WorldWideScience

Sample records for bursitis

  1. Bursitis

    Science.gov (United States)

    ... activities, like throwing a ball or swinging a tennis racket, elbow bursitis is one of the most common types of bursitis in teens. Knee. Bursitis in the knee can be the result of ... and tennis. Ankle. Someone who goes overboard with jumping, running, ...

  2. Tendinitis and Bursitis

    Science.gov (United States)

    ... Am A Patient / Caregiver Diseases & Conditions Tendinitis & Bursitis Tendinitis (Bursitis) Fast Facts Tendinitis and bursitis are inflammation ... becomes very painful, even during rest. What causes tendinitis and bursitis? Tendinitis can occur from a sudden ...

  3. Knee Bursitis

    Science.gov (United States)

    ... make a diagnosis of knee bursitis during a physical exam. Your doctor will inspect your knee by: Comparing the condition of both knees, particularly if only one is painful Gently pressing on different areas of your knee to detect warmth, swelling and the source of pain Carefully moving ...

  4. 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.)

  5. Bursitis of the heel

    Science.gov (United States)

    ... around the ankle. The focus will be on stretching your Achilles tendon. This can help the bursitis ... retrocalcaneal bursitis that DO NOT improve with rest. Prevention Things you can do to prevent the problem ...

  6. 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.)

  7. Retrocalcaneal bursitis in juvenile chronic arthritis.

    OpenAIRE

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

    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.

  8. Imaging features of iliopsoas bursitis

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    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.)

  9. 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.)

  10. 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.)

  11. [Ossifying bursitis praepatellaris of the knee joint].

    Science.gov (United States)

    Erler, M

    2009-01-01

    A 53-year-old patient was admitted to our hospital with a tumour at the site of the left knee joint praepatellar. The diagnostic imaging, operative findings and histology showed a chronic ossifying bursitis praepatellaris of the knee joint. Aetiology and pathogenesis of the ossifying bursitis are discussed.

  12. Ultrasonographic evaluation of lschial bursitis

    Energy Technology Data Exchange (ETDEWEB)

    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.

  13. 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

  14. 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.

  15. Atypical retroperitoneal extension of iliopsoas bursitis

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    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.)

  16. 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

  17. First case of Roussoella percutanea bursitis.

    Science.gov (United States)

    Almagro-Molto, M; Haas, A; Melcher, C; Nam-Apostolopoulos, Y C; Schubert, S

    2017-02-01

    Roussoella percutanea is a novel opportunistic pathogen firstly identified in 2014. It is known to cause subcutaneous infection in immunosuppressed patients. We report on the first case of R. percutanea bursitis in a renal transplant patient. We provide new data about its identification, drug susceptibility, and treatment outcome. Here we demonstrate that R. percutanea is a potential human pathogen.

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

    OpenAIRE

    Carlos Roberto Schwartsmann; Felipe Loss; Leandro de Freitas Spinelli; Roque Furian; Marcelo Faria Silva; Júlia Mazzuchello Zanatta; Leonardo Carbonera Boschin; Ramiro Zilles Gonçalves; Anthony Kerbes Yépez

    2014-01-01

    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 histo...

  19. 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.)

  20. Nasopharyngeal bursitis: from embryology to clinical presentation

    OpenAIRE

    2010-01-01

    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 bu...

  1. 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.

  2. 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.

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

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    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.)

  4. 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

  5. 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.

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

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    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.

  7. 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...

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

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    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. Subcalcaneal Bursitis With Plantar Fasciitis Treated by Arthroscopy

    OpenAIRE

    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 ...

  10. Antecubital Fossa Solitary Osteochondroma with Associated Bicipitoradial Bursitis

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    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.

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

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    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.

  12. Subacromial bursitis with rice bodies : a case report

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    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.

  13. Subcalcaneal bursitis with plantar fasciitis treated by arthroscopy.

    Science.gov (United States)

    Yamakado, Kotaro

    2013-05-01

    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.

  14. Association between trochanteric bursitis, osteoarthrosis and total hip arthroplasty☆☆☆

    Science.gov (United States)

    Schwartsmann, Carlos Roberto; Loss, Felipe; de Freitas Spinelli, Leandro; Furian, Roque; Silva, Marcelo Faria; Zanatta, Júlia Mazzuchello; Boschin, Leonardo Carbonera; Gonçalves, Ramiro Zilles; Yépez, Anthony Kerbes

    2014-01-01

    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. PMID:26229811

  15. Pterygoid hamulus bursitis as a cause of craniofacial pain: a case report.

    Science.gov (United States)

    Cho, Jin-Yong; Cheon, Kang-Yong; Shin, Dong-Whan; Chun, Won-Bae; Lee, Ho

    2013-06-01

    Pain on the soft palate and pharynx can originate in several associated structures. Therefore, diagnosis of patients who complain of discomfort in these areas may be difficult and complicated. Pterygoid hamulus bursitis is a rare disease showing various symptoms in the palatal and pharyngeal regions. As such, it can be one of the reported causes of pain in these areas. Treatment of hamular bursitis is either conservative or surgical. If the etiologic factor of bursitis is osteophytic formation on the hamulus or hypertrophy of the bursa, resection of the hamulus is usually the preferred surgical treatment. We report on a case of bursitis that was managed successfully by surgical treatment and a review of the literature.

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

    Science.gov (United States)

    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. PMID:28337351

  17. 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.

  18. 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.)

  19. 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.

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

    Directory of Open Access Journals (Sweden)

    Rhys D.R. Evans

    2009-03-01

    Full Text Available 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.

  1. 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.

  2. 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.

  3. 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.

  4. 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.)

  5. 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.

  6. 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.)

  7. SURGICAL MANAGEMENT OF REFRA CTORY RETRO - CALCANEAL BURSITIS EVALUATION OF ITS RESULTS

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    Vinod Kumar

    2015-06-01

    Full Text Available CONTEXT: Heel pain is common in middle and elderly people due various causes. BACKGROUND: Retrocalcaneal bursitis may not respond for medical treatment and may need surgery for relief of pain . AIM: To study the results of surgical treatment in Retrocalcaneal bursitis . MATERIALS AND METHODS: T he patients with refractory retrocalcaneal bursitis were taken up for the study. inclusion criteria is pain , swelling over poster o superior aspect of the heel no t responding to conservative treatment like heat , analgesics and local steroids. The only contraindication was uncontrolled diabetes. X - ray of heel lateral view was taken in all patients and prominence of posterio superior part was assessed. Pre and postop eratively the foot were assessed hy Ankle and foot scale. Through lateral incision the prominent bony prominence and retrocalcaneal bursa was excised. RESULTS: 25 patients with refractory retrocalcaneal bursitis underwent surgery. 15 males and 10 females w ith mean age of 46 years and mean duration fo r symptioms of one year and eight months and mean fallow up period of one year and one month. The pre - operative ankle and foot scale score was 37 to 43 points with a median of 41 points. Post - operative score was 76 to 83 with a median of 81 points. 20 patients ( 80% had complete relief of symptoms. Four patents ( 16% had minimal pain after long walking. O ne patient had moderate pain restricting his daily activities ( 4% . CONCLUSIONS: surgical excision of prominent spur along with retrocalcaneal bursa gives good result.

  8. 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

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

    NARCIS (Netherlands)

    Emad, Yasser; Ragab, Yasser; El-Shaarawy, Nashwa; Rasker, J.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 gout

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

    OpenAIRE

    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 sympto...

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

    Directory of Open Access Journals (Sweden)

    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.

  12. Anserina bursitis. A treatable cause of knee pain in patients with degenerative arthritis.

    Science.gov (United States)

    Brookler, M I; Mongan, E S

    1973-07-01

    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.

  13. Citric acid treatment of chronic nonhealing ulcerated tophaceous gout with bursitis.

    Science.gov (United States)

    Nagoba, Basavaraj S; Punpale, Ajay; Poddar, Ashok; Suryawanshi, Namdev M; Swami, Ganesh A; Selkar, Sohan P

    2013-12-01

    The ulceration associated with gout tophi is very difficult to treat because of impaired and halted local inflammatory response resulting from the gout treatment regimen. We report chronic nonhealing tophaceous gout with bursitis in an 80-year-old male, not responding to conventional treatment modality for months together. This nonhealing ulcer was treated successfully with local application of 3% citric acid ointment for 22 days.

  14. Prevalence of Locomotory System Disorders in Veal Calves and Risk Factors for Occurrence of Bursitis

    Directory of Open Access Journals (Sweden)

    Marta Brščić

    2011-12-01

    Full Text Available The study aimed to assess the prevalence of locomotory system disorders within a wide cross-sectional study in 174 veal calves farms and to investigate risk factors associated to disorders with a relevant prevalence (>1%. A representative sample of the European veal production systems was considered in the three major producing countries (100 in NL, 50 in FR, 24 in IT. One batch/farm was observed in three stages of the fattening. At each visit calves with evidence of bursitis, hoof lesions, joint lesions, and lameness were recorded. A set of production system descriptors gathered by an interview to the farmer were considered as potential risks. Results showed an average prevalence ≤1% of calves for hoof and joint lesions, and lameness at any stage. Bursitis was observed on 0.2%, 4.1% and 11.2% of calves at 3, 13 wks and at the end of fattening, respectively. Risk factors for bursitis were linked to concrete and wooden slatted floors, to space allowance ≤1.8 m2/calf, and floors aged <8 years while type of housing system (small vs. large groups was not relevant. There was a significant interaction between stage of fattening and type of floor on bursitis. At the early stage, slatted and bedded floor were similar while at the end of the fattening the highest least mean was observed for calves on concrete floors. Bedding materials had a preventive effect. Rubber or straw should be largely adopted for veal calves as alternative solutions to hard floors in order to improve animals’ comfort, locomotory system health and welfare status.

  15. Prevalence of Locomotory System Disorders in Veal Calves and Risk Factors for Occurrence of Bursitis

    Directory of Open Access Journals (Sweden)

    Marta Brščić

    2011-10-01

    Full Text Available The study aimed to assess the prevalence of locomotory system disorders within a wide cross-sectional study in 174 veal calves farms and to investigate risk factors associated to disorders with a relevant prevalence (>1%. A representative sample of the European veal production systems was considered in the three major producing countries (100 in NL, 50 in FR, 24 in IT. One batch/farm was observed in three stages of the fattening. At each visit calves with evidence of bursitis, hoof lesions, joint lesions, and lameness were recorded. A set of production system descriptors gathered by an interview to the farmer were considered as potential risks. Results showed an average prevalence ≤1% of calves for hoof and joint lesions, and lameness at any stage. Bursitis was observed on 0.2%, 4.1% and 11.2% of calves at 3, 13 wks and at the end of fattening, respectively. Risk factors for bursitis were linked to concrete and wooden slatted floors, to space allowance ≤1.8 m2/calf, and floors aged <8 years while type of housing system (small vs. large groups was not relevant. There was a significant interaction between stage of fattening and type of floor on bursitis. At the early stage, slatted and bedded floor were similar while at the end of the fattening the highest least mean was observed for calves on concrete floors. Bedding materials had a preventive effect. Rubber or straw should be largely adopted for veal calves as alternative solutions to hard floors in order to improve animals’ comfort, locomotory system health and welfare status.

  16. ESTUDIO DEL EFECTO DE LA ACUPUNTURA EN EL TRATAMIENTO DE LA BURSITIS DE HOMBRO

    OpenAIRE

    TORRES GARCIA, JOSE AGUSTIN

    2009-01-01

    LA BURSITIS ES LA INFLAMACION DE LAS BURSAS, QUE SON PEQUENAS BOLSAS LLENAS DE LIQUIDO SEROSO QUE SE ENCUENTRAN ENTRE LOS TENDONES Y EL PLANO OSEO. ALGUNOS AUTORES MENCIONAN QUE ESTE PADECIMIENTO SE ENCUENTRA, MAS FRECUENTEMENTE DESPUES DE LOS 40 ANOS DE EDAD. EN LA REGION DEL HOMBRO SE ENCUENTRAN CONJUNTADAS SIETE ARTICULACIONES LAS CUALES LE DAN FORMA A UN COMPLEJO LLAMADO CINTURA ESCAPULAR. EN ESTA CINTURA ESCAPULAR SE ENCUENTRAN ONCE BURSAS, DE LAS CUALES SE PUEDEN AFECTAR UNA O MAS EN F...

  17. 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

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  20. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

    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)

  2. A cross-sectional study of the prevalence and associated risk factors for bursitis in weaner, grower and finisher pigs from 93 commercial farms in England.

    Science.gov (United States)

    Gillman, C E; Kilbride, A L; Ossent, P; Green, L E

    2008-03-17

    A cross-sectional study of 93 farms in England was carried out to estimate the prevalence and associated risk factors for bursitis. A total of 6250 pigs aged 6-22 weeks were examined for presence and severity of bursitis. Details of pen construction, pen quality and farm management were recorded including floor type, presence of bedding, condition of the floor and floor materials. The prevalence of bursitis was 41.2% and increased with each week of age (OR 1.1). Two-level logistic regression models were developed with the outcome as the proportion of pigs affected with bursitis in a pen. Pigs kept on soil floors with straw bedding were used as the reference level. In comparison with these soil floors, bursitis increased on concrete floors where the bedding was deep throughout (OR 4.6), deep in part (OR 3.7), and sparse throughout (OR 9.0), part slatted floors (OR 8.0), and fully slatted floors (OR 18.8). Slip or skid marks in the dunging area (OR 1.5), pigs observed slipping during the examination of the pen (OR 1.3) and wet floors (OR 3.6) were also associated with an increased risk of bursitis. The results indicate that bursitis is a common condition of growing pigs and that the associated risk factors for bursitis were a lack of bedding in the lying area, presence of voids and pen conditions which increased the likelihood of injury.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  4. 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.

  5. Arthroscopic bursectomy with concomitant iliotibial band release for the treatment of recalcitrant trochanteric bursitis.

    Science.gov (United States)

    Farr, Derek; Selesnick, Harlan; Janecki, Chet; Cordas, Daniel

    2007-08-01

    Trochanteric bursitis with lateral hip pain is a commonly encountered orthopaedic condition. Although most patients respond to corticosteroid injections, rest, physical therapy (PT), stretching, and anti-inflammatory medications, those with recalcitrant symptoms may require operative intervention. Studies have explored the use of the arthroscope in the treatment of these patients. However, these reports have not addressed the underlying pathology in this chronic condition. We believe that the iliotibial band must be addressed and is the main cause of pain, inflammation, and trochanteric impingement leading to the development of bursitis. We report a new technique for arthroscopic trochanteric bursectomy with iliotibial band release. Our technique involves 2 incisions--one 4 cm proximal to the greater trochanter along the anterior border of the iliotibial band, and the other 4 cm distal and along the posterior border. The 30 degrees arthroscope is introduced through the inferior portal, and a cannula is introduced through the superior portal. A 5.5-mm arthroscopic shaver is inserted through the superior cannula to clear off the surface of the iliotibial band, so that it may be adequately visualized. A hooked electrocautery probe is then used to longitudinally incise the iliotibial band until it no longer rubs, causing impingement over the greater trochanter.

  6. 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.

  7. Trochanteric bursitis

    Science.gov (United States)

    ... Walk down instead. Swim instead of running or cycling. Run on a smooth, soft surface, such as a track. Avoid running on cement. If you have flat feet, try special shoe inserts and arch supports (orthotics). Make sure your ...

  8. Ankylosis of the distal interphalangeal joint in a horse after septic arthritis and septic navicular bursitis.

    Science.gov (United States)

    Honnas, C M; Schumacher, J; Kuesis, B S

    1992-04-01

    A 6-month-old 300-kg Quarter Horse filly was treated for septic arthritis of the distal interphalangeal joint and septic navicular bursitis that developed as a result of a deep puncture to the foot. Initial treatment consisted of establishing ventral drainage for the navicular bursa, lavage of the distal interphalangeal joint, and administration of broad-spectrum antimicrobial drugs and non-steroidal anti-inflammatory drugs. Because of continuing sepsis in the distal interphalangeal joint, subsequent treatment included packing the defect in the bottom of the foot with cancellous bone in an attempt to prevent ascending contamination of the joint, placing the limb in a short limb cast, and inserting a Penrose drain into the joint for passive drainage of septic exudate. The goal of treatment was to encourage ankylosis of the distal interphalangeal joint. Because of the filly's persistent lameness and laxity of the lateral collateral ligament in the contralateral carpus, the palmar nerves of the affected foot were injected with a long-acting local anesthetic at the level of the proximal sesamoid bones to encourage weight-bearing. Ankylosis of the distal interphalangeal joint was complete 9 months after the puncture, but a grade-2 lameness remained and the horse had a varus deformity resulting from ligamentous laxity of the lateral collateral ligament in the contralateral carpus.

  9. 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)

  10. [Impingement lesion of the distal anterior Achilles tendon in sub-Achilles bursitis and Haglund-pseudoexostosis-a therapeutic challenge].

    Science.gov (United States)

    Lohrer, H; Arentz, S

    2003-12-01

    Retrocalcaneal bursitis in athletes is frequently misdiagnosed. Results of conservative treatment are not very promising. This investigation evaluates the results of 39 consecutive cases in 38 patients surgically treated due to chronic retrokalkaneal bursitis in a sport specific population. Preoperative MRI and ultrasound investigation showed corresponding lesions (focal degeneration, partial rupture) of the anterior Achilles tendon. This is possibly the result of a previously undescribed impingement lesion produced by the Haglund's bone and the chronically inflamed retrocalcaneal bursa. During operation this lesion was additionally addressed in 85% of the cases. Follow up was done after 32 months. Success rate was 54%. VISA-A Score at follow up was 80.6 points. Training and competition activities were started at 16 weeks and 9 months respectively. Unsatisfying results were analysed. In two cases Haglund's bone resection was incomplete and had to be removed in a reoperation. Additionally one deep wound infection had to be revised. Due to the distal Achilles tendon fiber extensions around the medial and lateral calcaneal bone, an unintended Achilles tendon lesion, induced by the edge of the osteotome seems to be possible. Two calcanear stress fractures complicated the postoperative rehabilitation.

  11. 'Bald trochanter' spontaneous rupture of the conjoined tendons of the gluteus medius and minimus presenting as a trochanteric bursitis.

    Science.gov (United States)

    LaBan, Myron M; Weir, Susan K; Taylor, Ronald S

    2004-10-01

    A 66-yr-old white woman presented with progressive complaints of right lateral hip and thigh pain associated with a disabling limp without an antecedent history of trauma. Physical examination revealed localized pain over the right greater trochanter to palpation. A full pain-free range of motion of the right hip was associated with weakness in the hip abductors. The patient ambulated with a compensated right Trendelenburg gait. Subsequent magnetic resonance imaging demonstrated a trochanteric bursitis and an effusion of the hip and a full-thickness tear of the gluteus medius muscle, with both a disruption and retraction of the tendon of an atretic gluteus minimus muscle. Conjoined tendon pathology of both the gluteus medius and minimus as, revealed by magnetic resonance examination, is probably more frequent than heretofore commonly recognized. In patients presenting with "intractable" complaints of a trochanteric bursitis and an ambulatory limp due to weakness in the hip abductors, imaging studies calling attention to a possible tendon rupture may be diagnostic.

  12. Changes of synovial fluid protein concentrations in supra-patellar bursitis patients after the injection of different molecular weights of hyaluronic acid.

    Science.gov (United States)

    Chen, Carl P C; Hsu, Chih Chin; Pei, Yu-Cheng; Chen, Ruo Li; Zhou, Shaobo; Shen, Hsuan-Chen; Lin, Shih-Cherng; Tsai, Wen Chung

    2014-04-01

    Knee pain is commonly seen in orthopedic and rehabilitation outpatient clinical settings, and in the aging population. Bursitis of the knee joint, especially when the volume of the synovial fluid is large enough, can compress and distend the nearby soft tissues, causing pain in the knee joint. Out of all the bursae surrounding the knee joint, supra-patellar bursitis is most often associated with knee pain. Treatment strategies in managing supra-patellar bursitis include the aspiration of joint synovial fluid and then followed by steroid injection into the bursa. When supra-patellar bursitis is caused by degenerative disorders, the concept of viscosupplementation treatment may be effective by injecting hyaluronic acid into the bursa. However, the rheology or the changes in the concentrations of proteins (biomarkers) that are related to the development of bursitis in the synovial fluid is virtually unexplored. Therefore, this study aimed to identify the concentration changes in the synovial fluid total protein amount and individual proteins associated with supra-patellar bursitis using the Bradford protein assay and western immunoglobulin methods. A total of 20 patients were divided into two groups with 10 patients in each group. One group received the high molecular weight hyaluronic acid product of Synvisc Hylan G-F 20 and the other group received the low molecular weight hyaluronic acid product of Hya-Joint Synovial Fluid Supplement once per week injection into the bursa for a total of 3 weeks. Significant decreases in the synovial fluid total protein concentrations were observed after the second dosage of high molecular weight hyaluronic acid injections. Apolipoprotein A-I, interleukin 1 beta, alpha 1 antitrypsin, and matrix metalloproteinase 1 proteins revealed a trend of decreasing western immunoblotting band densities after hyaluronic acid injections. The decreases in apolipoprotein A-I and interleukin 1 beta protein band densities were significant in the high

  13. Arthroscopic Surgery in the Treatment of Limb Joint Bursitis%关节镜下手术治疗四肢关节滑囊炎

    Institute of Scientific and Technical Information of China (English)

    段圆慧; 田孟强; 刘军; 曹建刚; 田峥巍

    2013-01-01

    Objective To explore the therapeutic effects of arthroscopic surgery for limb joints bursitis.Methods From April 2008 to March 2011,arthroscopic bursa resection was performed on 17 cases of limb joint bursitis,including 13 cases of knee prepatellar subcutaneous bursitis,2 cases of elbow olecranon subcutaneous cyst and 2 cases of greater trochanteric bursitis.Results The operation time ranged from 23 to 60 min,with an average of 32 min.The postoperative hospital stay was 3-7 d (mean,4 d).17 patients were followed up for 2 to 19 months,with an average of 9.6 months.1 case of traumatic prepatellar bursitis relapsed and others healed well,without obvious scar on the skin,significant pain and dysfunction.Conclusion Arthroscopy surgery for larger limb joints bursitis has satisfactory therapeutic effects with small incision and quick recovery.%目的 探讨关节镜下手术治疗四肢关节滑囊炎的效果.方法 2008年4月~ 2011年3月,关节镜下滑囊切除术治疗四肢关节滑囊炎17例,其中膝关节髌前皮下滑囊炎13例,肘关节鹰嘴皮下囊肿2例,股骨大转子滑囊炎2例.结果 手术时间23 ~60 min,平均32 min.术后3~7d出院,平均4d.17例随访2~19个月,平均9.6月,1例外伤性髌前滑囊炎术后3周复发,余患者均愈合良好,皮肤无明显瘢痕,无明显疼痛和功能障碍.结论 关节镜下手术治疗四肢较大的关节周围滑囊炎效果良好,体表切口小,恢复快.

  14. 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.

  15. 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.

  16. Diagnosis of bursitis by B-mode ultrasonography in 160 cases%B超诊断160例滑囊炎

    Institute of Scientific and Technical Information of China (English)

    朱敬珍; 王美霞; 张梅

    2011-01-01

    目的:讨论滑囊炎的影像表现及滑囊与关节腔的关系。方法:对160例四肢大关节处滑囊炎进行B超定位诊断。结果:滑囊炎发生在肘部20例,臀部15例,膝前部50例,腘窝部80例,足踝部5例,均经手术、穿刺及病理学证实。超声诊断与手术符合率95%,结论:滑囊的B超定位诊断对滑囊炎的治疗方案与手术方法的选择有重要的参考意义。%Objective:To discuss the relationship between the bursitis image performance and slip joint space capsule. Methods:A total of 160 cases of bursitis in large joints limbs were examined by B-mode ultrasonography. Results:The patients included 20 with the disease in the elbow, 15 in hip, 50 in knee, 80 popliteal fossa and 5 in ankle. All the cases were confirmed with surgery, puncture and pathological examination. It was showed that the consistent rate of B-mode ultrasonography was 95%. Conclusion:B-mode ultrasonography is of great reference value for diagnosis and surgical treatment of bursitis.

  17. Treating goose foot bursitis by knife acupuncture plus ozone%小针刀配合臭氧治疗鹅足滑囊炎

    Institute of Scientific and Technical Information of China (English)

    李振

    2015-01-01

    目的:探讨小针刀配合臭氧治疗鹅足滑囊炎的疗效。方法:临床收集60例确诊为鹅足滑囊炎的患者,给予小针刀及臭氧治疗1~3次,观察疗效。结果:60例中临床控制13例,显效38例,有效8例,无效1例。结论:小针刀配合臭氧治疗鹅足滑囊炎疗效显著,值得临床推广。%Objective: Knife acupuncture plus ozone for goose foot bursitis was investigated. Methods: Clinical collected 60 diagnosed patients with goose foot bursitis, who recieved knife acupuncture plus ozone treatment 1~3 times. Results: In 60 cases, controlled in 13 cases, 38 cases of markedly effective, effective in 8 cases, 1 case was invalid. Conclusion: The knife acupuncture plus ozone for goose foot bursitis showed significant effects, is worthy of promotion.

  18. Surgical Correction of Posttraumatic Scapulothoracic Bursitis, Rhomboid Major Muscle Injury, Ipsilateral Glenohumeral Instability, and Headaches Resulting from Circus Acrobatic Maneuvers

    Directory of Open Access Journals (Sweden)

    John G. Skedros

    2015-01-01

    Full Text Available We report the case of a 28-year-old transgender (male-to-female patient that had a partial tear of the rhomboid major tendon, scapulothoracic bursitis, and glenohumeral instability on the same side. These conditions resulted from traumatic events during circus acrobatic maneuvers. Additional aspects of this case that make it unique include (1 the main traumatic event occurred during a flagpole exercise, where the patient’s trunk was suspended horizontally while a vertical pole was grasped with both hands, (2 headaches were associated with the periscapular injury and they improved after scapulothoracic bursectomy and rhomboid tendon repair, (3 surgical correction was done during the same operation with an open anterior capsular-labral reconstruction, open scapulothoracic bursectomy without bone resection, and rhomboid tendon repair, (4 a postoperative complication of tearing of the serratus anterior and rhomboid muscle attachments with recurrent scapulothoracic pain occurred from patient noncompliance, and (5 the postoperative complication was surgically corrected and ultimately resulted in an excellent outcome at the one-year final follow-up.

  19. A cross-sectional study of the prevalence and associated risk factors for capped hock and the associations with bursitis in weaner, grower and finisher pigs from 93 commercial farms in England.

    Science.gov (United States)

    KilBride, A L; Gillman, C E; Ossent, P; Green, L E

    2008-03-17

    The prevalence of capped hock in 5601 post-weaning pigs from 93 pig farms in England was 17.2%. The prevalence increased with age. Once adjusted for age, the lowest prevalence of capped hock was observed in pigs kept on soil floors (usually covered with deep straw bedding). There was no significant increase in the risk of capped hock in pigs kept on solid concrete floors with deep straw bedding. However, pigs kept on solid concrete with some, or the entire pen, sparsely bedded and pigs kept on partially or fully slatted floors had an approximately threefold increased risk of capped hock. This did not vary significantly between these four floor types. This was in contrast to the associated risks for bursitis in the same pigs, where as the floor went from highly resilient (straw and solid floors) to hard and perforated (fully slatted) the risk of bursitis increased in a similar way to a dose response. No other variables that were measured were associated with a change in risk for capped hock, while observation of pigs slipping or slip marks and wet, dirty and worn pens were also associated risks for bursitis. These results indicate that capped hock and bursitis are both affected by exposure to floors, but in different ways. The prevalence of capped hock was associated only with floor hardness, with deep straw protecting the pigs, while bursitis was associated with both changes in bedding depth (hardness), floor material (soil versus concrete) and floor construction (solid versus slatted floors) and in factors associated with locomotion (slipping and slip marks). These results indicate that the aetiology of capped hock and bursitis might differ.

  20. 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....

  1. Treating 48 cases of ischiogluteal bursitis in TCM%中医综合疗法治疗坐骨结节滑囊炎48例

    Institute of Scientific and Technical Information of China (English)

    杨雨果

    2015-01-01

    Objective: To observe efficacy of fire needle, cupping plus TCM medicine on ischiogluteal bursitis. Methods: 24 cases in the observed group received fire needle, cupping plus TCM medicine. 24 cases in the control group took conventional partial closure treatment. Results: The total efficiency in the observed group was 95.83%, obviously higher than 83.33% in the control group (P<0.05). Conclusion: TCM on ischiogluteal bursitis could get significant efficacy, was worthy of promotion.%目的:观察火针结合拔罐,同时辅以中药内服治疗坐骨结节滑囊炎的疗效.方法:观察组24例采用火针结合拔罐,同时辅以中药内服综合治疗,对照组24例采用常规局部封闭治疗.结果:观察组总有效率为95.83%,明显高于对照组的 83.33%,观察组与对照组比较,差异有统计学意义(P<0.05).结论:中医综合疗法治疗坐骨结节滑囊炎效果显著,具有较好的临床应用价值.

