Hwang, Ki; Jbara, Marlena; Maimon, Ron; Padron, Mario; Mota, Javier; Beltran, Luis; Sundaram, Murali

    2003-08-01

    To describe the normal MR anatomy and variations of the distal semimembranosus tendinous arms and the posterior oblique ligament as seen in the three orthogonal planes, to review the biomechanics of this complex and to illustrate pathologic examples. The distal semimembranosus tendon divides into five tendinous arms named the anterior, direct, capsular, inferior and the oblique popliteal ligament. These arms intertwine with the branches of the posterior oblique ligament in the posterior medial aspect of the knee, providing stability. This tendon-ligamentous complex also acts synergistically with the popliteus muscle and actively pulls the posterior horn of the medial meniscus during knee flexion. Pathologic conditions involving this complex include complete and partial tears, insertional tendinosis, avulsion fractures and bursitis.

  16. Brucellar Arthritis Involving Left Sternoclavicular Joint

    Directory of Open Access Journals (Sweden)

    Senem Şaş

    2016-09-01

    Full Text Available Brucellosis is a widely spread zoonosis and an important global public health problem, especially in the Mediterranean region. Brucellosis is a systemic infectious disease, and it is transmitted to humans by consumption of raw milk or its by-products as well as by contact with products of infected animals. Clinical findings differ depending on the Brucella species, the host, and the duration of illness. The diagnosis of brucellosis is made by positive culture. Since the organism is cultured on blood, the examination is made primarily on the basis of suspicion as well as the high levels of humoral antibody titer. The disease may cause various complications. The most common complications of brucellosis are osteoarticular complications, including arthritis, bursitis, and tendinitis. In this report, brucellar arthritis involving the sternoclavicular joint (STCJ is presented. In this report we present a rare example of an osteoarticular complication caused by brucellosis

  17. Arthroscopic Treatment of a Case with Concomitant Subacromial and Subdeltoid Synovial Chondromatosis and Labrum Tear

    Directory of Open Access Journals (Sweden)

    Nevres Hurriyet Aydogan

    2013-01-01

    Full Text Available Synovial chondromatosis is a disease that seldomly seen in shoulder joint and is related to benign synovial proliferation and synchronous chondral tissue formation within the joint cavity. Patients suffer from progressive restriction of range of motion and shoulder pain. Extra-articular involvement is an extremely rare condition. Degenerative osteoarthritis, joint subluxation, and bursitis are common complications in untreated patients. Open or arthroscopic surgery is suitable while there is no consensus related to superiority of different approaches. We presented an arthroscopic treatment of a male patient, 48 years old with labrum tear and synovial chondromatosis localized in subacromial and subdeltoid region. Advantages of arthroscopic surgery in the presence of intra- and extra-articular combined pathologies are also discussed.

  18. Imaging of musculoskeletal soft tissue infections

    Energy Technology Data Exchange (ETDEWEB)

    Turecki, Marcin B.; Taljanovic, Mihra S.; Holden, Dean A.; Hunter, Tim B.; Rogers, Lee F. [University of Arizona HSC, Department of Radiology, Tucson, AZ (United States); Stubbs, Alana Y. [Southern Arizona VA Health Care System, Department of Radiology, Tucson, AZ (United States); Graham, Anna R. [University of Arizona HSC, Department of Pathology, Tucson, AZ (United States)

    2010-10-15

    Prompt and appropriate imaging work-up of the various musculoskeletal soft tissue infections aids early diagnosis and treatment and decreases the risk of complications resulting from misdiagnosis or delayed diagnosis. The signs and symptoms of musculoskeletal soft tissue infections can be nonspecific, making it clinically difficult to distinguish between disease processes and the extent of disease. Magnetic resonance imaging (MRI) is the imaging modality of choice in the evaluation of soft tissue infections. Computed tomography (CT), ultrasound, radiography and nuclear medicine studies are considered ancillary. This manuscript illustrates representative images of superficial and deep soft tissue infections such as infectious cellulitis, superficial and deep fasciitis, including the necrotizing fasciitis, pyomyositis/soft tissue abscess, septic bursitis and tenosynovitis on different imaging modalities, with emphasis on MRI. Typical histopathologic findings of soft tissue infections are also presented. The imaging approach described in the manuscript is based on relevant literature and authors' personal experience and everyday practice. (orig.)

  19. Imaging of musculoskeletal tuberculosis; Imagerie de la tuberculose osteo-articulaire

    Energy Technology Data Exchange (ETDEWEB)

    Boussel, L.; Marchand, B.; Blineau, N.; Picaud, G.; Emn, M.; Coulon, A.; Pagnon, P.; Rode, A.; Pin-Leveugle, J.; Berthezene, Y.; Pariset, C.; Boibieux, A. [Hopital de la Croix-Rousse, 69 - Lyon (France); Hermier, M. [Hopital de la Croix-Rousse, Serv. de Neuroradiologie, 69 - Lyon (France)

    2002-09-01

    Purpose and methods. To perform an illustrated and educational review of musculoskeletal tuberculosis. Results. As the incidence of musculoskeletal tuberculosis still increases, a review appears justified. The following four main presentations are detailed and illustrated, by emphasizing the value of both CT and MR imaging: a) spine tuberculosis ({approx} 50 %/) commonly involves two adjacent vertebral bodies with usual large paravertebral abscesses. The following lesions are highly suggestive of tuberculosis: solitary vertebral involvement, solitary epidural abscess with or without erosive spondylitis; b) osteo-arthritis: peripherally located erosions at synovial insertions with gradual narrowing of the joint space are highly suggestive; c) osteomyelitis: unusual, may involve any bones; d) tenosynovitis and bursitis. Conclusion. Imaging studies are essential for diagnosis and to assess the extent of musculo-skeletal tuberculosis. (author)

  20. Osteomyelitis Infection of Mycobacterium marinum: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Hao H. Nguyen

    2015-01-01

    Full Text Available Mycobacterium marinum (M. marinum is a ubiquitous waterborne organism that grows optimally at temperatures around 30°C. It is a nontuberculous Mycobacterium found in nonchlorinated water with worldwide prevalence. It is the most common atypical Mycobacterium that causes opportunistic infection in humans. M. marinum can cause superficial infections and localized invasive infections in humans, with the hands being the sites most frequently affected. It can cause skin lesions, which are either single, papulonodular lesions, confined to an extremity, or may resemble cutaneous sporotrichosis. This infection can also cause deeper infections including tenosynovitis, bursitis, arthritis, and osteomyelitis. Disseminated infections and visceral involvements have been reported in immunocompromised patients. We here report a case of severe deep soft tissue infection with necrotizing fasciitis and osteomyelitis of the left upper extremity (LUE caused by M. marinum in an immunocompromised patient.

  1. The distal semimembranosus complex: normal MR anatomy, variants, biomechanics and pathology

    Energy Technology Data Exchange (ETDEWEB)

    Beltran, Javier; Jbara, Marlena; Maimon, Ron [Department of Radiology, Maimonides Medical Center, 4802 Tenth Avenue, NY 11219, Brooklyn (United States); Matityahu, Amir; Hwang, Ki [Department of Orthopedic Surgery, Maimonides Medical Center, Brooklyn, NY (United States); Padron, Mario [Department of Radiology, Clinica CEMTRO, Madrid (Spain); Mota, Javier [Department of Radiology, Instituto Clinica Corachan, Barcelona (Spain); Beltran, Luis [New York Medical College, Valhalla, NY (United States); Sundaram, Murali [Department of Radiology, Mayo Clinic, Rochester, MN (United States)

    2003-08-01

    To describe the normal MR anatomy and variations of the distal semimembranosus tendinous arms and the posterior oblique ligament as seen in the three orthogonal planes, to review the biomechanics of this complex and to illustrate pathologic examples. The distal semimembranosus tendon divides into five tendinous arms named the anterior, direct, capsular, inferior and the oblique popliteal ligament. These arms intertwine with the branches of the posterior oblique ligament in the posterior medial aspect of the knee, providing stability. This tendon-ligamentous complex also acts synergistically with the popliteus muscle and actively pulls the posterior horn of the medial meniscus during knee flexion. Pathologic conditions involving this complex include complete and partial tears, insertional tendinosis, avulsion fractures and bursitis. (orig.)

  2. Disorders of the hallux sesamoid complex: MR features

    Energy Technology Data Exchange (ETDEWEB)

    Karasick, D.; Schweitzer, M.E. [Thomas Jefferson Univ., Philadelphia, PA (United States). Dept. of Radiology

    1998-08-01

    Numerous painful conditions can affect the first metatarsophalangeal-sesamoid joint complex. Symptoms can be of sudden or insidious onset, and be of acute or chronic duration. Although conventional radiography is recognized as the initial diagnostic procedure for these symptoms, there is often a need to proceed to MR imaging. MR imaging is sensitive and can be utilized in the investigation of the hallux sesamoid complex to differentiate soft tissue from osseous pathology. Synovitis, tendonitis, and bursitis can be distinguished from bony abnormalities such as sesamoid fracture, avascular necrosis, and osteomyelitis. An understanding of MR imaging features and techniques will result in the highest diagnostic yield. Early and accurate diagnosis of sesamoid complex disorders can guide the physician to the appropriate clinical management and prevent potentially harmful longstanding joint dysfunction. (orig.) With 11 figs., 30 refs.

  3. MRI of cystic collection of the three joint; Les collections kystiques du genou en IRM

    Energy Technology Data Exchange (ETDEWEB)

    Boutry, N.; Cotten, A.; Dewatre, F.; Chastanet, P.; Gougeon, F. [Hopital R. Salengro, C.H.U., 59 - Lille (France)

    1997-09-01

    We present the main MR features of cystic lesions around the knee joint. Popliteal cysts are the most frequently seen. The usually result from extrusion of joint fluid into the gastrocnemio-semimembranosus bursa but they can have an atypical location or extension. They are most often due to a meniscal, ligamentous, degenerative or inflammatory joint disease responsible for a chronic joint effusion. Meniscal cysts are always associated with a horizontal tear. Medial meniscal cysts are larger and can extend far from the joint. Bursitis occur as a result of inflammation or infection of a bursa. Their location is stereotyped and they do not communicate with the knee joint. Ganglion cysts or ganglia are benign cystic lesions which can affect peri-articular tissues as well as subchondral bone or cruciate ligaments. MRI is now a simple and noninvasive way of obtaining etiologic diagnosis and guiding therapy. (authors). 46 refs.

  4. Scapulothoracic Anatomy and Snapping Scapula Syndrome

    Directory of Open Access Journals (Sweden)

    Rachel M. Frank

    2013-01-01

    Full Text Available The scapulothoracic articulation is a sliding junction between the deep aspect of the scapula and thoracic rib cage at the levels of ribs 2 through 7. Motion at this articulation is dynamically stabilized by a variety of muscular attachments, allowing for controlled positioning of the glenoid to assist in glenohumeral joint function. A thorough understanding of the complex anatomic relationships, including the various muscles, and bursa, is critical to the evaluation of patients presenting with scapulothoracic disorders. The snapping scapula syndrome is caused by either osseous lesions or scapulothoracic bursitis and can be difficult to recognize and treat. The purpose of this review is to discuss the anatomy of the scapulothoracic articulation with an emphasis on the pathology associated with snapping scapula syndrome.

  5. The safety of interleukin-1 receptor antagonist (anakinra in the treatment of rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    L. Riente

    2011-09-01

    Full Text Available The safety profile of interleukin-1 receptor antagonist (anakinra has been studied with randomised, placebo-controlled trials involving 2932 patients affected by rheumatoid arthritis. The most frequently reported adverse events were represented by injection site reactions (71% and headache (13.6%. No statistically significant difference in the incidence of infections was observed among the patients treated with the interleukin-1 receptor antagonist and the patients receiving placebo. In particular, the incidence of serious infections was 1,8% in rheumatoid arthritis patients on anakinra therapy and 0,7% in patients on placebo. The reported serious infections consisted of pneumonia, cellulitis, bone and joint infections, bursitis. No case of opportunistic infections or tubercolosis was observed. The results of clinical studies suggest that anakinra is a new well-tolerated drug for the treatment of patients affected by rheumatoid arthritis.

  6. Muscle impingement: MR imaging of a painful complication of osteochondromas

    Energy Technology Data Exchange (ETDEWEB)

    Uri, D.S. [Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104 (United States); Dalinka, M.K. [Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104 (United States); Kneeland, J.B. [Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104 (United States)

    1996-10-01

    The purpose of this study was to describe the magnetic resonance (MR) appearance of a newly recognized complication of osteochondromas. Two patients presented with pain and swelling over known osteochondromas. Plain radiographic studies were unrevealing. MR examinations were obtained to characterize the exostoses further and evaluate areas of palpable fullness. Increased signal was present in the muscles on T2-weighted images, which correlated with physical findings and was believed to represent muscle injury due to the osteochondroma. Pain and fullness may result from a number of osteochondroma-related complications, the most worrisome of which is malignant degeneration. Muscular impingement and injury should be considered in the differential diagnosis of pain and swelling in the region of an exostosis. MR imaging allows distinction of this entity, which may be radiographically occult and confused clinically with fracture, bursitis, or malignant degeneration. (orig.). With 2 figs.

  7. MR imaging assessment of clinical problems in rheumatoid arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Narvaez, Jose A.; Roca, Yolanda; Aguilera, Carlos [Department of CT and MR Imaging, Hospital Duran i Reynals, Universitaria de Bellvitge, Barcelona (Spain); Narvaez, Javier [Department of Medicine, Delfos Medical Center, Barcelona (Spain)

    2002-07-01

    Although MR imaging has been increasingly recognized as a useful tool in the diagnosis of early rheumatoid arthritis (RA) and in the assessment of disease activity, these applications have not yet been usually included in the routine management of this condition. Our goal is to review the current role of MRI in the everyday clinical management of patients with RA. The usefulness of MRI in the evaluation of articular and para-articular changes in specific locations, mainly the craniocervical region and the temporomandibular joint, are reviewed. Clinical problems derived from local extra-articular involvement, such as tenosynovitis, ''rice-bodies'' bursitis, and Baker's cyst rupture, are also described. Finally, we also review the value of MRI in evaluation of some complications of RA such as tendinous rupture, osteonecrosis, stress fracture, and septic arthritis/osteomyelitis. (orig.)

  8. Results of Closed Intramedullary Nailing using Talwarkar Square Nail in Adult Forearm Fractures

    Directory of Open Access Journals (Sweden)

    Nadeem A Lil

    2012-07-01

    Full Text Available The aim of the study was to evaluate results of closed intramedullary nailing using Talwarkar square nails in adult forearm fractures. We prospectively evaluated 34 patients with both bone forearm fractures. The average time to union was 12.8 (SD +3.2 weeks with cast support for a mean of 8.2 weeks. Union was achieved in 31 out of 34 patients. Using the Grace and Eversmann rating system, 17 patients were excellent, 10 were good, and 4 had an acceptable result. Three patients had non-unions, 2 for the radius and one for the ulna. There were two cases of superficial infection, one subject had olecranon bursitis, and one case of radio-ulnar synostosis. Complication rates associated with the use of square nails were lower compared to plate osteosynthesis and locked intramedullary nails. To control rotation post- operatively, there is a need for application of an above-elbow cast after nailing.

  9. Surgical treatment of synovial osteochondromatosis of the hip using a modified-Hardinge approach with a Z-shaped capsular incision

    Directory of Open Access Journals (Sweden)

    Yu Takeda

    2015-12-01

    Full Text Available Synovial osteochondromatosis of the hip is a rare condition, and the surgical treatment approach for this condition requires complete removal of loose bodies combined with synovectomy. While these, procedures are generally accepted as the optimal treatment method, this is still controversial topic. Recent studies have reported that open surgical procedures remain acceptable for synovial osteochondromatosis of the hip. These procedures include the dislocation of the femoral head, and complications such as femoral head necrosis and bursitis or great trochanter non-union due to trochanteric osteotomy have been reported. The present study reports a modified technique for surgical dislocation through a Z-shaped capsular incision without trochanteric flip osteotomy for the treatment of synovial osteochondromatosis of the hip.

  10. Ultrasound in the evaluation of enthesitis: status and perspectives

    DEFF Research Database (Denmark)

    Gandjbakhch, Frédérique; Terslev, Lene; Joshua, Fredrick

    2011-01-01

    affect the results of the examination. The objectives of this study were to first determine the level of homogeneity in the ultrasound definitions for the principal lesions of enthesitis in the published literature and second, to evaluate the metric properties of ultrasound for detecting enthesitis...... according to the OMERACT filter. METHODS: Search was performed in PUBMED and EMBASE. Both grey-scale and Doppler definitions of enthesitis, including describing features of enthesitis, were collected and metrological qualities of studies were assessed. RESULTS: After selection, 48 articles were analyzed....... The definition of ultrasound enthesitis and elementary features varied among authors. Grey-scale enthesitis was characterized by increasing thickness (94% of studies), hypoechogenicity (83%), enthesophytes (69%), erosions (67%), calcifications (52%), associated bursitis (46%) and cortical irregularities (29...

  11. Evaluation and management of shoulder pain in primary care clinics.

    Science.gov (United States)

    House, Jeff; Mooradian, Arshag

    2010-11-01

    Shoulder pain is a frequent clinical problem facing primary care physicians. Despite its common occurrence, many clinicians are unfamiliar with the diagnosis and treatment of many common shoulder ailments. Because therapy for most shoulder disorders can be made at the initial consultation, a good history and physical remain paramount. The purpose of this paper is to review the basic approach to diagnosis and management of shoulder pain. It will summarize a pragmatic approach to the initial history, with particular attention to differentiating extrinsic and intrinsic etiologies. Physical exam techniques for evaluating shoulder pain will be reviewed, including provocation testing for specific disorders. Specific disorders covered include supraspinatus tendonitis, subdeltoid bursitis, frozen shoulder, biceps tendonitis, and acromioclavicular (AC) joint arthritis.

  12. MR imaging of the pelvis: a guide to incidental musculoskeletal findings for abdominal radiologists.

    Science.gov (United States)

    Gaetke-Udager, Kara; Girish, Gandikota; Kaza, Ravi K; Jacobson, Jon; Fessell, David; Morag, Yoav; Jamadar, David

    2014-08-01

    Occasionally patients who undergo magnetic resonance imaging for presumed pelvic disease demonstrate unexpected musculoskeletal imaging findings in the imaged field. Such incidental findings can be challenging to the abdominal radiologist, who may not be familiar with their appearance or know the appropriate diagnostic considerations. Findings can include both normal and abnormal bone marrow, osseous abnormalities such as Paget's disease, avascular necrosis, osteomyelitis, stress and insufficiency fractures, and athletic pubalgia, benign neoplasms such as enchondroma and bone island, malignant processes such as metastasis and chondrosarcoma, soft tissue processes such as abscess, nerve-related tumors, and chordoma, joint- and bursal-related processes such as sacroiliitis, iliopsoas bursitis, greater trochanteric pain syndrome, and labral tears, and iatrogenic processes such as bone graft or bone biopsy. Though not all-encompassing, this essay will help abdominal radiologists to identify and describe this variety of pelvic musculoskeletal conditions, understand key radiologic findings, and synthesize a differential diagnosis when appropriate.

  13. Common Ice Hockey Injuries and Treatment: A Current Concepts Review.

    Science.gov (United States)

    Mosenthal, William; Kim, Michael; Holzshu, Robert; Hanypsiak, Bryan; Athiviraham, Aravind

    Injuries are common in ice hockey, a contact sport where players skate at high speeds on a sheet of ice and shoot a vulcanized rubber puck in excess of one hundred miles per hour. This article reviews the diagnoses and treatment of concussions, injuries to the cervical spine, and lower and upper extremities as they pertain to hockey players. Soft tissue injury of the shoulder, acromioclavicular joint separation, glenohumeral joint dislocation, clavicle fractures, metacarpal fractures, and olecranon bursitis are discussed in the upper-extremity section of the article. Lower-extremity injuries reviewed in this article include adductor strain, athletic pubalgia, femoroacetabular impingement, sports hernia, medial collateral and anterior cruciate ligament tears, skate bite, and ankle sprains. This review is intended to aid the sports medicine physician in providing optimal sports-specific care to allow their athlete to return to their preinjury level of performance.

  14. MRI of the shoulder

    Energy Technology Data Exchange (ETDEWEB)

    Vahlensieck, M.

    2000-02-01

    Shoulder imaging is one of the major applications in musculoskeletal MRI. In order to analyze the images it is important to keep informed about anatomical and pathological findings and publications. In this article MRI technique, anatomy and pathology is reviewed. Technical considerations about MR sequences and examination strategy are only shortly discussed with emphasis on turbo spin echo and short T1 inversion recovery imaging. Basic anatomy as well as recent findings, including macroscopic aspects of the supraspinatus fat pad, composition of the supraspinatus muscle belly, and variability of the glenohumeral ligaments or coracoid ligament, are presented. Basic pathological conditions are described in detail, e. g. instability particularly problems in differentiating the various subtypes of labral pathology. Rotator cuff diseases are elucidated with emphasis on some rarer entities such as subscapularis calcifying tendinitis, coracoid impingement, chronic bursitis producing the double-line sign, prominent coraco-acromial ligament and the impingement due to an inflamed os acromiale. (orig.)

  15. Minor rheumatology: Nonsystemic rheumatic disease of juxta-articular soft tissues of the upper extremity. Part 1

    Directory of Open Access Journals (Sweden)

    A. E. Karateev

    2015-01-01

    Full Text Available Rheumatic diseases of juxta-articular soft tissues (RDJAST (tendinitis, tenosynovitis, bursitis, etc. are one of the most common causes of disability and one the most common reasons for seeking medical advice. To manage patients with RDJAST is an important part of practising rheumatologists’ work. But unfortunately, the issues of diagnosis and therapy of this pathology have been relatively rarely discussed on the pages of Russian medical journals and at the scientific congresses and conferences of rheumatologists in recent years. This review is to refresh physicians’interest in this problem. Part 1 of this review briefly considers the general issues relating to the epidemiology, pathogenesis, and diagnosis of RDJAST of the upper extremity, such as rotator cuff tendinitis, lateral and medial epicondylitis, stenosing flexor tenosynovitis, de Quervain’s syndrome, and carpal tunnel syndrome.

  16. Isolated subacromial bursal fluid on MRI of the shoulder in symptomatic patients: correlation with arthroscopic findings

    Energy Technology Data Exchange (ETDEWEB)

    Monu, J.U.V. [Dept. of Radiology, Bowman Gray School of Medicine, Wake Forest Univ., Winston-Salem, NC (United States); Pruett, S. [Bowman Gray School of Medicine, Wake Forest Univ., Winston-Salem, NC (United States); Vanarthos, W.J. [Dept. of Radiology, Bowman Gray School of Medicine, Wake Forest Univ., Winston-Salem, NC (United States); Pope, T.L. Jr. [Dept. of Radiology, Bowman Gray School of Medicine, Wake Forest Univ., Winston-Salem, NC (United States)

    1994-10-01

    Fluid in the subacromial bursa (SAB) is a common finding on magnetic resonance (MR) images of the shoulder, and the implications of this finding have not been clarified. We retrospectively reviewed and correlated the MR features with arthroscopic findings in 21 symptomatic patients who had fluid in the SAB on MR imaging without demonstrable rotator cuff tear. Rotator cuff impingement was the most frequent surgical finding (42.9%). Other frequent surgical observations were glenbid labrum abnormality (28.6%), bursitis (19%), and supraspinatus tendinitis (14.3%). Distribution of acromial types was similar to that reported by Bigliani et al., and impingement was evenly distributed among acromial types in our study population. We conclude that in our patient population group the MR finding of isolated SAB fluid in symptomatic patients is highly likely to be associated with the finding of other abnormalities in the shoulder joint at surgery. (orig.)

  17. Current concepts in the diagnosis and treatment of shoulder impingement

    Directory of Open Access Journals (Sweden)

    Bijayendra Singh

    2017-01-01

    Full Text Available Subacromial impingement syndrome (SIS is a very common cause of shoulder pain in the young adults. It can cause debilitating pain, dysfunction, and affects the activities of daily living. It represents a spectrum of pathology ranging from bursitis to rotator cuff tendinopathy which can ultimately lead to degenerative tear of the rotator cuff. Various theories and concepts have been described and it is still a matter of debate. However, most published studies suggest that both extrinsic and intrinsic factors have a role in the development of SIS. The management is controversial as both nonoperative and operative treatments have shown to provide good results. This article aims to provide a comprehensive current concepts review of the pathogenesis, etiologies, clinical diagnosis, appropriate use of investigations, and discussion on the management of SIS.

  18. Scapulothoracic anatomy and snapping scapula syndrome.

    Science.gov (United States)

    Frank, Rachel M; Ramirez, Jose; Chalmers, Peter N; McCormick, Frank M; Romeo, Anthony A

    2013-01-01

    The scapulothoracic articulation is a sliding junction between the deep aspect of the scapula and thoracic rib cage at the levels of ribs 2 through 7. Motion at this articulation is dynamically stabilized by a variety of muscular attachments, allowing for controlled positioning of the glenoid to assist in glenohumeral joint function. A thorough understanding of the complex anatomic relationships, including the various muscles, and bursa, is critical to the evaluation of patients presenting with scapulothoracic disorders. The snapping scapula syndrome is caused by either osseous lesions or scapulothoracic bursitis and can be difficult to recognize and treat. The purpose of this review is to discuss the anatomy of the scapulothoracic articulation with an emphasis on the pathology associated with snapping scapula syndrome.

  19. Ultrasound findings in AL musculoskeletal amyloidosis.

    Science.gov (United States)

    Felea, Ioana; Fodor, Daniela; Schiotis, Ruxandra; Georgiu, Carmen; Bojan, Anca; Rednic, Simona

    2011-03-01

    Systemic AL amyloidosis is one of the differential diagnosis of chronic musculoskeletal disease, especially when swollen and painful joints is associated with claw hands. Ultrasound evaluation is a good diagnosis tool, showing a characteristic joint and tendon involvement and assisting in guided biopsy procedure. We report a 55 year old caucasian woman, diagnosed for two years with RA without improvement under different DMARDs, admitted for fixed flexion contractures of both hands ("claw hands"), worsening pain and swelling of small joints of hands and feet, elbows and shoulders. Pad shoulder sign and bilateral anterior wrist and elbow pads, macroglossia, thickened skin of fingers and ecchymotic rashes on forearm and around eyes were observed. Ultrasound examinations showed subdeltoid and bicipitoradial bursitis, presence of inhomogeneous hypoechoic material around bicipital tendons and tenosinovitis of the extensor tendons of the hand, and synovial thickening of elbow and shoulder joints. Complete analysis of the bone marrow biopsy and biopsy specimens from subacromial bursa were positive for AL amyloidosis.

  20. Spondyloarthritis: A Gouty Display

    Science.gov (United States)

    Gongidi, Preetam; Gough-Fibkins, Shawn

    2010-01-01

    Gout is a systemic, metabolic disease that typically affects the peripheral joints. We describe an unusual presentation of gout affecting the facet joints and costovertebral joints in the thoracic and lumbar spine. A 54-year old man presents to the emergency department with increasing swelling and pain at the left elbow for one week and difficulty ambulating. The imaging work-up included plain radiographs of the left elbow, left wrist, and chest with subsequent admission for possible septic arthritis. MRI of the elbow showed olecranon bursitis and an erosion of the lateral epicondyle. CT scan demonstrated lytic cloud-like lesions localized to the facet joints and costovertebral joints of the thoracic and lumbar spine as well as bilateral medullary nephrocalcinosis. Possible hyperparathyroidism manifestations (including Brown tumors and medullary nephrocalcinosis) were evaluated with plains films of the hands; x-rays instead showed classic gouty arthritis. Our report reviews the disease, epidemiology, classic radiologic findings, and treatment of gout. PMID:22470729

  1. Human Protothecosis

    Science.gov (United States)

    Lass-Flörl, Cornelia; Mayr, Astrid

    2007-01-01

    Human protothecosis is a rare infection caused by members of the genus Prototheca. Prototheca species are generally considered to be achlorophyllic algae and are ubiquitous in nature. The occurrence of protothecosis can be local or disseminated and acute or chronic, with the latter being more common. Diseases have been classified as (i) cutaneous lesions, (ii) olecranon bursitis, or (iii) disseminated or systemic manifestations. Infections can occur in both immunocompetent and immunosuppressed patients, although more severe and disseminated infections tend to occur in immunocompromised individuals. Prototheca wickerhamii and Prototheca zopfii have been associated with human disease. Usually, treatment involves medical and surgical approaches; treatment failure is not uncommon. Antifungals such as ketoconazole, itraconazole, fluconazole, and amphotericin B are the most commonly used drugs to date. Among them, amphotericin B displays the best activity against Prototheca spp. Diagnosis is largely made upon detection of characteristic structures observed on histopathologic examination of tissue. PMID:17428884

  2. Arthroscopic Finding of an Extra-Articular Loose Body in the Subacromial Space: Case Report Presentation and Literature Review.