  2. Treating36 cases of olecranon bursitis in the integrative medicine%中西医结合治疗尺骨鹰嘴滑囊炎36例

    Institute of Scientific and Technical Information of China (English)

    杨雨果

    2016-01-01

    Objective: To observe clinical effects of the integrative medicine on olecranon bursitis. Methods: 18 cases in the observed group were treated by fire needle plus western medicine. 18 cases in the control group received conventional partial closure. Results: The total efifciency in the observed group was 88.89%, higher than 83.33% in the control group, with a signiifcantly statistical difference (P<0.05). Conclusion: The integrative medicine was obviously effective on olecranon bursitis, and showed a good clinical value.%目的:观察火针结合西药内服治疗尺骨鹰嘴滑囊炎的疗效。方法:观察组18例采用火针结合西药内服治疗,对照组18例采用常规局部封闭治疗。结果:观察组总有效率为88.89%,高于对照组的83.33%,观察组与对照组比较,差异有统计学意义(P<0.05)。结论:中西医结合治疗尺骨鹰嘴滑囊炎效果显著,具有较好的临床应用价值。

  3. Surgical Treatment of Chronic Retrocalcaneal Bursitis:An analysis of 8 Cases%手术治疗慢性跟腱囊炎8例分析

    Institute of Scientific and Technical Information of China (English)

    张智; 陆俊峰; 吴小满; 赵东升

    2013-01-01

    Objective To investigate the effect of surgical treatment of chronic retrocalcaneal bursitis. Methods In this retrospective study,from February 2008 to February 2011,8 patients(9 heels) with retrocalcaneal bursitis were treated surgically. There were 3 male (3 heels) and 5 female (6 heels) with mean age of 50. 4years(from 32years to 61 years). The surgical treatment of chronic retrocalcaneal bursitis by means of complete detachment and reattachment of the Achilles tendon,removal of the retrocalcaneal exostosis,and excision of the retrocalcaneal bursa through a lateral approach. Postoperative use of a non-weight-bearig below-the-kneel cast for up 6~8 weeks with foot positioned at a plantarflexion. Patients were identified via chart review. Results The mean duration of postoperative follow-up was 12 months (10 months to 21 months). There were no wound complications or postoperative infections. The average time to return to normal daily function was 4 months. The American Orthopaedic Foot and Ankle Society score (AO-FAS) were 54befor operation and 92 after operation. Conclusion Complete detachment and reattachment of the Achilles tendon,removal of the retrocalcaneal exostosis,and excision of the retrocalcaneal bursa are effective treatment for the retrocalcaneal bursitis.%目的 探讨慢性跟腱囊炎的手术治疗效果.方法 我们对2008年2月至2011年2月收治的8例(9足)慢性跟腱囊炎病例进行回顾性分析,男3例(3足),女5例(6足),年龄32~51岁,平均50.4岁.手术方法采用跟腱外侧入路,剥离跟腱止点将跟腱向上掀起,清除跟骨后上炎性滑囊组织及侵蚀破坏的骨组织,用摆锯去除跟骨后上增生骨嵴并修理平整,如跟腱内有钙化及变性组织一并切除,用带线锚钉将跟腱缝合于止点上.术后踝关节跖屈位短腿石膏固定6~8周,定期随访.结果 8例患者随访10~21个月,平均随访12个月.切口均一期愈合,无感染.功能采用美国足踝协

  4. 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

  5. Manipulation Combined with Zhenggu Powder on the Treatment of 1 Cases of Chronic Suprapatellar Bursitis%手法配合正骨散外敷治疗慢性髌上滑囊炎1例

    Institute of Scientific and Technical Information of China (English)

    王洪浩; 李承环

    2015-01-01

    Objective: To investigate the application and analysis of manipulation combined Zhenggu Powder in clinical curative effect in treating chronic suprapatellar bursitis.Methods:Using Manipulation combined with zhenggu powder.Results:The patient recovered without recurrence,follow up.Conclusion:Manipulation combined with zhenggu powder for the treatment of chronic suprapatellar bursitis can have better clinical effect.%目的:探讨和分析应用手法结合正骨散治疗慢性髌上滑囊炎的临床疗效。方法:运用中医手法按摩及正骨散外敷。结果:患者痊愈,追访未复发。结论:手法结合正骨散对于治疗慢性髌上滑囊炎可有较好的临床效果。

  6. Bursitis and Tendinitis

    Science.gov (United States)

    ... typically increases risk for tendon inflammation. They include tennis elbow, golfer’s elbow, pitcher’s shoulder, swimmer’s shoulder, and jumper’s knee. Some common examples follow. Tennis Elbow and Golfer’s Elbow Tennis elbow refers to an ...

  7. Platelet-rich plasma for treatment of ischiogluteal bursitis%富血小板血浆治疗坐骨结节滑囊炎

    Institute of Scientific and Technical Information of China (English)

    沈梓维; 林子洪; 郑秋坚; 王良泽; 叶圣龙; 李盛; 钱思浓

    2014-01-01

    BACKGROUND:Ischiogluteal bursitis has been recognized for a long time, but its treatment stil limits to local blocking injection and surgery methods that were developed 40 years ago. OBJECTIVE:To observe the efficacy of platelet-rich plasma on ischiogluteal bursitis. METHODS:Data of 15 patients with ischiogluteal bursitis were colected. Al the patients with ischiogluteal bursitis were treated with bilateral platelet-rich plasma (n=10) or local blocking injection (n=5). Patients’ outcomes were assessed by visual analogue scale, the Treatment Satisfaction Questionnaire for Medication (TSQM) Version II and recurrence rate. The folow-up time was from 6 to 14 months. RESULTS AND CONCLUSION: There was no statistical difference in visual analogue scale score between the platelet-rich plasma group and local blocking group (F=0.219,P=0.643), but the score of visual analogue scale in the platelet-rich plasma group was higher during short-term folow-up (within 1 week after treatment), but lower in the long-term folow-up. In the aspects of overal satisfaction score, clinical effectiveness and side effects, the platelet-rich plasma group was inferior to the local blocking group at short-term folow-up, especialy at 1 week after treatment; however, these scores became better in the platelet-rich plasma group than the local blocking group during the long-term folow-up period. In addition, no statistical difference in the convenience score was found between the two groups. At the last folow-up, the recurrence rate in the platelet-rich plasma group was lower than that in the local blocking group. Both the platelet-rich plasma and local blocking injection can significantly reduce the pain of patients with ischiogluteal bursitis. Local blocking injection has better short-term effectiveness. Platelet-rich plasma injection works moderately, but its effectiveness can last for longer time, and the recurrence rate is lower.%背景:坐骨结节滑囊炎被认识长久,

  8. Ultrasound Diagnosis of Bursitis Around the Knee%膝关节周围滑囊炎的超声诊断

    Institute of Scientific and Technical Information of China (English)

    申素芳; 张志桐; 穆维娜

    2012-01-01

    Objective To study the ultrasound diagnosis value of bursitis around knee joint. Methods Knee joints of 124 cases were scanned, in order to observe whether every synovial bursal around knee joint became bigger and wider, and to measure its form, boundary, internal echo and so on, also to observe the relationship between bursal around the knee joint and surrounding structures, and whether it connected with joint cavity. Then the contrast observation of lateral knee joint and knee joint was proceeded. Results 62 cases showed simplex suprapatellar bursa effusion, 3leases showed popliteal fossa cyst, 11 cases showed subcutaneous prepatellar bursa effusion, 5 cases showed subcutaneous infrapatellar bursa effusion, 5 cases showed infrapatellar bursitis effusion, 6 cases showed anserine bursa pathology. Conclusion It is simple and feasible to examine synovial cyst around the knee joint by ultrasound diagnosis, which provide effective evidence for early diagnosis of orthopedic doctors.%目的 探讨超声检查对膝关节周围滑囊炎的诊断价值.方法 对120例患者的膝关节进行扫查,观察膝关节周围各滑液囊是否增大、增宽,测量其大小,观察其形态、边界及内部回声等特征,与周围的毗邻关系及是否与关节腔相连通,并与对侧膝关节对比观察.结果 单纯髌上囊积液62例,腘窝囊肿31例,髌前皮下囊积液l1例,髌下皮下囊积液5例,髌下深囊积液5例,鹅足囊病变6例.结论 超声对膝关节滑液囊肿的检查简便易行,为骨科医生的早期诊断提供了有效依据.

  9. 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.

  10. Efficacy Observation on Massage, Herbal Fumigation Combined with Behavioral Intervention Treating Radiohumeral Bursitis%推拿、中药熏蒸结合行为干预治疗网球肘的疗效观察

    Institute of Scientific and Technical Information of China (English)

    伍国维

    2014-01-01

    目的:观察推拿、中药熏蒸配合行为干预治疗网球肘的疗效。方法:将80例网球肘患者随机分为治疗组(40例)和对照组(40例),治疗组采用推拿、中药熏蒸结合行为干预治疗,对照组采用针刺治疗,观察两组临床疗效。结果:治疗组优良率为85.0%,高于对照组的55.0%(P<0.05)。结论:推拿、中药熏蒸配合行为干预治疗网球肘疗效显著。%Objective:To observe the curative effects of massage, herbal fumigation combined with behavioral intervention treating radiohumeral bur-sitis. Methods: 80 cases of radiohumeral bursitis were randomly divided into treatment group (40 cases) and control group (40 cases), treatment group adopted treatment of massage, herbal fumigation combined with behavioral intervention, control group treated with acupuncture, clinical effi-cacy of the two groups was observed. Results:The excellent and good rate of treatment group was 85%, higher than that of control group by 55%(P<0.05). Conclusion:Efficacy of massage, herbal fumigation combined with behavioral intervention treating radiohumeral bursitis is significant.

  11. 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

  12. 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.

  13. What Are Bursitis and Tendinitis?

    Science.gov (United States)

    ... elbow, pitcher’s shoulder, swimmer’s shoulder, and jumper’s knee. Tennis Elbow and Golfer’s Elbow Tennis elbow is an injury to the tendon in the ... be suggested such as: An elbow band for tennis elbow A brace for the ankle or foot A ...

  14. 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.

  15. What Are Bursitis and Tendinitis?

    Science.gov (United States)

    ... Two types of tendinitis can affect the shoulder. Biceps tendinitis causes pain in the front or side of the shoulder. Pain may also travel down to the elbow and forearm. Raising your arm over your head may also be painful. The biceps muscle in the front of the upper arm ...

  16. 消定膏治疗急性髌上滑囊炎的影像学评价%Imaging Evaluation of Xiaoding Ointment in the Treatment of Acute Patellar Bursitis

    Institute of Scientific and Technical Information of China (English)

    林志艳; 王学香; 王琳; 李莉

    2016-01-01

    OBJECTIVE:To evaluate clinical efficacy through comparing the change of CT image in infrapatellar fat pad before and after Xiaoding ointment in the treatment of acute patellar bursitis of knee joint. METHODS:73 patients with acute patellar bur-sitis were randomly divided into observation group(39 cases)and control group(34 cases). Observation group was given Xiaoding ointment for local application,qd,7 d as a courses,3 courses in total;control group was given triamcinolone acetonide 30 mg af-ter the extraction of articular cavity effusion,once a week,totally for 3 times. All patients of two groups underwent knee CT exami-nation for observation of the infrapatellar fat pad and articular cavity effusion volume change before and after treatment. Clinical ef-ficacies were compared between 2 groups. RESULTS:CT image alterations of treatment group showed that infrapatellar fat pad den-sity were decreased,anteroposterior diameter,vertical diameter,internal to external diameter were significantly reduced. The total effective rate of treatment group was 92.31%,which was better than that of control group(88.24%),with statistical significance (P<0.05). CONCLUSIONS:Xiaoding ointment demonstrate markedly curative effects in the treatment of acute patellar bursitis, and CT image is an effective method for diagnosis of infrapatellar fat pad.%目的:通过对比消定膏在治疗膝关节急性髌上滑囊炎前后患者髌下脂肪垫计算机体层成像(CT)图像的变化,评价其临床疗效.方法:73例急性髌上滑囊炎患者采用随机数字表法分为观察组39例和对照组34例.观察组患者给予消定膏局部敷贴, qd,7 d为1个疗程,共3个疗程;对照组患者在抽取关节腔积液后注入醋酸曲安奈德30 mg,每周1次,共治疗3次.两组患者治疗前后均行膝关节CT检查,对比观察髌下脂肪垫的变化,并比较临床疗效.结果:治疗后,观察组患者髌下脂肪垫的密度减低,前后径、上下径、内

  17. 高频彩色多普勒超声引导下髋部滑囊炎的介入治疗探讨%Investigation of high frequency color Doppler ultrasound guided intervention treatment for hip bursitis

    Institute of Scientific and Technical Information of China (English)

    王平; 李武; 梁小华; 鄂占森

    2016-01-01

    Objective To investigate effect by high frequency color Doppler ultrasound guided intervention treatment for hip bursitis. Methods A total of 90 hip bursitis patients were divided by different detection measures into group A (received high frequency color Doppler ultrasound imaging), group B (received noninvasive angiography) and group C (received three-dimensional C plane), with 30 cases in each group. Influence by bursitis on surrounding muscles, nerve, and blood vessel was evaluated in accordance with ultrasonogram characteristics, especially on hip back muscle group, hip back cross arterial circulation and sciatic nerve, to choose appropriate measure in intervention treatment. Curative effects were compared across the three groups. Results Group A had higher total effective rate by intervention treatment as 96.7% than group B (70.0%) and group C (66.7%), and their difference had statistical significance (P<0.05). Conclusion Implement of high frequency color Doppler ultrasound guided intervention treatment provides ideal effect, which is obviously better than effects in the other two groups. This method is worth promoting and applying.%目的:探讨高频彩色多普勒超声引导下髋部滑囊炎的介入治疗效果。方法90例髋部滑囊炎患者,根据检测方式不同分成 A 组(应用高频彩色多普勒超声成像技术)、B 组(应用无创血管造影技术)、C 组(应用三维 C 平面技术),各30例。根据声像图特点评估滑囊炎对周围肌肉、神经、血管等影响,尤其是对髋后区肌群、臀后十字动脉循环、坐骨神经等的影响,以选择合适的介入方式治疗。对比三组患者的治疗效果。结果A 组介入治疗有效率为96.7%,高于 B 组(70.0%)和 C 组(66.7%),差异具有统计学意义(P<0.05)。结论应用高频彩色多普勒超声引导下介入治疗效果最为理想,明显优于其他两组的治疗效果,值得推广应用。

  18. 针刺肘缝穴配合手法治疗膝关节鹅足滑囊炎临床研究%Clinical Study on Treatment of Knee Anserine Bursitis by Acupuncture on Zhoufeng Point and Manipulation Therapy

    Institute of Scientific and Technical Information of China (English)

    侯志

    2016-01-01

    目的:观察针刺肘缝穴配合手法治疗膝关节鹅足滑囊炎的临床疗效。方法:86例膝关节鹅足滑囊炎患者随机分为观察组和对照组各43例,观察组采用针刺肘缝穴配合手法治疗,对照组采用双氯芬酸二乙胺乳胶剂外用治疗,比较两组治疗前后Lysholm膝关节功能评分与鹅足囊处压痛压力值变化,评价临床疗效。结果:两组治疗后Lysholm膝关节功能评分、鹅足囊处压痛压力值较治疗前均显著升高,差异有统计学意义(P<0.05);治疗后观察组的Lysholm膝关节功能评分、鹅足囊处压痛压力值均高于对照组,差异有统计学意义(P<0.05);总有效率观察组97.67%,对照组83.72%,两组疗效比较差异有统计学意义(P<0.05)。结论:针刺肘缝穴配合手法治疗膝关节鹅足滑囊炎疗效较好。%Objective:To observe the clinical curative effect of acupuncture on Zhoufeng point and manipu-lation therapy on treatment of knee anserine bursitis. Methods:A total of 86 patients with knee anserine bursitis were randomly divided into observation group and control group,with 43 cases in each group. The observation group was treated by acupuncture on Zhoufeng point and manipulation therapy. The control group was treated by Votalin emulsion inunction. The Lysholm knee function score and value of tenderness on anserine bursa of the two groups were observed,then the clinical curative effect of the two groups were e-valuated. Results:After treatment,the knee function score and value of tenderness on anserine bursa of the two groups were significantly increased. Compared with those before treatment ,the differences were statistical-ly significant(P<0.05). After treatment,the knee function score and value of tenderness on anserine bursa of the observation group was higher than those of the control group and the differences were statistically signif-icant ( P<0 . 05 ) . The total effective rate of the

  19. Clinicopathologic features of ischial tuberosity bursitis complicated with ischemic fasciitis%坐骨结节囊肿伴缺血性筋膜炎的临床病理特征

    Institute of Scientific and Technical Information of China (English)

    肖艳景; 张全武; 娄欣; 赵红梅; 和莹莹; 乔思杰

    2010-01-01

    目的 探讨坐骨结节囊肿伴缺血性筋膜炎的临床表现、病理形态特征及鉴别诊断.方法 对2例坐骨结节囊肿伴缺血性筋膜炎病例进行组织形态学、免疫组织化学分析,并复习相关文献.结果 缺血性筋膜炎常见于老年患者,有长期卧床病史,好发于躯体突出部位的皮下组织.形态学表现:病变的中央为纤维素样坏死区,坏死区周围为增生的纤维母细胞和薄壁小血管所形成的肉芽肿样区域,可见大的、核仁明显、胞质深染、具有异型性的纤维母细胞.免疫组化:纤维母细胞vimentin(+),CK(-).结论 ①缺血性筋膜炎是一种罕见病变,临床表现及形态学与肉瘤相似,容易误诊;②以前报道认为该病变常见于年老体弱、长期卧床的患者,本文发现,在坐骨结节囊肿基础上也可发生该病变.%Objective To investigate the clinicopathologic features, diagnosis and differential diagnosis of ischial tuberosity bursitis complicated with ischemic fasciitis. Methods Two cases of ischial tuberosity bursitis complicated with ischemic fasciitis were reported. Based on histological and immunohistochemical studies and the literature was reviewed. Results Ischemic fasciitis occurred primarily in the deepsubcutis of the aged patients who were frequently immobilized or debilitated. It had a priority to occur over body prominences. The characteristic histologic appearances of the lesions were fibronoid necrosis in the central zones and myxoid change involving lobules of adipose tissue. These areas were surrounded by a peripheral rim of granulation tissue consisting of capillary and fibroblasts containing atypical, enlarged degenerated fibroblasts with abundant basophilic cytoplasm, large hyperchromatic, smudged nuclei, and prominent nucleoli. Immunohistochemical staining showed the fibroblasts were positive for vimentin and MSA, negative for fasciitis may occur in the base of ischial tuberosity patients, besides the above

  20. Trochanteric bursitis after total hip arthroplasty: treatment and risk factors for failure%髋关节置换术后股骨大粗隆滑囊炎的治疗及相关危险因素分析

    Institute of Scientific and Technical Information of China (English)

    瞿玉兴; 徐建达; 蒋涛; 赵洪; 高益; 郑冲

    2011-01-01

    [目的]探讨髋关节置换术后股骨大粗隆滑囊炎糖皮质激素注射治疗的疗效及非手术治疗失败的可能危险因素.[方法] 通过随访2003年3月~2009年4月本科收治的术后股骨大粗隆滑囊炎患者24例27髋的治疗情况,并结合临床特点分析非手术治疗失败的可能危险因素.[结果]经糖皮质激素注射治疗后,21例股骨大粗隆滑囊炎疼痛得到缓解,缓解率为78%.治疗预后与患者的年龄、体重指数、肢体不等长有关(P<0.05),而与患者的性别、手术入路无关.[结论]糖皮质激素注射治疗对全髋关节置换术后股骨大粗隆滑囊炎是有效的,同时在年轻患者、肥胖者及肢体短缩者中治疗效果一般.%[ Objective] To examine the therapeutic effect of corticosteroid injection as treatment for post- arthoplasty trochanteric bursitis and the risk factors for failure of nonoperative treatment. [ Methods] From March 2003 to April 2009, 24 patients (27 hip) were followed - up. Combined with the clinical features of patients, we analyzed the risk factors for failure of nonoperative treatment. [ Results] Symptoms were relieved in 21 hips (78%) after corticosteroid injection. We found a significant correlation between prognosis and age, BMI and leg- length discrepancy, but no correlation between gender and operative approach. [ Conclusion] Corticosteroid injection is an effective treatment for postarthoplasty trochanteric bursitis. The failure of medical treatment usually focuses on fatter or younger patients or those with leg - length discrepancy.

  1. Efficacy of Arthroscopic Resection of the Subacromial Bursa in Treatment of Simple Subacromial Bursitis%关节镜下切除肩峰下滑囊治疗单纯肩峰下滑囊炎疗效观察

    Institute of Scientific and Technical Information of China (English)

    刘玉健; 潘昭勋; 崔岩; 翟龙地; 曲连军

    2013-01-01

    Objective To evaluate the efficacy of arthroscopic resection of the subacromial bursa in treat-ment of simple subacromial bursitis.Methods From January 2006 to January 2012,40 cases of recurrent subacromial bursitis were treated in our department including 28 men and 10 women,aged 20~65 years old,an average of 43.All pa-tients had no history of trauma,diagnosed with simplex subacromial bursitis exact ,had the symptoms of shoulder pain or discomfort,muscle restricted activities,pain arc positive,Neer sign weakly positive.MRI scans showed high signal in the SAB in T1,X-ray showed shoulder was normal or mild degeneration .All the patients were randomly divided into group A and group B.The treatment of group A(observe group) was arthroscopic SAB resection .The treatment of group B(control group) was injection of hormones and anesthetics ,EMS and conventional shoulder functional exercise .All patients were observed and recorded VAS before and after treatment for 1 month,3months,1 year and 2 years.Results The VAS score of two groups after treatment for 1 month and 3 months was not significantly different (P>0.05).The VAS score of two groups after treatment for 1 year and 2 years had significant difference (P<0.01),and VAS score of group A was less than group B.Conclusion The arthroscopic resection of SAB is an effective treatment for simple subacromial bursitis and long-term efficacy is superior to conservative treatment .%  目的 观察关节镜下切除肩峰下滑囊(SAB)治疗单纯肩峰下滑囊炎的疗效。方法 我院自2006年1月~2012年1月收治40例单纯肩峰下滑囊炎的患者,其中男28例,女12例,年龄20~65岁,平均43岁。所有患者均无明显外伤史。所有患者诊断单纯肩峰下滑囊炎,确切排除其他疾病引起的肩峰下滑囊炎。患肩上举、外展困难并疼痛或不适,疼痛反应弧症阳性,Neer症弱阳性。 MRI示肩峰下滑囊T1高信号,X线示患肩无异常或轻度退变。

  2. Clinical study of the acupuncture treatment for subacromial bursitis assessed by SPADI%采用 SPADI 评估毫针点刺法治疗肩峰下滑囊炎的临床研究

    Institute of Scientific and Technical Information of China (English)

    李亨; 许学猛; 曾科学; 李鹏; 胡零三

    2014-01-01

    目的:探讨基于解剖认识,使用量表客观评估使用毫针点刺的方法治疗肩峰下滑囊炎患者的临床效果。方法104例肩峰下滑囊炎患者随机分成3组:试验Ⅰ组37例,采用毫针点刺加参麦针痛点注射方法治疗;试验Ⅱ组35例,采用毫针点刺法治疗;对照组32例,采用局部封闭法治疗。采用SPADI评分方法评估治疗后肩关节活动功能改善情况。结果治疗后3组患者症状均有不同程度缓解,术后随访1周总有效率分别为95%,91%和91%,术后随访3个月总有效率分别为92%,77%和72%。3组术后1周疗效比较无显著性差异,术后3个月试验组疗效明显优于试验Ⅱ组和对照组。结论毫针点刺法治疗肩峰下滑囊炎疗效较好,值得推广应用。%Objective It is to objectively evaluate the clinical curative effect of acupuncture therapy on subacromial bursi -tis by scales based on the understanding of anatomy .Methods 104 cases of subacromial bursitis patients were randomly divid-ed into three groups:test groupⅠ(n=37) treated with the use of a needle prick plus Shenmai trigger point injection therapy , test group Ⅱ( n=35) treated with the use of the needle prick therapy , control group ( n=32 ) treated with partial closure . The improvement of movement function of shoulder joint after treatment was evaluated by SPADI .Results The symptoms of all the patients in the three groups were relieved more or less after treatment , in one week after operation , the total effective rates of test groupⅠ, test groupⅡand control group were 95%, 91% and 91% respectively , in three months after operation the rates were 92%, 77%and 72%respectively .There was no significant difference in curative effect after one week among the three groups , but the effect after three months in test groupⅠwas much better than that in the other two groups .Conc lusion Acupuncture needle prick method has a good curative effect on

  3. Observation on Clinical Effect of Combined Modality Therapy in Treating Knee Osteoarthritis Complicated by Pes Anserine Bursitis%综合疗法治疗膝骨关节炎并发症鹅足滑囊炎临床疗效观察

    Institute of Scientific and Technical Information of China (English)

    付本升; 牛潞芳; 乔晋琳

    2013-01-01

    Objective To observe the clinic curative effect of combined modality therapy in treating knee osteoarthritis complicated by pes anserine bursitis. Methods Two hundred patients with knee osteoarthritis complicated by pes anserine bursitis were injected with 20 mg sodium hyaluronate into the joint cavity, combining with seal treatment in the pes anserine. After a course of treatment of five weeks, the changes of pain, contracture and swelling index in knee were statistically analyzed. Results After a course of treatment of five weeks, 59 patients showed full rehabilitation, 100 patients showed evident effect, 38 patients took a favorable turn,and 3 patients showed no effect. The recovery rate was 39.5%,the obvious effective rate was 79.5 %, and the total effective rate was 98.5 %. Conclusion The sodium hyaluronate injected into joint cavity combined with seal treatment can be effective in treating knee osteoarthritis complicated by pes anserine bursitis, and has a good clinical application value.%  目的观察综合疗法治疗膝骨关节炎并发症鹅足滑囊炎的疗效。方法膝骨关节炎并发症鹅足滑囊炎的患者200例,关节腔内注射玻璃酸钠20 mg,鹅足部局部封闭治疗。完成一个疗程(5周)的治疗后,对治疗前后患者膝部的疼痛、挛缩、肿胀等指标的变化情况进行统计学分析。结果治愈59例,显效100例,好转38例,无效3例,治愈率39.5%,显效率79.5%,临床总有效率98.5%。结论关节腔内注射玻璃酸钠合并鹅足部局部封闭治疗能有效治疗膝骨关节炎并发鹅足滑囊炎,具有较好的临床推广应用价值。

  4. 超声引导下复方倍他米松联合玻璃酸钠注射治疗肩峰下滑囊炎的临床研究%Effectiveness of ultrasound-guided subacromial bursa injection of betamethasone combined with hyaluronate in treatment of subacromial bursitis

    Institute of Scientific and Technical Information of China (English)

    成雪晴; 卢漫; 贺凡丁; 郭璇妍

    2015-01-01

    目的:评价超声引导下复方倍他米松联合玻璃酸钠注射治疗肩峰下滑囊炎(SAB)的疗效。方法收集2013年1月至2014年9月因肩部疼痛于四川省人民医院附属医院超声科就诊的门诊患者200例,将其中72例诊断为单纯性SAB且欲行超声引导下肩峰下滑囊注射治疗的患者纳入本研究,随机分为2组。试验组给予复方倍他米松联合玻璃酸钠注射,对照组给予复方倍他米松注射,所有患者治疗后第1周和第4周进行电话随访,治疗前、后均进行疼痛评分(视觉模拟评分法, VAS)和肩关节主动外展活动度评分。结果2组患者治疗后1周和4周,VAS评分及肩关节主动外展活动度评分均较治疗前明显改善(P均<0.05)。治疗后1周,试验组与对照组VAS评分及肩关节主动外展活动度评分比较,差异无统计学意义(P均>0.05);治疗后4周,试验组VAS评分明显低于对照组(2.08±1.95vs 3.14±2.0,P<0.05),试验组肩关节主动外展活动度评分明显高于对照组(7.12±2.10vs 6.11±1.93,P<0.05)。结论超声引导下肩峰下滑囊内复方倍他米松联合玻璃酸钠注射可有效治疗SAB,其缓解疼痛及改善肩关节主动外展活动范围的短期疗效优于单一使用复方倍他米松注射治疗。%ObjectiveTo evaluate the effectiveness of ultrasound-guided (US-guided) subacromial bursa injection of betamethasone combined with hyaluronate for treatment of subacromial bursitis.MethodsA total of 72 patients who were diagnosed as subacromial bursitis by ultrasound and then decided to performed US-guided subacromial bursa injection were randomly divided into two groups. The study group was treated with compound betamethasone suspension followed by sodium hyaluronate, and the control group was treated only with compound betamethasone suspension. Visual analogue score (VAS) and the shoulder active abduction range of motion (AAROM) score

  5. 激光针刀、药物注射联合超短波治疗鹅足滑囊炎的临床研究%Clinical research on triple therapy of laser needle-knife surgery plus drug injection and ultrashort wave therapy for Pes anserinus tendinitis bursitis syndrome

    Institute of Scientific and Technical Information of China (English)

    黄芳; 梁永翠; 郭俐宏; 张晓明

    2015-01-01

    Objective It is to observe the clinical efficacy of triple therapy( laser needle-knife surgery plus drug injection and ultrashort wave therapy)on Pes anserinus tendinitis bursitis syndrome(PATB).Methods Fifty-five patients with PATB were randomly allocated to treatment group ( 30 cases ) and control group ( 25 cases ) , the treatment group was treated by strengthen the riple therapy( laser needle-knife surgery plus drug injection and ultrashort wave therapy) , the control group was treated by Glucosamine sulfate capsules only.7 days was one treatment course and both groups were treated for two courses. VAS scores were evaluated before and after treatment in both group, and the clinical curative effect were compared.Results After treatment, VAS scores in both groups were improved compared with that before treatment (P<0.05), and the improve-ment of VAS scores in the treatment group was more significant than that in the control group(P<0.05).The clinical cure rate and total efficacy rate were significantly higher in the treatment group than that in the control group.Conclusion The triple ther-apy( laser needle-knife surgery plus drug injection and ultrashort wave therapy) has a good curative effect on PATB, which can obviously relive the patients'pain symptoms, and its effect is superior to that of treatment with glucosamine sulfate capsules only.%目的:观察激光针刀+药物封闭注射+超短波联合治疗鹅足滑囊炎的临床疗效。方法将55例鹅足滑囊炎患者按患者意愿分为2组,治疗组35例给予激光针刀+药物封闭注射+超短波联合治疗,对照组20例给予硫酸氨基葡萄糖胶囊口服,2组均以7 d为1个疗程,连续治疗4个疗程。观察2组治疗前后视觉模拟评分量表( VAS)疼痛评分,比较2组临床治疗效果。结果治疗结束后,2组VAS 疼痛评分均较治疗前明显改善( P 均<0.05),且治疗组VAS疼痛评分改善程度明显优于对照组(P<0.05)

  6. 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...

  7. 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.

  8. Sports and other soft tissue injuries, tendinitis, bursitis, and occupation-related syndromes.

    Science.gov (United States)

    Huang, H H; Qureshi, A A; Biundo, J J

    2000-03-01

    This review highlights three areas: plantar fasciitis, Achilles tendinitis, and carpal tunnel syndrome. The diagnosis and treatment of plantar fasciitis are reviewed; nonsurgical treatments remain the mainstay of management. Several recent articles support the use of night splints. Some novel treatments recently investigated, including low intensity laser irradiation and extracorporeal shock wave lithotripsy, are reviewed, as well as the effectiveness of steroid injection. Novel treatments for Achilles tendinitis are also reviewed, including the use of injection therapy and the treatment approach of one author for the management of Achilles tendon rupture. Nonsurgical techniques in the treatment of carpal tunnel syndrome, such as yoga, ultrasound, noninvasive laser neurolysis, manipulation, nerve and tendon gliding exercises, and medications, are reviewed. Prednisolone was shown to be effective in the treatment of mild to moderate disease and nonsteroidal anti-inflammatory drugs were found to be ineffective.

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

    Science.gov (United States)

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

    2009-10-01

    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.

  10. 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

  11. 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)…

  12. [Diseases of the extremities of swine in relationship to the floor condition with special reference to bursitis].

    Science.gov (United States)

    Berner, H; Hermanns, W; Papsthard, E

    1990-02-01

    In 2 pig farms, 102 sows kept in single ranging on plain concrete floor, 168 sows kept in single ranging on cast-iron grates and 27 fattening pigs kept in group penning on concrete slatted floors were repeatedly examined for the incidence of auxiliary synovial bursae (ASB). The clinical examination was completed by radiological, patho-anatomical and histological examinations of the rear legs. In sows, ASB were found on two prominences of the bones: on the latero-plantar area of the calcaneum and the fourth tarsal bone as well as on the plantar tarsal sesamoid bone. ASB on the rear legs were found in 41.2% of the sows kept on plain concrete floor and in 59.5% of the sows kept on cast-iron grates. The ASB of the sows kept on cast-iron grates were larger than those of the sows kept on plain concrete floor. In 49% of the sows kept on plain concrete floor the skin covering the ASB was reddened, in 45% of the sows kept on cast-iron grates it was covered with scab. Injury and necrosis of the skin as well as injury of the ASB themselves were found only in animals kept on cast-iron grates and made up 5% of the cases. In 30% of the cases, palpation of the ASB induced defensive movement. The palpation of ball-shaped, soft bursae more often caused defensive movement than did the palpation of flat-shaped, hard bursae. The occurrence of ASB was combined with kyphosis of the spine, false posture of the rear legs, dystasia, hyperextension of the fetlock, arthrosis of the ankle joint, and anomalies of the claws. In fattening pigs, the ASB were localized at the lateroplantar area of the calcaneum and the fourth tarsal bone as well as at the posterior surface of the calcaneum. At the end of the fattening period, ASB were detected in 26 out of 27 fattening pigs. All of the 48 ASB that were examined histologically showed signs of inflammation. In 30 cases the inflammation was chronic, in 18 cases it turned out to be florid. The results indicate that ASB cause pain during the developing phase and also in the chronic stage.

  13. 鼻内镜咽囊手术疗效观察%Nasal endoscopy in treatment of pharyngeal bursitis

    Institute of Scientific and Technical Information of China (English)

    方小明

    2006-01-01

    目的:探讨鼻内镜咽囊手术的疗效,并观察术后创面的变化.方法:鼻内镜手术治疗咽囊炎12例、咽囊囊肿8例.术后第3天起用生理盐水冲洗鼻腔、鼻咽, 每周鼻内镜下观察创面的变化.结果:治愈12例, 有效6例,无效2例.术后创面白膜在2~3周内脱落.结论:鼻内镜手术治疗咽囊炎、咽囊囊肿疗效较好、创伤小.

  14. CT Features of Ischial Tuberosity Bursitis%坐骨结节滑囊炎的CT表现

    Institute of Scientific and Technical Information of China (English)

    柳黔忠; 徐国富; 何永松

    2013-01-01

    目的:探讨坐骨结节滑囊炎的CT特征.材料与方法:回顾性分析28例经手术病理证实的坐骨结节滑囊炎的CT表现.结果:28例中,CT扫描于坐骨结节与臀大肌之间的间隙内可见28个囊性密度肿块,大小2.8cm×2.2 cm ~6.5 cm×4.3 cm,16例边界清楚,12例边界不清楚,4例患者行增强扫描示肿块内无明显强化,分隔及囊壁可有轻度强化.术前诊断正确率达85.7%.结论:坐骨结节滑囊炎的CT表现具有一定的特征性,CT对其诊断方面具有重要的临床应用价值.

  15. The massage treats bursitis in shoulder clinical experience%推拿治疗肩周炎临床体会

    Institute of Scientific and Technical Information of China (English)

    吴大鹏; 姚国荣; 贺仕雄; 袁久安; 蔡力; 韩毅; 田宏宇; 冯枭

    2011-01-01

    目的:观察以推拿为主封闭治疗肩周炎的临床效果.方法:将120例患者随机分为治疗组、对照组,每组各70例.比较两组治疗前后的疼痛评分与运动功能综合评分.结论:应用该方法治疗肩周炎,具有起效快、治愈率高等特点,是治疗肩周炎的有效方法之一.

  16. Arthroscopic therapy of olecranon bursitis%经关节镜治疗肘关节鹰嘴滑囊炎

    Institute of Scientific and Technical Information of China (English)

    郑鹏; 韩基雄; 杨轶

    2009-01-01

    [目的]总结报道5例肘关节鹰嘴滑囊炎经关节镜手术治疗方法和疗效.[方法]2006年2月~2007年7月对5例肘关节鹰嘴滑囊炎行关节镜下滑囊切除,观察疗效及并发症并进行疗效随访.[结果]5例患者均获得随访,随访时间为8~20个月,平均随访12个月.1例术后出现皮下积液,给予间断穿刺加压包扎后愈合.所有患者无局部疼痛,关节活动度正常,无复发.[结论]经关节镜微创治疗肘关节鹰嘴滑囊炎安全可行,疗效满意.

  17. 针灸治疗肩周炎概况%Acupuncture and moxibustion to treat bursitis in shoulder survey

    Institute of Scientific and Technical Information of China (English)

    徐菁菁; 易玮; 范志勇; 曹忠耀

    2010-01-01

    本文对目前临床上针灸治疗肩周炎的现状做一概述,并着重介绍了灸法,拔罐等温热治疗方法在临床上的运用及疗效.以此探讨针灸治疗肩周炎的研究上存在的问题以及温热疗法的临床价值及发展前景.

  18. 鼻内镜下咽囊炎的手术治疗%Endoscopic management for pharyngeal bursitis

    Institute of Scientific and Technical Information of China (English)

    程泽星; 张攀; 雷大鹏

    2006-01-01

    目的:探讨鼻内镜手术治疗咽囊炎的方法及疗效.方法:鼻内镜下手术治疗咽囊炎27例,其中电动切削器切除咽囊11例,等离子低温射频刀切除咽囊16例.结果:治愈20例,有效7例.结论:鼻内镜下咽囊手术直观、微创、安全、有效,等离子低温射频刀手术创伤更小.

  19. 咽囊炎漏诊误诊临床分析%Misdiagnosis of Pharyngeal bursitis: Clinical analysis

    Institute of Scientific and Technical Information of China (English)

    游龙贵; 张克辉; 张小安; 刘衍球; 蔡庄兰; 蓝玉清

    2006-01-01

    咽囊炎患者在临床并不多见.好发于儿童和青少年.我科近些年在临床工作中诊断了20余例咽囊炎病例.其中漏诊或误诊6例,现就这些病例漏渗或误诊的原因作一分析。

  20. 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.

  1. Tenosynovitis

    Science.gov (United States)

    ... of the tendon sheath References Biundo JJ. Bursitis, tendinitis, and other periarticular disorders and sports medicine. In: ... Saunders; 2016:chap 263. Schmidt MJ, Adams SL. Tendinopathy and bursitis. In: Marx JA, Hockberger RS, Walls ...

  2. What Are Shoulder Problems?

    Science.gov (United States)

    ... Surgery if tears are severe. Rotator Cuff Disease: Tendinitis and Bursitis In tendinitis of the shoulder, tendons become inflamed (red, sore, ... shoulder or by jobs with frequent overhead reaching. Tendinitis and bursitis may occur alone or at the ...

  3. Knee Injuries

    Science.gov (United States)

    ... bursitis . Symptoms of bursitis in the knee include warmth, tenderness, swelling, and pain on the front of ... injury without the aid of a television screen. Physical Therapy Depending on the type of knee injury ...

  4. 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.

  5. 累及黏液囊的关节病性银屑病%A case of bursitis related to psoriatic arthritis

    Institute of Scientific and Technical Information of China (English)

    屈丽娜; 张福仁

    2009-01-01

    报告关节病性银屑病致黏液囊炎1例.患者男,60岁.因银屑病15年,指(趾)关节疼痛3年,右肘伸侧肿胀1个月来诊.右肘关节外侧鳞屑性红斑伴压痛,关节伸侧有一囊肿;双膝关节肿胀无压痛.影像学检查示尺骨鹰嘴和髌上黏液囊炎均伴有邻近部位的附着点炎.

  6. 针灸推拿配合臭氧治疗肩周炎%Acupuncture and moxibustion massage coordination ozone therapy bursitis in shoulder

    Institute of Scientific and Technical Information of China (English)

    李绍维

    2011-01-01

    目的:探讨针灸推拿配合臭氧治疗肩周炎的有效方法.方法:对78例肩周炎患者运用针灸推拿配合臭氧治疗.结果:治疗78例,痊愈45例,显效20例,有效13例,无效0例,有效率100%.结论:针灸推拿配合臭氧治疗肩周炎效果显著.

  7. 推拿配合针灸治疗肩周炎疗效观察%Massage coordination acupunture therapy the bursitis in shoulder curative effect observation

    Institute of Scientific and Technical Information of China (English)

    马福学

    2010-01-01

    目的:观察推拿治疗肩周炎的临床疗效.方法:将56例肩周炎患者随机分为2组,治疗组采用手法配合针灸治疗,对照组单纯针灸治疗,每日1次.各组均以10次为1个疗程,连续治疗2个疗程后观察临床疗效.结果:治疗组疗效明显优于对照组,差异有统计学意义(P<0.05).结论:手法配合针灸治疗肩周是较有效的方法.

  8. The massage coordination electricity needle treats bursitis in shoulder 65 examples%推拿配合电针治疗肩周炎65例

    Institute of Scientific and Technical Information of China (English)

    王同; 张岩

    2010-01-01

    肩周炎是肩关节周围炎的简称.祖国医学又称"漏肩风"、"冻结肩"、"五十肩"等,是由于急、慢性劳损或其他原因所致肌腱、韧带、关节囊等软组织退行性变,以肩关节疼痛和肩关节运动受限为主要特征的常见疾病.

  9. Pathogeny and Therapeutic Development of Prepatellar Bursitis%髌前滑囊炎的病因和治疗进展

    Institute of Scientific and Technical Information of China (English)

    林霖; 王立德

    2002-01-01

    @@ 膝关节的周围有许多滑囊,多位于骨突与肌肉,肌腱与皮肤和肌肉与肌肉之间.滑囊的解剖与生理类似腱鞘与关节滑膜.正常情况下囊内存在有少许滑液,以适应膝关节活动.当有炎症时,则渗出增多,出现肿胀,疼痛.膑前皮下囊位于髌骨与皮肤之间,不与关节囊相通,是膝部易患病的滑囊之一.学者们主要从病因和治疗两个方面进行深入研究.本文根据目前国外有关研究报道情况将有关文献综述如下.

  10. 综合治疗肩周炎275例疗效观察%Complex therapy bursitis in shoulder 275 example curative effect observation

    Institute of Scientific and Technical Information of China (English)

    康永华; 吴晓峰

    2011-01-01

    肩周炎是常见病,多发病,治疗方法有很多种,往往单一疗效不确定,严重影响患者生活质量.笔者根据多年临床经验和体会,总结一套行之有效的综合治疗肩周炎方法,能够较快缓解病痛,直至治愈.下面详细介绍治疗方法,以供参考应用.

  11. 12例坐骨结节滑囊炎的手术治疗%Operation of 12 cases of ischiogluteal bursitis

    Institute of Scientific and Technical Information of China (English)

    李青松; 李林

    2010-01-01

    [背景]观察坐骨结节滑囊炎切除术的临床疗效.[病例报告]12例对保守治疗无效或反复发作的坐骨结节滑囊炎患者行滑囊切除术,无复发、感染及发生其他并发症病例.[讨论]坐骨结节滑囊炎应与坐骨神经痛相鉴别,一般经保守治疗多数可治愈,保守治疗无效或反复发作者应行滑囊切除术.

  12. 肩周炎病理及其治疗策略综述%Bursitis in shoulder pathology and its treatment strategy summary

    Institute of Scientific and Technical Information of China (English)

    王信

    2006-01-01

    目的:探讨肩周炎的病理及治疗策略.方法:从医学界多年来对肩周炎病理研究及治疗方法进行分析、总结.结果:目前肩周炎的病理研究及治疗方法都已日趋规范化和系统化.结论:作为一种常见病,医学界对此进行了大量研究,提出了许多独到的见解,与此相应的,肩周炎治疗方法的实践和研究,也取得了丰硕的成果,这都为肩周炎病症的最后攻克展现了光辉的前景.

  13. Plateau area bursitis in shoulder patient's health education%高原地区肩周炎病人的健康教育

    Institute of Scientific and Technical Information of China (English)

    杨晓英; 李东

    2006-01-01

    近几年来,高原地区肩周炎发病率逐年上升。目前,有部分临床病例,为更好地进行功能恢复,对肩周炎患者进行了合理健康教育,取得了一定的经验。现报告如下。

  14. 微创治疗慢性滑囊炎临床报导%Minimally invasive treatment of chronic bursitis clinical reports

    Institute of Scientific and Technical Information of China (English)

    张玮曾; 刘福尧

    2013-01-01

    目的 探讨慢性滑囊炎的微创治疗方法.方法 对8例慢性非特异性滑囊炎采用关节镜下滑囊切除术.结果 8例慢性滑囊炎全部治愈,无严重并发症.结论 采用关节镜下滑囊切除治疗慢性滑囊炎创伤小,效果良好.

  15. Massage physical therapy to treat bursitis in shoulder 78 example%推拿理疗治疗肩周炎78例

    Institute of Scientific and Technical Information of China (English)

    张岩; 杨洋

    2010-01-01

    肩周炎患者肩部疼痛各有其重点,功能障碍亦有偏重,在手法治疗时应掌握其重点.注意区别肩周炎发病所处的早、中、后三期.早期症状为疼痛较甚,夜不能寐,故应以轻柔和缓的手法活血通络止痛,慎用扳、摇、拨等被动手法,否则使肩部疼痛加重;中期疼痛较缓,肩部功能活动受限,应以轻柔手法与被动手法兼施,以达到活血通络止痛、松解关节粘连、恢复肩关节正常功能的目的;后期肩部疼痛基本消失,肩关节功能严重受限,主要以被动手法松解粘连,而辅以轻柔手法以止痛.另外,嘱患者作肩部功能的自我锻炼,注意保暖,能加强疗效,避免反复,早日康复.

  16. Arthroscopic radiofrequency treatment of olecranon bursitis%关节镜下等离子射频治疗尺骨鹰嘴滑囊炎

    Institute of Scientific and Technical Information of China (English)

    郭明锋

    2013-01-01

    目的 探讨关节镜下等离子射频治疗尺骨鹰嘴滑囊炎手术.方法 选择难治性尺骨鹰嘴滑囊炎病例18例,应用关节镜辅助下经皮等离子消融气化,治疗滑囊炎.结果 关节镜辅助下等离子射频气化治疗18例术后均无感染复发,无血管神经损伤等并发症.结论关节镜下等离子射频治疗尺骨鹰嘴滑囊炎,是一种操作安全、有效的治疗方法.

  17. Clinical Observations on Fire Needling Treatment for Subacromial Bursitis%燔针劫刺治疗肩峰下滑囊炎临床观察

    Institute of Scientific and Technical Information of China (English)

    周立武

    2009-01-01

    目的 观察燔针劫刺治疗肩峰下滑囊炎的临床疗效.方法 将110例肩峰下滑囊炎患者随机分为治疗组和对照组,每组各55例.治疗组采用燔针劫刺治疗,对照组采用药物治疗,共治疗2个疗程,治疗结束后4星期评定疗效.结果 治疗组总有效率为96.4%,对照组总有效率为89.1%,两组比较差异具有统计学意义(P<0.05),治疗组总有效率优于对照组.结论 燔针劫刺是治疗肩峰下滑囊炎的较佳方法.

  18. The curative effect of traumatic bursitis by arthroscopic%关节镜下治疗创伤性滑囊炎的疗效观察

    Institute of Scientific and Technical Information of China (English)

    陈为坚; 靳安民; 段杨; 胡孔和; 魏丹; 刘丽丽

    2010-01-01

    目的:观察关节镜监视下治疗创伤性滑囊炎的临床疗效.方法:选择创伤性滑囊炎患者51例,病程8天~12个月,平均46天.其中下肢35例,上肢16例.结果:随访2个月-1年,平均4个月,治愈48例,总有效率94.1%.结论: 关节镜下治疗创伤性滑囊炎创伤小,治愈率高,不影响关节功能,临床治疗效果满意.

  19. 膝周滑囊炎的鉴别诊断与治疗%Bursitis around the knee joint:differential diagnosis and treatment

    Institute of Scientific and Technical Information of China (English)

    王振海; 刘永灿; 王天胜

    2004-01-01

    目的探讨膝关节周围滑囊炎的鉴别诊断与治疗方法.方法回顾我院自2000年3月~2002年3月诊治的32例膝周滑囊炎,通过膝关节镜检查治疗后,经查体及患者主诉明确最后诊断.采取保守治疗,并进行临床随访分析.结果随访8~40周,9例无膝内病变且仅为一种滑囊炎的3周以内治愈.23例合并2种以上滑囊炎(包括4例合并膝内病变者)3~5周治愈.结论对膝周滑囊炎,根据主诉及查体,先区分关节内外,再辨别疼痛部位,可以进行鉴别诊断.本病保守治疗可治愈.

  20. B型超声波在80例滑囊炎诊断中的应用%Application of ultrasound in diagnosis of 80 cases of bursitis

    Institute of Scientific and Technical Information of China (English)

    高前丽

    2001-01-01

    对80例四肢大关节处滑囊炎进行定位诊断,其中肘部7例,臀部5例,膝前部18例,腘窝部48例,足踝部2例,均经手术、穿刺及病理证实.超声诊断与手术符合率95%.通过讨论滑囊炎的影像表现及滑囊与关节腔的关系,认为滑囊炎的定位诊断,对其治疗方案及手术方法的选择有重要参考意义.

  1. 小针刀配合臭氧治疗肩周炎58例%Small needle knife coordination ozone therapy bursitis in shoulder 58 example

    Institute of Scientific and Technical Information of China (English)

    李绍维

    2011-01-01

    目的:探讨小针刀配合臭氧技术治疗肩周炎的有效方法.方法:对58例肩周炎患者应用小针刀配合臭氧综合 方法进行治疗.结果:治疗58例,痊愈52例,占89%,显效4例,占6%,有效2例,占3%,无效 0例.总有效率100%.结论:小 针刀配合臭氧技术治疗肩周炎效果显著.

  2. Small needle knife to add the massage therapy to treat the bursitis in shoulder%小针刀加推拿疗法治疗肩周炎

    Institute of Scientific and Technical Information of China (English)

    李松林

    2010-01-01

    肩周炎是由寒湿侵入形成的慢性无菌性炎症,软组织广泛粘连,微循环障碍.小针刀能松解粘连,疏通阻滞,但局限性在于不能针对广泛粘连.推拿能利滑关节,增大肌肉伸展性,使变性组织改善,对结节及肌肉挛缩又有其局限.而先行小针刀再实施推拿,两者相辅相成取得了95%的优良率.

  3. Arthroscopie therapy of prepatellar bursitis with radiofrequency%关节镜下等离子刀治疗髌前滑囊炎

    Institute of Scientific and Technical Information of China (English)

    陈峰; 金先跃

    2008-01-01

    目的 探讨关节镜下等离子刀治疗髌前滑囊炎的可行性.方法 2005年2月~2007年2月,采用局麻关节镜监视下等离子刀治疗髌前滑囊炎10例.男3例,女7例,年龄25~66岁.镜视下将含有肾上腺素的生理盐水注入囊壁脏层组织,采用囊外剥离和囊内射频汽化切割处理囊壁组织.结果 术后随访10例,无感染和血管神经损伤,疗效满意.结论 局部麻醉关节镜下髌前滑囊切除术方法可行,安全可靠,疗效满意.

  4. 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.)

  5. Diagnosis and Treatment of Olecranon Bursitis on Dogs%犬肘头皮下黏液囊炎的诊治

    Institute of Scientific and Technical Information of China (English)

    韩名书; 于文会

    2013-01-01

    犬肘头皮下黏液囊炎俗称“肘肿”,多发生在大体型犬肘部皮下,是大型犬常发的一种外科病.患病犬有的一侧发病,有的两侧同时发病.本病治疗可采用手术治疗和保守治疗,发病初期可采用保守治疗,中后期保守治疗效果不佳,多采用手术治疗.

  6. Treatment of Prepatellar Bursitis with Debridement under Arthroscopy%关节镜下清理术治疗髌前滑囊炎

    Institute of Scientific and Technical Information of China (English)

    张羽飞; 王福生; 王立德; 乔刚

    2003-01-01

    目的:研究关节镜下治疗髌前滑囊炎的方法.方法:13例髌前滑囊炎患者,男8例,女5例.囊肿最大8cm×10cm,最小5cm×6cm,全部病例均于关节镜下手术切除囊肿,并彻底冲洗,局部加压包扎,术后伸膝位石膏固定.结果:术后随访时间3~21个月.全部病人无1例复发及感染.所有病人膝前皮肤均表现有不同程度的凹陷形成,仅有2例病人残留有膝前Ⅱ°疼痛,1例病人皮肤有麻木感.结论:关节镜下手术治疗髌前滑囊炎,疗效满意,方法简单,并发症少.

  7. To treat pharyngeal bursitis by microwave under nasal endoscope%鼻内镜下微波治疗咽囊炎的临床应用

    Institute of Scientific and Technical Information of China (English)

    甄宏韬; 高起学; 崔永华; 孔维佳

    2005-01-01

    目的:探讨鼻内镜下微波治疗咽囊炎的疗效,并观察术后创面的变化.方法:鼻内镜下微波治疗咽囊炎11例、咽囊囊肿6例.术后第2天起用生理盐水冲洗鼻腔、鼻咽,每周鼻内镜下观察创面的变化,并记录白膜脱落的时间.结果:治愈14例,有效3例.术后创面白膜在2~3周内脱落.结论:鼻内镜检查有助于咽囊炎的诊断.鼻内镜下微波治疗咽囊炎,术后用生理盐水冲洗鼻腔、鼻咽,疗效较好、创伤小.

  8. Arm clump of nerve to hinder the acupuncture coordination massage to treat the bursitis in shoulder%臂丛神经阻滞下针刺配合推拿治疗肩周炎

    Institute of Scientific and Technical Information of China (English)

    黄燕芳

    2011-01-01

    目的:了解臂丛神经阻滞下针刺配合推拿治疗肩周炎的临床疗效,总结临床治疗肩周炎的经验.方法:将40例肩周炎患者随机分为治疗组和对照组,各20例,治疗组使用臂丛神经阻滞下针刺配合推拿疗法,对照组使用单纯的针刺疗法,然后观察比较两组患者治疗前后的肩关节疼痛,运动功能,活动度等疗效.结果:治疗组在治愈率和总有效率,肩关节疼痛,运动功能,活动度上明显优于对照组,P<0.05.结论:臂丛神经阻滞下针刺配合推拿治疗肩周炎的疗效显著,应当予以临床推广.

  9. 压痛测试仪对于膝鹅足滑囊炎压痛值的评价研究%Evaluation on Tenderness Values of Anserine Bursitis of the Knee Joint by Tenderness Measurement Instrument

    Institute of Scientific and Technical Information of China (English)

    王平; 古恩鹏; 戚天臣

    2010-01-01

    目的:评价运用压痛测试仪测量鹅足囊处压痛方法及其对活血化瘀膏疗效的意义.方法:本研究60例鹅足滑囊炎患者,治疗组30例,外敷活血化瘀膏;对照组30例,外涂扶他林乳胶荆.应用压痛测试仪分别于治疗前、治疗1周、治疗2周测量鹅足囊处的压痛值.结果:活血化瘀膏组及扶他林乳胶剂组治疗前后鹅足囊处压痛均有缓解(P<0.05或P<0.01).结论:压痛测试仪有利于压痛的量化评定,活血化瘀膏可明显减轻鹅足滑囊炎中鹅足囊处的压痛.

  10. The electricity needle cupping glasses treats the bursitis in shoulder 50 examples curative effects observation%电针拔罐治疗肩周炎50例疗效观察

    Institute of Scientific and Technical Information of China (English)

    霍艳平

    2008-01-01

    肩周炎是祖国医学痹证的范畴,又称"肩凝证"和"漏肩风"等.在临床上多见于40岁以上的人,该病在治疗上方法较多,也都有一定的疗效,笔者近年来在临床上采用电针拔罐综合治疗的方法,取得了满意的效果.

  11. 脾虚奶牛黏液囊炎和关节炎发病机理及治疗%Pathogenesis and Therapy of the Bursitis and the Arthritis of Milch Cow with Spleen Deficiency Symptom

    Institute of Scientific and Technical Information of China (English)

    魏守海; 李英伦

    2006-01-01

    脾位于腹中,其经脉络于胃,与胃相表里,开窍于口。脾的生理功能是主运化和统摄血液,在体合肌肉,开窍于口,其华在唇。《安骥集.师皇五脏论》日:“脾是脏中之母”。脾虚证是临床上常见的慢性综合征侯群,按中医分型可包括脾气虚、脾阳虚、脾阴虚及有关的夹杂证等。其中以脾气虚为多见,简称脾虚。其病理症状及体征,主要表现为腹胀腹痛、大便溏泄、食欲不振、四肢倦怠、肌肉消瘦、水肿、内脏下垂、出血等。上述症状中以消化系统的改变为主。

  12. 围刺针法结合推拿治疗肱骨外上髁炎58例的临床分析%Therapy of 58 cases of radiohumeral bursitis by acupuncture combined with massage

    Institute of Scientific and Technical Information of China (English)

    张义方; 黄正国; 朱向会

    2007-01-01

    目的:观察围刺针法结合推拿治疗肱骨外上髁炎的临床疗效.方法:采用围刺针法结合推拿治疗58例,10 d为1疗程,治疗2个疗程.结果:治愈50例(87.0%),显效4例,有效2例,无效2例,总有效率为97%.结论:围刺针法结合推拿治疗肱骨外上髁炎疗效佳.

  13. 消防训练致髌上滑囊炎治疗方式探讨%Discussion of the treatment mode of fire service training induced suprapatellar Bursitis

    Institute of Scientific and Technical Information of China (English)

    赵岩

    2012-01-01

    目的 探讨消防员训练致髌上滑囊炎的治疗方法并提出预防措施.方法 将74例原发性髌上滑囊炎患者随机分为治疗组50例和对照组24例.对照组采用传统治疗方法,治疗组采用治疗髌上脂肪垫方法.治疗后比较2组临床疗效.结果 治疗组总有效率为100.0%高于对照组的79.2%,差异有统计学意义(P<0.05).结论 通过治疗髌下脂肪垫对于髌上滑囊炎的治疗有显著的疗效.

  14. The needle knife union liquid expansion law treats the bursitis in shoulder clinical observation%针刀联合液体扩张法治疗肩周炎的临床观察

    Institute of Scientific and Technical Information of China (English)

    李复兴

    2007-01-01

    目的:观察针刀联合液体扩张法对肩周炎的临床疗效.方法:采用完全随机抽样的方法,将观察病例分为治疗组192例,针刀对照组90例,将两组临床疗效及疼痛缓解时间进行评定.结果:治疗组治愈140例,好转44例,无效8例,总有效率95.84%;对照组治愈44例,好转28例,无效9例,总有效率80%.两组治愈率比较差异有显著性意义(P<0.01),治疗组临床总疗效优于对照组(P<0.05),疼痛缓解时间治疗组优于对照组(P<0.05).结论:针刀联合液体扩张法治疗肩周炎疗效显著,疼痛缓解时间短,临床治愈率及总疗效优于针刀组.其方法简单,便于操作,值得基层医院临床推广.

  15. 小针刀联合电针治疗肩周炎150例临床体会%The small needle knife union electricity needle will treat bursitis in shoulder 150 example clinical experience

    Institute of Scientific and Technical Information of China (English)

    袁明春

    2011-01-01

    目的:研究探讨采用小针刀和电针联合治疗肩周炎的临床体会.方法:对近几年来采用小针刀联合电针治疗肩周炎的临床资料进行分析和讨论.结果:150例中治愈120例、显效19例、好转10例、无效1例.结论:采用小针刀联合电针治疗肩周炎,操作简单、痛苦小、见效快、疗效短等优点,值得基层医院推广.