    Science.gov (United States)

    Hartelius, Carl; Apostolopoulos, Alexandros P; Zaman, Tariq

    2016-01-01

    Loose bodies are pieces of soft tissue that run free within a body cavity, typically in the synovium; loose bodies outside of synovial cavities are very rare. This case study demonstrates such an instance occurring in the subacromial space, which is especially unusual. We report on it coupled with an analysis of the literature of known cases that have occurred previously. A 55-year old right-hand-dominant female patient presented with left shoulder pain. She had injured her left shoulder 7 yr previously and had achieved adequate pain and symptomatic control with physiotherapy. A magnetic resonance imaging scan demonstrated subacromial subdeltoid bursitis with a large subacromial spur, a bulky acromioclavicular (AC) joint, and a partial tear of the supraspinatous tendon. The patient subsequently underwent shoulder arthroscopy for subacromial decompression and AC joint excision. Arthroscopy demonstrated a suspected impingement of the rotator cuff in the subacromial space, bursitis, and a prominent acromion that limited the subacromial space (bigliani, type III), but during the procedure a detached white mass was discovered in the subacromial bursa. After histological analysis, the mass showed osteocartilagenous tissue, consistent with a loose body. Following the procedure, there were no complications, and the patient's symptoms gradually resolved. Extraarticular loose bodies are extremely rare, especially in the subacromial bursa. Reported cases have all been associated with either traumatic or degenerative shoulder pathology, and the diagnosis was commonly established incidentally on arthroscopy. Cases were managed with removal during the same procedure. Arthroscopic removal of loose bodies and bursa debridement, good options for treatment of loose bodies in the subacromial space, can result in good function.

  3. Ultrasound-guided versus blind subacromial-subdeltoid bursa injection in adults with shoulder pain: A systematic review and meta-analysis.

    Science.gov (United States)

    Wu, Tao; Song, Hai Xin; Dong, Yan; Li, Jian Hua

    2015-12-01

    This systematic review and meta-analysis aimed to assess the effectiveness of ultrasound-guided (USG) versus blind (landmark-guided, LMG) corticosteroid subacromial-subdeltoid bursa injection in adults with shoulder pain. The searches were performed on PubMed, Ovid MEDLINE, Ovid EMBASE, Ovid CochraneCENTRAL, Web of Science, Google Scholar, and Scopus from database inception through March 27, 2015. Studies were included trials comparing USG versus LSG injections for the treatment of adults with subacromial-subdeltoid bursitis. Two reviewers independently performed data extraction and appraisal of the studies. The outcome measures collected were the decreased VAS and SDQ scores, the increased shoulder function scores and shoulder abduction motion range, and the effective rate at 6 weeks after injection. Seven papers including 445 patients were reviewed; 224 received LMG injections and 221 received USG injections. There was a statistically significant difference in favor of USG for pain score [MD = 1.19, 95% CI (0.39, 1.98), P = 0.003] and SDQ score [MD = 5.01, 95% CI (1.82, 8.19), P = 0.02] at 6 weeks after injection. Also there was a statistically significant difference between the groups, with greater improvement reported of shoulder function scores [SMD = 0.89, 95% CI (0.56, 1.23), P < 0.001] and shoulder abduction motion range [MD 32.69, 95% CI (14.82, 50.56), P < 0.001] in the USG group. More effective rate was also reported with USG group and the difference was statistically significant [risk ratio = 1.6, 95% CI (1.02, 2.50), P = 0.04]. Ultrasound-guided corticosteroid injections potentially offer a significantly greater clinical improvement over blind SASD bursitis injections in adults with shoulder pain. Copyright © 2015. Published by Elsevier Inc.

  4. Partial tears of the distal biceps tendon: MR appearance and associated clinical findings

    Energy Technology Data Exchange (ETDEWEB)

    Williams, B.D.; Schweitzer, M.E.; Weishaupt, D.; Miller, L.S. [Thomas Jefferson Univ., Philadelphia, PA (United States). Dept. of Radiology; Lerman, J. [Lerman Imaging, Brooklyn, NY (United States); Rubenstein, D.L. [Orthopaedic Surgery, Thomas Jefferson University Hospital, Philadelphia, PA (United States); Rosenberg, Z.S. [Dept. of Diagnostic Radiology, New York Univ. Medical Center, NY (United States)

    2001-10-01

    Purpose: To describe the magnetic resonance (MR) appearance and associated clinical findings of partial distal biceps tendon tears. Design: Twenty elbow MR images at 1.5 T, performed over a 7 year period, were reviewed for an appearance of partial tears in the distal biceps. These images were assessed by two musculoskeletal radiologists for the extent of: (a) abnormal signal intensity within the tendon, and the presence of (b) bicipitoradial bursitis, and (c) bony microavulsive injury of the radial tuberosity. Medical records for nine of the 20 cases were reviewed for the clinical findings of ecchymosis, trauma, sensation of a ''pop'', loss of function, and acuity of onset. Results: Twenty partial distal biceps tendon tears were seen. All displayed an abnormally increased signal in the distal biceps tendon. Three of 20 (15%) showed a 25% to 50% tear, ten of 20 (50%) showed a 50% tear, and seven of 20 (35%) showed a 75% to 90% tear. Bicipitoradial bursitis was seen in 11 of 20 (55%) cases. Bony microavulsive injury of the radial tuberosity was observed in 10 of 20 (50%). Of the nine cases reviewed for associated clinical findings, surprisingly, only three (33%) experienced an acute traumatic episode with an abrupt onset of pain. An insidious onset was reported in four of nine (44%). Sensation of a ''pop'' was recorded in only two of nine (22%) cases. Ecchymosis and loss of function were not seen in any of the cases. Finally, surgical conformation was obtained for three cases. Conclusion: Partial distal biceps tendon tears have a characteristic MR appearance, demonstrate little functional deficit, and may be attritional in their etiology due to the observation of a low number of patients reporting trauma or an acute onset. (orig.)

  5. MRI of lesser metatarsophalangeal joint plantar plate tears and associated adjacent interspace lesions

    Energy Technology Data Exchange (ETDEWEB)

    Umans, Hilary [Albert Einstein College of Medicine and Lenox Hill Radiology Imaging and Associates, Bronx, NY (United States); Srinivasan, Ramya; Elsinger, Elisabeth [Albert Einstein College of Medicine, Bronx, NY (United States); Wilde, Gregory E. [Lenox Hill Radiology Imaging and Associates, Bronx, NY (United States)

    2014-10-15

    To identify the variety of second and third intermetatarsal space (IS) lesions that may coexist with and without adjacent metatarsophalangeal joint (MTP) plantar plate (PP) tears. One hundred forefoot MRIs in 96 patients with metatarsalgia obtained between 30 September 2011 and 21 July 2012 using 1.5- or 3-T MRI were retrospectively reviewed in consensus by two MSK radiologists and one podiatrist (DPM). MRI was evaluated for second and third MTP PP tear and the presence/nature of second and third IS lesions. Second and third IS neuromas were measured in transverse (trans) dimension. A total of 40 PP tears were identified: 36 at the second and 4 at the third MTP. Second MTP PP tear was identified in 33 % of females and 40.5 % of males. In the 63 female feet there were 21 second MTP PP tears, all of which also had second IS lesions: pericapsular fibrosis (16), bursitis (4), and ganglion (1). In the 37 male feet there were 15 second MTP PP tears, 14 of which had second IS lesions: pericapsular fibrosis (8), bursitis (5), and ganglion (1). There was no definite second IS neuroma adjacent to any second MTP PP tear. In females without PP tear, there were 24 second (3 mm trans average) and 43 third IS neuromas (4.1 mm trans average). In males without PP tear, there were 9 second (3.4 mm trans average) and 16 third IS neuromas (4.1 mm trans average). MTP PP tears occurred in 40 % of our cases, 90 % of which occurred at the second MTP. Almost all coexisted with non-neuromatous second IS lesions. (orig.)

  6. MRI EVALUATION OF PAINFUL KNEE JOINT- THE CORRELATION OF MULTIPLE COEXISTING PATHOLOGIES, AGE AND SEX

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    Mukheswar Pame

    2017-03-01

    Full Text Available BACKGROUND 1. To evaluate the incidence and coexistence of multiple knee joint pathologies causing painful knee and their correlation to age and sex. 2. To evaluate the Magnetic Resonance Imaging (MRI features in various knee pathologies and to identify the common lesions. MATERIALS AND METHODS A retrospective study was performed using the clinical data of patients presenting with painful knee joint which were evaluated with MRI. Data from 200 patients examined between September 2015 and August 2016 were included into this study. The data was analysed statistically to evaluate the correlation between the MR pathological findings to age and sex of the patients. RESULTS The patient’s age ranged between 8 and 75 years (mean: 36 years. Anterior cruciate ligament (ACL tear was the commonest finding (60% followed by bursitis (55%, meniscal degeneration (54.6% and meniscal tear (52%. Primary signs of ACL tear were hyperintensity, discontinuity and nonvisualisation. Secondary signs like Posterior cruciate ligament (PCL buckling, PCL index of greater than 0.5, uncovered Lateral meniscus (LM and bone contusion assisted in diagnosis in indeterminate cases. Mid substance was the commonest site of ACL tear (64%. PCL tear accounted for only a small percentage (7%. Medial Meniscus (MM tear (35% was commoner than LM tear (17%. The posterior horn of meniscus was the commonest site of injury (86.5%. Age was significantly correlated with meniscal degeneration and tear, Medial collateral ligament (MCL degeneration, parameniscal cyst, and chondromalacia patellae. A significant correlation between male gender and ACL injury was noted. Meniscal injury was significantly correlated with bursitis, as well with MCL injury. Bone bruise was significantly correlated with ACL injury, MCL injury and Lateral collateral ligament (LCL injury. CONCLUSIONS MRI findings of certain pathologies in a painful knee can coexist and significantly correlate with each other, age and sex of

  7. Comparison between ultrasound and plain X-ray in evaluating the cause of shoulder pain.

    Science.gov (United States)

    Salek, K M; Mannan, M; Chowdhury, A Z; Haque, M A; Kaiser, M S; Nabi, S; Ferdousee, R A; Paul, B K; Ahmed, S M; Khan, M; Begum, M

    2011-01-01

    Painful shoulder is a common painful condition among patients. Apart from acute traumatic lesions such as fractures, dislocations, contusions, sprains and ruptured tendons, 85 to 90% of painful shoulders are due to adhesive capsulitis, acute or chronic calcific tendinitis, bursitis, bicipital tendinitis and lesions of the musculotendinous cuff. Arthritis is the cause of less than 5% of painful shoulders. For evaluating conditions of shoulder joint, X-ray has been regarded as only method of choice for long time. Magnetic resonance imaging (MRI) is an alternative procedure but the cost limits its utilization especially in Bangladesh. Ultrasonography is an effective imaging modality in the evaluation of both rotator and non-rotator cuff disorders. Because of low cost and availability, it can be an alternative procedure for the diagnosis of painful shoulder. The present study was conducted to assess ultrasonography as a useful modality in evaluating cases of shoulder pain and to compare the findings with X-ray findings. Thirty two patients with shoulder pain were evaluated by X-ray and Ultrasonography (USG). Clinical diagnosis was done for correlation. To identify the cause of shoulder pain, 100% patients were found normal in plain X-ray. On Ultrasonography (USG) 12.5% patients had displaced long head of biceps, 21.9% had biceps tendinitis, and 3.1% had bursitis. In the assessment of shoulder pathology, USG had a sensitivity of 73.3%, specificity of 88.2%, Positive predictive value (PPV) of 84.6%, Negative predictive value (NPV) of 78.9% and an accuracy of 81.3%. USG is a useful modality for evaluation the shoulder joint in case of painful shoulder even plain X-ray is non conclusive.

  8. Foot overuse diseases in rock climbing: an epidemiologic study.

    Science.gov (United States)

    Buda, Roberto; Di Caprio, Francesco; Bedetti, Letizia; Mosca, Massimiliano; Giannini, Sandro

    2013-01-01

    Literature examining the incidence of foot diseases in rock climbing is limited to traumatic injuries. We examined a large sample of climbers, assessed the chronic diseases of the foot, and correlated them with foot morphology, shoe type, and type of climbing practiced. Between May 1 and September 30, 2009, 144 climbers (mean age, 31.7 years) were examined to analyze the effect of rock climbing on the various foot diseases found at the time of the evaluation. Eighty-six percent of the climbers were affected by a pathologic condition. Nail disease was found in 65.3% of patients, followed by recurrent ankle sprains (27.8%), retrocalcaneal bursitis (19.4%), Achilles tendinitis (12.5%), metatarsalgia (12.5%), and plantar fasciitis (5.6%). Male sex, the use of high-type shoes, the high degree of climbing difficulty, and the competitive level were often related to the onset of foot diseases. Climbing shoes are usually smaller than common footwear. This "shoe-size reduction" averaged 2.3 sizes, forcing the foot into a supinated and cavus posture that favors lateral instability. The posterior edge of the shoe aperture produces increased pressure on the heel, with retrocalcaneal bursitis. Overuse foot diseases related to rock climbing are particularly frequent and debilitating. Detailed knowledge of these diseases and their predisposing factors may help us implement effective preventive or therapeutic measures, including changes in the type of climbing, correction of body weight, degree of difficulty, footwear, orthoses, and measures that maximize the support of the foot to the ground.

  9. [Low-field magnetic resonance imaging of penetrating hoof injuries in 10 horses].

    Science.gov (United States)

    Gerlach, Kerstin; Mader, Daniela; Delling, Uta; Theuß, Tobias; Müller, Kristin; Offhaus, Julia; Berner, Dagmar

    2016-08-17

    The aim of the present study was to verify the diagnostic validity of low-field magnetic-resonance-imaging (MRI) findings in septic diseases of the foot region following penetrating sole injuries caused by nails. MRI examinations were performed in 10 horses with injuries in the foot region. The diagnostic findings were validated by conventional methods (clinical, surgical, radiological, sonographic, and computed tomographic findings and/or post-mortem histological examination). Navicular bone involvement was revealed most accurately, with a high degree of predictability, and was best detected by fat-suppressed T2 or short-TI inversion recovery (STIR) sequences. MRI examinations of defects in the deep digital flexor tendon showed a high level of sensitivity, but these findings were less specific than changes to the navicular bone. They could be best reproduced in transverse T2-weighted fast spin echo sequences (T2w FSE). The penetration tract was recognisable in all cases and in all planes, and the T2w FSE proved to be very suitable for diagnosis. Septic bursitis was revealed least accurately by MRI. Bursal disease was best recognised in the sagittal plane. MRI is a reliable method for confirming the diagnosis of diseases in the foot region after injuries caused by foreign bodies, particularly nails. A transverse T2w FSE is best suited for demonstrating a penetration tract and tendon damage. Visualisation of the penetration tract and secondary reactions of the navicular bone are crucial for diagnosing bursitis. Fat-suppressed sequences can clearly show bone involvement when the penetration tract has not reached the bone. The cases described illustrate that MRI is an appropriate method for evaluating puncture wounds in the foot region. Only MRI allows for intravital assessment of various structures within the hoof capsule. This information is essential for deciding upon targeted therapy while avoiding unnecessary therapies.

  10. Muscle localization of heterotopic ossification following spinal cord injury.

    Science.gov (United States)

    Ohlmeier, Malte; Suero, Eduardo M; Aach, Mirko; Meindl, Renate; Schildhauer, Thomas A; Citak, Mustafa

    2017-10-01

    Heterotopic ossification (HO) is a known complication especially in people with traumatic spinal cord injury (SCI). Although some risk factors have already been described, the pathophysiology of HO is still unknown. The pelvis is the most common region for HO occurrence. However, the prevalence of HO by muscle groups about the hip is not well described. To analyze the prevalence of early HO in muscle groups about the hip in 267 patients with SCI. 267 patients with traumatic SCI and pelvic HO. Between January 2001 and December 2014, 267 patients with SCI were treated in our university hospital and were included in the study. Patients were routinely screened for HO using ultrasound. The diagnosis of HO was validated using magnetic resonance imaging (MRI) or computed tomography (CT). The primary outcome measure was the prevalence of HO by muscle groups around the hip. The following muscle groups around the hip were defined: (1) gluteal group, (2) adductor group, (3) iliopsoas group, and (4) deep muscle group. Additionally, the prevalence of concomitant trochanteric bursitis was recorded in all cases. The gluteal group showed the highest HO prevalence with 55.8%, followed by the deep muscle group with 31.1%. Concomitant trochanteric bursitis was found in 62 patients (23.2%). No association between pelvic trauma and HO development was observed (n=16, 11%). The most common muscular location for the occurrence of HO about the hip was the gluteal muscle group. Considering that no laboratory parameters are currently available for screening for HO, highly sensitive ultrasound screening examinations should be routinely performed, with particular attention paid to the gluteal muscles. Additionally, routine range of motion examination for extension and external rotation of the hip joint is warranted. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Bursite peritrocantérica: descrição de nova manobra semiológica para auxílio diagnóstico Peritrochanteric bursits: a description of a new semiologic maneuver for diagnostic assistance

    Directory of Open Access Journals (Sweden)

    Edson Noburo Fujiki

    2008-01-01

    Full Text Available O estudo tem como objetivo testar a validade de nova manobra semiológica no diagnóstico de bursite peritrocantérica. Foram avaliados 30 pacientes, com diagnóstico clínico de bursite do grande trocanter. Todos os pacientes foram submetidos à radiografia de bacia AP e Perfil. Quando necessário, outros exames de imagem foram realizados, com a finalidade de descartar doenças associadas; os pacientes foram submetidos a duas manobras semiológicas no quadril são e afetado. TESTE 1: paciente em decúbito dorsal, o membro examinado é aduzido em extensão cruzando sobre o membro contralateral, com o calcâneo em contato com a maca, faz-se a flexão do quadril até aproximadamente 90º, o quadril ao final da manobra estará em flexão, adução e leve rotação externa, durante a manobra poderá ser referida dor na região do trocanter maior. TESTE 2: a posição final do TESTE 1, é a posição inicial desta, faz-se a adução forçada do quadril, pode haver referencia de dor ou exacerbação. Os resultados das manobras foram submetidos ao estudo estatístico, que demonstrou serem os exames diferentes entre si, porém complementares. O teste 2 mostrou ser positivo em 96,6%. As manobras semiológicas denominadas de TESTE 1 e 2, podem ser utilizadas como auxiliares nos diagnósticos clínicos das bursites peritrocanterianas.The objective of the present study was to test the validity of a semiologic maneuver on the diagnosis of peritrochanteric bursitis. Thirty patients with a clinical diagnosis of great trochanter bursitis were assessed. All patients were submitted to X-ray studies at AP and LP. Whenever necessary, other imaging tests were performed, intending to rule out any associated diseases; the patients were submitted to two semiologic maneuvers on both hips, the affected and the normal one. TEST 1: with patient at supine position, the examined limb is adduced in extension and crossing it over the contralateral limb, with the calcaneus

  12. DEGRO guidelines for the radiotherapy of non-malignant disorders. Part II: Painful degenerative skeletal disorders

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    Ott, Oliver J. [University Hospitals Erlangen, Dept. of Radiation Oncology, Erlangen (Germany); Niewald, Marcus [Saarland University Medical School, Dept. of Radiotherapy and Radiation Oncology, Homburg/Saar (Germany); Weitmann, Hajo-Dirk [Fulda Hospital, Dept. of Radiooncology and Radiotherapy, Fulda (Germany); Jacob, Ingrid [Municipal Hospital Traunstein, Dept. of Radiotherapy, Traunstein (Germany); Adamietz, Irenaeus A. [Marien Hospital Herne/Ruhr University Bochum, Dept. of Radiotherapy and Radiation Oncology, Herne (Germany); Schaefer, Ulrich [Lippe Hospital, Dept. of Radiotherapy, Lemgo (Germany); Keilholz, Ludwig [Bayreuth Hospital, Dept. of Radiotherapy, Bayreuth (Germany); Heyd, Reinhard [Center for Radiosurgery, Frankfurt a. M. (Germany); Muecke, Ralph [Marien Hospital Herne/Ruhr University Bochum, Dept. of Radiotherapy and Radiation Oncology, Herne (Germany); Lippe Hospital, Dept. of Radiotherapy, Lemgo (Germany); Collaboration: German Cooperative Group on Radiotherapy for Benign Diseases (GCG-BD)

    2014-09-20

    The purpose of this article is to summarize the updated DEGRO consensus S2e guideline recommendations for the treatment of benign painful degenerative skeletal disorders with low-dose radiotherapy. This overview reports on the role of low-dose radiotherapy in the treatment of enthesiopathies (shoulder syndrome, trochanteric bursitis, plantar fasciitis, and elbow syndrome) and painful arthrosis (knee, hip, hand, and finger joints). The most relevant aspects of the DEGRO S2e Consensus Guideline Radiation Therapy of Benign Diseases 2014 regarding diagnostics, treatment decision, dose prescription as well as performance of radiotherapy and results are summarized. For all indications mentioned above, retrospective and some prospective analyses have shown remarkable effects in terms of pain relief. Nevertheless, the Level of Evidence (LoE) and the Grade of Recommendation (GR) vary: LoE 1b-4 and GR A-C. Low-dose radiotherapy for painful degenerative skeletal disorders is effective in the majority of the patients and therefore it may be a reasonable therapeutic alternative when simple and non-invasive methods have been used without persistent success. For all discussed entities, single fraction doses of 0.5-1.0 Gy and total doses of 3.0-6.0 Gy/series applied with 2-3 fractions per week are recommended. (orig.) [German] Zusammenfassung der Empfehlungen der DEGRO-S2e-Leitlinie zur Niedrigdosis-Radiotherapie von gutartigen schmerzhaften degenerativen Skeletterkrankungen. Die vorliegende Zusammenfassung berichtet ueber die Bedeutung der Niedrigdosis-Radiotherapie in der Behandlung von Enthesiopathien (Schultersyndrom, Ellenbogensyndrom, Bursitis trochanterica, Fasciitis plantaris) und schmerzhaften Arthrosen (Knie-, Hueft, Hand- und Fingergelenksarthrosen). Die wichtigsten Aspekte der aktuellen DEGRO-S2e-Konsensus-Leitlinie Strahlentherapie gutartiger Erkrankungen bezueglich Diagnostik, Therapieentscheidungen, Dosisempfehlungen und Durchfuehrung einer Radiotherapie werden

  13. Shoulder MRI features with clinical correlations in subacromial pain syndrome: a cross-sectional and prognostic study.

    Science.gov (United States)

    Kvalvaag, Elisabeth; Anvar, Masoud; Karlberg, Anna Cecilia; Brox, Jens Ivar; Engebretsen, Kaia Beck; Soberg, Helene Lundgaard; Juel, Niels Gunnar; Bautz-Holter, Erik; Sandvik, Leiv; Roe, Cecilie

    2017-11-21

    Previous studies on shoulder patients have suggested that the prevalence of rotator cuff or bursa abnormalities are weakly related to symptoms and that similar findings are often found in asymptomatic persons. In addition, it is largely unknown whether structural changes identified by magnetic resonance imaging (MRI) affect outcome after treatment for shoulder pain. The purpose of this study was therefore to evaluate the presence of structural changes on MRI in patients with subacromial pain syndrome and to determine to what extent these changes are associated with symptoms and predict outcome after treatment (evaluated by the Shoulder Pain and Disability Index (SPADI)). A prospective, observational assessment of a subset of shoulder patients who were included in a randomized study was performed. All participants had an MRI of the shoulder. An MRI total score for findings at the AC joint, subacromial bursa and rotator cuff was calculated. Multiple linear regression analysis was applied to examine the relationship between the MRI total score and the outcome measure at baseline and to examine to what extent the MRI total score was associated with the change in the SPADI score from baseline to the one year follow-up. There was a weak, inverse association between the SPADI score at baseline and the MRI total score (β = -3.1, with 95% CI -5.9 to -0.34; p = 0.03), i.e. the SPADI score was higher for patients with a lower MRI total score. There was an association between the change in the SPADI score from baseline to the one year follow-up and the MRI total score (β = 8.1, 95% CI -12.3 to -3.8; p bursitis (p = 0.04) were associated with a poorer outcome after one year. In this study, MRI findings were significantly associated with the change in the SPADI score from baseline and to one year follow-up, with a poorer outcome after treatment for the patients with higher MRI total score, tendinosis and bursitis on MRI. Clinicaltrials.gov no NCT01441830

  14. Intertester reliability of shoulder complaints diagnoses in primary health care.

    Science.gov (United States)

    Storheil, Benny; Klouman, Elise; Holmvik, Stian; Emaus, Nina; Fleten, Nils

    2016-09-01

    Shoulder complaints are frequently encountered in general practice, but precise diagnosing is challenging. This study investigated agreement of shoulder complaints diagnoses between clinicians in a primary health care setting. Cross-sectional study. Four primary health care clinicians used patients' history and functional examination of the shoulder by selective tissue tension techniques (STTs), to diagnose shoulder complaints. 62 patients, aged 18-75 years. Reliability of diagnoses was assessed by observed intertester agreement and Cohen's kappa. A total of 372 diagnostic pairs were available for intertester comparisons. Six diagnoses were assigned by all clinicians; supraspinatus-, infraspinatus-, subscapularis-tendinopathies; chronic subacromial bursitis; glenohumeral capsulitis, and acromioclavicular joint lesion. The observed agreement on these diagnoses ranged from 0.84 for glenohumeral capsulitis to 0.97 for acromioclavicular joint lesion. Kappa scores were 0.46 (95% CI 0.33, 0.58) for chronic subacromial bursitis; 0.53 (95% CI 0.34, 0.68), 0.59 (95% CI 0.47, 0.70), and 0.68 (95% CI 0.53, 0.82) for infraspinatus -, supraspinatus -, and subscapularis-tendinopathy, respectively. For glenohumeral capsulitis and acromioclavicular lesion kappa scores were 0.66 (95% CI 0.57, 0.73) and 0.78 (95% CI 0.61, 0.90). Kappa scores were higher for individual diagnoses than for individual tests, except for limitation in passive abduction (0.70, 95% CI 0.62, 0.78) and passive lateral rotation (0.66, 95% CI 0.57, 0.73). Although experienced clinicians showed substantial intertester agreement, precise diagnoses of shoulder complaints in primary health care remain a challenge. The present results call for further research on refined diagnoses of shoulder complaints. Key points   Based on medical history and a systematic functional examination by selective tissue tension techniques (STTs), we investigated the agreement of shoulder complaints diagnoses across four primary

  15. A síndrome anserina Anserine syndrome

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    Milton Helfenstein Jr

    2010-06-01

    Full Text Available Dor no joelho é uma condição comum na clínica diária e a patologia anserina, também conhecida como pata de ganso, tem sido considerada uma das principais causas. O diagnóstico tem sido realizado de maneira eminentemente clínica, o que tem gerado equívocos. Os pacientes queixam-se tipicamente de dor na parte medial do joelho, com sensibilidade na porção ínferomedial. Estudos de imagem têm sido realizados para esclarecer se tais pacientes possuem bursite, tendinite ou ambos os distúrbios na região conhecida como pata de ganso. Entretanto, o defeito estrutural responsável pelos sintomas permanece desconhecido, motivo pelo qual preferimos intitular como "Síndrome Anserina". O diabetes mellitus é um fator predisponente bem reconhecido. O sobrepeso e a osteoartrite de joelho parecem ser fatores adicionais de risco, contudo, seus papéis na gênese da moléstia ainda não são bem entendidos. O tratamento atual inclui anti-inflamatório, fisioterapia e infiltração de corticoide, com evolução muito variável, que oscila entre 10 dias e 36 meses. A falta de conhecimento sobre a etiofisiopatologia e dados epidemiológicos exige futuros estudos para esse frequente e intrigante distúrbio.Knee pain is a common complaint in clinical practice, and pes anserinus tendino-bursitis syndrome (PATB has been frequently diagnosed based only on clinical features that may cause equivocal interpretations. Patients complain of characteristic spontaneous medial knee pain with tenderness in the inferomedial aspect of the joint. Studies with different imaging modalities have been undertaken during the last years to identify whether these patients suffer from bursitis, tendinitis, or both. Nevertheless, little is known regarding the structural defect responsible for this disturbance. Due to these problems and some controversies, we suggest the term "anserine syndrome" for this condition. Diabetes Mellitus is a known predisposing factor for this syndrome