  16. The acupuncture adds the technique to treat the bursitis in shoulder 50 example attainment experience%针刺加手法治疗肩周炎50例心得体会

    Institute of Scientific and Technical Information of China (English)

    傅冰

    2010-01-01

    肩周炎又称肩关节周围炎,是以肩关节疼痛和活动不便为主要症状的常见病症.本病的好发年龄在50岁左右,故有"五十肩"之称.女性略多于男性,体力劳动者和脑力劳动者均可发病.本病如得不到有效治疗,有可能使肩关节发生粘连,妨碍日常生活.笔者采用针刺结合手法治疗的方法,疗效显著,值得推广,现将具体内容介绍如下.

  17. 战士基础训练动作致Gerdy结节创伤滑囊炎59例分析%Analysis of 59 cases about praumapic bursitis on Gerdy code result from the basic action training in soldiers

    Institute of Scientific and Technical Information of China (English)

    韩忠孝; 杨长山; 秦伟杰; 索骥

    2004-01-01

    Gerdy结节滑囊炎是内皮细胞组成的封闭性囊,少数与关节沟通,位于关节附近,介于肌肉或肌腱在骨突起的滑动处,我院于2000年7月—2003年7月共收治59例该病新兵患者,现分析如下。

  18. 针灸推拿治疗肩周炎临床疗效观察%The acupuncture and moxibustion massage treats the bursitis in shoulder clinical curative effect to observe

    Institute of Scientific and Technical Information of China (English)

    姜洪林

    2010-01-01

    目的:观察和讨论中医针灸,推拿治疗肩周炎的临床疗效.方法:取肩关节周围及肢体穴位,通过中医针灸,推拿,拔罐等治疗后,必要时配合穴位注射.结果:痊愈13例,好转4例,无效0例,总有效率100%.结论:通过观察,综合疗法能够迅速减轻痛苦,缩短治疗时间,具有很好的临床疗效,是一种治疗肩周炎的有效方法.

  19. 臂丛神经封闭和痛点注射在肩周炎治疗中的作用%Effect of brachial plexus block combined with paint injection on patients with bursitis in shoulder

    Institute of Scientific and Technical Information of China (English)

    侯春生; 张涛

    2008-01-01

    肩周炎是骨科门诊常见病、多发病。采用臂丛神经封闭和痛点注射能在阻断痛觉刺激传导的同时,缓解局部肌肉的紧张和痉挛从而达到治疗目的。作者对2005年至2007年104例肩周炎的临床资料进行分析,现将治疗体会报告如下。

  20. 针刺肩痛穴治疗肩周炎临床疗效观察%The Observation of Clinical Curative Effect of Treating Bursitis in Shoulder with Acupuncture by Pricking Shoulder Pain Point

    Institute of Scientific and Technical Information of China (English)

    刘圣; 王保卫; 杨洪; 张霞; 李志宇; 陈以国

    2007-01-01

    目的:观察针刺肩痛穴疗法对肩周炎的临床疗效.方法:采用针刺肩痛穴疗法:每5日为1疗程,治疗4个疗程,根据临床症状判断疗效.结果:针刺肩痛穴对肩周炎总有效率为95.9%,简单易行,费用低廉,适合在农村推广利用.

  1. 臭氧配合肩关节周围痛点阻滞治疗肩周炎42例%Ozone coordination shoulder joint the pain spot to hinder to treat bursitis in shoulder 42 example

    Institute of Scientific and Technical Information of China (English)

    李绍维

    2010-01-01

    目的:探讨臭氧配合痛点阻滞治疗肩周炎的有效方法.方法:对42例肩周炎患者运用臭氧配合痛点阻滞治疗.结果:治疗42例,痊愈38例,占90%,显效3例,占7%,有效1例,占2%,无效0例,有效率100%.结论:臭氧配合痛点阻滞治疗肩周炎效果显著.

  2. The medicine whip whips the therapy coordination to take care of treats bursitis in shoulder%药鞭拍打疗法配合调护治疗肩周炎

    Institute of Scientific and Technical Information of China (English)

    程卫国; 吴小萍

    2011-01-01

    肩周炎,属中医痹症范畴,是由风寒、湿热等外邪侵袭人体、闭阻经络气血运行不畅,引起的肢体关节肌肉疼痛、肿胀,重着麻木或活动不利的一类疾患.临床上常见以中老年人,伏案工作者,五十岁左右人多见,患者生活工作非常不便.笔者采用药鞭拍击法配合调护治疗肩周炎,即把桑枝和柳枝浸泡在中药酒液中后,再用柳枝或桑枝作器械,应用推拿手法轻快拍打患痛关节,利用拍打外力使药液渗透到肌体,发挥疗效.

  3. According to pulls the Daraf merge ultrashort wave to treat the bursitis in shoulder clinical observation%点按牵拉法合并超短波治疗肩周炎的临床观察

    Institute of Scientific and Technical Information of China (English)

    梁亮标; 何青

    2011-01-01

    目的:为了观察点按牵拉法合并超短波治疗肩周炎的临床效果.方法:将86例肩周炎患者随机分为两组,治疗组采用点按牵拉法合并超短波治疗,对照组采用传统电针、按摩治疗.结果:治疗1疗程后治疗组的疗效明显高于对照组,经统计学处理有显著意义(p<0.05),表明点按牵拉法合并超短波治疗肩周炎优于传统的电针、按摩治疗,值得推广应用.

  4. To massage the musculus subscapularis to treat the bursitis in shoulder clinically to analyze%按摩肩胛下肌治疗肩周炎的临床分析

    Institute of Scientific and Technical Information of China (English)

    朱丽华

    2010-01-01

    目的:探讨不同的按摩手法治疗肩周炎的疗效.方法:把30例肩周炎患者分成试验组和对照组,对照组进行常规手法治疗,试验组配合按摩肩胛下肌.结果:试验组的总有效率为93.33%,对照组为80%.结论:配合按摩肩胛下肌治疗肩周炎可提高临床治愈率.

  5. 髌上滑囊炎与髌下脂肪垫炎的治疗及两者相关性的临床研究%Treatment of suprapatellar bursitis and inflamation of subpatellar fat pad and their correlation

    Institute of Scientific and Technical Information of China (English)

    沈曙晶; 刘厚宁; 蒋佑升

    2008-01-01

    目的 探讨原发性髌上滑囊炎与髌下脂肪垫炎的治疗及其相关性.方法 对26例用传统方法治疗无效的原发性髌上滑囊炎患者,在髌下脂肪垫注射曲安奈德治疗并分析其疗效.结果 终止治疗后3~4个月评定效果.治愈17例,好转6例,无效3例,复发3例.结论 髌下脂肪垫注射曲安奈德治疗髌上滑囊炎治愈率高,复发率低,且疗效与病程密切相关,并推断原发性髌上滑囊炎可能继发于髌下脂肪垫炎.

  6. 鼻内镜下微波治疗慢性咽囊炎26例临床体会%Clinical effect of microwave therapy for 26 cases of chronic pharyngeal bursitis under nasal enaoscope

    Institute of Scientific and Technical Information of China (English)

    王世军; 张丽琴

    2009-01-01

    目的 探讨鼻内镜下微波治疗慢性咽囊炎的临床疗效.方法 对26例慢性咽囊炎患者在鼻内镜下采用微波治疗.结果 26例患者治疗均获成功.术后平均随访1年,症状消失,鼻咽部创面愈合良好,无复发.结论 鼻内镜下微波治疗慢性咽囊炎疗效良好.

  7. Ping Qi Acupuncture Needles with Catgut Implantation at the Treatment of 110 Cases of Bursitis Brachioradial%平针齐刺法配合穴位埋线治疗肱桡滑囊炎110例

    Institute of Scientific and Technical Information of China (English)

    林宪军; 王栋

    2009-01-01

    @@ 肱桡滑囊炎,又称肱骨外上髁炎,俗称"网球肘",是指由于肘关节急慢性劳损,前臂旋转用力不当,前臂深腕肌的起点损伤或风寒痹阻脉络经筋痉挛所引起的肱骨外上髁、肱桡关节滑囊处无菌性炎症.往往采取封闭、推拿、手术治疗,效果不是很理想.

  8. 温针灸加理疗治疗肩周炎疗效观察%Warm acupuncture and moxibustion adds the physical therapy to treat bursitis in shoulder curative effect observation

    Institute of Scientific and Technical Information of China (English)

    李忠爽

    2010-01-01

    肩周炎又称"五十肩、冻结肩"、"漏肩风"等,是好发于中老年的一种退行性、炎症性病变;虽部分患者经功能性锻练可自行痊愈,但时间长、痛苦大、功能恢复不全,如能积极地治疗,可缩短病程加速痊愈.我科近6年来采用温针灸配合物理疗法,治疗该病取得满意疗效,现报道如下.

  9. 温针灸配合拔罐治疗肩周炎32例%The Clinical Curative Effect Observations of 64 Cases the Bursitis in Shoulder Patients by the Warm Acupuncture Union Cupping

    Institute of Scientific and Technical Information of China (English)

    杜彦云; 鹿月惠; 崔洪亮

    2014-01-01

    目的 观察温针灸配合拔罐治疗肩周炎的临床疗效.方法 选取该病患者64例,随机分成两组.治疗组予温针灸配合拔罐治疗,对照组采用常规针刺方法治疗.结果 治疗三个疗程后(一个疗程10天)观察疗效.总有效率84.38%,愈显率62.50%.与对照组比较(P<0.01),差异具有显著意义.结论 温针灸配合拔罐疗法治疗肩周炎疗效优于单纯针刺疗法.

  10. Preliminary Clinical Observation of the Relationship Between Arrhythmia and Chronic Pharyngeal Bursitis in Children%儿童心律失常与慢性咽囊炎关系的临床初步观察

    Institute of Scientific and Technical Information of China (English)

    邹月娥; 王富森

    2002-01-01

    目的:探讨儿童心律失常与慢性咽囊炎的关系.方法:对22例8~14岁不明原因的心律失常患儿行鼻窦CT扫描及鼻咽纤维镜筛选检查,发现其中5例患儿合并有慢性咽囊炎,对5例合并慢性咽囊炎患儿行鼻内窥镜下病灶消除术,术后3月及6月行长程动态心电图检查,比较手术前后心电变化.结果:4例患儿术后3月症状消失,长程动态心电图恢复正常.1例患儿术后3月症状缓解,长程动态心电图检查仍有不同程度的心电异常,术后6月长程动态心电图恢复正常.结论:儿童慢性咽囊炎可能为心律失常的病因或诱因之一.

  11. 中西医结合治疗坐骨结节滑囊炎32例疗效观察%Treatment of 32 cases of ischial tuberosity bursitis by combined traditional Chinese and western medicine

    Institute of Scientific and Technical Information of China (English)

    顾成中; 朱定德

    2002-01-01

    目的观察中西医结合治疗坐骨结节滑囊炎的临床疗效.方法 47例坐骨结节滑囊炎患者随机分为2组,对照组15例单用西医方法,以坐骨结节滑囊炎穿刺抽液,并注入确炎舒松和普鲁卡因治疗,治疗组在对照组治疗的基础上加用阳和汤加减.2组均10日为1个疗程,5个疗程后统计疗效.结果治疗组总有效率96.9%,对照组总有效率73.3%,2组比较有显著性差异(P<0.05).结论中西医结合治疗坐骨结节滑囊炎疗效确切.

  12. 水针疗法配合中药外敷治疗肩周炎84例%The acupuncture with medicinal injection coordination traditional Chinese medicine externally applies treats the bursitis in shoulder 84 examples

    Institute of Scientific and Technical Information of China (English)

    李文强

    2009-01-01

    目的:通过用水针疗法配合自制中药外敷治疗肩周炎84例,观察它的治疗效果.方法:针对我院中医伤科门诊2008年1~8月收治的84病例,采用水针疗法,用当归、野木瓜注射液,或用利多卡因、祛炎舒松、维生素B12注射液,配合自制中药外敷隔日1次,5次为1个疗程.结果:通过用水针疗法配合自制中药外敷治疗肩周炎84例的疗效分析,经过统计学分析处理,总有效率达到97.6%.结论:用水针疗法配合自制中药外敷治疗肩周炎具有价格低廉、方法简单、疗效可靠、病人容易接受、具有广阔的发展前景,值得推广.

  13. 小针刀、手法配合超短波治疗肩周炎%The small needle sword wielder French penicillin gathers the ultrashort wave to treat bursitis in shoulder

    Institute of Scientific and Technical Information of China (English)

    李俊

    2011-01-01

    肩周炎又称肩关节周围炎,又名"冻结肩"、"五十肩".本病好发于50岁左右人群,女性高于男性,多见于体力劳动者.是以肩周活动时疼痛、功能受限为其主要临床表现.此病中西医治疗方法很多,如推拿、针灸、封闭、拔火罐等疗效不佳.本人采用小针刀结合手法、超短波治疗肩周炎取得满意疗效.

  14. 火针治疗膝关节周围慢性滑囊炎93例%Treating Chronic Bursitis Around Knee Joint with Fire Needle: A Report of 93 Cases

    Institute of Scientific and Technical Information of China (English)

    冯祯根

    2009-01-01

    膝关节周围慢性滑囊炎主要指髌前、髌下滑囊慢性炎症,以膝周有局限性肿块为主。一般中西药物较难见效,本人自1999年11月份起用火针局刺为主治疗取得较满意疗效,现将有完整资料的93例总结分析如下:

  15. 电针温针火罐发泡治疗肩周炎132例%The electricity needle acupuncture plus heat cupping glass becomes spongy treats the bursitis in shoulder 132 examples

    Institute of Scientific and Technical Information of China (English)

    杨明玉

    2010-01-01

    笔者通过长期的临床实践,总结出了肩周炎的治疗应以温通经脉、行气活血为原则,局部取穴:如肩髃、肩前、天宗和痛点为主,配合循经和辩证配穴,临床采用温针灸,电针加火罐发泡先结合具有止痛、改善局部循环、促进机体康复的作用.

  16. 38 CFR Appendix B to Part 4 - Numerical Index of Disabilities

    Science.gov (United States)

    2010-07-01

    ... Bursitis. 5020 Synovitis. 5021 Myositis. 5022 Periostitis. 5023 Myositis ossificans. 5024 Tenosynovitis... Musculocutaneous nerve (superficial peroneal), paralysis. 8523 Anterior tibial nerve (deep peroneal), paralysis. 8524 Internal popliteal nerve (tibial), paralysis. 8525 Posterior tibial nerve, paralysis....

  17. 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

  18. Shoe Inserts and Prescription Custom Orthotics

    Science.gov (United States)

    ... to treat injuries such as shin splints or tendinitis. Functional orthotics are usually crafted of a semi- ... treat foot problems such as plantar fasciitis, bursitis, tendinitis, diabetic foot ulcers, and foot, ankle, and heel ...

  19. Shoulder pain

    Science.gov (United States)

    ... or damaged. This condition is called rotator cuff tendinitis or bursitis. Shoulder pain may also be caused ... recommend such exercises. If you are recovering from tendinitis, continue to do range-of-motion exercises to ...

  20. Tennis elbow

    Science.gov (United States)

    ... side view References Adams JE, Steinmann SP. Elbow tendinopathies and tendon ruptures. In: Wolfe SW, Hotchkiss RN, ... PA: Elsevier; 2017:chap 25. Biundo JJ. Bursitis, tendinitis, and other periarticular disorders and sports medicine. In: ...

  1. Shoulder Pain and Common Shoulder Problems

    Science.gov (United States)

    ... into four major categories: • Tendon inflammation (bursitis or tendinitis) or tendon tear • Instability • Arthritis • Fracture (broken bone) ... o en occurs in association with rotator cuff tendinitis. The many tissues in the shoulder can become ...

  2. Questions and Answers About Shoulder Problems

    Science.gov (United States)

    ... deciding whether surgery is required. Rotator Cuff Disease: Tendinitis and Bursitis These conditions are closely related and may occur alone or in combination. Tendinitis is inflammation (redness, soreness, and swelling) of a ...

  3. 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 ... Health Topics Elbow Injuries and Disorders Sports Injuries Tendinitis Browse the Encyclopedia A.D.A.M., Inc. ...

  4. Arthritis and Rheumatic Diseases

    Science.gov (United States)

    ... Related Information Ankylosing Spondylitis, Q&A Bursitis and Tendinitis, Q&A Fibromyalgia, Q&A Gout, Q&A ... skin, kidneys, heart, lungs, blood vessels, and brain. Tendinitis. Inflammation of tendons (tough cords of tissue that ...

  5. 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.

  6. 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...

  7. Ultrasound in the evaluation of enthesitis: status and perspectives

    DEFF Research Database (Denmark)

    Gandjbakhch, Frédérique; Terslev, Lene; Joshua, Fredrick

    2011-01-01

    . 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...

  8. 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.)

  9. HAGLUND SYNDROME: A CASE REPORT

    OpenAIRE

    Indira; Prakash; Venkateshwaran,; Shivashankar,; Gowrish

    2015-01-01

    Haglund Syndrome is one of the causes of posterior heel pain. It is the inflammation of the tendoachilles at the calcaneal insertional site and the regional soft tissues. It comprises of insertional Achilles tendinopathy, retrocalcaneal & retroachilles bursitis and posterior calcaneal bony spur. Imaging plays a very important role in the diagnosis as it can be mimicked by several other conditions like isolated retrocalcaneal bursitis, enthesopathies and accessory soleu...

  10. Preventing Injuries in the U.S. Military: The Process, Priorities, and Epidemiologic Evidence

    Science.gov (United States)

    2008-12-01

    Tibial collateral ligament bursitis Inflammation and Pain 726.63 Fibular collateral ligament bursitis Inflammation and Pain 726.64 Patellar... tibial stress fracture in male runners. Med Sci Sports Exerc, 1999;31(8):1088-93. (24) Delfico AJ, Garrett WE, Jr. 1998. Mechanisms of injury of...Musculoskeletal System 5022 Periostitis X X X 50 Bones and Joints Disease 5000-5399 Musculoskeletal System 5023 Myositis Ossificans

  11. 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.

  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. 针刀结合手法分型治疗网球肘与单纯手法治疗的疗效比较%Comparison Curative Effect of Meed-knife Technique Type and Pure Technique Type in Treatment of Radiohumeral Bursitis

    Institute of Scientific and Technical Information of China (English)

    高国友; 梁雪

    2015-01-01

    Objective To study the needle knife combination technique and simple technique different effect for the treatment of tennis elbow.Methods Selected 62 patients with tennis elbow from January 2012 to January 2014, were randomly divided into two groups, the needle knife group because of more than 2%, and prednisolone closed, after stripping with 4 needle knife and cut the elbow and the starting point refers to the total muscle tendon adhesion and half ring parts, to cut off the local microvascular nerve bundle, the control group treated by simple technique, compared two groups of curative effect.Results Needle knife group was 85.29%, the control group was 46.43%, the difference between the two groups have statistical signiifcance. Grip strength and tenderness of needle knife group, the elbow joint function score is better than that of control group, the differences between the two groups have statistical significance.Conclusion Needle knife in the treatment of tennis elbow effect than simple operative curative effect is ideal.%目的:探讨针刀结合手法与单纯手法治疗网球肘的不同效果。方法选择2012年1月~2014年1月网球肘患者62例,随机分为两组,针刀组采用2%利多因加强的松龙作痛点封闭,之后用4号针刀剥离并切断肘关节伸指肌总腱起点附着处和半环形部分,切断局部微血管神经束,对照组采用单纯手法治疗,比较两组疗效。结果针刀组优良率85.29%,对照组优良率46.43%,P<0.05,差异具有统计学意义。针刀组的握力、压痛、肘关节功能等评分优于对照组,P<0.05,差异具有统计学意义。结论针刀治疗网球肘效果比单纯手术治疗疗效理想。

  14. The clinical studies with extracorporeal shock wave therapy(ESWT)to treat tennis elbows subacromial bursitis and painful heel%体外冲击波治疗网球肘、肩周炎及跟痛症的作用探讨

    Institute of Scientific and Technical Information of China (English)

    邢更彦; 井茹芳; 杨传铎

    2001-01-01

    目的探讨体外冲击波治疗网球肘、肩周炎及跟痛症的疗效 . 方法应用国产 ESWO冲击波骨科治疗机治疗网球肘 102例、肩周炎 95例及跟痛症 86例 , 并与对照组进行比较 . 结果经 8~ 26月随访 , 结果显示 , 3种疾病治疗组疗效优良率与对照组间差异均极其显著 ( P < 0.01) . 结论该法治疗上述疾病具有安全、有效、无创、没有并发症等特点 .

  15. 阳和汤熏洗联合西药治疗坐骨结节滑囊炎32例临床观察%Yanghe Decoction Fumigation Combined with Clinical Observation of 32 Cases of Western Medicine in the Treatment of Ischial Tuberosity Bursitis

    Institute of Scientific and Technical Information of China (English)

    杨海波

    2014-01-01

    [目的]观察阳和汤熏洗联合西药治疗坐骨结节滑囊炎疗效.[方法]使用前瞻性设计方法,对32例住院患者,以坐骨结节滑囊炎穿刺抽液,并注入曲氨奈德及利多卡因治疗.活血化瘀,消肿止痛,阳和汤(麻黄6g,熟地黄15g,白芥子10g,甘草3g,炮姜炭、桂枝10g),1剂/d,水煎1000mL,熏洗.均连续治疗2周为1疗程.观测临床症状、不良反应.连续治疗2疗程,判定疗效.[结果]痊愈26例,好转5例,无效1例,总有效率96.88%.[结论]阳和汤熏洗联合西药治疗坐骨结节滑囊炎疗效确切.

  16. Miao tattoos the face and exiles to the frontier gathers the joint activity treatment adhesion time bursitis in shoulder clinical research%缪刺配合关节活动治疗粘连期肩周炎的临床研究

    Institute of Scientific and Technical Information of China (English)

    李良; 赵绮娜

    2011-01-01

    目的:观察缪刺配合关节活动治疗粘连期肩周炎的临床疗效及相对普通针刺治疗的优势.方法:将60例粘连期肩周炎患者随机分为2组,实验组采用缪刺疗法配合关节活动治疗,对照组予普通针刺治疗,隔日治疗1次,15次为1个疗程.结果:治疗组疗效明显优于对照组,差异有统计学意义(P<0.05).结论:与普通针刺相比,缪刺配合关节活动的临床疗效更佳,即刻镇痛效应尤其显著.

  17. Arm clump of anaesthesia the technique lysis coordination massage treats the bursitis in shoulder clinical observation%臂丛麻醉下手法松解术配合推拿治疗肩周炎的临床观察

    Institute of Scientific and Technical Information of China (English)

    翁文水; 林玉芬; 郑国良; 黄少淳; 郑银家; 吴昌跃

    2010-01-01

    目的:观察臂丛神经麻醉下肩关节松解术配合推拿手法治疗肩周炎的疗效.方法:34例患肩周炎的患者在臂丛麻醉下通过手法松解关节粘连,术后配合推拿治疗.结果:大多数患者经治疗后效果满意,病情明显改善.结论:采用臂丛麻醉下进行肩关节炎的治疗,病人痛苦小,疗效确切,值得推广.

  18. The pain spot injection and the technique hold back treat 68 example stubborn bursitis in shoulder curative effect observation%痛点注射和手法按压治疗68例顽固性肩周炎疗效观察

    Institute of Scientific and Technical Information of China (English)

    昌玉华

    2010-01-01

    目的:寻找一种综合治疗顽固性肩周炎的有效方法.方法:痛点注射和手法按压,并配合理疗和中药热敷及功能锻炼,治疗68例顽固性肩周炎.结果:治愈42例占75%,显效8例占14.3%,有效5例占7.1%,总有效率98%.结论:痛点注射和手法按压治疗顽固性肩周炎见效快,疗效好.

  19. Effect of acupuncture with warmed needle combined with experience point on radiolhumeral bursitis in 56 patients%温针灸配合经验穴治疗肱骨外上髁炎56例临床疗效观察分析

    Institute of Scientific and Technical Information of China (English)

    程海龙

    2009-01-01

    目的 观察温针灸配合经验穴(冲阳穴)治疗肱骨外上髁炎的临床疗效.方法 采用随机分组的方法,治疗组56例,在主穴治疗的基础上配合经验穴和温针灸;对照组55例,在主穴治疗的基础上配合电针治疗.结果 治疗组总有效率100%,对照组总有效率96.4%.结论 温针灸配合经验穴治疗肱骨外上髁炎疗效明显优于对照组,疗效确切.

  20. 小针刀切剥加独角膏外敷治疗股骨大转子慢性滑囊炎%Treatment of chronic bursitis of trochanter major with the small needle knife and Dujiao (独角) mastic

    Institute of Scientific and Technical Information of China (English)

    颜慧玫; 钟强; 张雄辉

    2007-01-01

    我院自2000年6月-2005年7月,应用小针刀切剥加独角膏外敷法和注射法治疗股骨大转子慢性滑囊炎患者90例,其中小针刀切剥加独角膏外敷治疗50例,注射治疗40例,现总结报告如下。

  1. 阳和汤熏洗联合西药治疗坐骨结节滑囊炎32例临床观察%Yanghe Decoction Fumigation Combined with Clinical Observation of 32 Cases of Western Medicine in the Treatment of Ischial Tuberosity Bursitis

    Institute of Scientific and Technical Information of China (English)

    杨海波

    2014-01-01

    [目的]观察阳和汤熏洗联合西药治疗坐骨结节滑囊炎疗效.[方法]使用前瞻性设计方法,对32例住院患者,以坐骨结节滑囊穿刺抽液,并注入曲氨奈德及利多卡因治疗.活血化瘀,消肿止痛,阳和汤(麻黄6g,熟地黄15g,白芥子10g,甘草3g,炮姜炭、桂枝10g),1剂/d,水煎1000mL,熏洗.均连续治疗2周为1疗程.观测临床症状、不良反应.连续治疗2疗程,判定疗效.[结果]痊愈26例,好转5例,无效1例,总有效率96.88%.[结论]阳和汤熏洗联合西药治疗坐骨结节滑囊炎疗效确切.

  2. Herd- and sow-related risk factors for lameness in organic and conventional sow herds

    DEFF Research Database (Denmark)

    Knage-Rasmussen, Kristian Møllegaard; Houe, Hans; Rousing, Tine

    2014-01-01

    included in the study were clinical parameters and factors related to the production system. Sows were examined visually by one of four trained observers. The organic sows were assigned scores for lameness, body condition, hoof length, bursitis, abscesses and leg wounds, while the conventional sows were...... assigned scores for lameness, body condition and bursitis. A multivariable analysis was carried out by logistic regression with the herd and observer as random effects. The average herd lameness prevalence in gestation and lactation sows in organic herds was 11% in summer/autumn and 4.6% in winter....../spring. ‘Wounds, bursitis and abscess’ on legs (OR=4.7, P3 (OR=1.79, P=0.008) were associated with increased risk of lameness in Danish organic sow herds. Season (winter/spring v. summer/autumn) lowered the risk of lameness (OR=0.37, P

  3. MR imaging of the elbow in the injured athlete.

    Science.gov (United States)

    Wenzke, Daniel R

    2013-03-01

    This article summarizes key MR imaging findings in common athletic elbow injuries including little leaguer's elbow, Panner disease, osteochondritis dissecans, olecranon stress fracture, occult fracture, degenerative osteophyte formation, flexor-pronator strain, ulnar collateral ligament tear, lateral ulnar collateral ligament and radial collateral ligament tear, lateral epicondylitis, medial epicondylitis, biceps tear, bicipitoradial bursitis, triceps tear, olecranon bursitis, ulnar neuropathy, posterior interosseous nerve syndrome, and radial tunnel syndrome. The article also summarizes important technical considerations in elbow MR imaging that enhance image quality and contribute to the radiologist's success.

  4. 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.

  5. 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.)

  6. HAGLUND SYNDROME: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Indira

    2015-07-01

    Full Text Available Haglund Syndrome is one of the causes of posterior heel pain. It is the inflammation of the tendoachilles at the calcaneal insertional site and the regional soft tissues. It comprises of insertional Achilles tendinopathy, retrocalcaneal & retroachilles bursitis and posterior calcaneal bony spur. Imaging plays a very important role in the diagnosis as it can be mimicked by several other conditions like isolated retrocalcaneal bursitis, enthesopathies and accessory soleus muscle. Though plain radiograph is the initial modality of investigation, MRI is preferred as it offers superior soft tissue contrast resolution and accurate diagnosis.

  7. Haglund syndrome: historical and systematic review

    Directory of Open Access Journals (Sweden)

    A. P. Sereda

    2014-01-01

    Full Text Available Haglund syndrome is one of the leading causes of pain and functional disorders in the posterior heel. It consists of retrocalcaneal pain caused by retrocalcaneal bursitis and impindgement Achilles tendon tenopathy due to Haglund's deformity. Throughout historical rewiev and systematic rewiev of current conservative and surgical treatments for Haglund syndrome performed in the article.

  8. Haglund syndrome: historical and systematic review

    OpenAIRE

    A. P. Sereda; Kavalerskiy, G.M.

    2014-01-01

    Haglund syndrome is one of the leading causes of pain and functional disorders in the posterior heel. It consists of retrocalcaneal pain caused by retrocalcaneal bursitis and impindgement Achilles tendon tenopathy due to Haglund's deformity. Throughout historical rewiev and systematic rewiev of current conservative and surgical treatments for Haglund syndrome performed in the article.

  9. Mycobacterium marinum Infection After Exposure to Coal Mine Water.

    Science.gov (United States)

    Huaman, Moises A; Ribes, Julie A; Lohr, Kristine M; Evans, Martin E

    2016-01-01

    Mycobacterium marinum infection has been historically associated with exposure to aquariums, swimming pools, fish, or other marine fauna. We present a case of M marinum left wrist tenosynovitis and elbow bursitis associated with a puncture injury and exposure to coal mine water in Illinois.

  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. 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.

  12. TREATMENT OF 62 CASES OF EXTERNAL HUMERAL EPICONDYLITIS WITH STILETTO NEEDLE

    Institute of Scientific and Technical Information of China (English)

    JIA Jian-xin; WEN Zhi-hua

    2006-01-01

    @@ External humeral epicondylitis, also known as brachioradial bursitis, popularly called "tennis elbow" refers to the acute or chronic myofascitis, the injury of the common extensor tendon of the humeral epicondyle. The authors have recently treated 62 cases of the disease by means of stiletto needle, the therapeutic effect of the treatment is so satisfactory, following is the report of the treatment.

  13. Excessive Progression in Weekly Running Distance and Risk of Running-related Injuries

    DEFF Research Database (Denmark)

    Nielsen, R.O.; 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...

  14. 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

  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. 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.

  17. Capitellocondylar total elbow replacement in late-stage rheumatoid arthritis

    DEFF Research Database (Denmark)

    Ovesen, Janne; Olsen, Bo Sanderhoff; Johannsen, Hans Viggo

    2012-01-01

    of instability. Other complications included 2 maltracking elbows, 2 triceps tendon ruptures, 2 cases of operative olecranon bursitis, and 2 ulnar nerve palsies. One elbow showed radiolucent lines of more than 1 mm in the circumference of the ulnar component; none of the other elbows showed any signs...

  18. 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 t

  19. Effect of corticosteroid injection for trochanter pain syndrome: Design of a randomised clinical trial in general practice

    NARCIS (Netherlands)

    A. Brinks (Tineke); R.M. van Rijn (Rogier); A.M. Bohnen (Arthur); G.L.J. Slee (Gabriël); J.A.N. Verhaar (Jan); B.W. Koes (Bart); S.M. Bierma-Zeinstra (Sita)

    2007-01-01

    textabstractBackground. 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 evi

  20. 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...

  1. 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 matte

  2. Locomotor diseases among male long-haul truck drivers and other professional drivers

    DEFF Research Database (Denmark)

    Jensen, Anker; Kaerlev, Linda; Tüchsen, Finn

    2007-01-01

    -249) and for other truck drivers (SHR: 130, 95% CI: 108-156) compared to bus drivers (SHR: 110, 95% CI: 79-149). All drivers had high SHR for lesions of the ulnar nerve (SHR: 159, 95% CI: 119-207), especially bus drivers (SHR: 197, 95% CI: 116-311). Long-haul truck drivers had high SHRs for synovitis and bursitis...

  3. Soldier Mobility: Innovations in Load Carriage System Design and Evaluation (la Mobilite du combattant: innovations dans la conception et l’evaluation des gilets d’intervention)

    Science.gov (United States)

    2001-05-01

    patellar tendinitis , bursitis, and ligamentous strain. These conditions can arise from an abrupt increase in road marching mileage or intensity or...locomotion, helps lift the weight of body and backpack during the stride) - biceps femoris (flexes the knee, extends the hip) - tibialis anterior

  4. Haglund syndrome with pump bump.

    Science.gov (United States)

    Kucuksen, Sami; Karahan, Ali Yavuz; Erol, Kemal

    2012-01-01

    Haglund's syndrome, which is an inflammation of the bursa and a bony enlargement on the back of the heel that most often leads to painful bursitis, is a rare cause of retrocalcaneal pain. The clinical diagnosis is often confusing as the clinical picture may mimic other causes of hindfoot pain such as isolated retrocalcaneal bursitis or hindfoot involvement from more systemic disorders such as seronegative spondyloarthropathies (Reiter's syndrome, ankylosing spondylitis) or rheumatoid arthritis. This report is of a 60-year-old woman with a painful swelling of the right heel, who was diagnosed with Haglund syndrome. The characteristic clinical photograph (showing the prominent 'pump bump'), radiographical and magnetic resonance imaging features are presented.

  5. Surgical repair of the gluteal tendons: a report of 72 cases.

    Science.gov (United States)

    Walsh, Michael J; Walton, Judie R; Walsh, Nichola A

    2011-12-01

    Lateral hip pain is a common problem in middle-aged women. This pain is usually attributed to trochanteric bursitis and treated as such. This study reports the results of investigation, the findings at surgery, the operative technique, the histopathologic findings, and the results of gluteal tendon repair in 72 patients with long-standing trochanteric pain and reports a classification of the operative findings. Six patients (7%) in the original study cohort of 89 patients were lost to follow-up, but of the remaining patients, 65 of 72, or 90%, were pain-free or had minimal pain (P gluteal tendons causing chronic lateral hip pain addresses the problem directly and reliably relieves the symptoms of so-called "trochanteric bursitis."

  6. Diagnosis and treatment of heel pain in chronic inflammatory arthritis using ultrasound.

    Science.gov (United States)

    Cunnane, G; Brophy, D P; Gibney, R G; FitzGerald, O

    1996-06-01

    The authors examined the role of ultrasound (US) in diagnosis and management of heel pain in chronic inflammatory arthritis. Nineteen patients underwent US examination. Eight patients (2 with previously unsuccessful nonguided injections), had 11 US-guided corticosteroid injections for treatment of retrocalcaneal bursitis (n = 6), plantar fasciitis (n = 3), and posterior tibial tenosynovitis (n = 2). US-demonstrated Achilles tendon rupture (n = 2), Achilles tendinitis (n = 8), posterior tibial tenosynovitis (n = 6), peroneus longus tenosynovitis (n = 2), retrocalcaneal bursitis (n = 13), and plantar fasciitis (n = 4). Loss of smooth bone contour (n = 13) correlated with bone erosions on plain radiographs in all but one case. Ten of 11 guided injections resulted in full resolution of heel pain. The diverse causes of heel pain are highlighted, and the ability of US to provide information with management implications is confirmed. US-guided corticosteroid injection is beneficial, especially after failure of nonguided injection.

  7. Interobserver reliability in musculoskeletal ultrasonography: results from a "Teach the Teachers" rheumatologist course

    DEFF Research Database (Denmark)

    Naredo, ee.; Møller, I.; Moragues, C.

    2006-01-01

    : The shoulder, wrist/hand, ankle/foot, or knee of 24 patients with rheumatic diseases were evaluated by 23 musculoskeletal ultrasound experts from different European countries randomly assigned to six groups. The participants did not reach consensus on scanning method or diagnostic criteria before......, tendon lesions, bursitis, and power Doppler signal. Afterwards they compared the ultrasound findings and re-examined the patients together while discussing their results. RESULTS: Overall agreements were 91% for joint effusion/synovitis and tendon lesions, 87% for cortical abnormalities, 84......% for tenosynovitis, 83.5% for bursitis, and 83% for power Doppler signal; kappa values were good for the wrist/hand and knee (0.61 and 0.60) and fair for the shoulder and ankle/foot (0.50 and 0.54). The principal differences in scanning method and diagnostic criteria between experts were related to dynamic...

  8. 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

  9. 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

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

    OpenAIRE

    Hildebrand Kevin A; Medlicott Shaun AC; Lewkonia Peter

    2011-01-01

    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...

  11. Haglund's Syndrome: Diagnosis and Treatment Using Sonography

    OpenAIRE

    Sofka, Carolyn M.; Adler, Ronald S.; Positano, Rock; Pavlov, Helene; Luchs, Jonathan S.

    2006-01-01

    Haglund's syndrome is a cause of retrocalcaneal pain. The clinical diagnosis of Haglund's syndrome is often confusing as the clinical picture may mimic other causes of hindfoot pain such as isolated retrocalcaneal bursitis or hindfoot involvement from more systemic arthropathies such as Reiter's syndrome or rheumatoid arthritis. With the increasing frequency of employing sonography as a diagnostic tool in the evaluation of foot and ankle pathology, recognition of the sonographic appearance of...

  12. Surgical treatment of Haglund’s disease: case report

    OpenAIRE

    Atesalp, A. Sabri; Demiralp, Bahtiyar; Erler, Kaan; Gur, Ethem

    2004-01-01

    Haglund’s disease is the posterior heel pain resulted from the retrocalceneal bursitis and chronic inflammation on the prominence of posterior calcaneus. It becomes prominent following excessive functional stresses. Surgery is an alternative choice of treatment. In the paper, we present the result of surgical procedure of 25 year old male with bilateral Haglund’s disease and surgical treatment principles of Haglund’s disease.

  13. Haglund Deformity – Surgical Resection by the Lateral Approach

    OpenAIRE

    Natarajan, S; VL Narayanan

    2015-01-01

    The aim of this study was to analyse the outcome of surgical Haglund deformity is a prominence in the postero superolateral aspect of the calcaneum. Haglund deformity is a prominence in the postero superolateral aspect of the calcaneum, causing a painful bursitis, which may be difficult to treat by non-operative measures alone. Various surgical methods are available for effective treatment of refractory Haglund’s deformity. This study is to evaluate whether adequate resection of Haglund de...

  14. Calcaneal ostectomy for Haglund disease.

    Science.gov (United States)

    Pauker, M; Katz, K; Yosipovitch, Z

    1992-01-01

    From 1967 to 1987, operative treatment was performed on 28 feet in 22 patients with retrocalcaneal bursitis due to prominent posterior superior margin of the calcaneus (Haglund disease). Through a lateral or medial approach, the prominent bone was removed. The results indicated that excision of the retrocalcaneal bursa was not necessary. Preoperative planning and intraoperative examination was necessary in order to remove an adequate amount of bone, which was the key for a successful result.

  15. Rationale for Treatment of Hip Abductor Pain Syndrome

    OpenAIRE

    Bewyer, Dennis C; Bewyer, Kathryn J

    2003-01-01

    Patients with lower back or buttock pain that radiates into the posterior or lateral leg are often referred to physical therapy with a diagnosis of sciatica. Often the physical exam does not reveal neurologic findings indicative of radiculopathy. Instead, there is hip abductor muscle pain and weakness. This syndrome involves muscle imbalances that result in overuse strain of the gluteus medius and gluteus minimus muscles, myofascial trigger points, and trochanteric bursitis. This paper descri...

  16. Ergonomic Challenges in Conventional and Advanced Apparel Manufacturing.

    Science.gov (United States)

    1992-10-01

    their log information, but one case each of tendinitis , carpal tunnel syndrome, and bursitis was reported during the interview process. When employees at...day, diet, hormonal imbalances , season, type of clothing, etc. (Fanger, 1970). With ambient noise levels averaging above 8(0 dBA, trouser... tendinitis (1). There were also 14 reports of leg cramps among Plant A respondents (eight standing modular and six static standing workers reported this

  17. 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...

  18. 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.

  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. Postoperative osteomyelitis following implant arthroplasty of the foot: diagnosis with indium-111 white blood cell scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Bakst, R.H.; Kanat, I.O.

    1987-11-01

    Many complications can occur following insertion of silicone elastomer implants into the foot. Postoperative infection may be difficult to distinguish from other conditions such as dislodgment, fracture, ectopic and heterotopic new bone formation, synovitis, and bursitis. White blood cell scintigraphy, in conjunction with the clinical scenario, may prove to be an invaluable tool in the diagnosis of postoperative osteomyelitis, subsequent to implant arthroplasties. 32 references.

  1. 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

  2. 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.

  3. 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)

  4. 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.

  5. 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.)

  6. Soft-tissue rheumatism: diagnosis and treatment.

    Science.gov (United States)

    Reveille, J D

    1997-01-27

    Soft tissue rheumatism is one of the most common and most misunderstood categories of disorders facing the primary care physician. Among the more common types are subacromial bursitis, epicondylitis, trochanteric bursitis, anserine bursitis, and fibromyalgia. The keys to the diagnosis of soft-tissue rheumatism are the history and, more importantly, the physical examination. Extensive laboratory testing and radiographs are not as helpful in evaluating patients with these complaints. Treatment consists of nonsteroidal anti-inflammatory drugs (NSAIDs) and nonnarcotic analgesics. Especially in patients with localized disorders, intralesional injections of corticosteroids are particularly effective and safe and should be part of the armamentarium of the primary care practitioner. Fibromyalgia is a particularly challenging form of nonarticular rheumatism. The clinical presentation is rather characteristic, with the patient typically being a woman 30-60 years of age who presents with diffuse somatic pain. Patients often give a history of sleep disturbance, may be depressed, and show characteristic tender areas, or trigger points. Laboratory findings are normal. Management includes reassurance, correction of the underlying sleep disturbance with low doses of a tricyclic antidepressant, treatment with muscle relaxants and nonnarcotic analgesics or NSAIDs, and an exercise program with a strong aerobic component.

  7. 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.

  8. 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.

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

    Science.gov (United States)

    Karimzadeh, Hadi; Seyedbonakdar, Zahra; Mousavi, Maryam; Karami, Mehdi

    2016-01-01

    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 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. PMID:28331520

  10. 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.

  11. 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.)

  12. 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.

  13. MR imaging of the forefoot: Morton neuroma and differential diagnoses.

    Science.gov (United States)

    Zanetti, Marco; Weishaupt, Dominik

    2005-09-01

    Magnetic resonance (MR) imaging of Morton neuromas is highly accurate. Morton neuromas are more conspicuous when the patient is prone positioned and the foot is plantar flexed than in the supine position with the toes pointing upward. MR imaging of Morton neuromas has a large influence on the diagnostic thinking and treatment plan of orthopedic foot surgeons. The most common differential diagnoses include intermetatarsal bursitis, stress fractures, and stress reactions. Some diagnoses (nodules associated with rheumatoid arthritis, synovial cyst, soft tissue chondroma, and plantar fibromatosis) are rare and can be diagnosed with histologic correlation only.

  14. Practical US of the forefoot.

    Science.gov (United States)

    Bianchi, Stefano

    2014-06-01

    Disorders affecting the forefoot are common in the clinical practice. Accurate history and physical examination are the mainstays of diagnosis but imaging modalities are frequently obtained to confirm the clinical suspicion and plan appropriate treatment. In this article we will present the ultrasound (US) technique of examination of the forefoot followed by a brief description of the normal US anatomy and of US appearance of the most frequent forefoot disorders; rheumatoid arthritis, osteoarthritis, overuse arthropathy, Morton neuromas, bursitis, mucoid cysts, foreign bodies, bone disorders.

  15. Vaccination-related shoulder dysfunction.

    Science.gov (United States)

    Bodor, Marko; Montalvo, Enoch

    2007-01-08

    We present two cases of shoulder pain and weakness following influenza and pneumococcal vaccine injections provided high into the deltoid muscle. Based on ultrasound measurements, we hypothesize that vaccine injected into the subdeltoid bursa caused a periarticular inflammatory response, subacromial bursitis, bicipital tendonitis and adhesive capsulitis. Resolution of symptoms followed corticosteroid injections to the subacromial space, bicipital tendon sheath and glenohumeral joint, followed by physical therapy. We conclude that the upper third of the deltoid muscle should not be used for vaccine injections, and the diagnosis of vaccination-related shoulder dysfunction should be considered in patients presenting with shoulder pain following a vaccination.

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

    Science.gov (United States)

    Kong, Andrew; Van der Vliet, Andrew; Zadow, Steven

    2007-07-01

    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.

  17. Radiology.

    Science.gov (United States)

    Patel, Ketan; Wallace, Roxanne; Busconi, Brian D

    2011-04-01

    Hip and groin pain are a common complaint among athletes of all ages, and may result from an acute injury or from chronic, repetitive trauma. Hip injuries can be intraarticular, extraarticular, or both. Labral abnormalities may occur in asymptomatic patients as well as in those with incapacitating symptoms and signs. Athletic hip injury leading to disabling intraarticular hip pain most commonly involves labral tear. The extraarticular causes are usually the result of overuse activity, leading to inflammation, tendonitis, or bursitis. In clinical practice, the term athletic pubalgia is used to describe exertional pubic or groin pain.

  18. 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)

  19. Evaluacion de los desórdenes musculo-esqueléticos (DMEs) mediante el método ERIN: caso de los conductores de autobús de la Universidad del Quindío

    OpenAIRE

    Gómez Yepes, Milena Elizabeth; Cremades Oliver, Lázaro Vicente; Montoya Taborda, Juan Fernando

    2015-01-01

    Uno de los mayores retos de la ergonomía ha sido el estudio de la interacción del hombre frente a los requerimientos físicos (postura, fuerza, movimiento). Cuando estos requerimientos sobrepasan la capacidad de respuesta del individuo o no hay una adecuada recuperación biológica de los tejidos, este esfuerzo puede asociarse a la presencia de los Desórdenes Musculo-Esqueléticos (DME) causantes de ausentismo laboral. Los DME ocupacionales más conocidos son: cervicalgia, epicondiditis, bursitis,...

  20. 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

    The objective of this study was to describe ultrasonography (US) and magnetic resonance imaging (MRI) findings at painful Achilles tendons and entheses in patients with and without spondyloarthropathy (SpA and non-SpA) and healthy control persons (CTRLs). Particularly, we aimed to investigate....../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...

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

    Science.gov (United States)

    2010-01-27

    by some authors to be a prearthritic condition leading to chondral and labral lesions of the hip , which may progress to degenerative joint disease [6...derangement of joint 717.9 Juvenile osteochondrosis of pelvis 732.1 Cyst of bone pelvis 733.25 Aseptic necrosis of hip 733.42 Other symptoms referable to joint ...719.6 Nonallopathic lesions, not elsewhere classified 739.5 Other bursitis NOS 727.3 Sprain strain hip thigh NOS 843.9 Iliofemoral ligament sprain

  2. 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.

  3. 职业与滑囊炎

    Institute of Scientific and Technical Information of China (English)

    曾秀诗; 郑邦健; 沈国安

    2002-01-01

    @@ 滑囊炎(bursitis)又称滑膜炎(synovitis),可分为急性和慢性滑囊炎,按不同病因可分为创伤性滑囊炎和非特异性滑囊炎[1].创伤性滑囊炎常与职业有关,如矿工的髌前滑囊炎,鹰嘴滑囊炎和肩峰下滑囊炎,石板磨光工人的髌前滑囊炎,木工、水电工和网球运动员的桡肱滑囊炎等.

  4. 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.)

  5. Imaging of Soft Tissue Lesions of the Foot and Ankle

    Directory of Open Access Journals (Sweden)

    Seyed Hassan Mostafavi

    2010-05-01

    Full Text Available Differential diagnosis of soft tissue lesions of the foot may be narrowed with imaging. The cystic nature of ganglia, synovial cysts, and bursitis can be confirmed with MR imaging or sonography. Location and signal characteristics of noncystic lesions may suggest Morton's neuroma, giant cell tumor of the tendon sheath and plantar fibromatosis. Synovial-based lesions of the foot and ankle can be differentiated based on presence or absence of mineralization, lesion density, signal intensity, and the enhancement pattern. Knowledge of the incidence of specific neoplasms of the foot and ankle based on patient age aids in providing a limited differential diagnosis

  6. 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

  7. 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)

  8. Identificación de fármacos sintéticos en productos naturales comercializados en Brasil: el caso indiano "Talun"

    OpenAIRE

    2008-01-01

    "Indiano Talun" es un producto que estaba siendo comercializado en cápsulas, con la información en el rótulo de ser "una planta para el tratamiento de dolores en la columna, artritis, artrosis, bursitis y várices". Su producción y comercialización fueron prohibidas por la Agência Nacional de Vigilância Sanitária (ANVISA) en junio de 2006, pero tiempo después podía ser encontrado con otra presentación, con embalajes y finalidad medicinal semejante, pero nombres diferentes. Se analizaron dos mu...

  9. Xeroradiography in the diagnosis of the Haglund syndrome.

    Science.gov (United States)

    Burhenne, L J; Connell, D G

    1986-09-01

    Xeroradiography is the radiographic method of choice for assessment of soft tissues and calcaneal detail in patients suffering from a painful swelling localized in the heel. The radiographic triad of retrocalcaneal bursitis, superficial tendo Achillis bursitis, and Achilles tendon thickening, in the presence of an intact posterior superior calcaneal margin, are readily evaluated with xeroradiography. The Haglund syndrome is a painful inflammation involving the two bursae which surround the Achilles tendon. It is associated with a prominent posterior superior calcaneal margin. Of the two objective measurements devised to assess this prominence, neither the posterior calcaneal angle of Philip and Fowler of greater than 75 degrees nor the parallel pitch line (PPL) has proved to be a reliable index. In the present study, we evaluated four patients with heel pain and swelling as well as 100 control patients. The findings suggest that the prominence of the posterior calcaneal angle should be assessed relative to the known normal range rather than by comparison to a single fixed angulation which is arbitrarily designated as being abnormal.

  10. [Forefoot pain].

    Science.gov (United States)

    Damiano, Joël

    2010-03-20

    Forefoot chronic pain is a frequent problem in daily clinical practice. Mechanical pathology of the forefoot, usually called static metatarsalgia, represents the most frequent reason for consultation in pathology of the foot. The cause is a functionnal disorder or anatomic derangement of the forefoot architecture. Metatarsalgia can originate from a wide range of affections. Etiologies of chronic pain are described from medial to lateral with first ray pathologies (hallux valgus, hallux rigidus and sesamoid pathology) and first ray insufficiency, pathologies of the second, third and fourth ray and intermetatarsal spaces (second ray syndrome, Freiberg's disease, Morton neuroma, stress or bone insufficiency metatarsal fractures, intermetatarsal bursitis) and fifth ray pathology (lateral bursitis, quintus varus). Sometimes forefoot pain could also be caused by chronic inflammatory rheumatic diseases (rheumatoid and psoriatic arthritis) with a risk of structural metatarsophalangeal joints alteration. The pathology of the toes can, more rarely, explain a forefoot pain. So, several pathologic conditions can produce forefoot pain and the diagnostic approach must always be based on the anamnesis and clinical examination. In a second time if the cause is difficult to establish based solely on clinical findings, radiography and ultrasonography are today the most usefull auxiliary investigations.

  11. 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.

  12. Painful heel: MR imaging findings.

    Science.gov (United States)

    Narváez, J A; Narváez, J; Ortega, R; Aguilera, C; Sánchez, A; Andía, E

    2000-01-01

    Heel pain is a common and frequently disabling clinical complaint that may be caused by a broad spectrum of osseous or soft-tissue disorders. These disorders are classified on the basis of anatomic origin and predominant location of heel pain to foster a better understanding of this complaint. The disorders include plantar fascial lesions (fasciitis, rupture, fibromatosis, xanthoma), tendinous lesions (tendinitis, tenosynovitis), osseous lesions (fractures, bone bruises, osteomyelitis, tumors), bursal lesions (retrocalcaneal bursitis, retroachilleal bursitis), tarsal tunnel syndrome, and heel plantar fat pad abnormalities. With its superior soft-tissue contrast resolution and multiplanar capability, magnetic resonance (MR) imaging can help determine the cause of heel pain and help assess the extent and severity of the disease in ambiguous or clinically equivocal cases. Careful analysis of MR imaging findings and correlation of these findings with patient history and findings at physical examination can suggest a specific diagnosis in most cases. The majority of patients with heel pain can be successfully treated conservatively, but in cases requiring surgery (eg, plantar fascia rupture in competitive athletes, deeply infiltrating plantar fibromatosis, masses causing tarsal tunnel syndrome), MR imaging is especially useful in planning surgical treatment by showing the exact location and extent of the lesion.

  13. 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.

  14. Knee joint examinations by magnetic resonance imaging: The correlation of pathology, age, and sex

    Directory of Open Access Journals (Sweden)

    Serhat Avcu

    2010-01-01

    Full Text Available Aims: The aim of our study was to investigate the incidence and coexistence of multiple knee joint pathologies and the distribution of knee joint pathologies according to age and sex. Patients and Methods: A retrospective analysis was performed using the clinical data of patients evaluated with magnetic resonance imaging (MRI of the knee joint. Data from 308 patients examined between August 2002 and July 2003 were included into this study. A Pearson correlation analysis was performed to examine the relationship between the pathological findings and the age and sex of the patients. Results: The ages of the patients ranged between 1 and 74 years (mean: 43.3 years. Age was significantly correlated with meniscal degeneration and tears, medial collateral ligament degeneration, parameniscal cyst, and chondromalacia patellae. There was a significant correlation between male gender and anterior cruciate ligament injury. Meniscal injury was significantly correlated with bursitis, as well as medial collateral ligament injury. Bone bruise was significantly correlated with medial collateral ligament injury, lateral collateral ligament injury, Baker′s cyst, and anterior cruciate ligament injury. Chondromalacia patellae was significantly correlated with anterior cruciate ligament injury, patellae alta, and osteochondral lesion. Bursitis (in 53.2% of the patients followed by grade-II meniscal degeneration (in 43% of the patients were the most common knee pathologies observed by MRI. Conclusions: MRI findings of select knee pathologies are significantly correlated with each other and the age and sex of the patient.

  15. Painful Heel: MR Imaging Findings

    Directory of Open Access Journals (Sweden)

    Babak Sanei

    2010-05-01

    Full Text Available Heel pain is a common and frequently disabling clinical complaint that may be caused by a broad spectrum of osseous or soft-tissue disorders. "nThese disorders are classified on the basis of anatomic origin and predominant location of heel pain to foster a better understanding of this complaint. The disorders include plantar fascial lesions (fasciitis, rupture, fibromatosis, xanthoma, tendinous (tendonitis, tenosynovitis, osseous lesions (fractures, bone bruises, osteomyelitis, tumors, bursal lesions (retrocalcaneal bursitis, retroachilleal bursitis, tarsal tunnel syndrome, and heel plantar fat pad abnormalities. With its superior soft-tissue contrast resolution and multiplanar capability, magnetic resonance (MR imaging can help determine the cause of heel pain and help assess the extent and severity of the disease in ambiguous or clinically equivocal cases. Careful analysis of MR imaging findings and correlation of these findings with patient history and findings at physical examination can suggest a specific diagnosis in most cases. The majority of patients with heel pain can be successfully treated conservatively, but in cases requiring surgery (eg, plantar fascia rupture in competitive athletes, deeply infiltrating plantar fibromatosis, masses causing tarsal tunnel syndrome, MR imaging is especially useful in planning surgical treatment by showing the exact location and extent of the lesion

  16. 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.)

  17. 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.

  18. Knee joint examinations by magnetic resonance imaging: The correlation of pathology, age, and sex

    Directory of Open Access Journals (Sweden)

    Serhat Avcu

    2010-04-01

    Full Text Available Aims: The aim of our study was to investigate the incidence and coexistence of multiple knee joint pathologies and the distribution of knee joint pathologies according to age and sex. Patients and Methods: A retrospective analysis was performed using the clinical data of patients evaluated with magnetic resonance imaging (MRI of the knee joint. Data from 308 patients examined between August 2002 and July 2003 were included into this study. A Pearson correlation analysis was performed to examine the relationship between the pathological findings and the age and sex of the patients. Results: The ages of the patients ranged between 1 and 74 years (mean: 43.3 years. Age was significantly correlated with meniscal degeneration and tears, medial collateral ligament degeneration, parameniscal cyst, and chondromalacia patellae. There was a significant correlation between male gender and anterior cruciate ligament injury. Meniscal injury was significantly correlated with bursitis, as well as medial collateral ligament injury. Bone bruise was significantly correlated with medial collateral ligament injury, lateral collateral ligament injury, Baker’s cyst, and anterior cruciate ligament injury. Chondromalacia patellae was significantly correlated with anterior cruciate ligament injury, patellae alta, and osteochondral lesion. Bursitis (in 53.2% of the patients followed by grade-II meniscal degeneration (in 43% of the patients were the most common knee pathologies observed by MRI. Conclusions: MRI findings of select knee pathologies are significantly correlated with each other and the age and sex of the patient.

  19. 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

    Directory of Open Access Journals (Sweden)

    BC Menarim

    2012-01-01

    Full Text Available 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 mononuclear cell fraction as treatment for bicipital bursitis in a horse. A 7 year old crossbred draught gelding was presented with severe lameness of the left forelimb and pain in the shoulder region. Clinical and ultrasonographic evaluation revealed hemorrhagic synovial fluid, decrease of lameness after shoulder joint anesthesia and bicipital tendon fibers rupture and inflammation. The patient was successfully treated by triamcinolone injection adjacent to the tendon lesion followed by intralesional injection of bone marrow mononuclear cells seven days after the first treatment. Also, rest and controlled exercise were performed. Further clinical and ultrasound evaluations were executed at days 2, 15, 35, 75 and 120. After day 120 the horse started working and despite bicipital bursitis has been reported to exhibit high recurrence, neither clinical nor ultrasonographic signs of recurrence were reported for 15 months after lameness onset. These results suggest that use of regenerative medicine associated to rest and a controlled exercise protocol, accelerated tendon repair, reduced recovery period and allowed successful return to working activities without recurrence.La bursitis bicipital es la principal causa de cojera asociada al hombro equino, sin embargo representa un pequeño porcentaje de las causas de claudicaciones en caballos. Debido a la alta recurrencia observada en casos de tendinitis, tratamientos en base a medicina regenerativa se han tornado en un

  20. Muscle Gene Expression Patterns in Human Rotator Cuff Pathology

    Science.gov (United States)

    Choo, Alexander; McCarthy, Meagan; Pichika, Rajeswari; Sato, Eugene J.; Lieber, Richard L.; Schenk, Simon; Lane, John G.; Ward, Samuel R.