  16. Ultrasound and magnetic resonance findings and correlation in hemiplegic patients with shoulder pain.

    Science.gov (United States)

    Doğun, Asuman; Karabay, İlkay; Hatipoğlu, Cem; Özgirgin, Neşe

    2014-01-01

    The aim of this study was to evaluate the ultrasonography (US) and MRI findings in hemiplegic patients with shoulder pain and investigate the correlation between them. It is not possible for these patients to fully perform active range of motion (ROM) and stress tests, so imaging methods take center stage in diagnosis and treatment planning. A total of 68 hemiplegic patients with shoulder pain attending the inpatient rehabilitation program were included in the study. MRI and US results from the patient files were recorded. The frequency of each pathology identified by US and MRI was determined. The distribution of MRI and US findings was investigated to see whether there was a statistical difference between the correlation of MRI and US results. The mean (SD) age of the patients was 63.7 (8.3) years and the mean (SD) duration of hemiplegia was 49 (8.9) days. According to the MRI results, glenohumeral and acromioclavicular joint degeneration was found in 77.9% and 79.7% of the patients, respectively; subacromial-subdeltoid bursitis in 80.9%; fluid increase in the joint space in 41.2%; supraspinatus tendinitis in 36.8%; and supraspinatus partial rupture in 33.8%. Shoulder US findings were supraspinatus tendinitis in 54.4%, acromioclavicular joint degeneration in 26.5%, bicipital tendinitis in 20.6%, and subacromial-subdeltoid bursitis in 19.1%. There was a statistically significant difference between MRI and US findings. The results were not compatible with each other (P ≯ .05), and these findings were not consistent with each other since the kappa coefficient was under 0.40 for all these results. Although US is recommended as the first method in determining shoulder pathologies in hemiplegic patients, we suggest that MRI should be used as the first choice in hemiplegic patients with shoulder pain. MRI and US findings were not consistent, and US is dependent on the experience of the operator. MRI should be the first choice in cases where the diagnosis will affect

  17. Correlation of MRI findings with clinical findings of trochanteric pain syndrome

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    Blankenbaker, Donna G.; Ullrick, Steven R.; Davis, Kirkland W.; De Smet, Arthur A. [University of Wisconsin School of Medicine and Public Health, Department of Radiology, Madison, WI (United States); Haaland, Ben; Fine, Jason P. [University of Wisconsin School of Medicine and Public Health, Departments of Biostatistics and Medical Informatics and Statistics, Madison, WI (United States)

    2008-10-15

    Greater trochanter pain syndrome due to tendinopathy or bursitis is a common cause of hip pain. The previously reported magnetic resonance (MR) findings of trochanteric tendinopathy and bursitis are peritrochanteric fluid and abductor tendon abnormality. We have often noted peritrochanteric high T2 signal in patients without trochanteric symptoms. The purpose of this study was to determine whether the MR findings of peritrochanteric fluid or hip abductor tendon pathology correlate with trochanteric pain. We retrospectively reviewed 131 consecutive MR examinations of the pelvis (256 hips) for T2 peritrochanteric signal and abductor tendon abnormalities without knowledge of the clinical symptoms. Any T2 peritrochanteric abnormality was characterized by size as tiny, small, medium, or large; by morphology as feathery, crescentic, or round; and by location as bursal or intratendinous. The clinical symptoms of hip pain and trochanteric pain were compared to the MR findings on coronal, sagittal, and axial T2 sequences using chi-square or Fisher's exact test with significance assigned as p<0.05. Clinical symptoms of trochanteric pain syndrome were present in only 16 of the 256 hips. All 16 hips with trochanteric pain and 212 (88%) of 240 without trochanteric pain had peritrochanteric abnormalities (p=0.15). Eighty-eight percent of hips with trochanteric symptoms had gluteus tendinopathy while 50% of those without symptoms had such findings (p=0.004). Other than tendinopathy, there was no statistically significant difference between hips with or without trochanteric symptoms and the presence of peritrochanteric T2 abnormality, its size or shape, and the presence of gluteus medius or minimus partial thickness tears. Patients with trochanteric pain syndrome always have peritrochanteric T2 abnormalities and are significantly more likely to have abductor tendinopathy on magnetic resonance imaging (MRI). However, although the absence of peritrochanteric T2 MR abnormalities

  18. Acupuncture and rehabilitation of the painful shoulder: study protocol of an ongoing multicentre randomised controlled clinical trial [ISRCTN28687220

    Directory of Open Access Journals (Sweden)

    Jimenez Carmen

    2005-10-01

    Full Text Available Abstract Background Although the painful shoulder is one of the most common dysfunctions of the locomotor apparatus, and is frequently treated both at primary healthcare centres and by specialists, little evidence has been reported to support or refute the effectiveness of the treatments most commonly applied. According to the bibliography reviewed, physiotherapy, which is the most common action taken to alleviate this problem, has not yet been proven to be effective, because of the small size of sample groups and the lack of methodological rigor in the papers published on the subject. No reviews have been made to assess the effectiveness of acupuncture in treating this complaint, but in recent years controlled randomised studies have been made and these demonstrate an increasing use of acupuncture to treat pathologies of the soft tissues of the shoulder. In this study, we seek to evaluate the effectiveness of physiotherapy applied jointly with acupuncture, compared with physiotherapy applied with a TENS-placebo, in the treatment of painful shoulder caused by subacromial syndrome (rotator cuff tendinitis and subacromial bursitis. Methods/design Randomised controlled multicentre study with blind evaluation by an independent observer and blind, independent analysis. A study will be made of 465 patients referred to the rehabilitation services at participating healthcare centres, belonging to the regional public health systems of Andalusia and Murcia, these patients presenting symptoms of painful shoulder and a diagnosis of subacromial syndrome (rotator cuff tendinitis and subacromial bursitis. The patients will be randomised into two groups: 1 experimental (acupuncture + physiotherapy; 2 control (TENS-placebo + physiotherapy; the administration of rescue medication will also be allowed. The treatment period will have a duration of three weeks. The main result variable will be the change produced on Constant's Shoulder Function Assessment (SFA Scale

  19. MR imaging features of foot involvement in ankylosing spondylitis

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    Erdem, C. Zuhal E-mail: sunarerdem@yahoo.com; Sarikaya, Selda; Erdem, L. Oktay; Ozdolap, Senay; Gundogdu, Sadi

    2005-01-01

    Objective: To determine alterations of the soft tissue, tendon, cartilage, joint space, and bone of the foot using magnetic resonance (MR) imaging in ankylosing spondylitis (AS) patients. Materials and Method: Clinical and MR examination of the foot was performed in 23 AS patients (46 feet). Ten asymptomatic volunteers (20 feet) were studied on MR imaging, as a control group. MR imaging protocol included; T1-weighted spin-echo, T2-weighted fast-field echo (FFE) and fat-suppressed short tau inversion recovery (STIR) sequences in sagittal, sagittal oblique, and coronal planes using a head coil. Specifically, we examined: bone erosions, tendinitis (acute and chronic), para-articular enthesophyte, joint effusion, plantar fasciitis, joint space narrowing, soft tissue edema, bone marrow edema, enthesopathy in the Achilles tendon and plantar fascia attachment, subchondral signal intensity abnormalities (edema and sclerosis), tenosynovitis, retrocalcaneal bursitis, subchondral cysts, subchondral fissures, and bony ankylosis. Midfoot, hindfoot, and ankle were included in examined anatomic regions. Results: Clinical signs and symptoms (pain and swelling) due to foot involvement were present in 3 (13%) of the patients while frequency of involvement was 21 (91%) with MR imaging assessment. The MR imaging findings were bone erosions (65%), Achilles tendinitis (acute and chronic) (61%), para-articular enthesophyte (48%), joint effusion (43%), plantar fasciitis (40%), joint space narrowing (40%), subchondral sclerosis (35%), soft tissue edema (30%), bone marrow edema (30%), enthesopathy of the Achilles attachment (30%), subchondral edema (26%), enthesopathy in the plantar fascia attachment (22%), retrocalcaneal bursitis (22%), subchondral cysts (17%), subchondral fissures (17%), tendinitis and enthesopathy of the plantar ligament (13%), and bony ankylosis (9%). The most common involved anatomical region was the hindfoot (83%) following by midfoot (69% ) and ankle (22

  20. Osteoarticular Involvement among Brucellosis Cases in Konya City

    Directory of Open Access Journals (Sweden)

    Hale Turan Ozden

    2015-09-01

    Full Text Available Purpose: Brucellosis is a systemic disease that can affect many organs and tissues. Musculoskeletal system is one of the most commonly affected systems. Disease may present itself with sacroiliitis, peripheral arthritis, spondylitis, paraspinal abscess, bursitis or osteomyelitis. The objective of the present study was to determine the frequency, types and clinical features of osteoarticular involvement among cases with brucellosis in Konya city and to establish the differences between patients with and without osteoarticular involvement. Material and Methods: Three hundred and sixteen patients with Brucellosis who presented between June 2003 and June 2014 were included in the study. Brucellosis was diagnosed by positive Brucella Standard Agglutination Test ( and #61619;1/160 titer and/or growth of Brucella spp. in blood culture in addition to the presence of clinical signs and findings. Diagnosis of osteoarticular system complications was established by physical examination and radiological findings obtained by diagnostic imaging tools. Magnetic resonance images of the thoracic, lumbar or sacral vertebrae were acquired in patients with back pain, low back pain and sacro-iliac joint pain. Results: Osteoarticular involvement was noted in 129 patients (40.8% (females: 52% and males: 48%. The most common route of transmission was employment in farming and/or consumption of un-pasteurized milk or dairy products, especially fresh cheese, in 97 (75% cases. Mean age was 46 and #61617;18 years. Sacroiliitis was the most frequent osteoarticular involvement (n: 68, 52.7%, 70.5% of which were bilateral. Sacroiliitis was followed by spondylodiscitis in 35 (38.7%, peripheral arthritis in 20 (15.5%, bursitis in 1 (0.8% cases. Patients with osteoarticular involvement received medical treatment for at least three months. Discussion: Ratio and anatomical region of osteoarticular involvement in brucellosis shows variability among areas. In the present study, we

  1. A different approach to the management of greater trochanter pain syndrome

    Directory of Open Access Journals (Sweden)

    J.C. Van Rooy

    2009-02-01

    Full Text Available Greater trochanter pain syndrome (GTPS, also known astrochanteric bursitis, is a regional pain syndrome that is frequently treatedby physiotherapists in private practice or out-patient departments.  It is classi -fied as an overuse injury that could become chronic in nature and frequentlyco-exists with other pathologies.This case study describes the treatment of a 61-year-old female with GTPS of her left hip. The aim was to evaluate the effectiveness of specificsoft tissue mobilisation (SSTM and eccentric strengthening of the Gluteus Medius (GM muscle in treating this condition. Particular emphasis was placed on rehabilitation of lumbar spine control in order to improve proximal stability. A nother aim was to return the patient faster to her functional activitiesthan had been reported in the literature. The patient could return to her normal daily activities after four treatment sessions and was completely pain free after 12 weeks. This case study presents a different approach to the treatment of GTPS and proposes that GTPS maypresent in a similar manner to GM tendinosis. This phenomenon could therefore possibly explain the chronic nature ofthe condition.

  2. Methylprednisolone versus triamcinolone in painful shoulder using ultrasound-guided injection.

    Science.gov (United States)

    Chávez-López, Mario Alfredo; Navarro-Soltero, Luis Alberto; Rosas-Cabral, Alejandro; Gallaga, Adán; Huerta-Yáñez, Guillermo

    2009-01-01

    There is little evidence about the comparative efficacy of corticosteroids in the treatment of painful shoulder. The main aim was to compare the efficacy of methylprednisolone (MTP) versus triamcinolone (TMC) in the treatment of painful shoulder using an ultrasound-guided injection. Patients with painful shoulder due to subacromial bursitis and partial or full-thickness rotator cuff tears demonstrated by musculoskeletal ultrasound received a guided-injection of MTP acetate 40 mg (12 patients) or TMC acetonide 40 mg (12 patients). Range of motion and pain visual analogue scale were registered at 10 and 30 min, 1 and 2 weeks postinjection. Two weeks postinjection, both groups reported a mean improvement in range of motion (33%) and relief of pain (61%). Relief of pain of 50% or more was observed in 92% of patients in MTP group and 50% of TMC group (p = 0.02). Two months postinjection, 50% of the patients in MTP group and 25% in TMC group reported total relief of pain (p = 0.3). Patients with painful shoulder receiving an ultrasound-guided injection of MTP or TMC have a rapid and sustained overall response. Relief of pain tends to be more rapid with MTP than TMC.

  3. Clinical Mimics: An Emergency Medicine-Focused Review of Cellulitis Mimics.

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    Blumberg, Garrett; Long, Brit; Koyfman, Alex

    2017-10-01

    Cellulitis is a common clinical condition with low rates of morbidity and mortality if treated appropriately. Mimics of cellulitis presenting with erythema, edema, warmth, and pain can be associated with grave morbidity and mortality if misdiagnosed. This review investigates the signs and symptoms of cellulitis, mimics of cellulitis, and an approach to the management of both cellulitis and its mimics. The current emergency medicine definition of cellulitis includes erythema, induration, warmth, and swelling. Given the common pathophysiologic pathways, cellulitis mimics often present in an analogous manner. These conditions include septic bursitis, septic joint, deep vein thrombosis, phlegmasia cerulea dolens, necrotizing fasciitis, flexor tenosynovitis, fight bite (closed fist injury), orbital cellulitis, toxic shock syndrome, erysipelas, abscess, felon, paronychia, and gouty arthritis. Many of these diseases have high morbidity and mortality if missed by the emergency physician. Differentiating these mimics from cellulitis can be difficult in the fast-paced emergency setting. A combination of history, physical examination, and focused diagnostic assessment may assist in correctly identifying the underlying etiology. For many of the high mortality cellulitis mimics, surgical intervention is necessary. Cellulitis and its mimics present similarly due to the same physiologic responses to skin and soft tissue infections. A combination of history, physical examination, and diagnostic assessment will help the emergency physician differentiate cellulitis from mimics. Surgical intervention is frequently needed for high morbidity and mortality mimics. Published by Elsevier Inc.

  4. Primary hip spica with crossed retrograde intramedullary rush pins for the management of diaphyseal femur fractures in children: A prospective, randomized study.

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    Ruhullah, Mohammad; Singh, H R; Shah, Sanjay; Shrestha, Dipak

    2014-03-01

    Femoral fractures are common in children aged between 2 and 12 yearsand 75% of the lesions affect the femoral shaft. Traction followed by a plaster cast is universally accepted as a conservative treatment. We compared primary hip spica or traction followed by hip spica with closed reduction and fixation with retrogradely passed crossed Rush pins for diaphyseal femur fracture in 25 children of the age group 3-12 years, randomly distributed in each group. FIFTY CHILDREN (AGE: 3-13 years, mean; 9 years) with femoral fractures were evaluated; 25 of them underwent the conservative treatment using immediate hip spica (group A) and 25 underwent treatment with crossed retrograde Rush pins (group B). Mean duration of fracture union was within 15 weeks in group A and 12 weeks in group B. Mean duration of weight bearing was 14weeks in group A and 7 weeks in group A. Mean hospital stay were 4 days in group A and 8days in group B. The man follow-up period was 16 months in group A and 17 months in group B. Complications like angulation, shortening and infection were compared. Bursitis and penetration of pins at the site of Rush pin insertion is a complication associated with this method of treatment. Closed reduction and internal fixation with crossed Rush pins was a superior treatment method in terms of early weight bearing and restoration of normal anatomy.

  5. Accuracy of physical examination in subacromial impingement syndrome.

    Science.gov (United States)

    Silva, L; Andréu, J L; Muñoz, P; Pastrana, M; Millán, I; Sanz, J; Barbadillo, C; Fernández-Castro, M

    2008-05-01

    Shoulder pain is a common complaint, frequently caused by subacromial impingement syndrome (SIS). There are a number of physical examination (PE) manoeuvres that explore the subacromial space. MRI provides an accurate anatomic image of the subacromial space, being the current gold standard in the diagnosis of SIS. The aim of this study is to evaluate the accuracy of the PE in the diagnosis of SIS and/or subacromial-subdeltoid bursitis (SSB) confirmed by MRI. Consecutive outpatients with an episode of shoulder pain were prospectively included in the study. They were examined by a rheumatologist and, within 3 days, an MRI was done. Sensitivity, specificity, positive and negative predictive values, and accuracy of PE manoeuvres were calculated using a 2 x 2 table. Fourteen males and 16 females were included. All the tests exhibited acceptable sensitivity. As a result Yocum manoeuvre was considered the most sensitive and most accurate for SIS. With regard to SSB, the Gerber test was the most sensitive. The majority of the PE manoeuvres showed low specificity. Most PE manoeuvres identify reasonably well subacromial impingement of the shoulder, although, in general, they have low specificity. The Yocum test has the best sensitivity and precision. Our data suggest that imaging techniques should be recommended to better define shoulder lesions.

  6. Increased substance P in subacromial bursa and shoulder pain in rotator cuff diseases.

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    Gotoh, M; Hamada, K; Yamakawa, H; Inoue, A; Fukuda, H

    1998-09-01

    The subacromial bursa is recognized as a site associated with the shoulder pain caused by rotator cuff disease in the middle-aged and elderly. Substance P is contained in primary afferent nerves, and its quantity increases during chronic pain. The amount of substance P in the subacromial bursa of patients with rotator cuff disease was examined. Radioimmunoassay and immunohistochemistry were employed to quantify and localize substance P. The preoperative pain level was measured with a visual analogue scale with 0 as no pain, 5 as moderate, and 10 as severe. Thirty-seven patients that had undergone operation were divided into two groups: one composed of 19 patients with subacromial bursitis and a partial-thickness tear of the rotator cuff (nonperforated cuff) and the other composed of 18 patients with a full-thickness tear (perforated cuff). Subacromial bursae obtained from seven fresh cadavers with no shoulder pain before death were used as controls. The visual analogue scale showed significantly greater pain in the group with the nonperforated rotator cuff than in the group with the perforated cuff. Consistent with these results, the amount of substance P in the subacromial bursa was significantly greater in the former group than in the latter. Nerve fibers immunoreactive to substance P were localized around the vessels, with a larger number of fibers in the group with the nonperforated rotator cuff. Therefore, an increased amount of substance P in the subacromial bursa appears to correlate with the pain caused by rotator cuff disease.

  7. US guided corticosteroid injection into the subacromial-subdeltoid bursa: Technique and approach.

    Science.gov (United States)

    Molini, L; Mariacher, S; Bianchi, S

    2012-02-01

    Local injection of cortisone derivatives, sometimes combined with local anesthetics, is frequently administered in rheumatology as the treatment of choice in para-articular diseases or as an adjuvant to systemic therapy in the treatment of arthritis.One of the most frequent local corticosteroid injections administered in daily clinical practice by rheumatologists, orthopedic surgeons, physiatrists, sports medicine doctors and general practitioners is injection into the subacromialsubdeltoid bursa in the treatment of bursitis and anterior superior impingement syndrome of the shoulder.Before local corticosteroid injection is administered, it is important to identify possible contraindications and to examine the documentation provided by the patient. Absolute contraindications or those related to the procedure should be evaluated by the prescribing physician but also the physician performing the corticosteroid injection should evaluate possible contraindications to make sure that corticosteroid injection is feasible. The present paper describes the ultrasound (US) guided local corticosteroid injection procedure with particular attention to the equipment required, the position of the patient and the examiner as well as the approach. The main advantage of US guidance during corticosteroid injection is the possibility to identify vascular structures, nerves and tendons situated in the needle path in order to avoid these structures and be sure to inject the drug into the appropriate location. When all rules are complied with and the corticosteroid injection is carried out by an experienced physician, it is virtually painless and is performed in just a few minutes.

  8. Association of Bicipital Peritendinous Effusion with Subacromial Impingement: A Dynamic Ultrasonographic Study of 337 Shoulders.

    Science.gov (United States)

    Chang, Ke-Vin; Wu, Wei-Ting; Özçakar, Levent

    2016-12-12

    Bicipital peritendinous effusion (BPE) is the most common biceps tendon abnormality and can be related to various shoulder ultrasonographic findings. Since the association of BPE with subacromial impingement is unclear, our study aimed to explore its association with the dynamic subacromial impingement test during ultrasound (US) imaging. We included 337 shoulders referred for US examinations and quantified the amount of BPE. Effusion more than 1 mm in thickness was considered a positive finding. A comparison of three grades of subacromial impingement, adjusted by patient demographics, static sonographic shoulder pathology, and physical findings, by using multivariate regression models revealed that the odds ratio of subacromial impingement (with 95% confidence intervals) in the presence of BPE was 6.54 (3.21-13.32) in grade 1, 6.93 (3.05-15.76) in grade 2 and 3.18 (1.48-6.80) in grade 3. An increase in age, subdeltoid bursitis, full-thickness supraspinatus tendon tear, and shoulder stiffness were also associated with BPE. Since our study demonstrated a positive association of BPE with all grades of impingement, a US dynamic subacromial impingement test is suggested when BPE is present. Future prospective studies are needed to identify changes in BPE after treatment.

  9. [Influence of Operative and Conservative Therapy on the Ability to Work of Patients With Subacromial Impingement: A Prospective Clinical Comparative Study].

    Science.gov (United States)

    Schulze, Christoph; Köhler, Hans Christian; Kaltenborn, Alexander; Gutcke, André; Tischer, Thomas

    2017-08-01

    Background Subacromial impingement is a common reason for pain in the shoulder. Treatment is difficult and patients are not able to work for a long time. An increasing number of operative treatments can be observed although conservative treatment is effective, too. There is no study that observed how operative and conservative treatment influence ability to work. Methods 86 persons were included in this prospective study. Surgery was performed with an arthroscopy of the shoulder. Conservative treatment was carried out by a physiotherapist under control of the physician. Reevaluation was conducted 3 and 6 months after the initial contact. Here we observed the time the participant was not able to work, Constant Score and pain on the numeric rating scale. Results Both therapies were able to improve pain and function. During conservative treatment, improvement was faster than under operative care. Time without ability to work was 7 ± 5 weeks longer after operative treatment than under conservative therapy (p Bursitis subacromialis detected in the MRI was a predictor of faster recovery. Conclusion Conservative and operative treatment improved pain and function significantly. Properly carried out conservative therapy enables patients to get back to work earlier. Georg Thieme Verlag KG Stuttgart · New York.

  10. Fewer rotator cuff tears fifteen years after arthroscopic subacromial decompression.

    Science.gov (United States)

    Björnsson, Hanna; Norlin, Rolf; Knutsson, Anders; Adolfsson, Lars

    2010-01-01

    A successful clinical result is reported in 75% to 85% of impingement patients after arthroscopic subacromial decompression. The result is maintained over time, but few studies have investigated the integrity of the rotator cuff in these patients. Using ultrasonography, we examined the integrity of the rotator cuff in 70 patients 15 years after arthroscopic subacromial decompression. All patients had an intact rotator cuff at the index procedure. Tendons were still intact in 57 patients (82%), 10 (14%) had partial-thickness tears, and 3 (4%) had full-thickness tears. The total number of 18% tears (partial and full thickness) in this study, including patients clinically diagnosed with subacromial impingement at a mean age of 60 years, is unexpectedly low compared with 40% degenerative tears reported in asymptomatic adults of the same age. Arthroscopic subacromial decompression seems to reduce the prevalence of rotator cuff tears in impingement patients. This appears attributable to elimination of extrinsic factors such as mechanical wear and bursitis. The potential effect of surgery on intrinsic cuff degeneration is unknown, but intrinsic factors may explain tears still developing despite decompression. Level III, therapeutic study.

  11. Subacromial impingement syndrome caused by a voluminous subdeltoid lipoma.

    Science.gov (United States)

    Murray, Jean-Christophe; Pelet, Stéphane

    2014-01-01

    Subacromial impingement syndrome is a clinical diagnosis encompassing a spectrum of possible etiologies, including subacromial bursitis, rotator cuff tendinopathy, and partial- to full-thickness rotator cuff tears. This report presents an unusual case of subdeltoid lipoma causing extrinsic compression and subacromial impingement syndrome. The patient, a 60-year-old man, presented to our institution with a few years' history of nontraumatic, posteriorly localized throbbing pain in his right shoulder. Despite a well-followed 6-months physiotherapy program, the patient was still suffering from his right shoulder. The MRI scan revealed a well-circumscribed 6 cm × 2 cm × 5 cm homogenous lesion compatible with a subdeltoid intermuscular lipoma. The mass was excised en bloc, and subsequent histopathologic examination confirmed a benign lipoma. At 6-months follow-up, the patient was asymptomatic with a complete return to his activities. Based on this case and a review of the literature, a subacromial lipoma has to be included in the differential diagnosis of a subacromial impingement syndrome refractory to nonoperative treatment. Complementary imaging modalities are required only after a failed conservative management to assess the exact etiology and successfully direct the surgical treatment.

  12. Ehlers–Danlos Syndrome—Hypermobility Type: A Much Neglected Multisystemic Disorder

    Science.gov (United States)

    Gazit, Yael; Jacob, Giris; Grahame, Rodney

    2016-01-01

    Ehlers–Danlos syndrome (EDS)—hypermobility type (HT) is considered to be the most common subtype of EDS and the least severe one; EDS-HT is considered to be identical to the joint hypermobility syndrome and manifests with musculoskeletal complaints, joint instability, and soft tissue overuse injury. Musculoskeletal complaints manifest with joint pain of non-inflammatory origin and/or spinal pain. Joint instability leads to dislocation or subluxation and involves peripheral joints as well as central joints, including the temporomandibular joints, sacroiliac joints, and hip joints. Soft tissue overuse injury may lead to tendonitis and bursitis without joint inflammation in most cases. Ehlers–Danlos syndrome-HT carries a high potential for disability due to recurrent dislocations and subluxations and chronic pain. Throughout the years, extra-articular manifestations have been described, including cardiovascular, autonomic nervous system, gastrointestinal, hematologic, ocular, gynecologic, neurologic, and psychiatric manifestations, emphasizing the multisystemic nature of EDS-HT. Unfortunately, EDS-HT is under-recognized and inadequately managed, leading to neglect of these patients, which may lead to severe disability that almost certainly could have been avoided. In this review article we will describe the known manifestations of the extra-articular systems. PMID:27824552

  13. Ehlers–Danlos Syndrome—Hypermobility Type: A Much Neglected Multisystemic Disorder

    Directory of Open Access Journals (Sweden)

    Yael Gazit

    2016-10-01

    Full Text Available Ehlers–Danlos syndrome (EDS—hypermobility type (HT is considered to be the most common subtype of EDS and the least severe one; EDS-HT is considered to be identical to the joint hypermobility syndrome and manifests with musculoskeletal complaints, joint instability, and soft tissue overuse injury. Musculoskeletal complaints manifest with joint pain of non-inflammatory origin and/or spinal pain. Joint instability leads to dislocation or subluxation and involves peripheral joints as well as central joints, including the temporomandibular joints, sacroiliac joints, and hip joints. Soft tissue overuse injury may lead to tendonitis and bursitis without joint inflammation in most cases. Ehlers–Danlos syndrome-HT carries a high potential for disability due to recurrent dislocations and subluxations and chronic pain. Throughout the years, extra-articular manifestations have been described, including cardiovascular, autonomic nervous system, gastrointestinal, hematologic, ocular, gynecologic, neurologic, and psychiatric manifestations, emphasizing the multisystemic nature of EDS-HT. Unfortunately, EDS-HT is under-recognized and inadequately managed, leading to neglect of these patients, which may lead to severe disability that almost certainly could have been avoided. In this review article we will describe the known manifestations of the extra-articular systems.