    2014-01-01

    Background: Rotator cuff pathology is a common source of shoulder pain with variable etiology and pathoanatomical characteristics. Pathological processes of fatty infiltration, muscle atrophy, and fibrosis have all been invoked as causes for poor outcomes after rotator cuff tear repair. The aims of this study were to measure the expression of key genes associated with adipogenesis, myogenesis, and fibrosis in human rotator cuff muscle after injury and to compare the expression among groups of patients with varied severities of rotator cuff pathology. Methods: Biopsies of the supraspinatus muscle were obtained arthroscopically from twenty-seven patients in the following operative groups: bursitis (n = 10), tendinopathy (n = 7), full-thickness rotator cuff tear (n = 8), and massive rotator cuff tear (n = 2). Quantitative polymerase chain reaction (qPCR) was performed to characterize gene expression pathways involved in myogenesis, adipogenesis, and fibrosis. Results: Patients with a massive tear demonstrated downregulation of the fibrogenic, adipogenic, and myogenic genes, indicating that the muscle was not in a state of active change and may have difficulty responding to stimuli. Patients with a full-thickness tear showed upregulation of fibrotic and adipogenic genes; at the tissue level, these correspond to the pathologies most detrimental to outcomes of surgical repair. Patients with bursitis or tendinopathy still expressed myogenic genes, indicating that the muscle may be attempting to accommodate the mechanical deficiencies induced by the tendon tear. Conclusions: Gene expression in human rotator cuff muscles varied according to tendon injury severity. Patients with bursitis and tendinopathy appeared to be expressing pro-myogenic genes, whereas patients with a full-thickness tear were expressing genes associated with fatty atrophy and fibrosis. In contrast, patients with a massive tear appeared to have downregulation of all gene programs except inhibition of

  1. The Haglund syndrome: initial and differential diagnosis.

    Science.gov (United States)

    Pavlov, H; Heneghan, M A; Hersh, A; Goldman, A B; Vigorita, V

    1982-07-01

    Haglund syndrome is a common cause of posterior heel pain, characterized clinically by a painful soft-tissue swelling at the level of the achilles tendon insertion. On the lateral heel radiograph the syndrome is characterized by a prominent calcaneal bursal projection, retrocalcaneal bursitis, thickening of the Achilles tendon, and a convexity of the superficial soft tissues at the level of the Achilles tendon insertion, a "pump-bump." An objective method for evaluating prominence of the bursal projection is measurement using the parallel pitch lines. This measurement helps to identify patients with Haglund syndrome and patients predisposed to develop this condition, and also to differentiate local causes of posterior heel pain from systemic causes. The parallel pitch line measurement was determined in 10 symptomatic feet and 78 control feet and the results were analyzed statistically.

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

    OpenAIRE

    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...

  3. An intraosseous lipoma of the calcaneus: a case report.

    Science.gov (United States)

    Pappas, Alexander J; Haffner, Kyle E; Mendicino, Samuel S

    2014-01-01

    Intraosseous lipomas are one of the rarest bone tumors found in the body. The incidence has been reported to be intraosseous lipoma in the calcaneus include plantar fasciitis, retrocalcaneal bursitis, gout, stress fracture, unicameral bone cyst, aneurysmal bone cyst, osteoblastoma, enchondroma, chondromyxoid fibroma, nonossifying fibroma, giant cell tumor, chondroblastoma, fibrous dysplasia, and chondrosarcoma. It has been reported that 60% to 70% of patients with an intraosseous lipoma present with symptoms. This article describes a case of a pathologic fracture secondary to a large intraosseous lipoma, the surgical treatments, and the subsequent resolution of symptoms. The purpose of our report was 3-fold: (1) to increase awareness of intraosseous lipomas and their potential to cause pathologic fractures in the calcaneus; (2) to suggest a possible treatment protocol for intraosseous lipomas in the calcaneus; and (3) to describe a rare case of an intraosseous lipoma of the calcaneus not located exclusively in the neutral triangle.

  4. 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.

  5. [Greater trochanteric pain syndrome].

    Science.gov (United States)

    Gollwitzer, H; Opitz, G; Gerdesmeyer, L; Hauschild, M

    2014-01-01

    Greater trochanteric pain is one of the common complaints in orthopedics. Frequent diagnoses include myofascial pain, trochanteric bursitis, tendinosis and rupture of the gluteus medius and minimus tendon, and external snapping hip. Furthermore, nerve entrapment like the piriformis syndrome must be considered in the differential diagnosis. This article summarizes essential diagnostic and therapeutic steps in greater trochanteric pain syndrome. Careful clinical evaluation, complemented with specific imaging studies and diagnostic infiltrations allows determination of the underlying pathology in most cases. Thereafter, specific nonsurgical treatment is indicated, with success rates of more than 90 %. Resistant cases and tendon ruptures may require surgical intervention, which can provide significant pain relief and functional improvement in most cases.

  6. Disorders of the Peritrochanteric and Deep Gluteal Space: New Frontiers for Arthroscopy.

    Science.gov (United States)

    Byrd, John W Thomas

    2015-12-01

    Arthroscopic techniques for the hip joint have evolved into endoscopic methods for extra-articular disorders. These endoscopic strategies provide a less invasive alternative to open procedures for traditionally recognized forms of pathology. Endoscopy has defined new disorders amenable to surgical correction and has redefined some of these existing disorders. The peritrochanteric and deep gluteal regions represent 2 of the most currently active areas of exploration. Peritrochanteric problems include trochanteric bursitis, full-thickness and partial-thickness tears of the abductors including the gluteus medius and minimus, and external coxa saltans (snapping iliotibial band). Deep gluteal disorders include piriformis syndrome, and other variations of deep gluteal syndrome, and ischiofemoral impingement. Each of these evolving areas is highlighted in this chapter.

  7. A review of surgical repair methods and patient outcomes for gluteal tendon tears.

    Science.gov (United States)

    Ebert, Jay R; Bucher, Thomas A; Ball, Simon V; Janes, Gregory C

    2015-01-01

    Advanced hip imaging and surgical findings have demonstrated that a common cause of greater trochanteric pain syndrome (GTPS) is gluteal tendon tears. Conservative measures are initially employed to treat GTPS and manage gluteal tears, though patients frequently undergo multiple courses of non-operative treatment with only temporary pain relief. Therefore, a number of surgical treatment options for recalcitrant GTPS associated with gluteal tears have been reported. These have included open trans-osseous or bone anchored suture techniques, endoscopic methods and the use of tendon augmentation for repair reinforcement. This review describes the anatomy, pathophysiology and clinical presentation of gluteal tendon tears. Surgical techniques and patient reported outcomes are presented. This review demonstrates that surgical repair can result in improved patient outcomes, irrespective of tear aetiology, and suggests that the patient with "trochanteric bursitis" should be carefully assessed as newer surgical techniques show promise for a condition that historically has been managed conservatively.

  8. Gluteal Tendinopathy: Integrating Pathomechanics and Clinical Features in Its Management.

    Science.gov (United States)

    Grimaldi, Alison; Fearon, Angela

    2015-11-01

    Synopsis Gluteal tendinopathy is now believed to be the primary local source of lateral hip pain, or greater trochanteric pain syndrome, previously referred to as trochanteric bursitis. This condition is prevalent, particularly among postmenopausal women, and has a considerable negative influence on quality of life. Improved prognosis and outcomes in the future for those with gluteal tendinopathy will be underpinned by advances in diagnostic testing, a clearer understanding of risk factors and comorbidities, and evidence-based management programs. High-quality studies that meet these requirements are still lacking. This clinical commentary provides direction to assist the clinician with assessment and management of the patient with gluteal tendinopathy, based on currently limited available evidence on this condition and the wider tendon literature and on the combined clinical experience of the authors. J Orthop Sports Phys Ther 2015;45(11):910-922. Epub 17 Sep 2015. doi:10.2519/jospt.2015.5829.

  9. Herd- and sow-related risk factors for lameness in organic and conventional sow herds

    DEFF Research Database (Denmark)

    Knage-Rasmussen, Kristian Møllegaard; Houe, Hans; Rousing, Tine;

    2014-01-01

    Lameness in sows is an animal welfare problem which also presents an economic challenge to pig producers. Information about the prevalence of herd lameness in organic sows is relatively scarce. The first objective of this study was to establish the prevalence of lameness and to identify risk...... and fifty four gestation sows from 44 indoor conventional and nine organic sow herds were included in this study. The nine organic herds were visited twice: once in summer/autumn 2011, and once in winter/spring 2012. In winter/spring 2011, a total of 44 indoor conventional herds were visited. Risk factors...... assigned scores for lameness, body condition and bursitis. A multivariable analysis was carried out by logistic regression with the herd and observer as random effects. The average herd lameness prevalence in gestation and lactation sows in organic herds was 11% in summer/autumn and 4.6% in winter...

  10. "Bursal reactions" in rotator cuff tearing, the impingement syndrome, and calcifying tendinitis.

    Science.gov (United States)

    Ishii, H; Brunet, J A; Welsh, R P; Uhthoff, H K

    1997-01-01

    Subacromial bursal specimens from 63 patients undergoing surgery for rotator cuff tearing (n = 43), the impingement syndrome (n = 14), and calcifying tendinitis n = 6) were studied to characterize the reactions that develop at the tendinopathy "lesional" sites. Intensity of the bursal reactions and production of type III collagen vary considerably, with the highest incidence of both seen in patients with rotator cuff tears. The intensity of bursal reactions correlated with the degree of formation of perivascular new collagen and type III collagen expression. In 22 of the 63 patients the bursal reaction distant to the tendon lesion was also studied. It was minimal and did not correlate to the lesional bursal findings. A strong correlation, however, existed between surgical appearance and histologic grading. The term "localized bursal reaction" as opposed to bursitis more correctly describes bursal involvement. Resection of bursal tissues should be limited to the lesional tissue that interferes with subacromial motion.

  11. 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.

  12. 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

  13. 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.

  14. 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.)

  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. 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.)

  17. 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.)

  18. Corticosteroid Injections for Common Musculoskeletal Conditions.

    Science.gov (United States)

    Foster, Zoë J; Voss, Tyler T; Hatch, Jacquelynn; Frimodig, Adam

    2015-10-15

    Family physicians considering corticosteroid injections as part of a comprehensive treatment plan for musculoskeletal diagnoses will find few high-quality studies to assist with evidence-based decision making. Most studies of corticosteroid injections for the treatment of osteoarthritis, tendinopathy, bursitis, or neuropathy include only small numbers of patients and have inconsistent long-term follow-up. Corticosteroid injections for the treatment of adhesive capsulitis result in short-term improvements in pain and range of motion. For subacromial impingement syndrome, corticosteroid injections provide short-term pain relief and improvement in function. In medial and lateral epicondylitis, corticosteroid injections offer only short-term improvement of symptoms and have a high rate of symptom recurrence. Corticosteroid injections for carpal tunnel syndrome may help patients avoid or delay surgery. Trigger finger and de Quervain tenosynovitis may be treated effectively with corticosteroid injections. Patients with hip or knee osteoarthritis may have short-term symptom relief with corticosteroid injections.

  19. Rotator cuff tears: clinical, radiographic, and US findings.

    Science.gov (United States)

    Moosikasuwan, Josh B; Miller, Theodore T; Burke, Brian J

    2005-01-01

    Rotator cuff tears are a common cause of shoulder pain. Clinical and radiographic findings can suggest the presence of a rotator cuff tear. The most sensitive clinical findings are impingement and the "arc of pain" sign. Radiographic findings are usually normal in the acute setting, although the "active abduction" view may show decreased acromiohumeral distance. In more chronic cases, an outlet view may show decreased opacity and decreased size of the supraspinatus muscle due to atrophy. In late cases, the humeral head may become subluxated superiorly, and secondary degenerative arthritis of the glenohumeral joint may ensue. Ultrasonography (US), with over 90% sensitivity and specificity, can help confirm the diagnosis in clinically or radiographically equivocal cases. US can also reveal the presence of other abnormalities that may mimic rotator cuff tear at clinical examination, including tendinosis, calcific tendinitis, subacromial subdeltoid bursitis, greater tuberosity fracture, and adhesive capsulitis.

  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. 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.

  3. 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)

  4. EFFICACY OF ACUPUNCTURE THERAPY ON A, B AND O BLOOD GROUPS--Relationship between A, B, O blood groups and the acupuncture therapy

    Institute of Scientific and Technical Information of China (English)

    Amit Kr. Chakraborty; Mrigendranath Gantait; Biswapati Mukherjee

    2005-01-01

    Efficacy of acupuncture therapy varies in patients with similar ailments. The present study was undertaken to search for a marker for better efficacy of acupuncture therapy. The study was made in 224 patients including osteoarthritis 141 (62.94 %), polyarthritis 23 (10.26 %), Bursitis & synovitis 15 (6.69 %) and others 45 (20.08 %). ABO blood groups were tested for each patient. It appears that patients belonging to group AB and B responded well to acupuncture therapy in proportionately more number. Good result was achieved in 47.82 % cases in group AB and 46.04 % cases in group B, whereas patients of group A and O showed good result in 27.65 % and 26.15 % cases respectively. Apparently it may be concluded that patients of AB & B blood groups would respond comparatively well to acupuncture therapy.

  5. 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.

  6. RESULTS OF SURGICAL TREATMENT OF HAGLUND’S DESEASE

    Directory of Open Access Journals (Sweden)

    A. A. Kardanov

    2013-01-01

    Full Text Available Objectives. The article presents the results assessment of open calcaneal excision compared to percutaneous excision of patients with Haglund’s disease. Materials and methods. Twenty-one patients (26 feet underwent the surgical treatment during the period from 2010 to 2012. The clinical diagnosis was confirmed by axial load radiography estimated with “Fowler-Philip” and “posterior pitch lines” methods. Eight feet were treated with open calcaneal excision and 18 feet - with percutaneous procedure. The mean duration of follow-up was 21,8 months. Clinical evaluation criteria were deformity and/or bursitis recurrence, tenderness, pain by wearing shoes, return to the sport training, patient satisfaction, presence/absence of major complications. Results. Good results were reported for 21 patients; fair results - for 4 patients; and poor results - for one patient. No significant differences in results depending on the method of intervention have been identified.

  7. 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.

  8. 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.

  9. 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.)

  10. 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.

  11. 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.

  12. 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.

  13. Bloqueo tricompartimental del hombro doloroso: estudio preliminar Tricompartmental blockade of painful shoulder: A preliminary study

    OpenAIRE

    2009-01-01

    Introducción: El hombro doloroso constituye una de las consultas más frecuentes en atención primaria, y afecta entre el 7 y el 34% de la población general adulta. La etiología más frecuente es la disfunción del manguito de los rotadores, que supone más del 70% de los casos, incluyendo aquí la tendinitis, la bursitis y la rotura de éste o de alguno de sus componentes. Se han postulado diversos tratamientos para el hombro doloroso. El objetivo del estudio es exponer una nueva técnica para los p...

  14. 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.

  15. Is ankle involvement underestimated in rheumatoid arthritis? Results of a multicenter ultrasound study.

    Science.gov (United States)

    Gutierrez, Marwin; Pineda, Carlos; Salaffi, Fausto; Raffeiner, Bernd; Cazenave, Tomas; Martinez-Nava, Gabriela A; Bertolazzi, Chiara; Vreju, Florentin; Inanc, Nevsun; Villaman, Eduardo; Delle Sedie, Andrea; Dal Pra, Fernando; Rosemffet, Marcos

    2016-11-01

    The aim of this study is to investigate the prevalence of subclinical ankle involvement by ultrasound in patients with rheumatoid arthritis (RA). The study was conducted on 216 patients with RA and 200 healthy sex- and age-matched controls. Patients with no history or clinical evidence of ankle involvement underwent US examination. For each ankle, tibio-talar (TT) joint, tibialis anterior (TA) tendon, extensor halux (EH) and extensor common (EC) tendons, tibialis posterior (TP) tendon, flexor common (FC) tendon and flexor hallux (FH) tendon, peroneous brevis (PB) and longus (PL) tendons, Achilles tendon (AT) and plantar fascia (PF) were assessed. The following abnormalities were recorded: synovitis, tenosynovitis, bursitis, enthesopathy and rupture. BMI, DAS28, RF ESR and CRP were also obtained. A total of 432 ankles of patients with RA and 400 ankles of healthy controls were assessed. In 188 (87%) patients with RA, US showed ankle abnormalities whereas, in control group, US found abnormalities in 57 (28.5 %) subjects (p = 0.01). The most frequent US abnormality in RA patients was TP tenosynovits (69/216) (31.9 %), followed by PL tenosynovitis (58/216) (26.9 %), TT synovitis (54/216) (25 %), PB tenosynovitis (51/216) (23.6 %), AT enthesopathy (41/216) (19 %) and AT bursitis (22/216) (10.2 %). In 118 RA patients out of 216 (54.6%), a positive PD was found. No statistically significant correlation was found between the US findings and age, disease duration, BMI, DAS28, RF, ESR and CRP. The present study provides evidence of the higher prevalence of subclinical ankle involvement in RA patients than in age- and gender-matched healthy controls identified by US.

  16. 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.)

  17. 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.)

  18. 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

  19. 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

  20. A síndrome anserina Anserine syndrome

    Directory of Open Access Journals (Sweden)

    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

  1. 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

  2. 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

  3. Intertester reliability of shoulder complaints diagnoses in primary health care

    Science.gov (United States)

    Storheil, Benny; Klouman, Elise; Holmvik, Stian; Emaus, Nina; Fleten, Nils

    2016-01-01

    Objective 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. Design Cross-sectional study. Setting Four primary health care clinicians used patients’ history and functional examination of the shoulder by selective tissue tension techniques (STTs), to diagnose shoulder complaints. Subjects 62 patients, aged 18–75 years. Main outcome measure Reliability of diagnoses was assessed by observed intertester agreement and Cohen’s kappa. A total of 372 diagnostic pairs were available for intertester comparisons. Results 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). Conclusions 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

  4. 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

  5. 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

  6. MRI characteristics of enthesitis in peripheral ankylosing spondylitis%外周型强直性脊柱炎中附着点相关炎症的MRI表现

    Institute of Scientific and Technical Information of China (English)

    李国; 李建军; 詹峰; 陈峰

    2016-01-01

    Objective To explore the MRI findings of enthesitis in peripheral ankylosing spondylitis (AS). Methods We retrospectively reviewed the MRI obtained from 13 patients with clinically-diagnosed peripheral AS. MRI finding attributable to enthesitis could be visualized as tendon or ligament enthesitis, bone marrow edema (BME), synovitis, bursitis, tenosynovitis. Results MRI findings of knee showed enthesitis in 8 knees, mainly involved in the insertions of the quadriceps tendon at the upper patellar pole , the patellar ligament at the lower patellar pole and the tibial tubercle, BME in 8 knees, synovitis in 5 knees, bursitis in 3 knees, and tenosynovitis in 4 knees. MRI findings of ankle showed enthesitis in 3 ankles, involved in plantar insertion into calcaneus and Achilles tendon insertion into the calcaneus, BME in 1 ankle, and tenosynovitis in 3 ankles. Conclusion The lower extremities are more often involved in peripheral AS than the upper extremities. MRI characteristic of enthesitis may contribute to the diagnosis of peripheral AS early combined with HLA-B27.%目的:探讨外周型强直性脊柱炎的MRI表现。方法:收集我院经临床确诊为外周型强直性脊柱炎13例患者的MRI图像行回顾性分析,将MRI表现分为肌腱或韧带附着点炎、骨髓水肿、滑膜炎、滑囊炎、腱鞘炎五种。结果:膝关节MRI表现:附着点炎8膝,主要位于髌韧带髌骨附着点、髌韧带胫骨附着点、股四头肌肌腱髌骨端附着点;骨髓水肿8膝;滑膜炎5膝;滑囊炎3膝;腱鞘炎4膝。踝关节MRI表现:附着点炎3踝,位于足底筋膜跟骨附着点、跟腱跟骨附着点;骨髓水肿1踝;腱鞘炎4踝。结论:外周型强直性脊柱炎好发于下肢关节,结合HLA-B27检查,MRI的附着点相关炎症可对其早期诊断。

  7. 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.

  8. Haglund Deformity – Surgical Resection by the Lateral Approach

    Directory of Open Access Journals (Sweden)

    S Natarajan

    2015-03-01

    Full Text Available The aim of this study was to analyse the outcome of surgical Haglund deformity is a prominence in the postero superolateral aspect of the calcaneum. Haglund deformity is a prominence in the postero superolateral aspect of the calcaneum, causing a painful bursitis, which may be difficult to treat by non-operative measures alone. Various surgical methods are available for effective treatment of refractory Haglund’s deformity. This study is to evaluate whether adequate resection of Haglund deformity by a lateral approach provides good to excellent results. During the period from 2009 to 2012, 40 patients with 46 feet had undergone resection of Haglund deformity using lateral approach and the outcome was analysed using AOFAS Ankle-Hind Foot Scale. The mean AOFAS score at the follow up was 86/100, with the majority of patients reporting alleviation of pain at one year follow up. The lateral approach to calcaneal ostectomy can be an effective treatment for those suffering from refractory Haglund deformity. However, the patient must be made aware of the duration of recovery being long.

  9. Dynamic high-resolution ultrasound of the shoulder: how we do it.

    Science.gov (United States)

    Corazza, Angelo; Orlandi, Davide; Fabbro, Emanuele; Ferrero, Giulio; Messina, Carmelo; Sartoris, Riccardo; Perugin Bernardi, Silvia; Arcidiacono, Alice; Silvestri, Enzo; Sconfienza, Luca Maria

    2015-02-01

    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.

  10. Shockwave treatment for musculoskeletal diseases and bone consolidation: qualitative analysis of the literature

    Directory of Open Access Journals (Sweden)

    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.

  11. Forefoot pain involving the metatarsal region: differential diagnosis with MR imaging.

    Science.gov (United States)

    Ashman, C J; Klecker, R J; Yu, J S

    2001-01-01

    Many disorders produce discomfort in the metatarsal region of the forefoot. These disorders include traumatic lesions of the soft tissues and bones (eg, turf toe, plantar plate disruption, sesamoiditis, stress fracture, stress response), Freiberg infraction, infection, arthritis, tendon disorders (eg, tendinosis, tenosynovitis, tendon rupture), nonneoplastic soft-tissue masses (eg, ganglia, bursitis, granuloma, Morton neuroma), and, less frequently, soft-tissue and bone neoplasms. Prior to the advent of magnetic resonance (MR) imaging, many of these disorders were not diagnosed noninvasively, and radiologic involvement in the evaluation of affected patients was limited. However, MR imaging has proved useful in detecting the numerous soft-tissue and early bone and joint processes that occur in this portion of the foot but are not depicted or as well characterized with other imaging modalities. Frequently, MR imaging allows a specific diagnosis based on the location, signal intensity characteristics, and morphologic features of the abnormality. Consequently, MR imaging is increasingly being used to evaluate patients with forefoot complaints. Radiologists should be familiar with the differential diagnosis and MR imaging features of disorders that can produce discomfort in this region.

  12. Phaeohyphomycosis infection in the knee☆

    Science.gov (United States)

    Sadigursky, David; Nogueira e Ferreira, Luisa; Moreno de Oliveira Corrêa, Liz

    2016-01-01

    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. PMID:27069894

  13. Osteoarticular complications of brucellosis: a study of 169 cases.

    Science.gov (United States)

    Mousa, A R; Muhtaseb, S A; Almudallal, D S; Khodeir, S M; Marafie, A A

    1987-01-01

    Of 452 patients with brucellosis, 169 (111 male and 58 female) had osteoarticular complications. Brucella melitensis was isolated from the blood in 7.7% of the cases. Fever, chills, arthralgia, backache, high levels of C-reactive protein, positive rheumatoid factor, and splenomegaly were more frequent in osteoarticular brucellosis than in nonosteoarticular disease. Arthritis occurred in the hip joint in 90 cases (53%), knees in 61 (36%), sacroiliacs in 33 (20%), ankles in 25 (15%), elbows in nine (5.3%), shoulders in eight (5%), wrists in six (3.5%), and sternoclavicular arthritis occurred in three cases (1.8%). Spondylitis occurred in 10 cases (6%), osteomyelitis in four (2.4%), and tendinitis or bursitis in two (1.2%). Treatment with tetracycline or trimethoprim-sulfamethoxazole (TMP-SMZ) alone (four to eight weeks) or in combination with streptomycin (two to four weeks) resulted in a relapse rate of 16.6%. No relapses occurred in seven patients treated with repeated four- to six-weeks courses of rifampin plus tetracycline or TMP-SMZ plus streptomycin.

  14. Can We Measure the Heel Bump? Radiographic Evaluation of Haglund's Deformity.

    Science.gov (United States)

    Bulstra, Gythe H; van Rheenen, Thijs A; Scholtes, Vanessa A B

    2015-01-01

    Haglund's deformity is a symptomatic posterosuperior deformity of the heel. The lateral radiograph of the ankle will show a prominent, large, posterosuperior part of the calcaneus, which can be measured using the Fowler and Philips angle (FPA, the angle between the posterior and plantar surface of the calcaneus) and the calcaneal pitch angle (CPA, the angle between the sole of the foot and the plantar part of the calcaneus). Although these angles are commonly used, these radiographic angle measurements have never shown a relationship with Haglund's deformity. In 78 patients (51% male) with symptomatic Haglund's deformity and a control group of 100 patients (41% male) with no heel complaints, we measured the FPA and CPA on weightbearing lateral radiographs of the foot. Using an unpaired t tests, no significant difference was found between the 2 groups in the FPA (p = .40). We measured a significant difference in the CPA between the Haglund group and the control group (p = .014). Subgroup analysis showed that this difference was mainly found in females (p position results in extra traction on the Achilles tendon and can eventually cause tendinitis and bursitis. Radiographic measurement should be used as an auxiliary tool. If the calcaneus tends to change position, it would be interesting to understand this process, which could eventually lead to improvement in the treatment of Haglund's deformity.

  15. Differential diagnosis of pain around the hip joint.

    Science.gov (United States)

    Tibor, Lisa M; Sekiya, Jon K

    2008-12-01

    The differential diagnosis of hip pain is broad and includes intra-articular pathology, extra-articular pathology, and mimickers, including the joints of the pelvic ring. With the current advancements in hip arthroscopy, more patients are being evaluated for hip pain. In recent years, our understanding of the functional anatomy around the hip has improved. In addition, because of advancements in magnetic resonance imaging, the diagnosis of soft tissue causes of hip pain has improved. All of these advances have broadened the differential diagnosis of pain around the hip joint and improved the treatment of these problems. In this review, we discuss the causes of intra-articular hip pain that can be addressed arthroscopically: labral tears, loose bodies, femoroacetabular impingement, capsular laxity, tears of the ligamentum teres, and chondral damage. Extra-articular diagnoses that can be managed arthroscopically are also discussed, including: iliopsoas tendonitis, "internal" snapping hip, "external" snapping hip, iliotibial band and greater trochanteric bursitis, and gluteal tendon injury. Finally, we discuss extra-articular causes of hip pain that are often managed nonoperatively or in an open fashion: femoral neck stress fracture, adductor strain, piriformis syndrome, sacroiliac joint pain, athletic pubalgia, "sports hernia," "Gilmore's groin," and osteitis pubis.

  16. Imaging of hip and groin injuries in athletes.

    Science.gov (United States)

    Overdeck, Kimberlee Horton; Palmer, William Ewing

    2004-03-01

    Proper function of the hip joint is imperative for athletes who participate in sporting activities that rely on utilization of the lower extremity; these primarily include kicking, running, and jumping activities. Sports-related injuries of the hip and groin are not frequent sources of disability in athletes; however, they may present a significant diagnostic dilemma, both from a clinical and radiological standpoint. Delay in diagnosis and treatment may result in undesired complications, such as premature degenerative disease, as well as time lost from athletic activities. Magnetic resonance (MR) imaging of the hip, particularly following the intra-articular administration of gadolinium, has proven to be extremely valuable in the diagnosis of radiographically occult osseous abnormalities as well as soft-tissue injuries, such as pubalgia, musculotendinous abnormalities, and bursitis. This article will review several pathological conditions of the hip and groin in both recreational and professional athletes, with an emphasis on MR imaging as the modality of choice in the diagnosis of these injuries.

  17. EXCISION OF RETROCALCANEAL SPUR BY A LATERAL APPROA CH FOR RELIEF OF HEEL PAIN

    Directory of Open Access Journals (Sweden)

    Nandivada

    2013-04-01

    Full Text Available ABSTRACT : retrocalcaneal pain could be due to various reason s depending on the structure involved in the region. Bursal irritation is a comm on finding which is well relieved by non surgical modality of treatment rest, ice therapy, a nd other modalities of physiotherapy. CONTEXT (background: Podiatric or foot problems are increasing in our lif estyles due to various reasons . HEEL PAIN DUE TO RETROCALCANEAL S PUR IS AN IMPORTANT CAUSE AMONGST THE MANY CAUSES OF HEEL PAIN Retrocalcaneal bursitis is a common presentation which is easily identifiable and treated . The retr ocalcaneal spur or bony osteophyte poses a potential problem to the tendon of tendo achillis and results in its repeated irritation causing tendinitis and future weakening .Hence this study o f 5 cases showed that the excision of the retrocalcaneum provided greater relief and i feel t he lateral approach to the calcaneal spur area more comfortable . AIM: Aim of this case study is to inform the orthopaedic fraternity and the post graduate students about the pain relief obtained by excision of the retrocalcaneal spur by a lateral approach to the ankle postero lateral to the t endo achillis . MATERIAL AND METHODS : Between 2011 and 2013 an analysis of the retrocalca neal spur patients and their resistant heel pain cases were given a detailed x ray examination a nd were found to have an impinging retrocalcaneal spur and the method of treatment used was a lateral approach to the heel and excision of the posterior retrocalcaneal spur under d irect vision

  18. 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.

  19. 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

  20. 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.

  1. Ultrasound assessment of the elbow.

    Science.gov (United States)

    Radunovic, Goran; Vlad, Violeta; Micu, Mihaela C; Nestorova, Rodina; Petranova, Tzvetanka; Porta, Francesco; Iagnocco, Annamaria

    2012-06-01

    Ultrasonography of the elbow is a very helpful and reliable diagnostic procedure for a broad spectrum of rheumatic and orthopedic conditions, representing a possible substitute to magnetic resonance imaging for evaluation of soft tissues of the elbow. Musculoskeletal ultrasound (US) shows many advantages over other imaging modalities, probably the most important being its capability to perform a dynamic assessment of musculoskeletal elements with patient's partnership and observation during examination. In addition, ultrasonography is cost effective, easy available, and has excellent and multiplanar capability to visualize superficial soft tissue structures. Among all imaging procedures, US is highly accepted by patients. US assessment of the elbow requires good operator experience in the assessment of normal anatomy, and suitable high-quality equipment. US of the elbow provides detailed information including joint effusions, medial and lateral epicondylitis, tears of the distal biceps and triceps tendons, radial and ulnar collateral ligament tears, ulnar nerve entrapment, cubital or olecranon bursitis and intra-articular loose bodies. The aim of this paper is to review the screening technique and the basic normal and pathological findings in elbow US.