  14. Detection of subacromial bursa thickening by sonography in shoulder impingement syndrome.

    Science.gov (United States)

    Tsai, Yao-Hung; Huang, Tsung-Jen; Hsu, Wei-Hsiu; Huang, Kuo-Chin; Li, Yen-Yao; Peng, Kuo-Ti; Hsu, Robert Wen-Wei

    2007-01-01

    Normally, the subacromial-subdeltoid bursa is thinner than 2 mm using ultrasound examination. The subtle thickening of the bursa could be an early sign of subacromial impingement and possibly a rotator cuff tear. The aim of this study was to compare the thickness of subacromial bursa measured using ultrasonography in the painful shoulder with normal side, and also to differentiate Neer stages I and II impingements in patients with unilateral shoulder pain. We performed bilateral shoulder sonography in 268 consecutive patients with unilateral shoulder pain and clinical suggestion of rotator cuff pathology. The study group consisted of 102 cases of Neer stage I and 166 cases of Neer stage II impingement syndrome. The bursa thickness was calculated from the superficial peribursal fat to the upper margin of the supraspinatus. A statistically significant association was detected (p bursa in patients with Neer stage I impingement had no statistically important link the results of the patients with Neer stage II impingement. Increased bursa thickness in the symptomatic side may be an alternative sonographic indicator of subacromial bursitis and partial-thickness rotator cuff tears, even when measured to be less than 2 mm. Sonographic examination of subacromial bursa thickness is not an appropriate technique to differentiate the Neer stages I and II impingement. Further study is needed to quantify the echogenicity of the supraspinatus tendon and to show a level of accuracy in patients with rotator cuff tendinosis or partial tears.

  15. Clinical anatomy of the retrocalcaneal bursa.

    Science.gov (United States)

    Kachlik, D; Baca, V; Cepelik, M; Hajek, P; Mandys, V; Musil, V; Skala, P; Stingl, J

    2008-06-01

    The goal of the study was to perform a detailed anatomical description of the retrocalcaneal bursa (RB). Its morphological arrangement was studied on 10 fresh and 30 embalmed lower extremities by microdissection and light microscopy. The RB was present constantly and in all the cases contained 1-2 cm long synovial fold, beginning on the upper wall of RB and distally interposed between the anterior surface of the Achilles tendon and the posterior surface of the calcaneal tuberosity. The volume of RB was 1-1.5 ml. The histological analysis confirmed that the inner surface of the superior and posterior wall of RB have been covered by unilayered synovial membrane, projecting into synovial villi of different shapes and sizes. In the ceiling of RB, delicate fascicle of skeletal muscle fibers was discovered, radiating distally into the regularly present synovial fold. The whole bottom of RB has been covered by 200-500 microm layer of fibrous cartilage into which the calcaneal tendon attached. The cartilagineous layer continued anteroproximally to cover the whole bursal surface of the calcaneal tuberosity, where the thickness of the cortical bone was reduced on mere 50 microm. The obtained results can be used in the improvement of the differential diagnostics and therapy of diagnostics and therapy of the retrocalcaneal bursitis as well as of other kinds of achillar enthesopathies and heel pain.

  16. The deep infrapatellar bursa: prevalence and morphology on routine magnetic resonance imaging of the knee.

    Science.gov (United States)

    Aydingoz, Ustun; Oguz, Berna; Aydingoz, Onder; Comert, Ruhi Baris; Akgun, Isik

    2004-01-01

    To evaluate the presence, location, and dimensions of the deep infrapatellar bursa on routine magnetic resonance (MR) imaging of the knee. The study group consisted of 213 knees in 204 consecutive individuals who had undergone routine MR imaging examination of the knee within a 365-day period. Magnetic resonance examinations consisted of T1-, proton-density-, and T2-weighted sagittal; spectral presaturation inversion recovery coronal; and T2*-weighted transverse sequences. Exclusion criteria were previous knee arthroscopy or surgery or the presence of a mass lesion infiltrating the infrapatellar fat pad. The presence, location, and dimensions of the deep infrapatellar bursa were studied. The bursa was also analyzed with regard to knee joint synovial effusion (absent, mild, or marked). The deep infrapatellar bursa was detected in 68% of the knees, most commonly on the lateral paramedian sagittal MR images. There was no statistically significant difference between male and female subjects or between the knee sides with regard to the detection of the deep infrapatellar bursa (P > 0.05). No correlation was found between synovial effusion and the presence of the deep infrapatellar bursa. The mean anteroposterior and craniocaudal dimensions of the deep infrapatellar bursa on sagittal T2-weighted MR images were 2.1-2.7 mm and 7.3-9.1 mm, respectively, on its lateral, central, or medial location within the sagittal MR image stack. An awareness of the dimensions and location of the deep infrapatellar bursa is important in distinguishing it from pathologic lesions (eg, bursitis).

  17. Intra-articular, bursa, and tendon sheath injections: a survey of practice patterns among members of the American College of Rheumatology.

    Science.gov (United States)

    Lazaro, Deana; Alon, Leah; Ramessar, Nina; Cabas-Vargas, Jenny; Shwin, Kyawt; Stefanov, Dimitre G

    2014-03-01

    The objective of this study was to survey members of the American College of Rheumatology (ACR) regarding intra-articular and soft tissue (musculoskeletal [MSK]) injections and to determine if injection techniques vary depending on type of practice and years of experience. A survey was e-mailed to the members of the ACR to obtain demographics of the respondents, MSK injection practices, and adverse events seen. The most common indications for MSK injections were rheumatoid arthritis, osteoarthritis, and bursitis. Written consent and time-out procedures were more common in academic/government practices when compared with private practice. There was variation in the type of corticosteroid used. The most common preparations were methylprednisolone actetate (45.0%), triamcinolone acetonide (26.1%), triamcinolone hexacetonide (22.1%). This survey showed good agreement on the dosage of corticosteroid for MSK injections; however, as years of experience increased, clinicians were more likely to prescribe lower doses for shoulder and knee injections. In this survey of ACR members, we found self-reported differences in the type of corticosteroid used for MSK injections. There was general agreement on frequency of injections, but more experienced practitioners reported using lower doses of corticosteroid.

  18. [When should MRI for knee or hip osteoarthritis should be performed?].

    Science.gov (United States)

    Loeuille, Damien

    2012-05-01

    Radiograph is the gold standard to establish the diagnosis of osteoarthritis (OA) and to classify patients in function structural severity according to Kellgren and Lawrence's classification. Radiograph should be performed on standing position for weight-bearing joints. In clinical practice, MRI is usually used to eliminate other diagnosis when X-rays are considered as normal and to precise abarticular structures and bone lesions affected in OA. This imaging technic allows to directly visualize articular cartilage damage with an excellent correlation compared to arthroscopy But MRI is also able to depict articular damages associated with OA such as bone marrow lesion (BML), osteophytes, cysts, joint effusion, synovitis, menisci lesions, tendinitis and bursitis. Some of them were associated with pain (BML, synovitis, effusion) while some articular lesions were more implicated in chondrolysis (focal cartilage lesion, BML, menisci lesion, synovitis effusion). In cases of X-ray abnormalities (osteophytes, joint space narrowing, bone condensation, cysts), menisci lesions should not be considered as responsible for pain in knee OA. Thus, MRI is the only imaging technic able to precise which articular structure is affected during the disease (bone, synovial tissue or abarticular tissues) and helps clinician to have a more targeted therapeutic approach.

  19. Pelvic MRI findings of juvenile-onset ankylosing spondylitis.

    Science.gov (United States)

    Yilmaz, Mehmet Halit; Ozbayrak, Mustafa; Kasapcopur, Ozgur; Kurugoglu, Sebuh; Kanberoglu, Kaya

    2010-09-01

    Ankylosing spondylitis (AS) is the most common clinical subgroup of sero-negative spondyloarthropathies. Radiographic and clinical signs of bilateral inflammatory involvement of sacroiliac joints are the gold standard for the diagnosis of juvenile AS. Although radiographic evidence of sacroiliitis is included in the definition, it is not mandatory for the diagnosis of juvenile AS. The aim of this study is to describe pelvic enthesitis-osteitis MRI findings accompanying sacroiliitis in a group of juvenile AS. Eleven patients suffering from low back pain underwent MRI of the pelvis and were enrolled in this retrospective study. The mean duration of symptoms was 12 months. The mean age of the 11 cases in our study was 12.18 years (range, 6-19). There were eight boys and three girls. Anteroposterior radiographs of the pelvis were obtained in all patients. Sacroiliac joint involvement was detected in all of the cases by pelvic MRI. Pathologic signal changes were detected in the pubic symphisis (osteitis pubis) in ten cases, trochanteric bursitis in six cases, coxofemoral joint in five cases, crista iliaca in three cases, and ischion pubis in three cases. There was increased T2 signal intensity in eight of the 11 cases (72.7%) relevant with soft tissue edema/inflammation. This high correlation between sacroiliitis and enthesitis suggests that enthesitis could be an important finding in juvenile AS.

  20. Oxaprozin: Synthesis, SAR study, physico-chemical characteristics and pharmacology

    Directory of Open Access Journals (Sweden)

    Božić Bojan Đ.

    2011-01-01

    Full Text Available Oxaprozin (3-(4,5-difeniloksazol-2-ylpropanoic acid is a nonsteroidal anti-inflammatory drug (NSAID used in the treatment of numerous inflammatory musculoskeletal diseases, including rheumatoid arthritis, osteoarthritis, tendonitis, ankylosing spondylitis and bursitis. It is the first representative member of the diaryl-substituted heterocyclic compounds, which have found clinical use as selective cyclooxygenase-2 (COX-2 inhibitors. U.S. Food and Drug Administration (FDA approved its official use in 1992. Both anti-inflammatory and analgesic properties of oxaprozin are mainly due to the potent inhibition of COX. However, oxaprozin-induced benefits might be also regulated by other COX-independent pathways. It has been shown that oxaprozin induced direct proapoptotic effects in CD40L-treated human monocytes independently of COX inhibition. It also has several advantages in the treatment of inflammatory diseases in comparison to other NSAIDs such as aspirin, naproxen, indomethacin and phenylbutazone, which enabled oxaprozin to become one of the most used NSAIDs in America. Oxaprozin, as other members of the group of NSAIDs, can cause gastrointestinal complications, but significantly lower due to relatively high pKa value. In this paper, importance of oxaprozin in the treatment of arthritis and its pharmacokinetic properties were described, therewith its activity and side effects were compared with other commercially available anti-inflammatory drugs.

  1. Multiple intramedullary nailing of proximal phalangeal fractures of hand

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    Patankar Hemant

    2008-01-01

    Full Text Available Background: Proximal phalangeal fractures are commonly encountered fractures in the hand. Majority of them are stable and can be treated by non-operative means. However, unstable fractures i.e. those with shortening, displacement, angulation, rotational deformity or segmental fractures need surgical intervention. This prospective study was undertaken to evaluate the functional outcome after surgical stabilization of these fractures with joint-sparing multiple intramedullary nailing technique. Materials and Methods: Thirty-five patients with 35 isolated unstable proximal phalangeal shaft fractures of hand were managed by surgical stabilization with multiple intramedullary nailing technique. Fractures of the thumb were excluded. All the patients were followed up for a minimum of six months. They were assessed radiologically and clinically. The clinical evaluation was based on two criteria. 1. total active range of motion for digital functional assessment as suggested by the American Society for Surgery of Hand and 2. grip strength. Results: All the patients showed radiological union at six weeks. The overall results were excellent in all the patients. Adventitious bursitis was observed at the point of insertion of nails in one patient. Conclusion: Joint-sparing multiple intramedullary nailing of unstable proximal phalangeal fractures of hand provides satisfactory results with good functional outcome and fewer complications.

  2. Evaluation of a PCR multiplex for detection and differentiation of Mycoplasma synoviae, M. gallisepticum, and M. gallisepticum strain F-vaccine

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    Elena Mettifogo

    2015-01-01

    Full Text Available Mycoplasma gallisepticum (MG and Mycoplasma synoviae (MS are the mycoplasma infections of most concern for commercial poultry industry. MG infection is commonly designated as chronic respiratory disease (CRD of chickens and infections sinusitis of turkeys. MS causes sub clinical upper respiratory infection and tenosynovitis or bursitis in chickens and turkeys. The multiplex PCR was standardized to detect simultaneously the MS, MG field strains and MG F-vaccine strain specific. The generic PCR for detection of any species of Mollicutes Class was performed and compared to the multiplex PCR and to PCR using species-specific primers. A total of 129 avian tracheal swabs were collected from broiler-breeders, layer hens and broilers in seven different farms and were examined by multiplex PCR methods. The system (multiplex PCR demonstrated to be very rapid, sensitive, and specific. Therefore, the results showed a high prevalence of MS in the flocks examined (27.9%, and indicate that the MS is a recurrent pathogen in Brazilian commercial poultry flocks.

  3. Polymyalgia Rheumatica Revealing a Lymphoma: A Two-Case Report

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    Frank Verhoeven

    2016-01-01

    Full Text Available Introduction. Polymyalgia rheumatica (PMR is one of the most common inflammatory rheumatism types in elderly population. The link between cancer and PMR is a matter of debate. Methods. We report two cases of PMR leading to the diagnosis of lymphoma and the growing interest of PET-TDM in this indication. Results. A 84-year-old man known for idiopathic neutropenia presented an inflammatory arthromyalgia of the limb girdle since one month. Blood exams highlighted the presence of a monoclonal B cell clone. Bone marrow concluded to a B cell lymphoma of the marginal zone. He was successfully treated with 0.3 mg/kg/d of prednisone, and response was sustained after 6 months. A 73-year-old man known for prostatic neoplasia in remission for 5 years presented arthromyalgia of the limb girdle since one month. PET-CT revealed bursitis of the hips and the shoulders, no prostatic cancer recurrence, and a metabolically active iliac lymphadenopathy whose pathologic exam concluded to a low grade follicular lymphoma. He was successfully treated with 0.3 mg/kg/d of prednisone. Conclusion. These observations may imply that lymphoma is sometimes already present when PMR is diagnosed and PET-CT is a useful tool in the initial assessment of PMR to avoid missing neoplasia.

  4. Phaeohyphomycosis infection in the knee

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    David Sadigursky

    2016-04-01

    Full Text Available Phaeohyphomycosis is caused by cutaneous fungi and rarely affects large joints. This is a case report on phaeohyphomycosis in the left knee of an elderly individual without immunosuppression. It was accompanied by pain and swelling the anterior knee. The case was first suspected to be suprapatellar bursitis, and was treated with nonsteroidal anti-inflammatory drugs, without remission of symptoms. Surgical treatment was performed, with resection of the suprapatellar bursa and anterior region of the quadriceps tendon. The material was sent for anatomopathological examination and culturing. The pathological examination showed phaeohyphomycosis. The treatment instituted consisted of itraconazole, 200 mg/day for six weeks, and complete remission of symptoms was achieved. The physical examination remained normal after one year of follow-up. This is the first published case of phaeohyphomycosis infection in the suprapatellar region of the knee. Although almost all the cases reported have been associated with immunosuppressed patients, this was an exception. It is important to suspect phaeohyphomycosis in cases of knee infection, in the area of the suprapatellar bursa, when the symptoms do not resolve after clinical treatment.

  5. The support of the ultrasonography of the shoulder in the diagnosis of polymyalgia rheumatica with normal erythrocyte sedimentation rate

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    G. Frisone

    2011-06-01

    Full Text Available The Polymyalgia Rheumatica (PMR is a cronic inflammatory syndrome that affects the elderly population and whose diagnosis is mainly based on clinical criteria taking little advantage of the latest innovatory methods of diagnostic imaging, for instance ultrasonography. Although it is generally characterised by increasing of inflammation values as well as pain and stiffness on the shoulder and pelvic girdles, there is a significant percentage of patients with PMR whose erythrocyte sedimentation rate (ESR is normal; in this case to make a diagnosis is difficult. The purpose of our study is to demonstrate how useful ultrasound investigations on the shoulders joints could be in order to make a diagnosis of PMR, especially for those patients with atypical normal ESR. Our case control study included 23 patients with atypical PMR and 88 patients with standard symptomatic PMR; both groups underwent shoulder ultrasound scans before receiving steroid therapy. As it has been previously shown, the ultrasound method is able to detect distinctive aspects in the joints and tissues of the patients with PMR; so that we could find that 90% of the patients with PMR of both groups suffered from bilateral subdeltoid bursitis. This disorder is seldom found in healthy people and consequently its presence could be considered a useful diagnostic test/check for/of PMR independently from ESR values.

  6. Decline causes of Koalas in South East Queensland, Australia: a 17-year retrospective study of mortality and morbidity

    Science.gov (United States)

    Gonzalez-Astudillo, Viviana; Allavena, Rachel; McKinnon, Allan; Larkin, Rebecca; Henning, Joerg

    2017-02-01

    Koala populations are in catastrophic decline in certain eastern Australian regions. Spanning from 1997-2013, a database derived from wildlife hospitals in southeast Queensland with N = 20,250 entries was classified by causes of morbidity and mortality. A total of 11 aetiologies were identified, with chlamydiosis, trauma, and wasting being most common. The clinical diagnosis at submission varied significantly over the observation period. Combinations of aetiologies were observed in 39% of koalas submitted, with chlamydiosis frequently co-occurring. Urogenital (cystitis 26.8%, bursitis 13.5%) and ocular (conjunctivitis 17.2%) chlamydiosis were the most frequently diagnosed representations of the infection. Approximately 26% of submissions comprised koalas involved in vehicle accidents that were otherwise healthy. Age and sex of the koala as well as season and submission period were compared for the case outcomes of ‘dead on arrival’, ‘euthanized’, or ‘released’ for the four most common clinical diagnoses using multinomial logistic regression models. Exploratory space-time permutation scans were performed and overlapping space-time clusters for chlamydiosis, motor vehicle traumas and wasting unveiled high risk areas for koala disease and injury. Our results suggest that these aetiologies are acting jointly as multifactorial determinants for the continuing decline of koalas.

  7. MR imaging findings of medial tibial crest friction

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    Klontzas, Michail E., E-mail: miklontzas@gmail.com; Akoumianakis, Ioannis D., E-mail: ioannis.akoumianakis@gmail.com; Vagios, Ilias, E-mail: iliasvagios@gmail.com; Karantanas, Apostolos H., E-mail: akarantanas@gmail.com

    2013-11-01

    Objective: Medial tibial condyle bone marrow edema (BME), associated with soft tissue edema (STe) surrounding the medial collateral ligament, was incidentally observed in MRI examinations of young and athletic individuals. The aim of the present study was to 1. Prospectively investigate the association between these findings and coexistence of localized pain, and 2. Explore the possible contribution of the tibial morphology to its pathogenesis. Methods: The medial tibial condyle crest was evaluated in 632 knee MRI examinations. The angle and depth were measured by two separate evaluators. The presence of STe and BME was recorded. A third evaluator blindly assessed the presence of pain at this site. Results: BME associated with STe was found in 24 patients (with no history of previous trauma, osteoarthritis, tumor or pes anserine bursitis). The mean crest angle was 151.3° (95%CI 147.4–155.3°) compared to 159.4° (95%CI 158.8–160°) in controls (Mann–Whitney test, P < 0.0001). MRI findings were highly predictive of localized pain (sensitivity 92% specificity 99%, Fisher's exact test, P < 0.0001). Conclusion: Friction at the medial tibial condyle crest is a painful syndrome. MRI is a highly specific and sensitive imaging modality for its diagnosis.

  8. A Large Rice Body-Containing Cyst Mimicking Infection following Total Hip Arthroplasty: A Case Report

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    Wael Bayoud

    2017-01-01

    Full Text Available Introduction. Soft tissue mass following total hip arthroplasty raises several differential diagnoses not limited to infection, hematoma, wear debris, malignancy, and bursitis. Rice body formation in the hip region is an uncommon process denoting a chronic inflammation. We report here the second case of its kind in the medical literature of a wide symptomatic rice-like body cyst complicating a total hip arthroplasty. Case Presentation. This is the case of an 82-year-old white female, presenting with a warm, red, and inflated groin five years after revision of right total hip arthroplasty. Surgical intervention reveals a large well circumscribed cyst containing well-organized rice-like bodies. This eventuality was never reported in differential diagnosis of hip periprosthetic soft tissue masses before. Conclusion. This case report helps widening the array of the differential diagnosis in patients presenting with a slow growing soft tissue mass following total hip arthroplasty, making rice-like bodies cyst a valid one to consider.

  9. Fluid-fluid level on MR image: significance in Musculoskeletal diseases

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    Chung, Hye Won; Lee, Kyung Won [Seoul Naitonal University, Seoul (Korea, Republic of). Coll. of Medicine; Song, Chi Sung [Seoul City Boramae Hospital, Seoul (Korea, Republic of); Han, Sang Wook; Kang, Heung Sik [Seoul Naitonal University, Seoul (Korea, Republic of). Coll. of Medicine

    1998-01-01

    To evaluate the frequency, number and signal intensity of fluid-fluid levels of musculoskeletal diseases on MR images, and to determine the usefulness of this information for the differentiation of musculoskeletal diseases. MR images revealed fluid-fluid levels in the following diseases : giant cell tumor(6), telangiectatic osteosarcoma(4), aneurysmal bone cyst(3), synovial sarcoma(3), chondroblastoma(2), soft tissue tuberculous abscess(2), hematoma(2), hemangioma (1), neurilemmoma(1), metastasis(1), malignant fibrous histiocytoma(1), bursitis(1), pyogenic abscess(1), and epidermoid inclusion cyst(1). Fourteen benign tumors and ten malignant, three abscesses, and the epidermoid inclusion cyst showed only one fluid-fluid level in a unilocular cyst. On T1-weighted images, the signal intensities of fluid varied, but on T2-weighted images, superior layers were in most cases more hyperintense than inferior layers. Because fluid-fluid layers are a nonspecific finding, it is difficult to specifically diagnose each disease according to the number of fluid-fluid levels or signal intensity of fluid. In spite of the nonspecificity of fluid-fluid levels, they were frequently seen in cases of giant cell tumor, telangiectatic osteosarcoma, aneurysmal bone cycle, and synovial sarcoma. Nontumorous diseases such abscesses and hematomas also demonstrated this finding. (author). 11 refs., 1 tab., 4 figs.

  10. External Snapping Hip Syndrome: Emphasis on the MR Imaging

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    Choi, Jung Eun; Lee, Bae Young [Catholic University St. Paul' s Hospital, Seoul (Korea, Republic of); Sung, Mi Sook; Lee, Ki Haeng; Yoo, Won Jong; Lim, Hyun Wook; Chung, Myung Hee [Catholic University Bucheon St. Mary' s Hospital, Bucheon (Korea, Republic of); Park, Jeong Mi [Catholic University St. Mary' s Hospital, Seoul (Korea, Republic of); Kim, Jee Young [Catholic University St. Vincent' s Hospital, Suwon (Korea, Republic of)

    2010-02-15

    The aim of this study is to evaluate the MR imaging features of patients with external snapping hip syndrome. We retrospectively reviewed 63 hip MR images. The images were analyzed according to the thickness and contour of the iliotibial band and the gluteus maximus, the presence of bone marrow edema, bursitis, joint effusion and other associated findings. The MR imaging of 22 hips with snapping hip syndrome depicted the causes of external snapping hip syndrome in twenty cases (90%). The MR imaging features of the snapping hip included thickening of the iliotibial band in twelve cases (55%) and/or thickening of the anterior band of the gluteus maximus in nineteen (86%), and a wavy contour of the iliotibial band or the anterior band of the gluteus maximus in ten cases (45%). These findings show a significant p value (<0.01). The majority of patients with snapping hip syndrome revealed thickening of the iliotibial band, thickening of the anterior band of the gluteus maximus and wavy contour of the those structures on MR imaging.

  11. Radiographic features of tuberculous osteitis in greater trochanter and lschium

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    Hahm, So Hee; Lee, Ye Ri [Hanil Hospital Affiliated to KEPCO, Seoul (Korea, Republic of); Kim, Dong Jin; Sung, Ki Jun [Yonsei Univ. Wonju College of Medicine, Wonju (Korea, Republic of); Lim, Jong Nam [Konkuk Univ. College of Medicine, Seoul (Korea, Republic of)

    1996-11-01

    To evaluate, if possible, the radiographic features of tuberculous osteitis in the greater trochanter and ischium, and to determine the cause of the lesions. We reterospectively reviewed the plain radiographic findings of 14 ptients with histologically proven tuberculous osteitis involving the greater trochanter and ischium. In each case, the following were analyzed:morphology of bone destruction, including cortical erosion;periosteal reaction;presence or abscence of calcific shadows in adjacent soft tissue. On the basis of an analysis of radiographic features and correlation of the anatomy with adjacent structures we attempted to determine causes. Of the 14 cases evaluated, 12 showed varrious degrees of extrinsic erosion on the outer cortical bone of the greater trochanter and ischium ; in two cases, bone destruction was so severe that the radiographic features of advanced perforated osteomyelitis were simulated. In addition to findings of bone destruction, in these twelve cases, the presence of sequestrum or calcific shadows was seen in adjacent soft tissue. Tuberculous osteitis in the greater trochanter and ischium showed the characteristic findings of chronic extrinsic erosion. On the basis of these findings we can suggest that these lesions result from an extrinsic pathophysiologic cause such as adjacent bursitis.

  12. Do we really need radiographic assessment for the diagnosis of non-specific heel pain (calcaneal apophysitis) in children?

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    Kose, Ozkan [Diyarbakir Education and Research Hospital, Orthopaedics and Traumatology Clinic, Diyarbakir (Turkey); Diclekent Bulvari, Ataslar Serhat Evleri, Diyarbakir (Turkey)

    2010-04-15

    Non-specific heel pain (calcaneal apophysitis) is a common disorder, particularly in physically active growing children. Foot radiographs are usually obtained as part of the clinical evaluation in routine orthopaedic practice. However, there is still controversy about the specific findings on radiographs, and it is unclear what information is present on radiographs that may alter the diagnosis and management. The purpose of this study was to review a consecutive series of patients with the diagnosis of calcaneal apophysitis to assess the yield of routine radiographs of the foot. A prospective study was performed on 61 consecutive patients with a diagnosis of calcaneal apophysitis in a single-surgeon practice. Standard anteroposterior and lateral weight-bearing foot radiographs were obtained for each patient. Seventy-one sets of foot radiographs were reviewed to determine whether radiographs had an impact on diagnosis and management. Patients with antecedent trauma, penetrating injury, foot deformity, achilles tendonitis, bursitis and infections were excluded from the study. Seventy foot radiographs were considered to be normal. The radiographs changed the diagnosis in only one patient, in whom a simple bone cyst of the calcaneous was seen. Calcaneal apophysitis is a self-limiting disease, and patients can be treated conservatively. Neither the sclerosis nor the fragmentation of the apophysis could be used to establish the diagnosis of calcaneal apophysitis. Therefore, obtaining radiographs as an initial step in their evaluation does not seem to be justified. (orig.)

  13. Veal calves’ clinical/health status in large groups fed with automatic feeding devices

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    Giulio Cozzi

    2010-01-01

    Full Text Available Aim of the current study was to evaluate the clinical/health status of veal calves in 3 farms that adopt large group housing and automatic feeding stations in Italy. Visits were scheduled in three phases of the rearing cycle (early, middle, and end. Results showed a high incidence of coughing, skin infection and bloated rumen particularly in the middle phase while cross-sucking signs were present at the early stage when calves’ nibbling proclivity is still high. Throughout the rearing cycle, the frequency of bursitis increased reaching 53% of calves at the end. The percentage of calves with a poorer body condition than the mid-range of the batch raised gradually as well, likely due to the non-proportioned teat/calves ratio that increases competition for feed and reduces milk intake of the low ranking animals. The remarked growth differences among pen-mates and the mortality rate close to 7% showed by the use of automatic feeding devices for milk delivery seem not compensating the lower labour demand, therefore its sustainability at the present status is doubtful both for the veal calves’ welfare and the farm incomes.

  14. Musculoskeletal disorders associated with HIV infection and AIDS. Part I: Infectious musculoskeletal conditions

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    Tehranzadeh, Jamshid [Department of Radiological Sciences, University of California, Irvine, Irvine, California (United States); Department of Radiological Sciences, Rt. 140, 101 The City Drive ZC 5005, CA 92868-3298, Orange (United States); Ter-Oganesyan, Ramon R. [College of Medicine, University of California, Irvine, Irvine, California (United States); Steinbach, Lynne S. [Department of Radiological Sciences, University of California, San Francisco, San Francisco, California (United States)

    2004-05-01

    The musculoskeletal system can be affected by a variety of abnormalities in association with human immunodeficiency virus (HIV) infection. Although not as common as complications involving other organ systems, such as the pulmonary and the central nervous systems, HIV-associated musculoskeletal disorders are sometimes the initial presentation of the viral illness. Knowledge of the existence and the characteristic appearance of the conditions affecting bone, joint, and muscle in HIV-infected patients is valuable to radiologists for diagnosis and to clinicians for detection and appropriate treatment. We reviewed recent literature to provide a comprehensive assessment of the HIV-associated musculoskeletal disorders, and present radiologic examples from our own collection. This article is divided into two parts. In the first part we review the infectious musculoskeletal disorders associated with HIV illness and AIDS, including cellulitis, abscesses, pyomyositis, septic bursitis, septic arthritis, osteomyelitis, and bacillary angiomatosis. We also present a comprehensive spectrum of mycobacterial infections, consisting of tuberculous spondylitis and spondylodiskitis, arthritis, osteomyelitis, and tenosynovitis, as well as infections caused by atypical mycobacteria. Part II of this review will concentrate on non-infectious musculoskeletal conditions, including rheumatic disorders and neoplasms. (orig.)

  15. THE EFFECT OF HOUSING ON THE OCCURANCE OF HIND LEG WEAKNESSES IN MARKET PIGS OF THREE GENOTYPES

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    Blaž Šegula

    2006-10-01

    Full Text Available Degenerative changes of joints due to osteoarthrosis in tarsal joint, peritarsitis, tarsal bursitis and asymmetry of claws was studied on legs of 175 commercial pigs, with prolonged fattening (250 days of age of three genotypes (landrace pigs-11, crosses between landrace females and large white males-12, crosses between female 12 and duroc male- 123 housed either individually on the zincifi ed metal slatted fl oor or in groups of 8-9 pigs on the concrete slatted fl oor. Degenerative changes due to osteoarthrosis (OATD in small joints of the hock - os tarsale tertium (T3, os tarsale quartum (T4, os metatarsale tertium (Mt3 and os metatarsale quatrum (Mt4 and due to the peritarsitis were signifi cantly more important in pigs housed individually (P<0.001. Individually housed pigs grew faster and were signifi cantly heavier for the similar slaughter age (P<0.001. The effect of genotype was only minor; the crosses 12 had lesser asymmetry of claws (P<0.001 than pigs 11 or 123, whereas crosses 123 had signifi cantly (P<0.005 less pronounced degenerative changes due to osteoarthrosis on Mt3 and T3.

  16. Shockwave treatment for musculoskeletal diseases and bone consolidation: qualitative analysis of the literature

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    Paulo Kertzman

    2015-02-01

    Full Text Available Shockwave treatment is an option within orthopedics. The exact mechanism through which shockwaves function for treating musculoskeletal diseases is unknown. The aim of this study was to make a qualitative analysis on the effectiveness of shockwave treatment among patients with musculoskeletal pathological conditions and pseudarthrosis. Searches were conducted in the Cochrane Library, Medline and Lilacs databases. Thirty-nine studies that reported using shockwave treatment for musculoskeletal diseases were found. Their results varied greatly, as did the types of protocol used. The studies that evaluated the effectiveness of shockwave treatment for lateral epicondylitis, shoulder tendinopathy, knee osteoarthrosis, femoral head osteonecrosis and trochanteric bursitis reported inconsistent results for most of their patients. Those that evaluated patients with calcifying tendinopathy, plantar fasciitis, Achilles tendinopathy, patellar tendinopathy and pseudarthrosis showed benefits. Shockwave treatment is a safe and non-invasive method for chronic cases in which conventional techniques have been unsatisfactory and should be used in association with other treatment methods for tendinopathy. Further quality studies are needed.

  17. Obturator internus pyomyositis. A case report.

    Science.gov (United States)

    Birkbeck, D; Watson, J T

    1995-07-01

    Pyomyositis appears to be increasing in prevalence in temperate climates, and often the orthopaedist is integral in the decision making and care of these patients. This is the first reported case of spontaneous bacterial pyomyositis involving the obturator internus muscle. Deep pelvic infections involving the psoas, iliacus, piriformis, and obturator internus can be a significant cause of morbidity and mortality. The infection subsequently may exit the pelvis, and conceivably may progress to a septic hip, bursitis, or lower extremity cellulitis. Improvements in noninvasive imaging such as ultrasound, computed tomography, and magnetic resonance imaging have produced finer resolution of tissue planes. Because of the pathology's deep location within the pelvis of the patient described here, all 3 tests were integral in the surgical planning, exposure, and proper diagnosis. Although 95% of pyomyositis cases are caused by Staphylococcus aureus, cases of pyomyositis with negative cultures have been described. Consideration should be made of disseminated Neisseria gonorrhoeae in sexually active individuals, and cultures should include Thayer-Martin agar to decrease the likelihood of a false-negative culture result.

  18. [Hindfoot pain].

    Science.gov (United States)

    Damiano, Joël; Bouysset, Maurice

    2010-03-20

    The hindfoot is the part of the foot which is proximal to the midtarsal joint. The obvious causes of pain are not considered (post-traumatic etiologies, sprains and fractures but also cutaneous lesions). The main etiologies on the subject are successively exposed by following the localization of the pain. Diffuse pains (ankle arthritis tarsal osteoarthritis, algodystrophy, calcaneo-navicular synostosis but also bone diseases like stress fractures, Paget disease or tumors). Plantar talalgia (Sever's disease, plantar fasciitis and entrapment neuropathies such as (esions of the medial calcaneal nerve, of the first branch of the plantar lateral nerve, medial plantar nerve and lateral plantar nerve). Posterior pains: calcaneal tendinopathy including peritendinitis, tendinosis, retro-calcaneal bursitis and pathology of the postero-lateral talar tuberosity. Medial pains: tendinopathies of the posterior tibial tendon and tendinopathy of the flexor hallucis longus tendon and tarsal tunnel syndrome. Lateral pains: fibularis tendinopathies including split lesions of the fibularis brevis tendon, displacement of the fibularis iongus tendon, sinus tarsi syndrome and finally thickenings of capsules and ligaments and ossifications localized under the tibial malleoli. Anterior pains: antero-inferior tibio-fibular ligament, anterior tibial tendinopathy and anterior impingment syndrome.

  19. Shoulder pain in primary care: frozen shoulder.

    Science.gov (United States)

    Cadogan, Angela; Mohammed, Khalid D

    2016-03-01

    BACKGROUND AND CONTEXT Frozen shoulder is a painful condition that follows a protracted clinical course. We aim to review the management of patients with a diagnosis of frozen shoulder who are referred for specialist orthopaedic evaluation against existing guidelines in primary care. ASSESSMENT OF PROBLEM Referrals and clinical records were reviewed for all patients referred for orthopaedic specialist assessment who received a specialist diagnosis of frozen shoulder. Diagnostic, investigation and management practices from a regional primary health care setting in New Zealand were compared with guideline-recommended management. RESULTS Eighty patients with frozen shoulder were referred for orthopaedic evaluation in the 13 month study period, mostly from general practice. Fifteen patients (19%) were identified as having a frozen shoulder in their medical referral. Most (99%) had received previous imaging. Seven patients (12%) had received guideline recommended treatment. STRATEGIES FOR IMPROVEMENT Education of all clinicians involved in patient management is important to ensure an understanding of the long natural history of frozen shoulder and provide reassurance that outcomes are generally excellent. HealthPathways now include more information regarding diagnosis, imaging and evidence-based management for frozen shoulder. LESSONS Frozen shoulder may be under-diagnosed among patients referred for orthopaedic review. Ultrasound imaging is commonly used and may identify occult and unrelated pathology in this age-group. When managed according to clinical guidelines, patients report significant clinical and functional improvement with most reporting 80% function compared with normal after 1 year. KEYWORDS Adhesive capsulitis; bursitis; injections; practice guideline; primary health care; ultrasound.

  20. Retrospective Evaluation Of MRI Findings Of Knee Joint In 255 Patients

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    Ahmet Mete

    2003-03-01

    Full Text Available Retrospective evaluation of knee MRI obtained from 255 cases and to demonstrate most common knee joint pathologies in our region.In our study knee joints of 255 cases who admitted to different clinics of our hospital with various complains of knee between October 1996 and December 1998 were examined in wide spectrum with MRI. Via 1.0 Tesla MRI device and special knee coil in sagittal, coronal and axial plains MRI images were obtained. The number of male and female patients were 173 and 82 and their ages were ranged between 14 and 70, and the mean age was 3413.The most common knee pathologies were intra-articular fluid (%58.04, medial (%46,66 and lateral (%12.55 meniscal injuries, anterior cruciate ligament injury (%17.25 and osteoarthritis (%14.9. The other important lesions were degeneration of medial and lateral meniscus, Baker’s cyst, bursitis, posterior cruciate ligament injury , medial and lateral collateral ligament injuries, synovial hypertrophy, chondromalasia of patella, and contusion.In our images of knee the most common lesions were injuries of meniscus and ligament. Because of being noninvasive technique for knee joint pathologies, capacity of multiplanar imaging, high contrast resolution and chance of detailed anatomic evaluation MR imaging was found to be most appropriate imaging technique for knee joint pathologies.

  1. MRI for the diagnosis of scapular dyskinesis: a report of two cases

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    Morita, Wataru; Tasaki, Atsushi [St. Luke' s International Hospital, Department of Orthopaedic Surgery, Tokyo (Japan); Nozaki, Taiki [St. Luke' s International Hospital, Department of Radiology, Tokyo (Japan)

    2017-02-15

    Scapular dyskinesis describes the altered position of the scapula and/or abnormal movements of the scapulothoracic joint. It is caused by bony anatomical variations, bursitis, tumors, and muscular pathological conditions including loss of innervation and fibrosis. Scapular dyskinesis is just as often subclinical as it is symptomatic, and as the periscapular anatomical changes may not result in patient symptoms, a precise diagnosis of the etiology and pathophysiology has been a challenge. Scapular bony prominence is a common etiology of scapular dyskinesis, but does not always result in morbidity. We report a case of a 39-year-old man in whom an extensive MRI with fluid-sensitive imaging sequences covering the whole of the scapula was beneficial in diagnosing the inflammation adjacent to the bony deformity, which confirmed the etiology of scapular dyskinesis. Furthermore, in a 41-year old man without any anatomical variances, a similar MRI showed inflammation at the subscapular fossa that suggested altered scapular kinematics. An arthroscopic debridement of the lesion improved the symptoms. MRI in conjunction with plain radiographs, CT and physical examination enabled a precise diagnosis of the etiology. Fluid-sensitive MR images are important in defining the presence of inflammation, and are beneficial in determining the pathological significance of findings through other diagnostic measures. (orig.)

  2. Patellofemoral Pain Syndrome in Iranian Female Athletes

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    Hamid Reza Baradaran

    2011-03-01

    Full Text Available Patellofemoral pain syndrome (PFPS is the most common overuse syndrome in athletes. It is one of the causes of anterior knee pain in athletic population who come to the sports medicine clinic. Patellofemoral pain is more common among female athletes especially adolescents and young adults. Symptoms include: persistent pain behind the patella or peripatella. Pain increases on ascending and descending stairs and squatting and prolonged sitting. The aim of this study was to evaluate the prevalence of PFPS in Iranian female athletes. 418 female athletes aged 15-35 years were examined in five sports: Soccer (190, volleyball (103, running (42, fencing (45 and rock climbing (38. The athletes who had non- traumatic onset anterior knee pain of at least 3 months that increased in descending and ascending stairs and squatting, had no other causes of anterior knee pain such as ligament instability, bursitis, meniscal injury, tendonitis and arthritis and no history of knee surgery during the one past year were diagnosed as PFPS. 26/190 (13.68 % soccer players, 21/103(20.38 % volleyball players, 7/42 (16.66 % runners, 6/45(13.33 % fencers and 10/38 (26.31% rock climbers had patellofemoral pain. Among the 418 female athletes who were evaluated 70 had PFPS. Rock climbers were the most common athletes with PFPS followed by volleyball players and runners.

  3. Ultrasound-guided interventional procedures around the shoulder.

    Science.gov (United States)

    Messina, Carmelo; Banfi, Giuseppe; Orlandi, Davide; Lacelli, Francesca; Serafini, Giovanni; Mauri, Giovanni; Secchi, Francesco; Silvestri, Enzo; Sconfienza, Luca Maria

    2016-01-01

    Ultrasound is an established modality for shoulder evaluation, being accurate, low cost and radiation free. Different pathological conditions can be diagnosed using ultrasound and can be treated using ultrasound guidance, such as degenerative, traumatic or inflammatory diseases. Subacromial-subdeltoid bursitis is the most common finding on ultrasound evaluation for painful shoulder. Therapeutic injections of corticosteroids are helpful to reduce inflammation and pain. Calcific tendinopathy of rotator cuff affects up to 20% of painful shoulders. Ultrasound-guided treatment may be performed with both single- and double-needle approach. Calcific enthesopathy, a peculiar form of degenerative tendinopathy, is a common and mostly asymptomatic ultrasound finding; dry needling has been proposed in symptomatic patients. An alternative is represented by autologous platelet-rich plasma injections. Intra-articular injections of the shoulder can be performed in the treatment of a variety of inflammatory and degenerative diseases with corticosteroids or hyaluronic acid respectively. Steroid injections around the long head of the biceps brachii tendon are indicated in patients with biceps tendinopathy, reducing pain and humeral tenderness. The most common indication for acromion-clavicular joint injection is degenerative osteoarthritis, with ultrasound representing a useful tool in localizing the joint space and properly injecting various types of drugs (steroids, lidocaine or hyaluronic acid). Suprascapular nerve block is an approved treatment for chronic shoulder pain non-responsive to conventional treatments as well as candidate patients for shoulder arthroscopy. This review provides an overview of these different ultrasonography-guided procedures that can be performed around the shoulder.

  4. Evaluation of elbow pain in adults.

    Science.gov (United States)

    Kane, Shawn F; Lynch, James H; Taylor, Jonathan C

    2014-04-15

    The elbow is a complex joint designed to withstand a wide range of dynamic exertional forces. The location and quality of elbow pain can generally localize the injury to one of the four anatomic regions: anterior, medial, lateral, or posterior. The history should include questions about the onset of pain, what the patient was doing when the pain started, and the type and frequency of athletic and occupational activities. Lateral and medial epicondylitis are two of the more common diagnoses and often occur as a result of occupational activities. Patients have pain and tenderness over the affected tendinous insertion that are accentuated with specific movements. If lateral and medial epicondylitis treatments are unsuccessful, ulnar neuropathy and radial tunnel syndrome should be considered. Ulnar collateral ligament injuries occur in athletes participating in sports that involve overhead throwing. Biceps tendinopathy is a relatively common source of pain in the anterior elbow; history often includes repeated elbow flexion with forearm supination and pronation. Olecranon bursitis is a common cause of posterior elbow pain and swelling. It can be septic or aseptic, and is diagnosed based on history, physical examination, and bursal fluid analysis if necessary. Plain radiography is the initial choice for the evaluation of acute injuries and is best for showing bony injuries, soft tissue swelling, and joint effusions. Magnetic resonance imaging is the preferred imaging modality for chronic elbow pain. Musculoskeletal ultrasonography allows for an inexpensive dynamic evaluation of commonly injured structures.

  5. US guided corticosteroid injection into the subacromial-subdeltoid bursa: Technique and approach

    Science.gov (United States)

    Molini, L.; Mariacher, S.; Bianchi, S.

    2012-01-01

    Local injection of cortisone derivatives, sometimes combined with local anesthetics, is frequently administered in rheumatology as the treatment of choice in para-articular diseases or as an adjuvant to systemic therapy in the treatment of arthritis. One of the most frequent local corticosteroid injections administered in daily clinical practice by rheumatologists, orthopedic surgeons, physiatrists, sports medicine doctors and general practitioners is injection into the subacromialsubdeltoid bursa in the treatment of bursitis and anterior superior impingement syndrome of the shoulder. Before local corticosteroid injection is administered, it is important to identify possible contraindications and to examine the documentation provided by the patient. Absolute contraindications or those related to the procedure should be evaluated by the prescribing physician but also the physician performing the corticosteroid injection should evaluate possible contraindications to make sure that corticosteroid injection is feasible. The present paper describes the ultrasound (US) guided local corticosteroid injection procedure with particular attention to the equipment required, the position of the patient and the examiner as well as the approach. The main advantage of US guidance during corticosteroid injection is the possibility to identify vascular structures, nerves and tendons situated in the needle path in order to avoid these structures and be sure to inject the drug into the appropriate location. When all rules are complied with and the corticosteroid injection is carried out by an experienced physician, it is virtually painless and is performed in just a few minutes. PMID:23396761

  6. Role of FDG PET/CT in Baastrup's disease.

    Science.gov (United States)

    Subramanyam, Padma; Palaniswamy, Shanmuga Sundaram

    2016-01-01

    Baastrup's disease is a benign condition, which presents as chronic low back pain. It is also known as "kissing spine syndrome" and refers to close approximation of adjacent spinous processes producing inflammation and back pain. This condition is often misdiagnosed, resulting in incorrect treatment and persistence of symptoms. Diagnosis of Baastrup's disease is verified with clinical examination and imaging studies. Conventionally, clinicians resort to magnetic resonance imaging (MRI) of spine rather than X-ray or computed tomography (CT) in the evaluation of back pain. MRI can additionally identify flattening, sclerosis, enlargement, cystic lesions, and bone edema at the articulating surfaces of the two affected spinous processes. Studies have reported that (18)Fluorine fluorodeoxyglucose-positron emission tomography/CT (FDG-PET/CT) can detect a bursitis or an inflammation as a form of stress reaction despite a negative MRI and (99m)Tc Methylene diphosphonate (MDP) bone scan. PET/CT is usually not a recommended investigation for this condition. However, this case report highlights the benefit of FDG-PET/CT in identifying the site of inflammatory pathology. It is also known to identify the exact site of inflammation where steroid or local anesthetic injection can be administered to alleviate pain, especially in patients with multilevel vertebral involvement.

  7. MRI findings in renal transplant recipients with hip and knee pain

    Energy Technology Data Exchange (ETDEWEB)

    Donmez, Fuldem Yildirim [Baskent University Faculty of Medicine, Department of Radiology, Fevzi Cakmak Caddesi 10. sokak no: 45, Bahcelievler 06490, Ankara (Turkey)], E-mail: fuldemyildirim@yahoo.com; Basaran, Ceyla [Baskent University Faculty of Medicine, Department of Radiology, Fevzi Cakmak Caddesi 10. sokak no: 45, Bahcelievler 06490, Ankara (Turkey)], E-mail: ceylab@baskent-ank.edu.tr; Ulu, Esra Meltem Kayahan [Baskent University Faculty of Medicine, Department of Radiology, Fevzi Cakmak Caddesi 10. sokak no: 45, Bahcelievler 06490, Ankara (Turkey)], E-mail: emkayahanulu@yahoo.com; Uyusur, Arzu [Baskent University Faculty of Medicine, Department of Radiology, Fevzi Cakmak Caddesi 10. sokak no: 45, Bahcelievler 06490, Ankara (Turkey)], E-mail: arzuuyusur@yahoo.com; Tarhan, Nefise Cagla [Baskent University Faculty of Medicine, Department of Radiology, Fevzi Cakmak Caddesi 10. sokak no: 45, Bahcelievler 06490, Ankara (Turkey)], E-mail: caglat@baskent-ank.edu.tr; Muhtesem Agildere, A. [Baskent University Faculty of Medicine, Department of Radiology, Fevzi Cakmak Caddesi 10. sokak no: 45, Bahcelievler 06490, Ankara (Turkey)], E-mail: amuhtesem@superonline.com

    2009-09-15

    Purpose: To evaluate and demonstrate the MRI findings of renal transplant recipients with hip and knee pain and to investigate the most common etiology of pain. Materials and methods: 69 hip MRIs of 57 patients with hip pain and 30 knee MRIs of 24 patients with knee pain with no history of trauma were retrospectively evaluated by two radiologists. Results: In the evaluation of hip MRIs, 24 patients had avascular necrosis and effusion, 2 patients had bone marrow edema consistent with early stage of avascular necrosis. 18 patients had only intraarticular effusion, 6 patients had tendinitis, 6 patients had bursitis and 1 patient had soft tissue abscess. Five patients had muscle edema and five patients had muscle atrophy as additional findings to the primary pathologies. Among patients with knee pain, nine patients had degenerative joint disease. Seven patients had chondromalacia, five had bone marrow edema, six had meniscal tear, six had ligament rupture and two had bone infarct. Three of the patients had muscle edema accompanying to other pathologies. Conclusion: The most common etiology of hip pain in renal transplant recipients is avascular necrosis as expected, intraarticular effusion is found to be Second reason for pain. However, knee pain is explained by ligament pathology, meniscal tear, chondromalacia or degenerative joint disease rather than osteonecrosis.

  8. [Acute and overuse injuries of the shoulder in sports].

    Science.gov (United States)

    Doyscher, R; Kraus, K; Finke, B; Scheibel, M

    2014-03-01

    During sports the shoulder complex is exposed to considerable load especially where throwing is important and various pathological changes can occur. In the last two decades the shoulder in athletes has become a special term in clinical sports medicine Selective literature review in PubMed and consideration of personal experience, research results as well as national and international recommendations In general acute lesions of the shoulder caused by sudden sport injuries, such as traumatic luxation, acromioclavicular (AC) joint disruption, traumatic tendon ruptures, labral lesions, cartilage defects and fractures have to be distinguished from chronic or long-standing pathologies due to recurrent microtrauma, such as overuse bursitis and tendinitis, as well as secondary forms of impingement along with rotator cuff tears and labral lesions. Besides common pathological changes that can be observed in almost all overhead-sports, there are also injuries that are more sport-specific due to the particular load profile in each sport. These injuries are especially common in racquet and throwing sports (e.g. golf, tennis, handball and volleyball) as well as in individual and artistic sports (e.g. swimming, gymnastics, dancing and rowing), contact and extreme sports (e.g. judo, mixed martial arts, bodybuilding, weightlifting, motocross and downhill mountain biking). Knowledge about sport-specific load profiles as well as about the variety of treatment options is crucial for successful treatment of these injuries.

  9. Subacromial Impingement Syndrome Caused by a Voluminous Subdeltoid Lipoma

    Directory of Open Access Journals (Sweden)

    Jean-Christophe Murray

    2014-01-01

    Full Text Available Subacromial impingement syndrome is a clinical diagnosis encompassing a spectrum of possible etiologies, including subacromial bursitis, rotator cuff tendinopathy, and partial- to full-thickness rotator cuff tears. This report presents an unusual case of subdeltoid lipoma causing extrinsic compression and subacromial impingement syndrome. The patient, a 60-year-old man, presented to our institution with a few years' history of nontraumatic, posteriorly localized throbbing pain in his right shoulder. Despite a well-followed 6-months physiotherapy program, the patient was still suffering from his right shoulder. The MRI scan revealed a well-circumscribed 6 cm × 2 cm × 5 cm homogenous lesion compatible with a subdeltoid intermuscular lipoma. The mass was excised en bloc, and subsequent histopathologic examination confirmed a benign lipoma. At 6-months follow-up, the patient was asymptomatic with a complete return to his activities. Based on this case and a review of the literature, a subacromial lipoma has to be included in the differential diagnosis of a subacromial impingement syndrome refractory to nonoperative treatment. Complementary imaging modalities are required only after a failed conservative management to assess the exact etiology and successfully direct the surgical treatment.

  10. Detailed Shoulder MRI Findings in Manual Wheelchair Users with Shoulder Pain

    Directory of Open Access Journals (Sweden)

    Melissa M. B. Morrow

    2014-01-01

    Full Text Available Shoulder pain and pathology are common in manual wheelchair (MWC users with paraplegia, and the biomechanical mechanism of injury is largely unknown. Establishing patterns of MRI characteristics in MWC users would help advance understanding of the mechanical etiology of rotator cuff disease, thus improving the logic for prescribed interventions. The purpose of this study was to report detailed shoulder MRI findings in a sample of 10 MWC users with anterolateral shoulder pain. The imaging assessments were performed using our standardized MRI Assessment of the Shoulder (MAS guide. The tendon most commonly torn was the supraspinatus at the insertion site in the anterior portion in either the intrasubstance or articular region. Additionally, widespread tendinopathy, CA ligament thickening, subacromial bursitis, labral tears, and AC joint degenerative arthrosis and edema were common. Further reporting of detailed shoulder imaging findings is needed to confirm patterns of tears in MWC users regarding probable tendon tear zone, region, and portion. This investigation was a small sample observational study and did not yield data that can define patterns of pathology. However, synthesis of detailed findings from multiple studies could define patterns of pathological MRI findings allowing for associations of imaging findings to risk factors including specific activities.

  11. Magnetic resonance imaging of hindfoot involvement in patients with spondyloarthritides: Comparison of low-field and high-field strength units

    Energy Technology Data Exchange (ETDEWEB)

    Eshed, Iris; Althoff, Christian E. [Department of Radiology, Charite Medical School, Berlin (Germany); Feist, Eugen [Department of Rheumatology and Clinical Immunology, Charite Medical School, Berlin (Germany); Minden, Kirsten [Helios Clinics, 2nd Children' s Hospital Berlin-Buch, Rheumatology Unit, Berlin (Germany); German Rheumatology Research Center, Berlin (Germany); Schink, Tania [Department of Medical Biometry, Charite Medical School, Berlin (Germany); Hamm, Bernd [Department of Radiology, Charite Medical School, Berlin (Germany); Hermann, Kay-Geert A. [Department of Radiology, Charite Medical School, Berlin (Germany)], E-mail: kgh@charite.de

    2008-01-15

    Objective: To compare MRI evaluation of a painful hindfoot of patients with spondyloarthritides (SpA) on low-field (0.2 T) versus high-field (1.5 T) MRI. Materials and methods: Patients with SpA and hindfoot pain were randomly referred to either high-field or low-field MRI. Twenty-seven patients were evaluated (male/female: 17:10; mean age: 39 {+-} 1.4 years). Fifteen patients were examined by low-field and 12 by high-field MRI. Two patients (evaluated by high-field MRI) were excluded. Images were separately read by two radiologists who later reached a consensus. In each patient the prevalence of erosions, fluid, synovitis or bone marrow edema of the hindfoot joints, tendinosis or tenosynovitis of tendons, enthesitis of the plantar fascia and Achilles tendon and retrocalcaneal bursitis were recorded. Clinical and demographic parameters were comparable between both groups. Results: MRI evaluation of joints and tendons of the hindfoot revealed no significant differences in patients with SpA groups for all parameters. Analyzing all joints or tendons together, there was no statistically significant difference between the two groups. Conclusion: Low-field and high-field MRI provide comparable information for evaluation of inflammatory hindfoot involvement. Thus, low-field MRI can be considered as a reliable diagnostic tool for the detection of hindfoot abnormalities in SpA patients.

  12. Articular manifestations in patients with Lyme disease.

    Science.gov (United States)

    Vázquez-López, María Esther; Díez-Morrondo, Carolina; Sánchez-Andrade, Amalia; Pego-Reigosa, Robustiano; Díaz, Pablo; Castro-Gago, Manuel

    To determine the percentage of Lyme patients with articular manifestations in NW Spain and to know their evolution and response to treatment. A retrospective study (2006-2013) was performed using medical histories of confirmed cases of Lyme disease showing articular manifestations. Clinical and laboratory characteristics, together with the treatment and evolution of the patients, were analysed. Seventeen out of 108 LD confirmed patients (15.7%) showed articular manifestations. Regarding those 17 patients, 64.7%, 29.4% and 5.9% presented arthritis, arthralgia and bursitis, respectively. The knee was the most affected joint. Articular manifestations were often associated to neurological, dermatological and cardiac pathologies. Otherwise, most patients were in Stage III. The 11.8% of the cases progressed to a recurrent chronic arthritis despite the administration of an appropriate treatment. Lyme disease patients showing articular manifestations should be included in the diagnosis of articular affections in areas of high risk of hard tick bite, in order to establish a suitable and early treatment and to avoid sequels. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  13. Olecranon osteotomy for exposure of fractures and nonunions of the distal humerus.

    Science.gov (United States)

    Ring, David; Gulotta, Lawrence; Chin, Kingsley; Jupiter, Jesse B

    2004-08-01

    Although olecranon osteotomy provides excellent exposure of the distal humerus, enthusiasm for this approach has been limited by reports suggesting numerous complications. It has been suggested that specific techniques for creating and repairing an olecranon osteotomy may help limit complications. This paper describes a technique for olecranon osteotomy using an apex, distal, chevron-shaped osteotomy, Kirschner wires directed out the anterior ulnar cortex distal to the coronoid process and bent 180degrees and impacted into the olecranon proximally, and two 22- gauge, figure-of-eight, stainless steel tension wires. A single surgeon used this technique for exposure of a fracture (16 patients) or nonunion (29 patients) of the distal humerus in 45 consecutive patients. One patient returned to activity too soon, had loosening of the wire fixation, and required a second operation for plate fixation of the ulna. The remaining 44 osteotomies (98%) healed with good alignment within 6 months. There were no broken or migrated wires prior to healing. Twelve patients (27%) had removal of the wires used to repair the olecranon: in 6 patients, this was for symptoms related to the wires (13%); 1 for septic olecranon bursitis, and 5 at the time of another procedure (elbow capsular release in 4 patients and submuscular ulnar nerve transposition in 1). Olecranon osteotomy can be used for exposure of the distal humerus with a low rate of complications when specific techniques are used.