  2. Antiinflammatory activity of tenoxicam gel on carrageenan-induced paw oedema in rats

    Directory of Open Access Journals (Sweden)

    Gupta G

    2006-01-01

    Full Text Available Tenoxicam is a nonsteroidal antiinflammatory drug, used in the treatment of inflammatory and degenerative disorders of the musculoskeletal system. It is from the oxicam group of nonsteroidal antiinflammatory agents. It is widely prescribed for the treatment of osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, gout, extra-articular disorders, bursitis, tendonitis, and nonarticular rheumatic condition. Tenoxicam has some side effects when taken orally, viz., epigastric pain, heartburn, nausea, diarrhoea, vomiting, peptic ulcer, and hepatic impairment. The aim of this study was to formulate topical gel containing 1% of tenoxicam in 1% carbopol-940 and PEG-4000 and to evaluate it for antiinflammatory activity using carrageenan-induced paw oedema in rats. The studies were conducted on Wistar rats of either sex (160-180 g. The change in oedema volume of the rat hind paw was measured using mercury plethysmometer. The readings were measured in terms of volume displaced in millimetre using a micropipette that has mark to 10 divisions in 1 ml. The carbopol gel formulation of tenoxicam containing 15% of ethanol and 5% of sodium lauryl sulphate was significantly more effective against oedema formation than the other formulation of tenoxicam gel and compared to the marketed product of piroxicam gel. Results suggest that the 1% tenoxicam gel in carbopol-940 inhibited 52% of carrageenan-induced oedema formation as compared with the 44% inhibition obtained with marketed product of piroxicam gel.

  3. Shockwave treatment for musculoskeletal diseases and bone consolidation: qualitative analysis of the literature.

    Science.gov (United States)

    Kertzman, Paulo; Lenza, Mario; Pedrinelli, André; Ejnisman, Benno

    2015-01-01

    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.

  4. 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.

  5. 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.

  6. The diagnostic accuracy of magnetic resonance imaging and ultrasonography in gluteal tendon tears--a systematic review.

    Science.gov (United States)

    Westacott, Daniel J; Minns, Jonathon I; Foguet, Pedro

    2011-01-01

    Gluteal tendon tears are one of the many pathologies causing pain around the greater trochanter that are often labelled as trochanteric bursitis. We systematically reviewed the peer-reviewed literature to establish the accuracy of magnetic resonance imaging and ultrasonography in the diagnosis of gluteal tendon tears in patients with persistent lateral hip pain or Greater Trochanteric Pain Syndrome (GTPS). 7 studies met the inclusion criteria, comparing either imaging modality with a reference standard of surgical findings. Included studies were assessed for methodological quality using the QUADAS checklist. MRI had sensitivity of 33-100%, specificity of 92-100%, positive predictive value of 71-100% and negative predictive value of 50%. False-positives were common. High signal located superior to the trochanter had a stronger association with tears. Ultrasonography had a sensitivity of 79-100% and positive predictive value of 95-100%. The amount and quality of literature on the subject is limited and further well-designed studies are required to establish the optimum diagnostic strategy in this condition. Ultrasonography may prove to be the investigation of choice, despite requiring a skilled practitioner. The orthopaedic surgeon should liaise with an experienced musculoskeletal radiologist to best investigate and diagnose gluteal tendon tears in the clinical picture of GTPS.

  7. MRI for the diagnosis of scapular dyskinesis: a report of two cases

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  8. [Direct endoscopic approach improves prognosis of septic-synovitis in the horse].

    Science.gov (United States)

    ter Braake, F

    The medical records of 71 horses with sepic arthritis, bursitis, or tenosynovitis, treated between 1996 and 2001 at Dierenkliniek Enmeloord, were reviewed. A total number of 81 joints, tendon sheaths and bursae were treated (21 tarsi, 17 digital tendon sheaths, 14 metacarpo/metatarso-phalangeal joints, 12 stifles, 6 carpi, 4 coffin joints, 2 navicular bursae, 1 elbow joint, 1 proximal-interphalangeal joint, 1 tarsal sheath, 1 bursa calcanei subtendineum). The aetiology in 42 cases was a penetrating wound (group 1), in 4 cases an intra-articular injection, and in 2 cases arthroscopic surgery (group II), and in 13 cases septic arthritis in young foals (group III); in 10 cases the aetiology was unknown (group V). A total of 93 endoscopic lavages was performed on 81 joints, tendon sheaths, and bursae (1-3 lavages, mean 1.18 lavage per synovial structure). Survival rates were 95% for group I, 100% for group II, 73% for group III and 100% for group IV. Horses were discharged after 4-73 days of hospitalization (mean 20 days). Longterm follow-up revealed a survival rate of 92% for group I, 100% for group II, 67% for group III, and 90% for group IV. Of the surviving horses, 89% were sound and 11% had some degree of residual lameness. It is concluded that instant aggressive treatment using endoscopic techniques yields the best results so far and is therefore recommended.

  9. Retrospective Evaluation Of MRI Findings Of Knee Joint In 255 Patients

    Directory of Open Access Journals (Sweden)

    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.

  10. 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.

  11. IMAGING OF ROTATOR CUFF PATHOLOGY- IS ULTRASOUND AS GOOD AS MRI

    Directory of Open Access Journals (Sweden)

    Vinot

    2015-12-01

    Full Text Available Aim of this study is to compare the diagnostic accuracy of ultrasound versus MRI in detecting rotator cuff pathology. Rotator cuff pathology involves group of disorder, which progresses from bursitis to tendinitis to partial tear and full thickenss tear. The most commonly affected tendon is the supraspinatus tendon. In our prospective study of 35 patients as initial ultrasound was followed by MRI sensitivity, specificity and accuracy for diagnosis of full thickness tear of supraspinatus when USG was compared to MRI was 100%, whereas sensitivity, specificity and accuracy of diagnosing partial thickness tear using ultrasound compared to MRI are 100%, 78% and 84%. There is no significant p value difference on comparing ultrasound with MRI on detecting tears. Ultrasound and MRI showed almost similar diagnostic accuracy in associated findings like tendon retraction, muscle atrophy, bursal effusion. Ultrasound also has additional value of dynamic evaluation, which is useful in evaluating subacromial and subcoracoid impingement. Modality choice for the evaluation of rotator cuff pathology should be based on several factors like availability, patient preference and clinical information being sought. The high resolution sonography is an attractive screening modality for rotator cuff in patients presenting with painful shoulder. A well performed ultrasound examination in most cases obviates the need for more invasive diagnostic tests like arthrography and cumbersome and expensive MRI examinations.

  12. Minimally Invasive Sacroiliac Joint Fusion: One-Year Outcomes in 40 Patients

    Directory of Open Access Journals (Sweden)

    Donald Sachs

    2013-01-01

    Full Text Available Background. SI joint pain is difficult to diagnose due to overlapping symptoms of the lumbar spine, and until recently, treatment options have been limited. The purpose of this retrospective study is to report on the safety and effectiveness of MIS SI joint arthrodesis using a series of triangular, porous plasma coated implants in patients refractory to conservative care. Methods. We report on the first 40 consecutive patients with one-year follow-up data that underwent MIS SI joint fusion with the iFuse Implant System (SI-BONE, Inc., San Jose, CA by a single surgeon. Medical charts were reviewed for demographics, perioperative metrics, complications, pain scores, and satisfaction. Results. Mean age was 58 years (range 30–81 and 75% of patients were female. Postoperative complications were minimal and included transient trochanteric bursitis (5%, facet joint pain (20%, and new low back pain (2.5%. There were no reoperations at one year. Mean pain score improved from 8.7 (1.5 SD at baseline to 0.9 (1.6 at 12 months, a 7.8-point improvement (P<.001. Patient satisfaction was very high. Conclusions. The results of this case series reveal that MIS SI joint fusion using the iFuse Implant System is a safe and effective treatment option in carefully selected patients.

  13. Rapid onset of muscle weakness (rhabdomyolysis) associated with the combined use of simvastatin and colchicine.

    Science.gov (United States)

    Justiniano, Maria; Dold, Sylvia; Espinoza, Luis R

    2007-10-01

    We report a case of a patient with mild chronic renal insufficiency who had been taking simvastatin for over a year and developed acute weakness within 3 weeks after the start of treatment with colchicine for acute gouty bursitis. Profound muscle weakness of lower extremities with inability to stand up and/or walk was present. Elevated muscle enzymes and findings on electromyography were consistent with myopathy. Rapid improvement in muscle strength accompanied by prompt resolution of abnormal elevation of muscle enzymes followed cessation of both medications. Both colchicine and statin therapy may be associated with myopathy, which usually occurs after several months of therapy. The concomitant use, however, of colchicine and statin has been associated with the rapid onset of muscle weakness. Four patients with similar clinical and laboratory characteristics to our patient's after the combined use of colchicine and statins have been described in the literature. Patients receiving combination therapy with colchicine and simvastatin, particularly in the presence of renal insufficiency, should be monitored for the development of myopathy, including rhabdomyolysis.

  14. Detailed shoulder MRI findings in manual wheelchair users with shoulder pain.

    Science.gov (United States)

    Morrow, Melissa M B; Van Straaten, Meegan G; Murthy, Naveen S; Braman, Jonathan P; Zanella, Elia; Zhao, Kristin D

    2014-01-01

    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.

  15. Helpful tips for performing musculoskeletal injections.

    Science.gov (United States)

    Metz, John P

    2010-01-01

    Injections are valuable procedures for managing musculoskeletal conditions commonly encountered by family physicians. Corticosteroid injections into articular, periarticular, or soft tissue structures relieve pain, reduce inflammation, and improve mobility. Injections can provide diagnostic information and are commonly used for postoperative pain control. Local anesthetics may be injected with corticosteroids to provide additional, rapid pain relief. Steroid injection is the preferred and definitive treatment for de Quervain tenosynovitis and trochanteric bursitis. Steroid injections can also be helpful in controlling pain during physical rehabilitation from rotator cuff syndrome and lateral epicondylitis. Intra-articular steroid injection provides pain relief in rheumatoid arthritis and osteoarthritis. There is little systematic evidence to guide medication selection for therapeutic injections. The medication used and the frequency of injection should be guided by the goal of the injection (i.e., diagnostic or therapeutic), the underlying musculoskeletal diagnosis, and clinical experience. Complications from steroid injections are rare, but physicians should understand the potential risks and counsel patients appropriately. Patients with diabetes who receive periarticular or soft tissue steroid injections should closely monitor their blood glucose for two weeks following injection.

  16. Musculoskeletal injections: a review of the evidence.

    Science.gov (United States)

    Stephens, Mark B; Beutler, Anthony I; O'Connor, Francis G

    2008-10-15

    Injections are valuable procedures for managing musculoskeletal conditions commonly encountered by family physicians. Corticosteroid injections into articular, periarticular, or soft tissue structures relieve pain, reduce inflammation, and improve mobility. Injections can provide diagnostic information and are commonly used for postoperative pain control. Local anesthetics may be injected with corticosteroids to provide additional, rapid pain relief. Steroid injection is the preferred and definitive treatment for de Quervain tenosynovitis and trochanteric bursitis. Steroid injections can also be helpful in controlling pain during physical rehabilitation from rotator cuff syndrome and lateral epicondylitis. Intra-articular steroid injection provides pain relief in rheumatoid arthritis and osteoarthritis. There is little systematic evidence to guide medication selection for therapeutic injections. The medication used and the frequency of injection should be guided by the goal of the injection (i.e., diagnostic or therapeutic), the underlying musculoskeletal diagnosis, and clinical experience. Complications from steroid injections are rare, but physicians should understand the potential risks and counsel patients appropriately. Patients with diabetes who receive periarticular or soft tissue steroid injections should closely monitor their blood glucose for two weeks following injection.

  17. Heel pain: A systematic review

    Institute of Scientific and Technical Information of China (English)

    Edward Kwame Agyekum; Kaiyu Ma

    2015-01-01

    Heel pain is a very common foot disease.Varieties of names such as plantar fasciitis,jogger's heel,tennis heal,policeman's heel are used to describe it.Mechanical factors are the most common etiology of heel pain.Common causes of hell pain includes:Plantar Fasciitis,Heel Spur,Sever's Disease,Heel bump,Achilles Tendinopathy,Heel neuritis,Heel bursitis.The diagnosis is mostly based on clinical examination.Normally,the location of the pain and the absence of associated symptoms indicating a systemic disease strongly suggest the diagnosis.Several therapies exist including rest,physical therapy,stretching,and change in footwear,arch supports,orthotics,night splints,anti-inflammatory agents,and surgery.Almost all patients respond to conservative nonsurgical therapy.Surgery is the last treatment option if all other treatments had failed.Rest,ice,massage,the use of correct exercise and complying with a doctor's advice all play important part in helping to recover from this hell pain condition,but getting good quality,suitable shoes with the appropriate amount of support for the whole foot is the most important.

  18. THE EFFECT OF HOUSING ON THE OCCURANCE OF HIND LEG WEAKNESSES IN MARKET PIGS OF THREE GENOTYPES

    Directory of Open Access Journals (Sweden)

    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.

  19. Injection techniques in the management of local pain.

    Science.gov (United States)

    Fischer, A A

    1996-01-01

    This is a review of local anesthetic (LA) injections and infiltrations particularly combined with 'needling' for management of local musculoskeletal pain. New techniques are described including preinjection blocks (PIBs) which consist of blocking the sensory input from an area prior to giving an injection. PIBs prevent pain which would be caused by needle penetration of sensitive tissue. Needling and infiltration (N and I) with 1% lidocaine has been performed after PIB in 179 tender spots (TSs), trigger points (TrPs), and muscle spasms by the author, in 123 patients with the goal to relieve pain and promote healing. The immediate effect after the procedure as well as long-term results from 1 week to 7 months have been evaluated independently by a physiatrist experienced with injections (Dr. Tae Mo Chang). N and I extending over the entire taut band of abnormal muscle fibers, caused effective relief of pain and functional improvement in tender spots (TSs), trigger points (TrPs) and in muscle spasm caused by a variety of conditions including: acute and chronic sports and work injuries, motor vehicle accidents, muscle and ligament sprains (supraspinous, sacroiliac), overuse and repetitive stress syndromes, tennis elbow; local injuries or radicular irritation; and local inflammations such as bursitis, tendinitis, and osteoarthritis; and traumatic dystrophy, a type of reflex sympathetic dystrophy. Needling and infiltration of trigger areas and tender spots is effective treatment in several conditions. Pre-injection blocks allow the performance of the N and I of tender areas without pain.

  20. Assessment of injuries sustained in mixed martial arts competition.

    Science.gov (United States)

    Scoggin, James F; Brusovanik, Georgiy; Pi, Michael; Izuka, Byron; Pang, Pierre; Tokumura, Seren; Scuderi, Gaetano

    2010-05-01

    Mixed martial arts (MMA) competitions have gained much popularity, and the sport is watched by many millions annually. Despite ongoing controversy, there have been no objective studies of the injuries sustained in MMA based on on-site evaluation. In the study reported in this article, we attempted to delineate injury patterns for MMA participants. We conducted an observational cohort study of MMA competitions held in Hawaii between 1999 and 2006. The study included 116 bouts, involving 232 "exposures" and 179 male participants between ages 18 and 40. All the fighters were examined by 1 of 4 physicians, both before and after each bout. Fighters were referred to an emergency department when necessary, and follow-up was recommended as needed. Among the 232 exposures were 55 injuries: 28 abrasions and lacerations (6 requiring on-site suturing or referral to an emergency department for suturing), 11 concussions (4 with retrograde amnesia), 5 facial injuries (2 nasal fractures, 1 tympanum rupture, 1 temporomandibular joint sprain, 1 Le Fort fracture), and 11 orthopedic injuries (3 metacarpal injuries, with 1 confirmed fracture; 1 acromioclavicular separation; 1 traumatic olecranon bursitis; 1 elbow subluxation; 1 midfoot sprain; 1 aggravation of elbow medial collateral ligament sprain; 1 elbow lateral collateral ligament strain; 1 trapezius strain; 1 Achilles tendon contusion). We describe the injuries sustained in MMA competition to make comparisons with other sports. We discuss distribution and mechanism of injuries as well as injury incidence based on on-site evaluation in MMA.

  1. 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.

  2. Magnetic resonance imaging of hindfoot involvement in patients with spondyloarthritides: Comparison of low-field and high-field strength units

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    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.

  3. Frecuencia y caracterización de lesiones anatomo-patológicas en la enfermedad de gumboro y enfermedades secundarias asociadas en nuestras condiciones ambientales. Estudio retrospectivo (Frequency and characterization of anatomo-pathological lesions in gumboro disease and secondary illnesses associated under our environmental conditions. A retrospective study

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    Roberto González Insua

    2005-07-01

    Full Text Available El análisis retrospectivo de las historias clínicas de 59 casos de la enfermedad de Gumboro diagnosticados durante el período 1994-1998 a través de la sintomatología clínica y el estudio morfopatológico de las lesiones, determinó las frecuencias de lesiones observadas en diferentes órganos así como enfermedades secundarias y gérmenes más frecuentes asociados a ella. El diagnóstico de laboratorio se realizó mediante los hallazgos de lesiones macroscópicas en la bolsa de Fabricio durante la necropsia y la evaluación microscópica de esas lesiones utilizando para ello la técnica de inclusión en parafina y la coloración de hematoxilina-eosina. Se incluyeron las enfermedades y patologías más frecuentes asociadas a la entidad patológica, se expresan en una tabla y dos gráficos las características más sobresalientes de la bursitis infecciosa en el periodo mencionado.

  4. 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.)

  5. 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.

  6. 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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    Mohammad Ruhullah

    2014-01-01

    Full Text Available Background: 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. Materials and Methods: 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. Results: 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. Conclusion: 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.

  7. 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.

  8. Subacromial Impingement Syndrome Caused by a Voluminous Subdeltoid Lipoma

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    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.

  9. Detailed Shoulder MRI Findings in Manual Wheelchair Users with Shoulder Pain

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    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.

  10. 如何治疗(足母)外翻%How to treat hallux valgus

    Institute of Scientific and Technical Information of China (English)

    陈宝兴

    2002-01-01

    @@ 本期有三篇分析(足母)外翻外科治疗效果的文 章.(足母)外翻(hallux abducto valgus,HAV)是足外科最常见的疾病,门诊患者几乎占2/3以上.HAV的治疗目的是矫正畸形,但曾有规定将(足母)外翻的治疗归为美容学范等,因而许多医院将(足母)外翻改称为(足母)囊炎(bunion,bursitis),实际上二者是并存的.(足母)外翻的病因有两种说法:遗传及鞋.北京足踝外科研究所的调查显示,20%的患者有家族史,但主要的原因还是"鞋".不穿鞋时,(足母)趾与跖骨在同一顺列,穿鞋后产生外翻角.

  11. Oxaprozin: Synthesis, SAR study, physico-chemical characteristics and pharmacology

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    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.

  12. 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.

  13. 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.

  14. DISTAL TRICEPS AVULSION: A CASE REPORT

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    Ramkumar Reddy

    2015-05-01

    Full Text Available Triceps rupture is an uncommon injury. Fracture of olecranon or a dislocation / fracture is most often common injury for similar mechanism of fall. It is commonly associated with anabolic steroid use, weight lifting, and direct laceration. Risk factors include local steroid injection, olecranon bursitis, and hyperparathyroidism. Distal triceps rupture is usually caused by a fall on an outstretched hand. Eccentric loading of a contracting triceps has been implicated. Initial diagnosis may be difficult because a palpable defect is not always present. Pain and swelling may limit the ability to evaluate strength and elbow range of motion. Although plain radiographs are helpful in ruling out other elbow pathology, MRI is used to confirm the diagnosis, classify the injury, and plan management. Incomplete tears with active elbow extension against resistance are managed non - surgically. Surgical repair is indicated in active persons with complete tears and for incomplete tears with concomitant loss of strength. Good to excellent results have been reported with surgical repair in triceps, even for chronic tears. BACKGROUND: Distal triceps tendon avulsions occur very infrequently, and the diagnosis is often missed when the injury is acute. The literature provides little guidance regarding treatment or the outcome of these injuries. The goal of this report was to report our experience with the diagnosis, timing and technique of surgical treatment, and outcome of treatment of distal triceps tendon rupture.

  15. 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.

  16. 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.

  17. 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.

  18. 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.

  19. A different approach to the management of greater trochanter pain syndrome

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    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.

  20. 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.

  1. 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.)

  2. Evaluation of a PCR multiplex for detection and differentiation of Mycoplasma synoviae, M. gallisepticum, and M. gallisepticum strain F-vaccine

    Directory of Open Access Journals (Sweden)

    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. Ehlers–Danlos Syndrome—Hypermobility Type: A Much Neglected Multisystemic Disorder

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    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.

  4. Schwannoma de plexo braquial en el diagnóstico diferencial del hombro doloroso: Diferential diagnostic in the shoulder pain Brachial plexus schwannoma

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    S. Cortés

    2006-11-01

    Full Text Available Los schwannomas son tumores derivados de las células de Schwann, infrecuentes y generalmente de comportamiento benigno. El dolor y la radiculopatía son los síntomas iniciales más frecuentes. El diagnóstico se realiza mediante resonancia magnética y la resección quirúrgica es el tratamiento de elección. Presentamos el caso de una paciente de 50 años con omalgia atraumática izquierda de 5 años de evolución, durante los cuáles fue valorada por diferentes especialistas que incluían traumatólogos, reumatólogos, neurólogos y rehabilitadores. Inicialmente la paciente fue tratada con diversos AINES, rehabilitación (fisioterapia, onda corta, magnetoterapia sin mejoría. Como pruebas complementarias se realizaron un estudio neurofisiológico del miembro superior izquierdo (informado como normal, una resonancia magnética (RM cervical y una RM de hombro donde se informa de una rotura parcial del tendón supraespinoso y bursitis subacromial, por lo que se decide llevar a cabo una descompresión subacromial artroscópica. A pesar del tratamiento quirúrgico la paciente no mejora y se mantiene un dolor severo (EVA > 6. Posteriormente fue tratada con AINEs asociados a parches de fentanilo, pregabalina, infiltraciones de corticoides y nuevas sesiones de rehabilitación sin mejoría. Se decidió ampliar las pruebas de imagen y realizar una tomografia axial computerizada (TAC torácica, ecografía de hombro izquierdo y RM de plexo braquial que mostraron la existencia de una lesión compatible con schwannoma del plexo braquial. La paciente fue intervenida quirúrgicamente para resección del tumor mejorando del dolor progresivamente encontrándose actualmente asintomática.Schwannomas are tumors origined from Schwann cells, unfrequent, and generally benign. Pain and radiculopathy are common initial symptoms. Diagnosis is based in magnetic resonance imaging (MRI and surgery is the election treatment. We describe the case of a 50 years old woman

  5. The clinical study of modified nasal endoscopic sinus surgery for nasal cavity%改良经鼻内镜下泪囊鼻腔造孔术临床探讨

    Institute of Scientific and Technical Information of China (English)

    蒋家澧

    2015-01-01

    Objective To investigate the clinical effect of improving the treatment of chronic lacrimal sac with the treatment of chronic in-flammation of the lacrimal sac through the endoscopic treatment of nasal endoscope. Method 45 cases of chronic dacryocystitis bursitis pa-tients were selected,according to the different surgical methods,they were divided into two groups,the treatment group and the control group, after operation were compared between the two groups of patients with differences in efficacy. Results Observation group,23 cases of chronic dacryocystitis bursitis patients,improved under nasal endoscope of lacrimal sac and nasal cavity made hole surgery treatment,the total efficien-cy of 100%. The operations were successful;after 6 to 24 months follow - up,patients with overflow tears symptoms disappear,anatomical structure and opening up to the outside world,irrigation of lacrimal passage unobstructed and no purulent sex secretion. Conclusion The modi-fied by nasal endoscopic nasal lacrimal sac made hole technique has the advantages of simple operation,with no facial scar and less complica-tion in the treatment of chronic dacryocystitis,the clinical practice proved to have very good treatment effect and application prospect.%目的:探讨改良经鼻内镜下泪囊鼻腔造孔术治疗慢性泪囊炎的临床效果。方法:选择45例慢性泪囊炎患者,根据手术方式不同,将其分为2组,对照组和治疗组,术后比较两组患者的疗效差异。结果:观察组23例慢性泪囊炎患者,经改良经鼻内镜下泪囊鼻腔造孔术治疗,总有效率为100%,手术均获得成功;经过6~24个月的随访,患者溢泪症状消失,解剖结构开放,泪道冲洗通畅并无黏液脓性分泌物。结论:改良经鼻内镜下泪囊鼻腔造孔术治疗慢性泪囊炎具有操作简便、无面部疤痕、并发症少等优点,经临床实践证实具有非常好的治疗效果和应用前景。

  6. Application of ultrasound in shoulder lesions%超声在肩关节疾病诊断中的应用价值

    Institute of Scientific and Technical Information of China (English)

    刘汀; 贾建文; 林发俭; 傅先水; 崔立刚

    2008-01-01

    Objective To evaluate the value of ultrasound in diagnosing shoulder lesions.Methods Ultrasound images were obtained by two museuloskeletal sonologists in 111 patients suspected of having rotator cuff and non-rotator cuff lesions which were confirmed by following arthroscopic surgery.Results The arthroscopic findings demonstrated that there were two or more lesions in one patient in majority of patients,included 67 supraspinous tendon tears,5 infraspinous or subscapular tendon injuries,10 calcific tendonosis,2suprascapular notch cysts,34 subaeromial bursitis,1 intrabursa loose body,13 biceps longus tendon dislocation or disruption,and 21 lahrum injury.The accuracy of ultrasonogrpahy was 92% in diagnosis of supraspinous tendons tear,97% in subscapular tendon inj uries,96% in calcific tendonitis,1 00% in suprascapular notch cysts,88% in subacromial bursitis,100% in biceps longus tendon dislocation or disruption,and 81% in labrum injury.Conclusions Ultrasound can evaluate shoulder lesions effectively.%目的 评价超声对肩关节病变的诊断价值.方法 对肩袖及非肩袖病变患者111例进行超声检查,结果与关节镜手术对照.结果 肩关节镜结果显示111例患者共发现病变153个,其中67个冈上肌腱撕裂(包括全层撕裂和部分撕裂),5个冈下肌、肩胛下肌腱损伤,10个钙化性肌腱炎,2个肩胛切迹周围囊肿,34个肩峰下滑囊炎,1个滑囊内游离体,13个肱二头肌长头腱断裂或脱位(不包括上盂唇起点处撕脱),21个盂唇撕脱损伤.超声评价各种肩关节软组织病变准确性分别为:冈上肌撕裂92%,冈下肌、肩胛下肌腱损伤97%,钙化性肌腱炎96%,肩胛切迹附近囊肿100%,肩峰下滑囊炎88%,肱二头肌长头腱脱位100%,盂唇损伤81%.结论 超声能够有效地评价肩关节病变,是一种可靠的无创性影像学诊断手段.

  7. Metabolic syndrome associated to non-inflammatory Achilles enthesopathy.

    Science.gov (United States)

    Abate, Michele; Di Carlo, Luigi; Salini, Vincenzo; Schiavone, Cosima

    2014-01-01

    Enthesopathies are frequently found in rheumatic inflammatory diseases, but can be observed also in absence of systemic inflammation. Aging, overuse, and microtraumas can be responsible for enthesis-degenerative phenomena. Despite that Achilles enthesis is the more frequently affected, no systematic study on the risk factors associated to this enthesopathy has been yet performed. The aim of this paper was to assess whether the metabolic syndrome could be associated to entheseal lesions. Forty-five subjects with symptomatic non-inflammatory Achilles enthesopathy were compared to 45 asymptomatic controls. An ultrasound study of the Achilles enthesis was carried out, and the presence/absence of lesions (morphologic abnormalities, calcific deposits, enthesophytes, cortical abnormalities, and adjacent bursitis) was assessed. On the basis of history, comorbidities (osteoarthritis, diabetes, and hypertension) were recorded. In each subject, body mass index (BMI), glucose, total, and HDL cholesterol were also evaluated. All symptomatic subjects showed at ultrasound evaluation at least one structural entheseal alteration; pathologic features in asymptomatic subjects were found in 6/45 (13.3 %) of cases. Higher values of BMI and glucose were found in subjects with symptomatic enthesopathy. At multiple logistic regression analysis, the presence of high values of BMI and glucose was related to a higher probability to detect entheseal lesions. Metabolic syndrome and overweight may have a role in the pathogenesis of Achilles enthesopathy due to their synergistic worsening effect on other pathogenetic factors of tendon degeneration, such age and overuse. Therefore, subjects with metabolic syndrome practicing sports and other activities stressing the Achilles tendon should receive advice for more frequent controls.

  8. Femoro-acetabular impingement: can indirect MR arthrography be considered a valid method to detect endoarticular damage? A preliminary study.

    Science.gov (United States)

    Pozzi, Grazia; Stradiotti, Paola; Parra, Cleber Garcia; Zagra, Luigi; Sironi, Sandro; Zerbi, Alberto

    2009-01-01

    To assess the effectiveness of indirect Magnetic Resonance arthrography (i-MRa) in the detection of chondral and labral lesions related to femoro-acetabular impingement (FAI) a series of 21 hip joints in 17 patients with a clinical diagnosis of FAI were examined either with standard MR imaging, i-MRa and direct-MR arthrography (d-MRa). Sensitivity and accuracy of i-MRa in detecting chondral, labral and tardive lesions were calculated and compared with standard MR. The agreement in detecting endoarticular damage between i-MRa and d-MRa and the interobserver agreement was assessed by K statistic (p<0.05). Finally the presence of trocanteric bursitis was evaluated. I-MRa showed higher values of both sensivity and accuracy than standard MR in detecting chondral damage, with an increase to 92% for the first item and 95% for the second. The same was noticed in labrum evaluation with an increase to 88% and 90% respectively. The level of agreement between i-MRa and d-MRa in detection of chondral lesions was excellent, substantial for the labral damage and absolute for early osteoarthritic changes. An excellent interobserver agreement resulted in detection of both chondral and labral damages with i-MRa. In 6 hips (28,5%) we also found the presence of peri-trochanteric soft tissue inflammation that indicated the possibility of extrarticular involvement in FAI. Indirect-MRa can be considered a valid method of assessing endoarticular damage related to FAI, in comparison to d-MRa. It should be performed instead of standard MR if d-MRa is not available.