  14. Magnetic resonance imaging appearance of the hands and feet in patients with early rheumatoid arthritis.

    Science.gov (United States)

    Boutry, Nathalie; Lardé, Anne; Lapègue, Franck; Solau-Gervais, Elizabeth; Flipo, René-Marc; Cotten, Anne

    2003-04-01

    To describe the magnetic resonance (MRI) imaging findings of the feet in patients with early rheumatoid arthritis (RA), and to compare MRI appearance of the feet with that of the hands. Thirty consecutive patients (18 women, 12 men; age range 19-64 yrs) with early RA underwent MRI of hands and feet. Axial fat suppressed gadolinium enhanced T1 weighted spin-echo and gadolinium enhanced 3-dimensional gradient-echo (FLASH) images were obtained. In the hands, MRI findings suggested active synovitis of the wrist and metacarpophalangeal (MCP) joints in 28 (93%) and 27 (90%) patients, respectively. In the feet, active synovitis was observed in 29 (97%) patients. Bone erosions were seen in the wrist joints in 24 (80%) patients. Observers found as many bony changes in the MCP as in the metatarsophalangeal joints [23 (77%) patients]. MRI detected tenosynovitis in 16 (53%) patients in the hands, and in 18 (60%) patients in the feet. Bursitis located between or beneath the metatarsal heads was a common MRI finding [19 (63%) patients]. Additional MRI of the feet may be useful when evaluation of the hands does not help identify early RA.

  15. Ultrasonographic study of Achilles tendon and plantar fascia in chondrocalcinosis.

    Science.gov (United States)

    Falsetti, Paolo; Frediani, Bruno; Acciai, Caterina; Baldi, Fabio; Filippou, Georgios; Prada, Edwin Parra; Sabadini, Luciano; Marcolongo, Roberto

    2004-11-01

    To investigate by high frequency grey-scale ultrasonography (US) and power Doppler sonography (PDS) the modality and frequency of involvement of the Achilles tendon and plantar fascia in chondrocalcinosis (CC), and to correlate these findings with clinical complaints and radiographic evidence. The heels of 57 consecutive patients with CC were evaluated by US, PDS, and radiography. One control group of 50 consecutive patients with osteoarthritis (OA) without signs of CC was studied in the same way. A second control group of 50 healthy subjects underwent only US/PDS examination. All subjects also underwent clinical assessment. US revealed Achilles tendon calcifications in 57.9% of those with CC, but none in the control groups. Plantar fascia calcifications were observed in 15.8% of CC and in 2% of OA cases, but not in healthy controls. US showed no significant difference in postero-inferior and inferior calcaneal enthesophytosis between subjects with CC (59.6% and 61.4%, respectively) and those with OA (46% and 44%, respectively). Such alterations were also present, in lower percentages, in the healthy controls. Posterior and inferior calcaneal erosions were absent in all groups. Achilles enthesopathy was found in 22.8% of patients with CC (14.9% of heels, with vascular signals in 11.4% of heels on PDS). Deep retrocalcaneal bursitis was found in 10.5% of patients with CC (7% of heels, with vascular signals in 5.2% of heels on PDS). Plantar fasciitis was found in 40.3% of patients with CC (36% of heels, with vascular signals in 2.6% of heels on PDS) and in 14% of OA patients, but not in healthy controls. No significant correlation was found between talalgia or sex of patients and presence of calcifications. A significant correlation was observed between talalgia and Achilles enthesopathy (r = 0.78, p talalgia and vascular signals on PDS was observed in Achilles enthesopathy (r = 0.91, p < 0.0001) and deep retrocalcaneal bursitis (r = 0.65, p < 0.0001). The presence of

  16. Lateral trochanteric pain following total hip arthroplasty: radiographic assessment of altered biomechanics as a potential aetiology.

    Science.gov (United States)

    Abdulkarim, Ali; Keegan, Cathy; Bajwa, Raazi; Sheehan, Eoin

    2018-01-15

    Lateral trochanteric pain (LTP) complicates up to 17% of cases of total hip arthroplasty (THA). Studies have refuted underlying trochanteric bursitis. Restoration of the femoral offset and reproduction of the natural femoral centre of rotation are important in successful arthroplasty. LTP is believed to be associated with their alteration. The aim of our study was to evaluate the effect of femoral offset and centre of rotation on the incidence of LTP post-THA. A retrospective case control study was developed from 158 patients who underwent a THA over a two-year period to form two patient cohorts. Twenty-nine patients diagnosed with LTP were matched with 110 control subjects. The direct lateral approach was used in all cases. Anterior-posterior pelvic radiographs before and after surgery were compared to assess the femoral, cup and global offsets and limb length discrepancies between the two groups. Statistical analyses were performed using the Mann-Whitney U test and independent samples t test. Twenty-nine diagnosed with post-operative LTP. Sixty-two percent of symptomatic patients were female (p = 0.13). The median ages were 74.33 (symptomatic) and 70.71 (control) (p = 0.11). The differences (pre-post) of the femoral (p = 0.17), cup (p = 0.5) and global offsets (p = 0.99) and mean of limb length discrepancy (LLD) (p = 0.83) were not significant between the two groups. No relationship was found between LTP and femoral offset or femoral centre of rotation. Disruption of the soft tissues during a lateral approach with resultant abductor tear, tendon defects and tendinitis might play a role in LTP and explain the apparent efficacy of corticosteroid injections.

  17. DIFFERENTIAL DIAGNOSIS OF DEEP GLUTEAL PAIN IN A FEMALE RUNNER WITH PELVIC INVOLVEMENT: A CASE REPORT

    Science.gov (United States)

    Podschun, Laura; Kolber, Morey J.; Garcia, Ashley; Rothschild, Carey E.

    2013-01-01

    Background: Gluteal injuries, proximal hamstring injuries, and pelvic floor disorders have been reported in the literature among runners. Some suggest that hip, pelvis, and/or groin injuries occur in 3.3% to 11.5% of long distance runners. The purpose of this case report is to describe the differential diagnosis and treatment approach for a patient presenting with combined hip and pelvic pain. Case description: A 45-year-old female distance runner was referred to physical therapy for proximal hamstring pain that had been present for several months. This pain limited her ability to tolerate sitting and caused her to cease running. Examination of the patient's lumbar spine, pelvis, and lower extremity led to the initial differential diagnosis of hamstring syndrome and ischiogluteal bursitis. The patient's primary symptoms improved during the initial four visits, which focused on education, pain management, trunk stabilization and gluteus maximus strengthening, however pelvic pain persisted. Further examination led to a secondary diagnosis of pelvic floor hypertonic disorder. Interventions to address the pelvic floor led to resolution of symptoms and return to running. Outcomes: Pain level on the Visual Analog Scale decreased from 7/10 to 1/10 over the course of treatment. The patient was able to return to full sport activity and improved sitting tolerance to greater then two hours without significant discomfort. Discussion: This case suggests the interdependence of lumbopelvic and lower extremity kinematics in complaints of hamstring, posterior thigh and pelvic floor disorders. This case highlights the importance of a thorough examination as well as the need to consider a regional interdependence of the pelvic floor and lower quarter when treating individuals with proximal hamstring pain. Level of Evidence: Level 4 PMID:24175132

  18. Musculoskeletal pain and musculoskeletal syndromes in adolescents are related to electronic devices.

    Science.gov (United States)

    Queiroz, Lígia Bruni; Lourenço, Benito; Silva, Luiz Eduardo Vargas; Lourenço, Daniela Mencaroni Rodrigues; Silva, Clovis Artur

    2017-11-21

    To evaluate television and simultaneous electronic devices use in adolescents with musculoskeletal pain and musculoskeletal pain syndromes. A cross-sectional study was performed in 299 healthy adolescents of a private school. All students completed a self-administered questionnaire, including: demographic data, physical activities, musculoskeletal pain symptoms, and use of simultaneous television/electronic devices (computer, internet, electronic games, and cell phones). Seven musculoskeletal pain syndromes were also evaluated: juvenile fibromyalgia, benign joint hypermobility syndrome, myofascial syndrome, tendinitis, bursitis, epicondylitis, and complex regional pain syndrome. Inter-rater agreement between pretest and retest was 0.83. Musculoskeletal pain and musculoskeletal pain syndrome were found in 183/299 (61%) and 60/183 (33%), respectively. The median age (15 [10-18] vs. 14 [10-18] years, p=0.032) and years of education (10 [5-12] vs. 9 [5-12] years, p=0.011) were significantly higher in adolescents with musculoskeletal pain when compared with those without this condition. The frequencies of female gender (59% vs. 47%, p=0.019), cell phone use (93% vs. 81%, p=0.003), and simultaneous use of at least two electronic devices (80% vs. 67%, p=0.011) were significantly higher in the former group. Further comparisons between adolescents with and without musculoskeletal pain syndromes revealed that the frequency of female gender was significantly higher in the former group (75% vs. 25%, p=0.002), and with a significantly reduced median of weekends/holidays electronic games use (1.5 [0-10] vs. 3 [0-17]h/day, p=0.006). A high prevalence of musculoskeletal pain/syndromes was observed in female adolescents. Musculoskeletal pain was mostly reported at a median age of 15 years, and students used at least two electronic devices. Reduced use of electronic games was associated with musculoskeletal pain syndromes. Copyright © 2017 Sociedade Brasileira de Pediatria

  19. Sport specialization's association with an increased risk of developing anterior knee pain in adolescent female athletes.

    Science.gov (United States)

    Hall, Randon; Barber Foss, Kim; Hewett, Timothy E; Myer, Gregory D

    2015-02-01

    To determine if sport specialization increases the risk of anterior knee pain in adolescent female athletes. Retrospective cohort epidemiology study. Female basketball, soccer, and volleyball players (N = 546) were recruited from a single county public school district in Kentucky consisting of 5 middle schools and 4 high schools. A total of 357 multisport and 189 single-sport (66 basketball, 57 soccer, and 66 volleyball) athlete subjects were included due to their diagnosis of patellofemoral pain (PFP) on physical exam. Testing consisted of a standardized history and physician-administered physical examination to determine the presence of PFP. This study compared self-reported multisport athletes with sport-specialized athletes participating in only 1 sport. The sports-participation data were normalized by sport season, with each sport accounting for 1 season of exposure. Incidence rate ratios and 95% confidence intervals (CI) were calculated and used to determine significant differences between athletes who specialized in sport in early youth and multisport athletes. Specialization in a single sport increased the relative risk of PFP incidence 1.5-fold (95% CI 1.0-2.2, P = .038) for cumulative PFP diagnoses. Specific diagnoses such as Sinding Larsen Johansson/ patellar tendinopathy (95% CI 1.5-10.1, P = .005) and Osgood Schlatter disease (95% CI 1.5-10.1, P = .005) demonstrated a 4-fold greater relative risk in single-sport compared with multisport athletes. Incidence of other specific PFP diagnoses such as fat pad, plica, trauma, pes anserine bursitis, and iliotibial-band tendonitis was not different between single-sport and multisport participants (P > .05). Early sport specialization in female adolescents is associated with increased risk of anterior knee-pain disorders including PFP, Osgood Schlatter, Sinding Larsen-Johansson compared with multisport athletes.

  20. Sports Specialization is Associated with An Increased Risk of Developing Anterior Knee Pain in Adolescent Female Athletes

    Science.gov (United States)

    Hall, Randon; Foss, Kim Barber; Hewett, Timothy E.; Myer, Gregory D.

    2014-01-01

    Objectives This study sought to determine if sport specialization increases the risk of anterior knee pain in adolescent female athletes. Design Retrospective cohort epidemiology study. Methods Female basketball, soccer and volleyball players (N=546) were recruited from a single county public school district in Kentucky consisting of five middle schools and four high schools. A total of 357 multi-sport, and 189 single sport (66 basketball, 57 soccer and 66 volleyball) athlete subjects were included due to their diagnosis of patellofemoral pain on physical exam. Testing consisted of completion of a standardized history and physician-administered physical examination to determine the presence of patellofemoral pain (PFP). This study compared self-reported multi-sport athletes with sport specialized athletes participating in only one sport. The sports participation data was normalized by sport season with each sport accounting for one season of exposure. Incidence rate ratios (IRR) and 95% confidence intervals (CI) were calculated and used to determine significant differences between athletes who specialized in sport in early youth and multi-sport athletes. Results Specialization in a single sport increased the relative risk of PFP incidence by 1.5 fold (95% CI 1.0 to 2.2; p=0.038) for cumulative PFP diagnoses. Specific diagnoses such as Sinding Larsen Johansson/patellar tendinopathy (95% CI 1.5 to 10.1; p=0.005) and Osgood Schlatter Disease (95% CI 1.5 to 10.1; p=0.005) demonstrated a four-fold greater relative risk in single sport compared to multiple sport athletes. Other specific PFP diagnoses such as Fat Pad, Plica, Trauma, Pes Anserine Bursitis and IT Band Tendonitis incidence were not different between single sport and multiple sport participants (p>0.05). Conclusion Early sport specialization in female adolescents is associated with increased risk of anterior knee pain disorders including PFP, Osgood Schlatter, Sinding Larsen-Johansson compared to multi

  1. Ultrasound-guided interventional procedures around the shoulder

    Science.gov (United States)

    Messina, Carmelo; Banfi, Giuseppe; Orlandi, Davide; Lacelli, Francesca; Serafini, Giovanni; Mauri, Giovanni; Secchi, Francesco; Silvestri, Enzo

    2016-01-01

    Ultrasound is an established modality for shoulder evaluation, being accurate, low cost and radiation free. Different pathological conditions can be diagnosed using ultrasound and can be treated using ultrasound guidance, such as degenerative, traumatic or inflammatory diseases. Subacromial–subdeltoid bursitis is the most common finding on ultrasound evaluation for painful shoulder. Therapeutic injections of corticosteroids are helpful to reduce inflammation and pain. Calcific tendinopathy of rotator cuff affects up to 20% of painful shoulders. Ultrasound-guided treatment may be performed with both single- and double-needle approach. Calcific enthesopathy, a peculiar form of degenerative tendinopathy, is a common and mostly asymptomatic ultrasound finding; dry needling has been proposed in symptomatic patients. An alternative is represented by autologous platelet-rich plasma injections. Intra-articular injections of the shoulder can be performed in the treatment of a variety of inflammatory and degenerative diseases with corticosteroids or hyaluronic acid respectively. Steroid injections around the long head of the biceps brachii tendon are indicated in patients with biceps tendinopathy, reducing pain and humeral tenderness. The most common indication for acromion–clavicular joint injection is degenerative osteoarthritis, with ultrasound representing a useful tool in localizing the joint space and properly injecting various types of drugs (steroids, lidocaine or hyaluronic acid). Suprascapular nerve block is an approved treatment for chronic shoulder pain non-responsive to conventional treatments as well as candidate patients for shoulder arthroscopy. This review provides an overview of these different ultrasonography-guided procedures that can be performed around the shoulder. PMID:26313499

  2. Blood supply of the subacromial bursa and rotator cuff tendons on the bursal side.

    Science.gov (United States)

    Põldoja, Elle; Rahu, Madis; Kask, Kristo; Weyers, Imke; Kolts, Ivo

    2017-07-01

    Vascularity of the subacromial bursa and rotator cuff tendons is key factors in the pathogenesis of subacromial bursitis and impingement syndrome, rotator cuff tendinitis, and rotator cuff tears. The purpose of this study was to investigate and describe blood supply to the cranial and caudal parts of the subacromial bursa and the vascularity of the rotator cuff tendons on the bursal side. Fourteen fresh cadaveric shoulders from six females and eight males with a mean age of 71.7 (±10.8) years were studied. Before dissection, an arterial injection of 10% aqueous dispersion of latex was administered. Post-injection, the shoulders were fixed in an alcohol-formalin-glycerol solution. The cranial and caudal bursa of all specimens was mainly supplied by the thoracoacromial, suprascapular, and anterior and posterior circumflex humeral arteries. The cranial part of the bursa was supplied anteriorly by the thoracoacromial artery, and posteriorly and medially by the posterior circumflex humeral artery as far as the medial third. The caudal part received arterial blood anteriorly from the anterior circumflex humeral artery, and posteriorly and medially by the posterior circumflex humeral artery as far as the medial third of the caudal bursa. In addition, the suprascapular artery branched at the upper surface of the coracohumeral ligament, and the subcoracoid artery branched at the under surface of the same ligament. The subacromial bursa appears well vascularized. The results of the present investigation showed that blood supply to the subacromial bursa at the caudal part and rotator cuff tendons on the bursal side was linked to the same arteries. The subcoracoid artery supplied interval rotator structures close to the caudal bursa. It is the wish of the authors that this meticulous anatomical work will help surgeons in their day-to-day clinical work, e.g. to minimize the risk of complications such as perioperative bleeding.

  3. Subacromial impingement syndrome--effectiveness of physiotherapy and manual therapy.

    Science.gov (United States)

    Gebremariam, Lukas; Hay, Elaine M; van der Sande, Renske; Rinkel, Willem D; Koes, Bart W; Huisstede, Bionka M A

    2014-08-01

    The subacromial impingement syndrome (SIS) includes the rotator cuff syndrome, tendonitis and bursitis of the shoulder. Treatment includes surgical and non-surgical modalities. Non-surgical treatment is used to reduce pain, to decrease the subacromial inflammation, to heal the compromised rotator cuff and to restore satisfactory function of the shoulder. To select the most appropriate non-surgical intervention and to identify gaps in scientific knowledge, we explored the effectiveness of the interventions used, concentrating on the effectiveness of physiotherapy and manual therapy. The Cochrane Library, PubMed, EMBASE, PEDro and CINAHL were searched for relevant systematic reviews and randomised clinical trials (RCTs). Two reviewers independently extracted data and assessed the methodological quality. A best-evidence synthesis was used to summarise the results. Two reviews and 10 RCTs were included. One RCT studied manual therapy as an add-on therapy to self-training. All other studies studied the effect of physiotherapy: effectiveness of exercise therapy, mobilisation as an add-on therapy to exercises, ultrasound, laser and pulsed electromagnetic field. Moderate evidence was found for the effectiveness of hyperthermia compared to exercise therapy or ultrasound in the short term. Hyperthermia and exercise therapy were more effective in comparison to controls or placebo in the short term (moderate evidence). For the effectiveness of hyperthermia, no midterm or long-term results were studied. In the midterm, exercise therapy gave the best results (moderate evidence) compared to placebo or controls. For other interventions, conflicting, limited or no evidence was found. Some physiotherapeutic treatments seem to be promising (moderate evidence) to treat SIS, but more research is needed before firm conclusions can be drawn. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  4. Assessment of peritrochanteric high T2 signal depending on the age and gender of the patients

    Energy Technology Data Exchange (ETDEWEB)

    Haliloglu, Nuray, E-mail: nurayunsal2@hotmail.co [Ankara University School of Medicine, Department of Radiology (Turkey); Inceoglu, Deniz; Sahin, Gulden [Ankara University School of Medicine, Department of Radiology (Turkey)

    2010-07-15

    Introduction: The aim of this study is to evaluate the incidence of peritrochanteric high T2 signal (peritrochanteric edema, peritendinitis) on routine MR imaging studies and to determine whether reporting peritrochanteric edema is always clinically relevant depending on the age and gender of the patients. Materials and methods: We evaluated 79 consecutive bilateral hip MR images performed in our department between January 2006 and December 2006 (57 female, 22 male patients, mean age 49 years). Each study was evaluated for areas of T2 hyperintensity representing edema around the greater trochanter. Patients with a known fracture, tumor, history of radiation therapy, history of hip surgery and prothesis were excluded from the study. Patients with signal intensity alterations within the thickened gluteus medius/minimus tendons (tendinitis) or peritrochanteric bursal fluid accumulation (bursitis) were also excluded. All patients were scanned with our routine MR imaging protocol for hip imaging. Results: In 55 of the 79 patients (70%) peritrochanteric edema was detected on MR images and 52 of these 55 patients (95%) had these changes on both hips. The median age was 56 years for the patients with peritrochanteric edema and 35.5 years for the patients without peritrochanteric edema. There was statistical significance between the median ages of the patients and a significant increased risk of peritrochanteric edema was found over 40 years of age. There was no significant difference between male and female patients. Conclusion: Bilateral peritrochanteric high T2 signal may be a part of the degeneration process and we suggest that it may not be necessarily reported if the clinical findings do not support greater trochanteric pain syndrome.

  5. [Overuse injury syndromes of the calf and foot] ].

    Science.gov (United States)

    Smerdelj, M; Madjarević, M; Oremus, K

    2001-12-01

    The lower leg, foot and ankle form a functional unit of the locomotor system with an important static and dynamic function. Injury or loss of function of any muscle group of the lower leg and the foot influences normal gait or impedes standing. Increased or frequent loads on the muscle group may lead to pain syndromes known as overuse syndromes or overuse injuries. Athletes and certain professions involving standing or walking for a long time are especially susceptible to increased muscle strains. This article describes and clarifies the causes and the development of the pain syndromes in the lower leg, foot and ankle associated with certain professions or sports. The description of anatomical relationships and functions of individual muscle groups is here to clarify the occurrence of overuse injuries which may involve the muscle itself, the tendon, or the point of their attachment to the bone. The article describes observations and experiences from everyday clinical practice, but it also summarises results described in recent publications. The focus is also put on the therapy, which is usually conservative. Particular mention is given to new non-invasive surgical techniques. The article describes the most common overuse injuries of the lower leg such as shin splints, tibialis posterior syndrome, chronic anterior compartment syndrome, overuse injury of the Achilles tendon, enthesitis of the tendo Achilles, retrocalcanear bursitis and rupture of the Achilles tendon. In the foot area the most frequent overuse syndromes are the plantar fasciitis, tibialis posterior tendinitis, tendinitis of the long flexor of the toe, toe extensor tendinitis, and also anterior and posterior impingement syndromes of the ankle.

  6. The utility of MR imaging of the shoulder joint: comparison of the MR imaging between conventional MR imaging and arthrographic MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Dong Sik; Ryu, Kyung Nam; Kim, Ihn Sub; Rhee, Yong Girl [Kyunghee Univ., College of Medicine, Seoul (Korea, Republic of)

    1998-09-01

    To evaluate the diagnostic value of MRI of the shoulder. Between January and June 1997, shoulder MRI and arthroscopy were performed in a total of 48 patients with shoulder pain (n=3D30) or shoulder instability (n=3D18). Forty-five were males and three were females; their ages ranged from 16 to 67 (mean 32.5) years. The period between shoulder MRI and arthroscopy was between one and 390 (mean, 42.2) days. Twenty-six patents underwent MR arthrography (AMR), and 22 conventional MRI(CMR). Each image was analyzed for rotator cuff injury, glenoid labral injury, SLAP lesion, and biceps tendon injury. On arthroscopy, one disease was found in 34 patients, two were found in six, three diseases were found in seven, and one patient had four diseases. Arthroscopic diagnosis was as follows:rotator cuff injury, 29;SLAP lesion, 12;glenoid labral injury, 10;biceps tendon injury, 4;subacromial bursitis, 2;chronic synovitis, 1;adhesive capsulitis, 1;superior glenohumeral ligament injury, 1;normal, 1. For rotator cuff injury, the sensitivity of MRI was 65.5% and specificity was 93.0% (AMR:66.7%, 95.8%, CMR:65.2%, 86.4%). For SLAP lesion, sensitivity was 58.3% and specificity was 97.2% (AMR:66.7%, 100%, CMR:50%, 93.8%);for glenoid labral injury, sensitivity was 80.0% and specificity was 89.5% (AMR:85.7%, 84.2%, CMR:66.7%, 94.7%), and for biceps tendon injury, the false negative rate was 100%. In cases involving glenoid labral injury, the diagnostic accuracy of shoulder MRI was relatively high;in rotator cuff injury and SLAP lesion, however, diagnosis was limited, and in biceps tendon injury was difficult. We suggest, however, that MR arthrography has certain diagnostic advantages over conventional MRI.=20.

  7. Achilles enthesis ultrasound: the importance of the bursa in spondyloarthritis.

    Science.gov (United States)

    Falcao, Sandra; de Miguel, Eugenio; Castillo-Gallego, Concepción; Peiteado, Diana; Branco, Jaime; Martín Mola, Emilio

    2013-01-01

    This paper aims to assess the prevalence and relevance of the bursa-synovial lesion in spondyloarthritis (SpA). A transversal blind and controlled two-dimensional (2D) and three-dimensional (3D) ultrasound (US) study of Achilles enthesis bursa in early SpA was undertaken. Clinical outcome measures were collected. Bilateral Achilles enthesis of 66 early SpA patients (34 women) and 46 control patients (23 asymptomatic healthy subjects and 23 rheumatoid arthritis [RA] patients) were analysed. Mean BASDAI, BASFI and BASRI-spine were 4.55±2.08, 2.16±1.95 and 0.65±0.77, respectively. Mean erythrocyte sedimentation rate (ESR) was 10.93±12.35 mm/h and C-reactive protein (CRP) was 6.46±10.09 mg/l. The κ-values for intra-reader agreement for 2D and 3D images and bursa measurement were 0.82 and 0.98, respectively. Bursas were visualised in 89/132 SpA enthesis (67.4%) vs. 27/46 enthesis (58.7%) of healthy controls (pbursas were analysed, the SpA group had a mean of 1.52±1.47 mm versus 0.76±0.76 mm in the healthy control group (pbursa >2 was found. No Doppler signal was detected in controls, but 6.6% of SpA Achilles enthesis had Doppler bursitis. Heel pain was more frequent when bursa was present (pbursa and Doppler signal at retrocalcaneal bursa level could have a relevant contribution to differentiate SpA patients, and were correlated with clinical outcomes of SpA disease activity.

  8. Ultrasound-guided corticosteroid injections for treatment of greater trochanteric pain syndrome: greater trochanter bursa versus subgluteus medius bursa.

    Science.gov (United States)

    McEvoy, Jennifer R; Lee, Kenneth S; Blankenbaker, Donna G; del Rio, Alejandro Munoz; Keene, James S

    2013-08-01

    The purpose of this study was to evaluate the effectiveness of corticosteroid injections into the greater trochanteric bursa as opposed to the subgluteus medius bursa in patients with greater trochanteric pain syndrome. We retrospectively reviewed 183 injections (149 performed in women, 34 performed in men; age range 23-90 years; median, 53 years) performed for treatment of greater trochanteric pain syndrome. A 10-cm visual analog scale survey was used to assess pain level before the procedure and 14 days after the procedure. A 3-mL corticosteroid solution was injected into either the greater trochanteric bursa or the subgluteus medius bursa under direct ultrasound guidance. Procedure images were retrospectively reviewed to determine the site of injection. Diagnostic images obtained at the time of the procedure were also reviewed for findings of tendinopathy, bursitis, and enthesopathy. Statistical analysis of differences in pain reduction was performed, as was analysis for association between pain relief and demographic variables of age, sex, previous injections, and ultrasound findings. Sixty-five injections met the inclusion criteria; 56 performed in women and nine performed in men (age range, 30-82 years; median, 53 years). Forty-one injections were into the greater trochanteric bursa and 24 into the subgluteus medius bursa. There was a statistically significant difference in pain reduction between greater trochanteric bursa and subgluteus medius bursa injections with a median pain reduction of 3 as opposed to 0 (p bursa may be more effective than injections into the subgluteus medius bursa for treatment of greater trochanteric pain syndrome.

  9. Transmission of infectious diseases from internationally adopted children to their adoptive families.

    Science.gov (United States)

    Sciauvaud, J; Rigal, E; Pascal, J; Nourrisson, C; Poirier, P; Poirier, V; Vidal, M; Mrozek, N; Laurichesse, H; Beytout, J; Labbe, A; Lesens, O

    2014-08-01

    Internationally adopted children may suffer from different pathologies, including infectious diseases contracted in the country of origin. We evaluated the frequency of infectious diseases that may disseminate from adoptees to adoptive families on their arrival in France. All children who attended the clinic for international adoption in Clermont-Ferrand from January 2009 through to December 2011 were eligible for inclusion in the study. Standardized medical records dedicated to international adoption were retrospectively reviewed for demographic data, clinical diagnosis, and biological and radiological results. Data were completed by phone interviews with adoptive families after informed consent. One hundred and forty-two medical records were retrospectively reviewed and 86% of families agreed to be interviewed. One hundred and seventy-one potentially transmissible infections were diagnosed in 142 children, 12% (n = 20) of which were transmitted to adoptive families. Most of these infections were benign and transmission was restricted to the close family. Tinea was diagnosed in 44 adoptees and transmitted in 15 cases. Panton Valentine leukocidin producing methicillin-sensitive S. aureus (MSSA) was transmitted to an adoptive father who required hospitalization for bursitis. Transmission also occurred for CMV (n = 1), hepatitis A (n = 1), giardiasis (n = 1), scabies (n = 1), Moluscum (n = 2) and pediculosis (n = 2). Two cases of chronic hepatitis B and latent tuberculosis were diagnosed without subsequent transmission. In conclusion, infectious diseases are common in internationally adopted children and should be detected shortly after arrival to avoid transmission. © 2013 The Authors Clinical Microbiology and Infection © 2013 European Society of Clinical Microbiology and Infectious Diseases.

  10. A cross sectional study of the prevalence, risk factors and population attributable fractions for limb and body lesions in lactating sows on commercial farms in England

    Directory of Open Access Journals (Sweden)

    Gillman Claire E

    2009-08-01

    Full Text Available Abstract Background Lesions on sows' limbs and bodies are an abnormality that might impact on their welfare. The prevalence of and risks for limb and body lesions on lactating sows on commercial English pig farms were investigated using direct observation of the sows and their housing. Results The prevalence of lesions on the limbs and body were 93% (260/279 and 20% (57/288 respectively. The prevalence of limb and body lesions was significantly lower in outdoor-housed sows compared with indoor-housed sows. Indoor-housed sows had an increased risk of wounds (OR 6.8, calluses (OR 8.8 and capped hock (OR 3.8 on their limbs when housed on fully slatted floors compared with solid concrete floors. In addition, there was an increased risk of bursitis (OR 2.7, capped hock (OR 2.3 and shoulder lesions (OR 4.8 in sows that were unwilling to rise to their feet. There was a decreased risk of shoulder lesions (OR 0.3 and lesions elsewhere on the body (OR 0.2 in sows with more than 20 cm between their tail and the back of the crate compared with sows with less than 10 cm. Conclusion The sample of outdoor housed sows in this study had the lowest prevalence of limb and body lesions. In lactating sows housed indoors there was a general trend for an increased risk of limb and body lesions in sows housed on slatted floors compared with those housed on solid concrete floors with bedding. Sows that were less responsive to human presence and sows that had the least space to move within their crates had an additional increased risk of lesions.

  11. MR Imaging in symptomatic osteochondromas

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Soo Young; Kim, Jee Young; Kim, Sang Heum; Chun, Kyung Ah; Park, Young Ha [Catholic University of Korea, Seoul (Korea, Republic of)

    1998-06-01

    The purpose of this study is to assess the MR findings of symptomatic osteochondromas. We evaluated 31 patients who between July, 1994 and May, 1997 underwent MR imaging for symptomatic osteochondroma. Fourteen were males and 17 were females, and their ages ranged from 8 to 49 (mean, 23) years. Using T1WI, T2WI and gadolinium-DTPA-enhanced T1WI, images were analysed according to signal intensity in the osseous component of the osteochondroma, thickness of the cartilage cap, and associated change in surrounding soft tissue. Clinical manifestation included a palpable mass or tendency to grow (n=22) and pain on movement (n=9). Complications were of three types : that which followed change in the osseous component of the tumor, associated change in surrounding soft tissue, and malignant transformation. In the osseous component, bone marrow edema or contusion was seen in 21 cases (67.7%), and in two (65%), fracture was observed. In surrounding soft tissue, muscle impingement was seen in 21 cases (67.7%), bursitis was in 7 cases (22.6 %), tenosynovitis in seven (22.6 %), and vascular compression in five (16.1 %). In three cases (9.7%), transformation to chondrosarcoma had occurred; two of these were derived from osteochondromatosis and one from a single osteochondroma. The thickness of the cartilage cap was as follow : < 5 mm (n=16), 5-10 mm (n=12), and > 10 mm (n=3). In patients with symptomatic osteochondroma, MR imaging is useful for detecting both complications and malignant transformation. (author). 21 refs., 1 tab., 6 figs.

  12. Radiotherapy for shoulder impingement; Bestrahlung beim Impingementsyndrom des Schultergelenks

    Energy Technology Data Exchange (ETDEWEB)

    Adamietz, B. [Universitaetsklinikum Erlangen (Germany). Inst. fuer Radiologie; Sauer, R.; Keilholz, L. [Universitaetsklinikum Erlangen (Germany). Strahlentherapeutische Klinik

    2008-05-15

    Background and Purpose: Up to now, degenerative shoulder diseases were summarized by the term 'periarthritis humeroscapularis'. Actual shoulder diseases can be differentiated etiopathologically according to a primary and secondary impingement syndrome. Narrowing of the subacromial space, which is caused by an osseous shape variant, leads to primary impingement. Secondary impingement develops, when the subacromial space is reduced by swelling tissue below the osseous shoulder roof. This study aimed for the exact diagnosis to indicate therapy and to classify the results according to the Constant score. Patients and Methods: From August 1999 to September 2002, 102 patients with 115 shoulder joint conditions underwent radiation therapy (RT). All joints received two RT series (6 x 0.5 Gy/series) applied in two to three weekly fractions, totaling a dosage of 6.0 Gy (250 kV, 15 mAs, 1-mm Cu filter). The second RT course started 6 weeks after the end of the first. 115 shoulders were examined before RT, 6 weeks after the second RT course and, finally, during the follow-up from January to May 2003. Results: Pain relief was achieved in 94/115 shoulder joints (82%) after 18-month follow-up (median). A significant difference existed between secondary impingement and primary/non-impingement according to response. Tendinosis calcarea, bursitis subdeltoidea, tendovaginitis of the long biceps tendon, and capsulitis adhaesiva responded well to therapy. Conclusion: Shoulder diseases of secondary impingement demonstrate a good response to RT. Less or no benefit was found in primary impingement syndrome or complete rotator cuff disruption and acute shoulder injuries, respectively. (orig.)

  13. Hereditary multiple exostoses: from genetics to clinical syndrome and complications

    Energy Technology Data Exchange (ETDEWEB)

    Vanhoenacker, Filip M.; Hul, Wim van; Wuyts, Wim; Willems, P.J.; Schepper, Arthur M. de

    2001-12-01

    Objective: To give an overview of genetic, clinical and radiological aspects in two families over four generations with known hereditary multiple exostoses (HME). Methods and material: After linkage analysis in both families to localize the defective gene, mutation analysis was performed in these genes to identify the underlying mutation. In the 31 affected individuals, location, number and morphology and evolution of exostosis, evolution of remodeling defects at the metaphysis, and the extent of possible complications were evaluated on clinical and imaging (plain radiography, computed tomography (CT), and magnetic resonance imaging (MRI)) data over a lifetime period. Results and conclusions: Both families demonstrate the gene defect in the same EXT-2 gene locus on chromosome 11p. Exostoses are preferentially located in the lower extremity (hip, knee and lower leg), humerus, and forearm. Any other bone may be involved, except for the calvaria of the skull and the mandible. Exostoses are rather sessile than pedunculated. Exostosis is rarely present at birth but develops gradually and may persist to grow slowly after closure of the growth plates. Preferential expression of the remodeling defect was seen in the hip, distal femur (trumpet-shaped metaphysis) and forearm (shortening of the ulna with secondary bowing of the radius and development of a pseudo-Madelung deformity). These radiological manifestations start at the age of 4-5 years and become more obvious as the enchondral bone formation progresses with age. Reported complications in these families consist of local entrapment phenomenons (vessel, tendon, nerve), frictional bursitis, and sarcomatous transformation. MRI was able to suggest these complications and is the imaging technique of choice in the evaluation of symptomatic exostoses.

  14. MR imaging after therapeutic injection of the subacromial bursa

    Energy Technology Data Exchange (ETDEWEB)

    Major, N.M. [Duke University Medical Center, Department of Radiology, Division Musculoskeletal, Durham, NC (United States)

    1999-11-01

    Objective. As a therapeutic injection into the subacromial bursa (SAB) is commonly performed for impingement syndrome, it is important to know whether this fluid can be retained for a period of time and cause confusion with a pathologic collection of fluid. This study identifies and describes the appearance of recent subacromial injection using MR imaging, and the appearance of a potential complication.Design and patients. Fourteen asymptomatic shoulders were studied with MR imaging using fast spin echo T2-weighted imaging (1.5 T) prior to injection with 7 cm{sup 3} of xylocaine. Four shoulders had subacromial fluid and were eliminated from the study. The remaining 10 (9 men, 1 woman; age range 27-36 years, average age 33 years) were then re-imaged immediately, and at 6, 12 and 24 h after the injection or until fluid resolved. Each set of images was reviewed for the presence of fluid in the SAB and for additional abnormalities.Results. Fluid was identified in all subjects in the SAB in the immediate, 6 and 12 h post-injection images. At 24 h, fluid was not identified within the SAB in eight of 10 patients. In one patient fluid resolved in 48 h. The other continued to demonstrate fluid in the SAB and in the joint as well as abnormal signal in the infraspinatus muscle from a presumed myositis. Imaging was performed up to 10 days after the injection in this patient.Conclusions. It is known that fluid identified in the SAB without evidence of a cuff tear may be due to bursitis. However, if MR imaging is performed within 24 h of injection, the presence of the fluid may be iatrogenic. In addition, the history of recent therapeutic injection is very important as complications such as myositis can occur as a result of the injection. Knowledge of injection prior to imaging is vital for accurate interpretation of MR shoulder examinations. (orig.)

  15. Dynamic high-resolution ultrasound of the shoulder: How we do it

    Energy Technology Data Exchange (ETDEWEB)

    Corazza, Angelo, E-mail: angelcoraz@libero.it [Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Genova, Via Alberti 4, 16132 Genova (Italy); Orlandi, Davide, E-mail: theabo@libero.it [Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Genova, Via Alberti 4, 16132 Genova (Italy); Fabbro, Emanuele, E-mail: emanuele.fabbro@gmail.com [Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Genova, Via Alberti 4, 16132 Genova (Italy); Ferrero, Giulio, E-mail: giulio.ferrero@gmail.com [Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Genova, Via Alberti 4, 16132 Genova (Italy); Messina, Carmelo, E-mail: carmelomessina.md@gmail.com [Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Milano, Piazza Malan 2, 20097 San Donato Milanese (Italy); Sartoris, Riccardo, E-mail: riccardo.sartoris@hotmail.it [Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Genova, Via Alberti 4, 16132 Genova (Italy); Perugin Bernardi, Silvia, E-mail: silvy-86-@hotmail.it [Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Genova, Via Alberti 4, 16132 Genova (Italy); Arcidiacono, Alice, E-mail: a.arcidiacono84@gmail.com [Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Genova, Via Alberti 4, 16132 Genova (Italy); Silvestri, Enzo, E-mail: silvi.enzo@gmail.com [Dipartimento di Radiologia, Ospedale Evangelico Internazionale, Corso Solferino 29A, 16121 Genova (Italy); and others

    2015-02-15

    Highlights: • This paper shows how to apply US technique to image soft tissues around the shoulder. • Readers will learn to recognize normal US anatomy of tendons of the shoulder. • Readers will learn to apply dynamic maneuvers to improve rotator cuff visibility. - Abstract: Ultrasonography (US) is an established and well-accepted modality that can be used to evaluate articular and peri-articular structures around the shoulder. US has been proven to be useful in a wide range of rotator cuff diseases (tendon tears, tendinosis, and bursitis) as well as non-rotator cuff abnormalities (instability problems, synovial joint diseases, and nerve entrapment syndromes). Diagnostic accuracy of shoulder US when evaluating rotator cuff tears can reach 91–100% for partial and full thickness tears detection, respectively, having been reported to be as accurate as magnetic resonance imaging in experienced hands. US is cheap, readily available, capable to provide high-resolution images, and does not use ionizing radiations. In addition, US is the only imaging modality that allows performing dynamic evaluation of musculoskeletal structures, that may help to further increase diagnostic performance. In this setting, a standardized imaging protocol is essential for an exhaustive and efficient examination, also helping reducing the intrinsic dependence from operators of US. Furthermore, knowledge of pitfalls that can be encountered when examining the shoulder may help to avoid erroneous images interpretation. In this article we use detailed anatomic schemes and high-resolution US images to describe the normal US anatomy of soft tissues, articular, and para-articular structures located in and around the shoulder. Short video clips emphasizing the crucial role of dynamic maneuvers and dynamic real-time US examination of these structures are included as supplementary material.

  16. The effectiveness of diagnostic imaging methods for the assessment of soft tissue and articular disorders of the shoulder and elbow

    Energy Technology Data Exchange (ETDEWEB)

    Shahabpour, M. [Department of Radiology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Laarbeeklaan 101, 1090 Brussels (Belgium)], E-mail: Maryam@shahabpour.uzbrussel; Kichouh, M.; Laridon, E. [Department of Radiology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Laarbeeklaan 101, 1090 Brussels (Belgium); Gielen, J.L. [Department of Radiology, Universitair Ziekenhuis Antwerpen, Universiteit Antwerpen, Wilrijkstraat 10, 2650 Edegem (Belgium); De Mey, J. [Department of Radiology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Laarbeeklaan 101, 1090 Brussels (Belgium)

    2008-02-15

    There are no clear guidelines for diagnostic imaging of articular and soft tissue pathologies of the shoulder and elbow. Several methods are used, including magnetic resonance imaging (MRI), magnetic resonance arthrography (MRA) and ultrasound (US). Their cost-effectiveness is still unclear. We performed a meta-analysis of the relevant literature and discussed the role of MR imaging of the shoulder and elbow compared with other diagnostic imaging modalities. For the shoulder impingement syndrome and rotator cuff tears, MRI and US have a comparable accuracy for detection of full-thickness rotator cuff tears. MRA and US might be more accurate for the detection of partial-thickness tears than MRI. Given the large difference in cost of MR and US, ultrasound may be the most cost-effective diagnostic method for identification of full-thickness tears in a specialist hospital setting (Evidence level 3). Both MRA and CT arthrography (CTA) are effective methods for the detection of labrum tears. More recently, multidetector CTA has offered the advantages of thinner slices than with MRA in a shorter examination time. Still, MRA has the advantage towards CTA to directly visualize the affected structures with a better evaluation of extent and location and to detect associated capsuloligamentous injuries. For the elbow pathologies, plain MRI or MRA have the advantage towards CTA to detect occult bone injuries. CTA is better for the assessment of the thin cartilage of the elbow. Both US and MRI are reliable methods to detect chronic epicondylitis; US is more available and far more cost-effective (Evidence level 2). MRA can differentiate complete from partial tears of the medial collateral ligament. US or MRI can detect partial and complete biceps tendon tears and/or bursitis. MRI can provide important diagnostic information in lesions of the ulnar, radial, or median nerve.

  17. Epidemiological profile of workers with musculoskeletal disorders of a supermarket company

    Directory of Open Access Journals (Sweden)

    Marcia Benites da Silva

    Full Text Available AbstractIntroduction The epidemiological profile is considered a sensitive indicator of living conditions and the disease process. The musculoskeletal disorders are the most common causes of pain and can lead to disability or restriction of daily activities. These disorders take the name of RCT/OWRD when they are associated with work activities and may be associated with risk conditions at work.Objectives To describe the epidemiological profile of supermarket workers with musculoskeletal disorders under treatment at a physiotherapy clinic in the city of Porto Alegre, Brazil.Methods This was a cross-sectional, observational study which used retrospective data collected from 360 records of patients treated from January 2010 to December 2011 in a physiotherapy clinic that provides health services for a supermarket chain.Results There was a predominance of females (73.9%, aged 30–39 years (35.1%; 63.0% reported being single and 73.4% lived in Porto Alegre. The most commonly reported occupation was cashier (31.2%. The main reasons for referral to physiotherapy treatment were low back pain (21.4%, neck pain (19.7%, pain (16.1%, subacromial bursitis (13.9% and back pain (12.2%. Among the signs and symptoms 95.8% of the sample reported pain in chronic phase.Conclusion The prevalence of musculoskeletal pain was high in this group. The presence of pain can disable the worker for daily activities and physiotherapy becomes the therapeutic procedure of choice for their rehabilitation.

  18. Ultrasonography as a prognostic and objective parameter in Achilles tendinopathy: A prospective observational study

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    Bakkegaard, Mads, E-mail: mbakkegaard@hotmail.com [Department of Rheumatology, Holbæk Hospital, Smedelundsgade 60, 4300 Holbæk (Denmark); Johannsen, Finn E., E-mail: f.e.johannsen@dadlnet.dk [Private Department of Rheumatology, Furesø-reumatologerne, Farum and ISMC, Institute of Sports Medicine Copenhagen, Bispebjerg Hospital, Bispebjerg Bakke 23, 2. Tværvej, Indgang 8, 1. sal, 2400 København NV (Denmark); Højgaard, Betina, E-mail: beho@kora.dk [Danish Institute for Local and Regional Government Research, Købmagergade 22, 1150 København K (Denmark); Langberg, Henning, E-mail: henninglangberg@gmail.com [Institute of Social Medicine, Department of Public Health and Centre for Healthy Ageing, Faculty of Heath Sciences, University of Copenhagen, Øster Farimagsgade 5, bygn. 24, postboks 2099, 1014 København (Denmark)

    2015-03-15

    Objectives: To study prospectively whether structural changes determined by ultrasound scanning (US) can be used as prognostic markers for outcome in patients with symptomatic Achilles tendinopathy (AT) and to investigate whether there exists an association between US findings and pain measured by visual analog scale (VAS) and a general assessment score (GA). Methods: 92 consecutive patients with AT symptoms were recruited from two outpatient clinics in rheumatology. The patients underwent a conservative treatment protocol consisting of reduced activities, controlled rehabilitation including eccentric exercises of the calf muscles and if needed supplemented with corticosteroid injections. The patients were examined clinically and by US (tendon thickness, hyper- and hypoechogenicity, calcification, bursitis, calcaneusspure, tenosynovitis, gray scale and color Doppler focusing on increased flow intra- or peritendinous). The clinical and US examination were performed at entry, 1, 2, 3 and at 6 month. Results: 42 women and 50 men were included (mean age of 47 years). They had symptoms for more than 13 months and a symptomatic Achilles tendon mean thickness of 7.4 ± 2.3 mm. Heterogeneity at the initial examination was found to be a prognostic marker for the clinical outcome. Tendon thickness, hypoechogenicity and increased flow at any time point were significantly correlated to pain at function, palpatory pain and morning pain at the same time points. A reduction in tendon thickness was statistically associated with a decrease in palpatory pain. Conclusion: Heterogeneity is a prognostic marker in AT. Tendon thickness, hypoechogenicity and increased Doppler activity can be used as objective outcome parameters for the treatment effect of AT.

  19. Profile of the subjects with soft tissue injuries attended at an occupational health service and the RSI

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    Camila de Freitas

    2015-07-01

    Full Text Available Aim: To investigate the profile of subjects with soft tissue injuries attended at the Reference Center of Occupational Health – CEREST in the municipality of Santos, Sao Paulo state, in 2010, and the social insurance benefits granted.Materials and Methods: Analysis of medical records of the subjects assisted at CEREST in 2010, surveying data on gender, age, occupation, clinical diagnostics, clinical complaints, retirement, etc. The clinical diagnostics were categorized according to the International Classification of Diseases - ICD-10, subjects with soft tissue injuries were selected, and the diagnostics related to mental health disorders were registered. Data were recorded in Microsoft Excel spreadsheet and analyzed using statistical software R Development Core Team.Results: Of the 206 medical records analyzed, 18.0% (n=37 showed soft tissue injuries, 81.1% were female and 18.9% were male, and the subjects’ mean age was 43.24 years (SD=8.76. Subjects between 31 and 50 years old (70.2% were the most affected. The most affected occupations were cleaners, general service workers, and bank clerks. The most prevalent clinical diagnoses were synovitis and tenosynovitis, shoulder bursitis, and rotator cuff syndrome, with 62.2% of the subjects presenting more than one clinical diagnosis. 13.5% of the subjects also presented mental disorders. Association between retirement from work and the presence of soft tissue injury was observed (p=0.032. Only 13.5% of the diagnoses had some association with the work conditions.Conclusions: The general profile of the workers with soft tissue injuries was obtained: prevalence in women, diseases manifested in productive age, difficulty of association with work conditions, need for interdisciplinary interventions.

  20. INTEGRATION BETWEEN MRI AND PHYSICAL THERAPY TO IMPROVE TREATMENT OF PATIENTS WITH SHOULDER PAIN

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    Awad Mohamed Elkhadir

    2016-08-01

    Full Text Available Background: Shoulder pain is the second most common musculoskeletal disorder treated by physical therapists. The cause for the shoulder pain is multifactorial. However, a specific diagnosis is crucial in the right management of shoulder dysfunction. Therefore, the aim of this study was to find out the efficacy of integrating the MRI for the accurate diagnosis and impact of this on rendering the effective physical therapy interventions in shoulder dysfunction patients. Methods: A retrospective study conducted on 14 patients who undergone an MRI with a 1.5 T unit MAGNETOM Symphony (Siemens, for their shoulder pain, where the diagnosis might be Muscle tears like, subscapularis, infraspinatus,supraspinatus and teres minor muscles; subacromial or subdeltoid bursitis and labral tears were included. All the subjects were then continued with usual physical therapy treatments for four weeks depending on their diagnosis which includes; advice, stretching, mobilization and strengthening exercises, manual therapy, massage, strapping, and electrotherapy . The outcome measures documented from the case sheet were; Visual Analogue Scale grade and passive range of motion of shoulder external / internal rotation and abduction. Results: Paired t test was used to compare the PROM between pre rehabilitation and post rehabilitation testing and the non parametric test, Mann Whitney U test was used for the comparison of VAS. All patients showed a significant improvement in VAS and PROM of abduction, internal and external rotation following physical therapy (P≤ 0.05. Conclusion: MRI is found to be a reliable method of diagnostic procedure for the shoulder pain and the integration of MRI and physical therapy to treat shoulder dysfunction leads to a better outcome.

  1. Ultrasound-guided retro-calcaneal bursa corticosteroid injection for refractory Achilles tendinitis in patients with seronegative spondyloarthropathy: efficacy and follow-up study.

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    Srivastava, Puja; Aggarwal, Amita

    2016-06-01

    Ultrasound (US)-guided corticosteroid injection has been shown to be safe and effective for varied causes of plantar fasciitis; however, its use for Achilles tendinitis is controversial. We studied the efficacy and changes in US findings at Achilles enthesitis after corticosteroid injection in patients with spondyloarthropathy (SpA). Patients with SpA with symptomatic Achilles enthesitis, refractory to 6 weeks of full-dose NSAIDs, were offered US-guided local corticosteroid injection. Injected entheses were examined by US (both B mode and power Doppler) at baseline and 6 weeks after injection. Standard OMERACT definitions were used to define enthesitis. Achilles tendon thickness >5.29 mm, 2 cm proximal to insertion in long axis, was considered thickened. Twenty-seven symptomatic Achilles tendons (in 18 patients) were injected with 20 mg methylprednisolone under US guidance baseline, and 6-week follow-up US features were compared. All patients reported improvement in pain (VAS) in the affected tendon after injection (p < 0.0001). Simultaneously, improvement in local inflammatory changes were noted, in the form of significant reduction in tendon thickness (p < 0.0001), vascularity (p < 0.0001), peritendinous oedema (p = 0.001), bursitis and bursal vascularity (p < 0.001 and < 0.0001, respectively). There was no change in bone erosions and enthesophyte. None of the patients had tendon rupture or other injection-related complications at 6 weeks of follow-up. US-guided local corticosteroid injection is an effective and safe modality for refractory Achilles enthesitis in patients with SpA and leads to reversion of acute changes at entheseal site.

  2. Defect reconstruction over the olecranon with the distally extended lateral arm flap.

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    Wettstein, R; Helmy, N; Kalbermatten, D F

    2014-08-01

    Defect reconstruction over the olecranon should be reliable, quick, relatively simple and with minimal complications. More recently, perforator flaps have been described with the benefit of minimal donor site morbidity when compared with muscle flaps or flaps relying on the major arteries of the upper extremity. So far, most of these flaps were harvested on the upper arm and rotated 180° into the defect. The aim of the present study was to analyse the results with the proximally based, distally extended lateral arm flap for soft-tissue reconstruction over the olecranon. The subcutaneous tissue layer in this area is thinner than in the upper arm, and less rotation of the pedicle is necessary. The location of the perforator just proximal to the lateral epicondyle and the precise territory of the flap are well known. Nine consecutive male patients with a mean age of 57±27 years presenting with soft-tissue defects after surgical treatment of bursitis (eight cases) or a pressure sore (one case) were operated on. The mean operation time was 60±15 min. In eight of the nine cases, the flap healed uneventfully or with a minor complication (fistula). One patient underwent revision surgery due to marginal flap necrosis. The defect was closed with a local advancement flap. In conclusion, the flap was reliable, relatively simple and quick to harvest, and yielded acceptable aesthetic results with minimal bulging over the olecranon. Postoperative recovery was relatively painless and short. Copyright © 2014 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  3. Dry Needling Versus Cortisone Injection in the Treatment of Greater Trochanteric Pain Syndrome: A Noninferiority Randomized Clinical Trial.

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    Brennan, Kindyle L; Allen, Bryce C; Maldonado, Yolanda Munoz

    2017-04-01

    Study Design Prospective, randomized, partially blinded. Background Greater trochanteric pain syndrome (GTPS) is the current terminology for what was once called greater trochanteric or subgluteal bursitis. Cortisone (corticosteroid) injection into the lateral hip has traditionally been the accepted treatment for this condition; however, the effectiveness of injecting the bursa with steroids is increasingly being questioned. An equally effective treatment with fewer adverse side effects would be beneficial. Objective To investigate whether administration of dry needling (DN) is noninferior to cortisone injection in reducing lateral hip pain and improving function in patients with GTPS. Methods Forty-three participants (50 hips observed), all with GTPS, were randomly assigned to a group receiving cortisone injection or DN. Treatments were administered over 6 weeks, and clinical outcomes were collected at baseline and at 1, 3, and 6 weeks. The primary outcome measure was the numeric pain-rating scale (0-10). The secondary outcome measure was the Patient-Specific Functional Scale (0-10). Medication intake for pain was collected as a tertiary outcome. Results Baseline characteristics were similar between groups. A noninferiority test for a repeated-measures design for pain and averaged function scores at 6 weeks (with a noninferiority margin of 1.5 for both outcomes) indicated noninferiority of DN versus cortisone injection (both, P<.01). Medication usage (P = .74) was not different between groups at the same time point. No adverse side effects were reported. Conclusion Cortisone injections for GTPS did not provide greater pain relief or reduction in functional limitations than DN. Our data suggest that DN is a noninferior treatment alternative to cortisone injections in this patient population. Level of Evidence Therapy, level 1b. Registered December 2, 2015 at www.clinicaltrials.gov (NCT02639039). J Orthop Sports Phys Ther 2017;47(4):232-239. Epub 3 Mar 2017. doi:10

  4. Efficacy of triamcinolone acetate and methylprednisolone acetonide for intrabursal injection after ultrasound-guided percutaneous treatment in painful shoulder calcific tendonitis: a randomized controlled trial.

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    Battaglia, Milva; Guaraldi, Federica; Gori, Davide; Castiello, Emanuela; Arvat, Emanuela; Sudanese, Alessandra

    2017-08-01

    Background Ultrasound-guided percutaneous irrigation of calcific tendinopathy (US-PICT) with intrabursal steroid injection is an elective treatment for painful rotator cuff calcific tendinopathy. Purpose To compare the efficacy of post-US-PICT intrabursal 40 mg injection of triamcinolone acetonide (TA) versus methylprednisolone acetate (MA). Material and Methods Forty patients (22 women; mean age 48.7 ± 7.2 years) with painful shoulder calcific tendinopathy, treated with TA or MA injected intrabursally after US-PICT, were included in this randomized controlled trial. At baseline and after 1, 7, 15, 30, 45, and 180 days, patients underwent US and clinical examination, using Constant (CS) and VAS (VS) scores. Complications and analgesic use were also recorded. Results Compared to baseline, at the 45-day follow-up, TA and MA group showed a similar improvement (Δ) in CS (42 ± 10 versus 36 ± 9 points) and VS (-4.4 ± 1.3 versus -3.6 ± 1.3 points). At the 180-day follow-up, the improvement was higher in TA versus MA (ΔCS: 53 ± 7 versus 44 ± 7 points; ΔVS: -4.9 ± 1.1 versus -3.9 ± 1 points). Multivariate analysis showed a mean CS higher ( P = 0.02) in TA versus MA group, while VS was similar. TA had a 5 × higher ( P = 0.007) chance of reaching complete remission (CS = 100 points) than MA group. A progressive decrease in analgesic use, concomitant to a significant and similar reduction of bursitis and calcifications, was observed in both groups. No major complications occurred. Conclusion Two-needle US-PICT with intrabursal steroid injection is safe and effective. The chance of reaching better scores and, even more important for a clinical perspective, of functional recovery, is higher in patients treated with TA than MA.

  5. Exercise therapy for patellofemoral pain syndrome.

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    Heintjes, E; Berger, M Y; Bierma-Zeinstra, S M A; Bernsen, R M D; Verhaar, J A N; Koes, B W

    2003-01-01

    Patellofemoral pain syndrome (PFPS) is a common problem among adolescents and young adults, characterised by retropatellar pain (behind the kneecap) or peripatellar pain (around the kneecap) when ascending or descending stairs, squatting or sitting with flexed knees. Etiology, structures causing the pain and treatment methods are all debated in literature, but consensus has not been reached so far. Exercise therapy to strengthen the quadriceps is often prescribed, though its efficacy is still debated. This review aims to summarise the evidence of effectiveness of exercise therapy in reducing anterior knee pain and improving knee function in patients with PFPS. We searched the Cochrane Musculoskeletal Injuries Group and Cochrane Rehabilitation and Related Therapies Field specialised registers, the Cochrane Controlled Trials Register, PEDro - The Physiotherapy Evidence Database, MEDLINE, EMBASE, CINAHL, up till December 2001 for controlled trials (randomised or not) comparing exercise therapy with control groups, or comparing different types of exercise therapy. Only trials focusing on exercise therapy in patients with PFPS were considered. Trials in patients with other diagnoses such as tendinitis, Osgood Schlatter syndrome, bursitis, traumatic injuries, osteoarthritis, plica syndrome, Sinding-Larssen-Johansson syndrome and patellar luxations were excluded. From 750 publications 12 trials were selected. All included trials studied quadriceps strengthening exercises. Outcome assessments for knee pain and knee function in daily life were used in a best evidence synthesis to summarise evidence for effectiveness. One high and two low quality studies used a control group not receiving exercise therapy. Significantly greater pain reduction in the exercise groups was found in one high and one low quality study, though at different time points. Only one low quality study reported significantly greater functional improvement with exercise. Five studies compared exercise

  6. Subacromial injections of corticosteroids and xylocaine for painful subacromial impingement syndrome.

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    Yu, Chung-Ming; Chen, Chih-Hwa; Liu, Hsien-Tao; Dai, Ming-Hsun; Wang, I-Chun; Wang, Kun-Chung

    2006-01-01

    patients) that did not have satisfactory improvement. Of these patients, eight shoulders (seven patients) had a partial tear of the rotator cuff and 10 shoulders (eight patients) had complete rotator cuff tears. Subacromial injection of corticosteroids and local anesthesia is an effective therapy for the treatment of symptomatic subacromial pathology, such as impingement pain, tendonitis and bursitis. The injection can substantially reduce pain and increase range of motion of the shoulder. If there is no improvement following injections, a rotator cuff tear should be suspected.

  7. Comparison of subacromial tenoxicam and steroid injections in the treatment of impingement syndrome.

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    Çift, Hakan; Özkan, Feyza Ünlü; Tolu, Sena; Şeker, Ali; Mahiroğulları, Mahir

    2015-01-01

    This study aims to assess and compare the efficacy of subacromial tenoxicam and steroid injections in treating patients with shoulder impingement syndrome. Forty patients having shoulder impingement syndrome with findings of rotator cuff tendinitis or subacromial bursitis on magnetic resonance imaging were included in the study. Patients were randomized into two subacromial injection groups: patients in the first group (10 males, 10 females; mean age 45.3 years; range 32 to 67 years) were administered 20 mg tenoxicam three times by weekly intervals, and patients in the second group (8 males, 12 females; mean age 46.5 years; range 29 to 73 years) were administered 40 mg methylprednisolone acetate just for once. Visual analog scale (VAS), active range of motion (ROM) of the shoulder joint, and Disabilities of Arm, Shoulder and Hand (DASH) questionnaire scores were evaluated at baseline, six weeks after treatment, and first year. Visual analog scale, DASH, and active ROM scores in both groups were statistically significantly improved. No statistically significant difference was detected between subacromial tenoxicam and steroid injections in terms of post-treatment VAS, DASH, and active ROM scores. Mean pre- and post-treatment VAS scores in tenoxicam group were 7.8 (range, 3-9) and 2.6 (range, 2-4), respectively. Mean pre- and post-treatment VAS scores in steroid group were 6.2 (range, 3-10) and 3.6 (range, 0-7), respectively. Mean pre- and post-treatment DASH scores in tenoxicam group were 59.4 (range, 45-80) and 14.7 (range, 8.3-25.8), respectively. Mean pre- and post-treatment DASH scores in steroid group were 56.7 (range, 33.3-85.8) and 18.1 (range, 0-69.2), respectively. Although the improvement in active ROM was higher in the steroid group, difference between two groups was not statistically significant. Both subacromial tenoxicam and steroid injections may be successfully used in the treatment of patients with impingement syndrome. Subacromial tenoxicam

  8. Clinical Value of FDG-PET/CT for the Evaluation of Rheumatic Diseases: Rheumatoid Arthritis, Polymyalgia Rheumatica, and Relapsing Polychondritis.

    Science.gov (United States)

    Kubota, Kazuo; Yamashita, Hiroyuki; Mimori, Akio

    2017-07-01

    FDG is a tracer for visualizing glucose metabolism. PET/CT using FDG is widely used for the diagnosis of cancer, because glycolysis is elevated in cancer cells. Similarly, active inflammatory tissue also exhibits elevated glucose metabolism because of glycolysis in activated macrophages and proliferating fibroblasts. Elevated FDG uptake by active inflammatory tissues, such as those affected by arthritis, vasculitis, lymphadenitis, and chondritis, has enabled the diagnosis of inflammatory diseases using FDG-PET/CT. Rheumatoid arthritis (RA) is a systemic, chronic inflammation of the joints resulting in synovitis. Several clinical studies of RA have demonstrated that FDG uptake in affected joints reflects the disease activity of RA, with strong correlations between FDG uptake and various clinical parameters having been noted. Furthermore, the use of FDG-PET for the sensitive detection and early monitoring of the response to RA therapy has been reported. RA is sometimes associated with subclinical vasculitis, which is related to systemic inflammation. FDG-PET/CT can be used to evaluate subclinical vasculitis in the aorta or carotid artery. Polymyalgia rheumatica (PMR) is an autoimmune musculoskeletal disease of unknown etiology characterized by pain and stiffness in the shoulder, neck, and pelvic girdle, but not in the small finger joints in the hands, together with fever, fatigue, and weight loss. There is no specific test for PMR, and its diagnosis is based on clinical diagnostic criteria and the exclusion of other diseases with similar symptoms. However, FDG-PET/CT reveals a characteristic FDG uptake by the bursitis in ischial tuberosity, greater trochanter, lumbar or cervical spinous process, and scapulohumeral joint. A combination of FDG-PET/CT findings showed a high diagnostic value for PMR in a differential diagnosis from RA. FDG-PET/CT is also very useful for evaluating large vessel vasculitis, which is often associated with PMR. Relapsing polychondritis is a

  9. Sonography of the iliopsoas tendon and injection of the iliopsoas bursa for diagnosis and management of the painful snapping hip.

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    Blankenbaker, Donna G; De Smet, Arthur A; Keene, James S

    2006-08-01

    The purpose of this study was to compare sonographic evaluations of patients referred with suspected snapping of their iliopsoas tendon with the pain relief achieved from anesthetic injection of the iliopsoas bursa, and with the subsequent surgical outcome. This study also assessed the effectiveness of Kenalog injection into the iliopsoas bursa for long-term pain relief. Dynamic and static sonography was performed in 40 patients with clinically diagnosed snapping hips. The iliopsoas bursa was injected with Bupivicaine and Lidocaine in the first 22 patients, and an additional 1 ml Kenalog-40 was added to this mixture in the last 18 patients. We compared the static and dynamic sonographic findings with change in the patients' level of pain at 2 days after anesthetic injection. The sonographic findings and response to anesthetic injection were also compared to the response to Kenalog injection and the results of any subsequent surgery. Static sonography of the iliopsoas tendon was normal in 38 patients, and detected iliopsoas bursitis in one patient and iliopsoas tendinopathy in another. Snapping of the iliopsoas tendon was observed using dynamic sonography in 9 of the 40 patients. Following anesthetic injection of the iliopsoas bursa, 29 patients had complete or partial pain relief, and 11 patients had no pain relief. Eight of the nine patients with a snapping iliopsoas tendon had complete or partial pain relief from the bursal injection. Twelve of the 29 patients with pain relief after anesthetic injection later had an arthroscopic iliopsoas tendon release, and all of these 12 patients had a good postoperative result. Of the 18 patients who had Kenalog-40 injected into the iliopsoas bursa and did not have iliopsoas surgery, 16 had sustained pain relief following the injection. Patients with groin pain and a clinically suspected snapping iliopsoas tendon can benefit from injection into the iliopsoas bursa even if the snapping tendon is not visualized sonographically

  10. Factors Associated with the Outcome of Ultrasound-Guided Trochanteric Bursa Injection in Greater Trochanteric Pain Syndrome: A Retrospective Cohort Study.

    Science.gov (United States)

    Park, Ki Deok; Lee, Woo Yong; Lee, Jihae; Park, Min-Ho; Ahn, Jae Ki; Park, Yongbum

    2016-05-01

    osteoarthritis (odds ratio = 0.329, P = .021). Age, gender, body mass index, and pain duration were not independent predictors of a clinically successful outcome. There was no statistically significant association between effective treatment and the ultrasound findings of tendinosis, bursitis, partial or full-thickness tear, and enthesopathic changes. Retrospective chart review without a control group. This study suggests that knee osteoarthritis and lower back pain might be associated with a poor outcome of ultrasound-guided trochanteric bursa injection for GTPS. Assessment of these clinical factors should be incorporated into the evaluation and counseling of patients with GTPS who are candidates for ultrasound-guided trochanteric bursa injection. Bursa injection, corticosteroid, greater trochanteric pain syndrome, knee osteoarthritis, lower back pain, lumbar facet joint, ultrasonography, S-I joint pain.

  11. Effect of corticosteroid injection for trochanter pain syndrome: design of a randomised clinical trial in general practice

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    Verhaar Jan AN

    2007-09-01

    Full Text Available Abstract Background Regional pain in the hip in adults is a common cause of a general practitioner visit. A considerable part of patients suffer from (greater trochanteric pain syndrome or trochanteric bursitis. Local corticosteroid injections is one of the treatment options. Although clear evidence is lacking, small observational studies suggest that this treatment is effective in the short-term follow-up. So far, there are no randomised controlled trials available evaluating the efficacy of injection therapy. This study will investigate the efficacy of local corticosteroid injections in the trochanter syndrome in the general practice, using a randomised controlled trial design. The cost effectiveness of the corticosteroid injection therapy will also be assessed. Secondly, the role of co-morbidity in relation to the efficacy of local corticosteroid injections will be investigated. Methods/Design This study is a pragmatic, open label randomised trial. A total of 150 patients (age 18–80 years visiting the general practitioner with complaints suggestive of trochanteric pain syndrome will be allocated to receive local corticosteroid injections or to receive usual care. Usual care consists of analgesics as needed. The randomisation is stratified for yes or no co-morbidity of low back pain, osteoarthritis of the hip, or both. The treatment will be evaluated by means of questionnaires at several time points within one year, with the 3 month and 1 year evaluation of pain and recovery as primary outcome. Analyses of primary and secondary outcomes will be made according to the intention-to-treat principle. Direct and indirect costs will be assessed by questionnaires. The cost effectiveness will be estimated using the following ratio: CE ratio = (cost of injection therapy minus cost of usual care/(effect of injection therapy minus effect of usual care. Discussion This study design is appropriate to estimate effectiveness and cost-effectiveness of the

  12. Prototecose: uma doença emergente Protothecosis: an emergent disease

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    Expedito K.A. Camboim

    2010-01-01

    Full Text Available Prototecose, causada por Prototheca zopfii ou P. wickerhamii, é uma doença emergente em animais e humanos. Em bovinos, P. zopfii é uma importante causa de mastite ambiental. Em cães e gatos, a prototecose é causada principalmente por P. zopfii. Em cães, causa infecção cutânea ou uma forma sistêmica envolvendo diversos órgãos. Em gatos, predominam as lesões tegumentares na região da face e plano nasal. No homem, a prototecose, causada principalmente por P. wickerhamii, manifesta-se sob três formas: cutânea, articular com bursite do olécrano e sistêmica. Pode ocorrer em indivíduos imunocompetentes, os quais podem apresentar bursite e/ou infecções cutâneas localizadas, ou em indivíduos imunossuprimidos, nos quais a enfermidade pode ser disseminada e/ou com envolvimento visceral. A prototecose causada por P. wickerhamii foi descrita recentemente em caprinos como causa de rinite afetando o vestíbulo nasal, união mucocutânea, pele da face e orelha. Nesta revisão são abordadas as características microbiologias e susceptibilidade a antimicrobianos do agente, e a epidemiologia, sinais clínicos, patologia, diagnóstico, tratamento e controle da prototecose em animais domésticos e no homem.Protothecosis, caused by Prototheca zopfii or P. wickerhamii, is an emergent disease of human and animals. In cattle, P. zopfii is an important cause of environmental mastitis. In dogs and cats protothecosis is caused mainly by P. zopfii, causing cutaneous infections or a systemic form affecting many organs in dogs, and cutaneous infection affecting mainly the skin of the face and nose in cats. In humans, protothecosis, caused mainly by P. wickerhamii, occurs in three forms: cutaneous; olecran bursitis; and disseminated. The lesion is usually localized in the site of inoculation in immunocompetent individuals; however, in immunocompromised patients, it can become widespread. Protothecosis caused by P. wickerhamii was recently reported in

  13. MAGNETIC RESONANCE IMAGING EVALUATION OF ROTATOR CUFF IMPINGEMENT

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    Chandrakanth K. S

    2017-06-01

    Full Text Available BACKGROUND Shoulder pain is a common clinical problem. Impingement syndrome of the shoulder is believed to be the most common cause of shoulder pain. The term ‘impingement syndrome’ was first used by Neer to describe a condition of shoulder pain associated with chronic bursitis and partial thickness tear of Rotator Cuff (RC. The incidence of Rotator Cuff (RC tear is estimated to be about 20.7% in the general population. This study is intended to analyse various extrinsic and intrinsic causes of shoulder impingement. MATERIALS AND METHODS 110 consecutive patients referred for MRI with clinical suspicion of shoulder impingement were prospectively studied. All the patients were evaluated for Rotator Cuff (RC degeneration and various extrinsic factors that lead to degeneration like acromial shape, down-sloping acromion, Acromioclavicular (AC joint degeneration and acromial enthesophyte. Intrinsic factors like degeneration and its correlation with age of the patients were evaluated. RESULTS Of the total 110 patients, 19 (17.3% patients had FT RC tear and 31 (28.2% had PT (both bursal and articular surface tears. There was no statistically significant correlation (p=0.76 between acromion types and RC tear. Down-sloping acromion and enthesophytes had statistically significant association with RC tear (p=0.008 and 0.008, respectively. Statistically significant (0.008 correlation between the severity of AC joint degeneration and RC tears was noted. AC joint degeneration and RC pathologies also showed a correlation with the age of the patients with p values of <0.001 and 0.001, respectively. CONCLUSION No statistically significant correlation between RC pathologies with hooked acromion was found, that makes the role played by hooked acromion in FT RC tear questionable. AC joint degeneration association with RC tear is due to the association of both RC tear and AC joint degeneration with age of the patient. Down-sloping acromion, AC joint degeneration

  14. Reliability of diagnostic tests in rotator cuff muscle pathology

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    R. Sadenbergh

    2006-02-01

    Full Text Available Background: Several tests to assist it in the diagnoses of rota-tor cuff impairment have been described in the literature but controversystill exists as to the accuracy of these tests. A study was therefore conducted to determine the reliability of the rotator cuff muscle tests (empty can, full can, lift off and external rotation as a diagnostic tool.Methodology: Fifty three patients experiencing shoulder pain were assessedusing manual muscle tests (empty can; full can; lift off and external rotationtests. Both pain and weakness were recorded using numerical scales adapted from tests performed by Itoi et al, (1999. These results were compared to ultrasonic diagnoses made by a surgeon. Informed consent was obtained and anonymity was ensured for all participants.Results: A test was false positive when ultrasonic diagnosis indicated no tear in the muscle (although oedema or calcification may have been present, but the manual muscle test was positive regarding pain and weakness. A test on the other hand was false negative when the ultrasonic diagnosis indicated a muscle tear but the manual muscle tests indicated no pain or muscle weakness. Reliability was tested using sensitivity and specificity tests. The sensitivity of all four tests was high (80%, but the specificity was low (20% to 40%, implying that a large number of false positive diagnoses can be made. The major contributors to the false positive results were sub-acromial sub-deltoid bursitis and a decreased acromio-humeral space. When considering pain alone for a positive result the correlation increased a  little, however, taking both pain and muscle weakness into account, the correlation increased even more.Conclusion: The manual muscle tests were not as reliable as expected, but concurrent pathologies may be the main factor influencing the results of the tests. The combination of muscle strength and pain could be recommendedas criteria for a positive test. The empty can and full can

  15. Symptomatic knee disorders in floor layers and graphic designers. A cross-sectional study

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    Jensen Lilli

    2012-09-01

    Full Text Available Abstract Background Previous studies have described an increased risk of developing tibio-femoral osteoarthritis (TF OA, meniscal tears and bursitis among those with a trade as floor layers. The purpose of this study was to analyse symptomatic knee disorders among floor layers that were highly exposed to kneeling work tasks compared to graphic designers without knee-demanding work tasks. Methods Data on the Knee injury and Osteoarthritis Outcome Score (KOOS were collected by questionnaires. In total 134 floor layers and 120 graphic designers had a bilateral radiographic knee examination to detect TF OA and patella-femoral (PF OA. A random sample of 92 floor layers and 49 graphic designers had Magnetic Resonance Imaging (MRI of both knees to examine meniscal tears. Means of the subscales of KOOS were compared by analysis of variance. The risk ratio of symptomatic knee disorders defined as a combination of radiological detected knee OA or MRI-detected meniscal tears combined with a low KOOS score was estimated by logistic regression in floor layers with 95% confidence interval (CI and adjusted for age, body mass index, traumas, and knee-straining sports activities. Symptomatic knee OA or meniscal tears were defined as a combination of low KOOS-scores and radiographic or MRI pathology. Results Symptomatic TF and medial meniscal tears were found in floor layers compared to graphic designers with odds ratios 2.6 (95%CI 0.99-6.9 and 2.04 (95% CI 0.77-5.5, respectively. There were no differences in PF OA. Floor layers scored significantly lower on all KOOS subscales compared to graphic designers. Significantly lower scores on the KOOS subscales were also found for radiographic TF and PF OA regardless of trade but not for meniscal tears. Conclusions The study showed an overall increased risk of developing symptomatic TF OA in a group of floor layers with a substantial amount of kneeling work positions. Prevention would be appropriate to reduce the

  16. Rheumatic diseases presenting as sports-related injuries.

    Science.gov (United States)

    Jennings, Fabio; Lambert, Elaine; Fredericson, Michael

    2008-01-01

    Most individuals seeking consultation at sports medicine clinics are young, healthy athletes with injuries related to a specific activity. However, these athletes may have other systemic pathologies, such as rheumatic diseases, that may initially mimic sports-related injuries. As rheumatic diseases often affect the musculoskeletal system, they may masquerade as traumatic or mechanical conditions. A systematic review of the literature found numerous case reports of athletes who presented with apparent mechanical low back pain, sciatica pain, hip pain, meniscal tear, ankle sprain, rotator cuff syndrome and stress fractures and who, on further investigation, were found to have manifestations of rheumatic diseases. Common systemic, inflammatory causes of these musculoskeletal complaints include ankylosing spondylitis (AS), gout, chondrocalcinosis, psoriatic enthesopathy and early rheumatoid arthritis (RA). Low back pain is often mechanical among athletes, but cases have been described where spondyloarthritis, especially AS, has been diagnosed. Neck pain, another common mechanical symptom in athletes, can be an atypical presentation of AS or early RA. Hip or groin pain is frequently related to injuries in the hip joint and its surrounding structures. However, differential diagnosis should be made with AS, RA, gout, psudeogout, and less often with haemochromatosis and synovial chondochromatosis. In athletes presenting with peripheral arthropathy, it is mandatory to investigate autoimmune arthritis (AS, RA, juvenile idiopathic arthritis and systemic lupus erythematosus), crystal-induced arthritis, Lyme disease and pigmented villonodular synovitis. Musculoskeletal soft tissue disorders (bursitis, tendinopathies, enthesitis and carpal tunnel syndrome) are a frequent cause of pain and disability in both competitive and recreational athletes, and are related to acute injuries or overuse. However, these disorders may occasionally be a manifestation of RA, spondyloarthritis

  17. Sex and growth effect on pediatric hip injuries presenting to sports medicine clinic.

    Science.gov (United States)

    Stracciolini, Andrea; Yen, Yi-Meng; d'Hemecourt, Pierre A; Lewis, Cara L; Sugimoto, Dai

    2016-07-01

    To compare sports-related hip injuries on the basis of sex and age in a cohort of young athletes. A 5% random probability sample of all new patients' charts over a 10-year time period was selected for investigation. The most common hip injury diagnoses, sport at time of injury, mechanism (acute/traumatic vs. overuse), and types (bony vs. soft tissue) were compared by sex and age (preadolescent vs. adolescent). Descriptive and χ-analyses were carried out. The interaction of sex and age with respect to hip injury over time was examined by two-way (sex, age) analysis of variance. A total of 2133 charts were reviewed; N=87 hip injuries. The main diagnoses for males included labral tear (23.1%), avulsion fracture (11.5%), slipped capital femoral epiphysis (11.5%), dislocation (7.7%), and tendonitis (7.7%). The main diagnoses for females were labral tear (59.0%), tendonitis (14.8%), snapping hip syndrome (6.6%), strain (4.9%), and bursitis (4.9%). The five most common sports/activities at the time of hip injury were dancing/ballet (23.0%), soccer (18.4%), gymnastics (9.2%), ice hockey (8.1%), and track and field (6.9%). Age by sex comparisons showed a greater proportion of the total hip injuries (38.5%) in males compared with females (8.2%) during preadolescence (5-12 years). However, in adolescence (13-17 years), the hip injury proportion was significantly higher in females (91.8%) compared with males (61.5%; PInjury mechanism and type differed by sex, with females sustaining more chronic/overuse (95.1%) and soft tissue type injuries (93.4%) compared with males (50.0 and 53.8%, respectively; Phip injury proportion as they progressed through puberty compared with males (analysis of variance sex-by-age interaction; PHip injury mechanism and type differed significantly between males and females during growth. Notably, the proportion of hip injuries in the young female athletes showed a significantly greater increase with advancing age compared with males. Hip injuries in

  18. Diagnosis of shoulder impingement syndrome; Diagnostik des Schulterimpingementsyndroms

    Energy Technology Data Exchange (ETDEWEB)

    Hodler, J. [Orthopaedische Universitaetsklinik Balgrist, Zuerich (Switzerland)

    1996-12-01

    des Schultergelenkes. Die 3 Stadien (Einblutung und Oedem, Tendionpathie und Bursitis, Rotatorenmanschettenlaesion) sind klinisch nicht einfach zu unterscheiden und zu quantifizieren. Die bildgebende Diagnostik spielt eine wesentliche Rolle zur Diagnose und Therapieplanung. Sie beginnt in der Regel mit konventionellen Roentgenaufnahmen. Damit werden indirekte Zeichen eines Schulterimpingements dargestellt, wie subchondrale Sklerosierung des Tuberculum majus, subakromiale Osteophyten und Formvarianten des Aktromions. Fortgeschrittene Rupturen sind infolge Humerushochstands direkt erkennbar. Die Roentgenuntersuchung stellt auch Differentialdiagnosen wie die Tendinitis calcarea, Frakturen und Neoplasien dar. Als Zusatzuntersuchung fuer die Weichteildiagnostik ist die Sonographie geeignet. Sie stellt Veraenderungen der Rotatorenmanschetten und der Bursa subacromialis dar. Voraussetzungen fuer reproduzierbare Resultate sind allerdings eine geeignete Ausruestung und ein erfahrener Untersucher. Die MRT ist wegen ihrer geringeren Untersuchungsabhaengigkeit und hoeherer Spezifitaet vor allem fuer chirurgische Therapieentscheide und die dazugehoerende Operationsplanung vorzuziehen. Je nach Fragestellung kann die MR-Arthrographie die Treffsicherheit der MRT erhoehen. (orig.)

  19. Informativeness of X-Ray and Ultrasound Techniques in the Diagnosis of Reactive Arthritis in Children

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    H.S. Senatorova

    2016-04-01

    Full Text Available Background. Reactive arthritis is an important problem in pediatrics, which is associated with its highest specific weight (41–56 % in the structure of the joint pathology in children. The importance of the problem is also caused by the risk of chronicity of inflammatory process and transformation in juvenile rheumatoid arthritis and osteoarthritis. Timely diagnosis plays a big role in the course and outcomes of the disease. Along with clinical and laboratory examination, X-ray and ultrasonic methods play an important role in the diagnosis and differential diagnosis of joint diseases in children. Objective: to optimize the diagnosis of reactive arthritis in children by means of a comparative evaluation of the informativeness of radiological and ultrasonic techniques. Materials and methods of the study. A total of 30 children with a diagnosis of reactive arthritis aged 2 to 16 years were examined. Along with the ge­nerally accepted clinical-laboratory and X-ray examination, all patients underwent ultrasonography of the joints. Results. The changes on radiographs were recorded only in 10 (33.3 ± 8.7 % children in the form of an increase in the volume and thickening of periarticular tissues, 2 (6.7 ± 4.6 % children had expansion of joint space of the affected joint. Sensitivity of radiography as a method for the diagnosis of reactive arthritis in children was 40 %. Ultrasound examination of the joints revealed pathological changes in 100 % of cases. During ultrasonography of the joints, we have detected the changes in the joints as synovitis, thickening of synovial membranes, expansion of joint space, tendinitis, bursitis. Conclusion. In the diagnosis of the different course of reactive arthritis, the method of ultrasonic imaging of inflammatory changes in the joints, which has 100% sensitivity, becomes very important. Ultrasonography, as a non-invasive, available method with no contraindications, is a significantly (p < 0.05 more sensitive

  20. The Maastricht Ultrasound Shoulder pain trial (MUST: Ultrasound imaging as a diagnostic triage tool to improve management of patients with non-chronic shoulder pain in primary care

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    Cals Jochen WL

    2011-07-01

    Full Text Available Abstract Background Subacromial disorders are considered to be one of the most common pathologies affecting the shoulder. Optimal therapy for shoulder pain (SP in primary care is yet unknown, since clinical history and physical examination do not provide decisive evidence as to the patho-anatomical origin of the symptoms. Optimal decision strategies can be furthered by applying ultrasound imaging (US, an accurate method in diagnosing SP, demonstrating a clear relationship between diagnosis and available therapies. Yet, the clinical cost-effectiveness of applying US in the management of SP in primary care has not been studied. The aim of this paper is to describe the design and methods of a trial assessing the cost-effectiveness of ultrasound imaging as a diagnostic triage tool to improve management of primary care patients with non-chronic shoulder pain. Methods/Design This randomised controlled trial (RCT will involve 226 adult patients with suspected subacromial disorders recruited by general practitioners. During a Qualification period of two weeks, patients receive care as usual as advised by the Dutch College of General Practitioners, and patients are referred for US. Patients with insufficient improvement qualify for the RCT. These patients are then randomly assigned to the intervention or the control group. The therapies used in both groups are the same (corticosteroid injections, referral to a physiotherapist or orthopedic surgeon except that therapies used in the intervention group will be tailored based on the US results. Ultrasound diagnosed disorders include tendinopathy, calcific tendinitis, partial and full thickness tears, and subacromial bursitis. The primary outcome is patient-perceived recovery at 52 weeks, using the Global Perceived Effect questionnaire. Secondary outcomes are disease specific and generic quality of life, cost-effectiveness, and the adherence to the initial applied treatment. Outcome measures will be assessed