  9. Greater trochanteric pain syndrome due to tumoral calcinosis in a patient with chronic kidney disease.

    Science.gov (United States)

    Baek, Dongjin; Lee, Sang Eun; Kim, Woo-Jin; Jeon, Sanghoon; Lee, Kihwa; Jung, Jaewook; Joo, Hyunchul; Park, Jaehong; Kim, Yonghan; Choi, Young-gyun

    2014-01-01

    Tumoral calcinosis is a rare syndrome characterized by massive subcutaneous soft tissue deposits of calcium phosphate near the large joints. It is more prevalent in patients with chronic kidney disease undergoing dialysis. A 57-year-old woman was referred to our pain clinic with the complaint of severe pain in the left buttock and lateral hip. The patient had been suffering from chronic kidney disease for 10 years and had been undergoing peritoneal dialysis over the past 5 years. The patient's symptom was initially suspected to be of lumbar origin at the L5 level and a left L5 transforaminal epidural block was performed, but without success. Re-evaluation of the physical examination revealed severe tenderness over the left greater trochanter and piriformis muscle. On ultrasonographic evaluation, multiple mass-like lesions in the left buttock were observed. About 30 mL of fluid was aspirated from the cystic lesions, followed by 30 mL mixture of 0.08% levobupivacaine and triamcinolone 40 mg injected into the bursa under ultrasound guidance, which brought pain relief. Trochanteric bursitis was thought of as the cause of the symptoms. The patient was diagnosed with tumoral calcinosis based on the past medical history, simple plain radiographs, and hip magnetic resonance imaging (MRI). We diagnosed a case of greater trochanteric pain syndrome due to tumoral calcinosis related to chronic kidney disease in a patient whose symptoms had initially been considered to be radiating leg pain caused by lumbar spinal disease. We report our experience of symptomatic improvement following the repeated ultrasound-guided aspiration of calcific fluid and the injection of a mixture of local anesthetic and steroid.

  10. 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

  11. Tubercular myositis of infraspinatus: a rare clinical entity

    Directory of Open Access Journals (Sweden)

    Vikas Verma

    2016-08-01

    Full Text Available Tuberculosis of the musculoskeletal system is generally confined to bones and joints. The surrounding soft tissue is secondarily infected. Tuberculous bursitis, tenosynovitis and primary pyomyositis are rarer manifestations of the disease. Of these, primary tuberculouspyomyositis is probably the rarest entity. We report a case of tubercular myositis of infraspinatus in an 8 year-old female who presented with pain, low grade fever, weight loss, anorexia, progressively increasing pain in the scapular region and restriction of movements. There was no history of trauma, diabetes, immunosuppression, corticosteroid usage, or renal failure. History of contact was present. Tenderness was present along the medial border of scapula and movements of upper extremity requiring movement of the scapula were painful and grossly restricted. MRI of the scapulothoracic region and shoulder revealed small amount of fluid along medial border of scapula with T2 hyperintensity of infraspinatus. Histopathology showed caseous necrosis, inflammatory cells and granulomatous cells suggestive of tuberculosis. Polymerase Chain Reaction for Mycobacterium tuberculosis was found to be positive. Patient was started on four-drug antitubercular treatment and regular dressings. The patient's general condition improved and at 4 weeks post starting ATT, there was no pain and the patient was able to perform complete range of movement. This is probably the first reported case of tubercular myositis of infraspinatus in an immunocompetent patient without any identifiable focus elsewhere in the body. Rarity of the condition, presence of characteristic findings on MRI and histopathology make the case illustrative for young Orthopaedics surgeons. [Int J Res Med Sci 2016; 4(8.000: 3619-3621

  12. Assessment of peritrochanteric high T2 signal depending on the age and gender of the patients

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    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.

  13. Ultrasound-guided retro-calcaneal bursa corticosteroid injection for refractory Achilles tendinitis in patients with seronegative spondyloarthropathy: efficacy and follow-up study.

    Science.gov (United States)

    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.

  14. [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.

  15. Does group size have an impact on welfare indicators in fattening pigs?

    Science.gov (United States)

    Meyer-Hamme, S E K; Lambertz, C; Gauly, M

    2016-01-01

    Production systems for fattening pigs have been characterized over the last 2 decades by rising farm sizes coupled with increasing group sizes. These developments resulted in a serious public discussion regarding animal welfare and health in these intensive production systems. Even though large farm and group sizes came under severe criticism, it is still unknown whether these factors indeed negatively affect animal welfare. Therefore, the aim of this study was to assess the effect of group size (30 pigs/pen) on various animal-based measures of the Welfare Quality(®) protocol for growing pigs under conventional fattening conditions. A total of 60 conventional pig fattening farms with different group sizes in Germany were included. Moderate bursitis (35%) was found as the most prevalent indicator of welfare-related problems, while its prevalence increased with age during the fattening period. However, differences between group sizes were not detected (P>0.05). The prevalence of moderately soiled bodies increased from 9.7% at the start to 14.2% at the end of the fattening period, whereas large pens showed a higher prevalence (15.8%) than small pens (10.4%; Panimal relationship was improved in large in comparison to small groups. On the contrary, negative social behaviour was found more often in large groups. Exploration of enrichment material decreased with increasing live weight. Given that all animals were tail-docked, tail biting was observed at a very low rate of 1.9%. In conclusion, the results indicate that BW and feeding system are determining factors for the welfare status, while group size was not proved to affect the welfare level under the studied conditions of pig fattening.

  16. Profile of the subjects with soft tissue injuries attended at an occupational health service and the RSI

    Directory of Open Access Journals (Sweden)

    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.

  17. Endoscopic Treatment of Gluteus Medius Tears: A Review.

    Science.gov (United States)

    Lerebours, Frantz R; Cohn, Randy; Youm, Thomas

    2016-03-01

    Greater trochanteric pain syndrome (GTPS) is a term used to describe disorders of the peritrochanteric region. This constellation of conditions includes greater trochanteric bursitis, gluteus medius (GM) tears, and external coxa saltans or snapping hip syndrome. Tears of the abductor mechanism, more specifically gluteus medius tears, have recently gained a considerable amount of interest in the orthopaedic literature. Abductor tears were first described by Bunker and Kagan in the late 1990s. They used the rotator cuff as an analogous structure to describe the pathological process associated with gluteus medius tears. Tears of the gluteus medius tendon can often be difficult to recognize. The clinical presentation is often attributed to trochanteric bursal inflammation, without any further workup. Provocative hip physical examination findings are an important key to proper diagnosis of abductor injuries. Depending on the size of the tear, patients with abductor tendon pathology may present with a Trendelenburg gait and reduced resisted abduction strength accompanied by pain. Initial noninvasive management of greater trochanteric pain syndrome includes oral or topical anti-inflammatory medication and activity modification. Physical therapy or other treatment modalities can be considered, with a focus on core strengthening, truncal alignment, and iliotibial band stretching. Gluteus medius tears have historically been repaired in an open fashion; however, the advent of new endoscopic surgery techniques has allowed for a less invasive approach. Access to the peritrochanteric space affords the surgeon with access to pathology associated with the greater trochanter, iliotibial band, trochanteric bursa, sciatic nerve, short external-rota tors, iliopsoas tendon, and the gluteus medius and minimus tendon attachments. Over the last decade, we have seen rapid technological advances in hip arthroscopy, improved diagnostic imaging and interpretation, and an improved

  18. Surgical repair of chronic tears of the hip abductor mechanism.

    Science.gov (United States)

    Davies, Hywel; Zhaeentan, Sohelia; Tavakkolizadeh, Adel; Janes, Gregory

    2009-01-01

    Lateral sided hip pain frequently presents to the orthopaedic clinic. The most common cause of this pain is trochanteric bursitis. This usually improves with conservative treatment. In a few cases it doesn't settle and warrants further investigation and treatment. We present a series of 28 patients who underwent MRI scanning for such pain, 16 were found to have a tear of their abductors. All 16 underwent surgical repair using multiple soft tissue anchors inserted into the greater trochanter of the hip to reattach the abductors. There were 15 females and 1 male. All patients completed a self-administered questionnaire pre-operatively and 1 year post-operatively. Data collected included: A visual analogue score for hip pain, Charnley modification of the Merle D'Aubigne and Postel hip score, Oxford hip score, Kuhfuss score of Trendelenburg and SF36 scores.Of the 16 patients who underwent surgery 5 had a failure of surgical treatment. There were 4 re ruptures, 3 of which were revised and 1 deep infection which required debridement. In the remaining 11 patients there were statistically significant improvements in hip symptoms. The mean change in visual analogue score was 5 out of 10 (p=0.0024) The mean change of Oxford hip score was 20.5 (p=0.00085). The mean improvement in SF-36 PCS was 8.5 (P=0.0020) and MCS 13.7 (P=0.134). 6 patients who had a Trendelenburg gait pre-surgery had normal gait 1 year following surgery.We conclude that hip abductor mechanism tear is a frequent cause of recalcitrant trochanteric pain that should be further investigated with MRI scanning. Surgical repair is a successful operation for reduction of pain and improvement of function. However there is a relatively high failure rate.

  19. Performance of ultrasound to monitor Achilles enthesitis in patients with ankylosing spondylitis during TNF-a antagonist therapy.

    Science.gov (United States)

    Wang, Cong-hua; Feng, Yuan; Ren, Zhen; Yang, Xichao; Jia, Jun-feng; Rong, Meng-yao; Li, Xue-yi; Wu, Zhen-biao

    2015-06-01

    Enthesitis is considered as the primary anatomical lesion in ankylosing spondylitis (AS). We aimed to investigate the potential of ultrasound to detect early changes after TNF-a antagonist therapy of Achilles enthesitis of AS patients. One hundred AS patients with active disease, requiring TNF-a antagonist therapy, were included (etanercept n = 25, infliximab n = 25, adalimumab n = 25, non-biologic disease-modifying antirheumatic drugs (DMARDs) n = 25). Physical examination was performed to evaluate disease activity and detect Achilles enthesitis and/or retrocalcaneal bursitis. Ultrasound of the Achilles enthesitis was performed bilaterally. Follow-up examinations were performed 3 months after the initiation of therapy. Gray scale (GS) scores, Power Doppler (PD) scores, and total additive scores (TS) decreased significantly during TNF-a antagonist therapy but not in traditional non-biologic traditional DMARDs group. The bath ankylosing spondylitis disease activity index (BASDAI), bath ankylosing spondylitis metrology index (BASMI), bath ankylosing spondylitis functional index (BASFI), and Maastricht ankylosing spondylitis enthesitis score (MASES) all showed significant improvements. When three different TNF-a antagonists were analyzed separately, no significant difference was observed in GS, PD, and total scores. Subclinical Achilles enthesitis, detected only with GS ultrasound, is present in a subset of AS patients and a significant improvement can be demonstrated after 3 months of TNF-a antagonist therapy. Doppler ultrasound provides a reliable estimation to monitor the therapeutic response to TNF antagonists in AS patients with Achilles enthesitis. TNF-a antagonists have been shown to be effective in decreasing ultrasound signs of enthesitis after 3 months of therapy in AS patients.

  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. 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.)

  2. Hereditary multiple exostoses: from genetics to clinical syndrome and complications

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    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.

  3. 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.)

  4. The utility of MR imaging of the shoulder joint: comparison of the MR imaging between conventional MR imaging and arthrographic MR imaging

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    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.

  5. 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.

  6. 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.

  7. Treatment of Pediatric Open Femoral Fractures with External Fixator Versus Flexible Intramedullary Nails

    Directory of Open Access Journals (Sweden)

    Hossein Aslani

    2013-12-01

    Full Text Available   Background: In children, inappropriate treatment of open femoral fractures may induce several complications. A few studies have compared the external fixator with flexible intramedullary nails in high-grade open femoral fractures of children. The present study aims at comparing results of these two treatment methods in open femoral fractures. Methods: In this descriptive analytical study, 27 patients with open femoral fractures, who were treated using either the external fixator (n=14 or TEN nails (n=13 method from 2006-2011, were studied. Some patients were treated with a combination method of TEN and pin. The results were evaluated considering infection, union, malunion, and refracture and the patients were followed up for two years. Results: Mean time required for fracture union was 3.89 (range: 2-5.8 and 3.61 (range: 2-5.6 months for the external fixator and TEN groups, respectively. The difference was not statistically significant and there was not any significant difference between the two groups considering infection of the fractured area. Osteomyelitis was not observed in any group. There was an infection surrounding the external fixator pin in 4 cases (28.5% and so this required changing the location of the pin. In the TEN group, one case (7.6% of painful bursitis was observed at the entry point of TEN and so the pin was removed earlier than usual. There were two cases (14.2% of femoral refracture in the external fixator group. Malunion requiring correction was not observed in any of the groups. There were no complications observed in five patients treated with a combined method of pin and flexible intramedullary nails. Conclusion: Both external fixator and intramedullary nail methods are effective ways in treating high grade open femoral fractures in children and final treatment results are similar. Combining pins and flexible intramedullary nails is effective in developing more stability and is not associated with more

  8. Application of Irwin diagnostic procedures for chronic cough

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    Guo-fang FENG

    2011-07-01

    Full Text Available Objective To explore the advantages and disadvantages of the diagnostic procedures suggested by the Irwin group,and summarize the experiences in diagnosis and treatment,and to beter understand the etiology,diagnosis,differential diagnosis and treatment of chronic cough.Methods Data of 118 patients,who were finally diagnosed as chronic cough according to the diagnostic procedures suggested by Irwin group in the First Affiliated Hospital of General Hospital of PLA in 2009,were retrospectivety analyzed.Results With the Irwin diagnostic procedures of chronic cough,118 patients were diagnosed definitely.The final diagnostic rate reached 100%.The duration to reach the final diagnosis was 1 day to 30 days.Of the 118 patients with chronic cough,113 were cured(96%.32 cases(27.1% were caused by asthma and related diseases(allergic rhinitis,allergic pharyngitis,cough variant asthma and eosinophilic bronchitis;28 cases(23.7% were due to upper airway cough syndrome and related diseases(chronic rhinitis,sinusitis,pharyngeal bursitis,postnasal drip syndrome,chronic laryngitis,and vocal cord polyps;23 cases(19.5% due to gastroesophageal reflux disease;14 cases(11.9% due to lower respiratory tract infection and related diseases(endobronchial tuberculosis,pulmonary tuberculosis,endotracheal mucosal adenocarcinoma,lung cancer,bronchiectasis,and pulmonary fibrosis;10 cases(8.5% due to cardiac insafficiency;6 cases(5.1% due to administration of angiotensin-converting enzyme inhibitor(ACEI-like antihypertensive agents;3 cases(2.5% were psychogenic cough,and 2 cases(1.7% were induced by other causes.Conclusions The Irwin diagnosis of chronic cough is a comprehensive and thorough procedure,and it should be used with delibcration in clinic.The etiology of chronic cough is complicated,mainly including asthma and related diseases,sinusitis and upper airway cough syndrome,and gastroesophageal reflux disease.

  9. 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.

  10. MR Imaging in symptomatic osteochondromas

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    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.

  11. Cytogenetic analysis of the pathology of frozen shoulder

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    Kabbabe Benjamin

    2010-01-01

    Full Text Available Background : Frozen shoulder (FS is a debilitating musculoskeletal condition with an uncertain etiology and pathogenic mechanism. The aim of this study was to investigate the hypothesis that an alteration in the level of cytokines may disrupt the normal inflammatory and tissue healing process in the shoulder, leading to the development of FS. Materials and Methods: A prospective case-control study was undertaken, analyzing patients undergoing arthroscopic treatment of FS and control patients being treated for subacromial bursitis. Synovial biopsies were taken from all subjects. Synovial RNA levels were analyzed using quantitative polymerase chain reaction (qPCR. Results : Thirteen patients with FS were recruited, four of whom were diagnosed with diabetes mellitus, along with 10 control patients. Cytogenetic analysis using qPCR revealed both fibrogenic cytokine matrix metalloproteinase 3 (MMP 3 (1.98Χ10 5 vs. 755.0, P=0.068 and inflammatory cytokine interleukin 6 (IL 6 (1679.2 vs. 372.8, P=0.062 to be elevated in FS cases as compared to controls. Comparison between diabetic and non-diabetic patients revealed a decrease in the level of expression of inflammatory cytokine, monocyte colony stimulating factor (M-CSF (12,496 vs. 305.1, P=0.04 in diabetic FS patients. Conclusions: The results demonstrate that levels of inflammatory and fibrogenic cytokines are elevated in the synovium of patients with FS compared with controls. This indicates that altered levels of inflammatory cytokines may be associated with the pathogenesis of inflammation evolving into fibrosis, which is the characteristic feature of FS. We have also shown the opposite to be the case in patients with diabetic FS.

  12. 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

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    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.

  13. [Piriformis muscle syndrome: etiology, pathogenesis, clinical manifestations, diagnosis, differential diagnosis and therapy].

    Science.gov (United States)

    Grgić, Vjekoslav

    2013-01-01

    The term 'piriformis syndrome' (PS), introduced by Robinson in 1947, implies a group of signs and symptoms caused by piriformis muscle (PM) disorders. Since PM disorders lead to irritation/compression of the anatomic structures passing under its belly, the main clinical PS signs and symptoms are actually the clinical signs and symptoms of irritation/ compression of neural and vascular structures passing through the infrapiriform foramen: sciatic nerve/SN, inferior gluteal nerve, posterior femoral cutaneous nerve, pudendal nerve, inferior gluteal artery and vein and inferior pudendal artery and vein. The clinical picture is usually dominated by signs and symptoms of irritation/compression of SN (SN irritation --> low back and buttock pain, sciatica,paresthesias in distribution of SN; SN compression --> low back and buttock pain,sciatica, paresthesias and neurologic deficit in distribution of SN). Irritation/compression of other structures can result in the following signs and symptoms: inferior gluteal nerve --> atrophy of gluteal muscles; posterior femoral cutaneous nerve --> pain, paresthesias and sensory disturbances in the posterior thigh; pudendal nerve --> pudendal neuralgia, painful sexual intercourse (dyspareunia), sexual dysfunction, urination and defecation problems; inferior gluteal artery --> ischemic buttock pain; inferior pudendal artery --> ischemic pain in the area of external sex organs, perineum and rectum, sexual dysfunction, urination and defecation problems; inferior gluteal vein --> venous stasis in gluteal area; inferior pudendal vein --> venous stasis in external sex organs and rectum. Functional/non-organic and organic PM disorders can cause PS: spasm, shortening, hypertrophy, anatomic variations, edema, fibrosis, adhesions, hematoma, atrophy, cyst, bursitis, abscess, myositis ossificans, endometriosis, tumors (functional disorders: PM spasm and shortening). The most common causes for PS are PM spasm, shortening and hypertrophy and anatomic

  14. 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

    Science.gov (United States)

    2011-01-01

    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 at baseline, 13, 26, 39

  15. Preliminary effect of proximal femoral nail antirotation on emergency treatment of senile patients with intertrochanteric fracture

    Institute of Scientific and Technical Information of China (English)

    TANG Xin; LIU Lei; YANG Tian-fu; TU Chong-qi; WANG Guang-lin; FANG Yue; DUAN Hong; ZHANG Hui; PEI Fu-xing

    2010-01-01

    Objective: To retrospectively analyse the clinical outcome of emergency treatment of senile intertrochanteric fractures with proximal femoral nail antirotation (PFNA).Methods: From September 2008 to March 2009, 35 senile patients with intertrochanteric fracture, aged from 65 to 92 years with an average age of 76.5 years, were treated with PFNA within 24 hours after injury. There were 10 type Ⅰ fractures, 19 type Ⅱ and 6 type Ⅲ according to upgraded Evans-Jensen classification system. All patients were complicated with osteoporosis, and 19 patients had preexisting internal medical diseases. According to the rating scale of disease severity by the American Society of Anesthesiologists (ASA), there were 9 grade Ⅰ, 14 grade Ⅱ, 8 grade Ⅲ, and 4 grade Ⅳ.Results: The duration for operation ranged from 45 to 73 minutes with an average of 57.6 minutes. The volume of blood loss during operation ranged from 50 to 120 ml with an average of 77.5 ml. Patients could ambulate 2-4 days after operation (mean 3.5 days). Hospital stay was 4-7 days (mean 5.3 days). Full weight bearing time was 10-14 weeks (mean 12.8 weeks). During hospitalization period, there was no regional or deep infection, hypostatic pneumonia, urinary tract infection and bedsore except for 2 cases of urine retention. All cases were followed up with an average period of 12.3 months, and bone healing achieved within 15-18 weeks (mean 16.6 weeks). No complications such as delayed union, coxa vara or coxa valga, screw breakage or backout occurred and only 2 cases had trochanter bursitis because of thin body and overlong end of the antirotated nail. According to the Harris grading scale, the results were defined as excellent in 21 cases, good in 9 cases and fair in 5 cases, with the excellent and good rates of 85.7%.Conclusion: The emergency treatment of senile intertrochanteric fracture with proximal femoral nail antirotation has the advantages of minimal invasion, easy manipulation,less blood loss

  16. Synthetic rubber surface as an alternative to concrete to improve welfare and performance of finishing beef cattle reared on fully slatted flooring.

    Science.gov (United States)

    Brscic, M; Ricci, R; Prevedello, P; Lonardi, C; De Nardi, R; Contiero, B; Gottardo, F; Cozzi, G

    2015-08-01

    The aim of this study was to compare a fully slatted concrete floor (concrete slatted (CS)) with the same floor on which synthetic rubber slats were placed on the concrete slats (rubber slatted (RS)) as housing solution for finishing beef cattle. The present study involved five commercial beef cattle farms in which the floor of at least three pens was kept as fully slatted, and in an equal number of pens a rubber cover was placed on the floor, tightly matching the gap profile of the concrete slats to allow the drainage of manure. A total of 326 finishing beef bulls were used (153 on CS and 173 on RS), and regardless of the floor treatment animals were housed in groups of 6 to 12 bulls/pen with a space allowance of 3.1 ± 0.2 m2/bull. Bulls had similar initial live weights (422.3 kg on CS and 425.0 kg on RS), but bulls on RS were heavier at the end of the finishing period with a higher average daily gain than bulls kept on CS (1.53 v. 1.46 kg/day; PRubber covering prevented the occurrence of bursitis, but it increased the odds for hoof overgrowth at end of the finishing period. Hoof overgrowth detected in vivo in bulls on RS was confirmed at the slaughterhouse by the longer dorsal wall and diagonal lengths of the hoof as well as by a more acute toe angle. Compared with bulls on CS, bulls on RS showed less inactivity and resting time, increased social interactions, decreased abnormal lying down and unsuccessful attempts to lie down, as well as shortened the time for lying down. Bulls in RS pens were dirtier compared with those in CS pens, likely due to the draining gaps being reduced to 11.6 ± 1.2% of the total pen surface compared with the 16.9 ± 1.7% in CS pens. This study gave further evidence about the positive effects of the RS floor on growth performance and welfare of finishing beef cattle, although compromising cleanliness and hoof overgrowth.

  17. Subacromial Tenoxicam Injection in the Treatment of Impingement Syndrome

    Science.gov (United States)

    Çift, Hakan; Özkan, Feyza Ünlü; Şeker, Ali; İşyar, Mehmet; Ceyhan, Erman; Mahiroğulları, Mahir

    2014-01-01

    Objectives: As subacromial bursa injection is widely used for pain relief and functional improvements in patients with periarticular shoulder disorder, we aimed to present our results of subacromial tenoxicam injection in the treatment of impingement syndrome. Methods: Patients presented to the Department of Orthopaedics and Traumatology, Istanbul Medipol University with the primary complaints of shoulder pain from January 2012 to June 2013 were selected. Those who met the following inclusion criteria were finally considered: 1) who had a clinical sign of a painful arc and positive in Hawkins test and/or Neer impingement sign; 2) who had a precise rotator cuff injury including partial cuff tears, or subacromial bursitis detected during ultrasonography or MRI. The exclusion criteria were as follows: 1) who underwent shoulder surgery; 2) who had full thickness rotator cuff rupture; 3) who had hemiplegic shoulder pain; and 4) who displayed any suspected fracture on X-ray or had a recent shoulder trauma; 5) who showed limited active ROM and stiffness due to adhesive capsulitis. Thirty one shoulders out of thirty patients were treated with subacromial tenoxicam injection. Ten of them were left shoulders. Fifteen of the patients were women.. Patients had a mean age of 51.6 (30-73). Patients were evaluated 4 times. Before the first injection, 1 week after the first injection, 2 weeks after the second injection and 3 weeks after the third injection. In every injection 20 mg tenoxicam was performed. Results: In order to relieve the pain; two patients were given only one injection, thirteen patients were given two injections and “3 injections protocol” were done to fifteen patients. The mean pre- and posttreatment VAS scores were 7.9 (between, 7-9) and 2.7 (between, 2-4) points respectively. The average pre and posttreatment DASH scores were 59.41 (between, 45-80) and 14 (between, 8.3-25.8) points respectively. The mean pre and posttreatment range of motion were 106

  18. 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

    Directory of Open Access Journals (Sweden)

    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

  19. 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.)

  20. Associations of sonographic abnormalities of the shoulder with various grades of biceps peritendinous effusion (BPE).

    Science.gov (United States)

    Chang, Ke-Vin; Chen, Wen-Shiang; Wang, Tyng-Guey; Hung, Chen-Yu; Chien, Kuo-Liong

    2014-02-01

    Bicipital peritendinous effusion (BPE), a common ultrasonographic finding of the long head of the biceps tendon, may be associated with shoulder joint derangement, but supporting evidence from large-scale studies is lacking. The aim of this cross-sectional study was to determine the strength of the association between BPE and sonographic abnormalities of the shoulder joint. We reviewed the sonographic reports of patients with suspected shoulder disorders investigated ultrasonographically between January 2011 and January 2012. BPE was graded according to its measured thickness as absent (3 mm). The associations between BPE and sonographic abnormalities were examined using multinomial logistic regression adjusted for age, gender, affected side and clinical diagnosis of frozen shoulder. The prevalence rates of absent, mild, moderate and severe BPE among the 907 shoulders examined were 64.1%, 17.8%, 10.4% and 7.7%, respectively. Frozen shoulder was associated with mild BPE (relative risk [RR] vs. participants without BPE = 1.83, 95% confidence interval [CI] = 1.28-2.50). Sonographic findings of biceps tendinopathy, subdeltoid bursitis and full-thickness tears of the supraspinatus tendon were significantly associated with the entire spectrum of BPE, whereas subscapularis tendon tears were significantly associated with moderate (RR = 2.47, 95% CI = 1.29-4.69) and severe (RR = 3.11, 95% CI = 1.51-6.33) BPE. Severe BPE was associated with articular-sided partial-thickness tears of the supraspinatus tendon (RR = 14.32, 95% CI = 4.30-34.35), posterior recess effusion (RR, 7.98, 95% CI = 1.44-34.93) and biceps medial subluxation (RR = 7.25, 95% CI = 1.90-22.33). Our study indicates that BPE is related to various shoulder abnormalities and that the strengths of these associations depend on the severity of BPE. Clinicians encountering BPE should grade its severity and be alert for hidden lesions of the shoulder joint.

  1. 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

  2. Prototecose: uma doença emergente Protothecosis: an emergent disease

    Directory of Open Access Journals (Sweden)

    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

  3. Prevalence of lymphedema in women undergoing treatment for breast cancer in a referral center in southeastern Brazil

    Directory of Open Access Journals (Sweden)

    Paiva Daniella MF

    2013-02-01

    Full Text Available Abstract Background Lymphedema is a highly prevalent condition in women who have undergone treatment for breast cancer. Lymphedema negatively affects the quality of life. The objective of this study was to estimate the prevalence of lymphedema and associated factors in women treated for breast cancer in the municipality of Juiz de Fora. Methods We performed a cross-sectional study that evaluated 250 women who were being treated for breast cancer. Pre-screening of the sample by analysis of medical records was performed to select women who met the inclusion criteria as follows: women who had an operation more than 6 months ago; absence of active disease, locoregional or distant; the absence of functional change in the affected limb before surgery, which could lead to swelling of the limb; and simulating or masking symptoms of lymphedema, such as bursitis, tendonitis, and work-related musculoskeletal disorders. Women with bilateral breast cancer, absence of axillary intervention (partial or complete axillary dissection and/or SLN biopsy, active disease in the region, or lympho-venous alteration of the limb before surgery were excluded. Data were collected from the medical records of the selected cases, and they subsequently underwent an interview and a physical assessment. Results The prevalence of lymphedema was 44.8%. There were medical records on the presence of this condition in 5.4% of cases. With regard to shoulder joint mobility, restrictions on abduction movements, internal and external rotation, and anterior shoulder adduction were significantly associated with lymphedema. Variables, including the presence of seroma, vascular changes, time elapsed after surgery, episodes of redness in the extremities, and cuticle removal from the hand with pliers were considered as major associated factors for lymphedema (p Conclusions The prevalence of 44.8% for lymphedema found in this study is considered to be relevant because it is a morbidity that

  4. Home Intravenous Self-Injection of Antibiotic Therapy

    Directory of Open Access Journals (Sweden)

    Alain Y Martel

    1994-01-01

    Full Text Available The current medical climate has forced all health care providers to search for alternative methods for the delivery of health care. This search has led to the use of sites outside the conventional hospital walls for peritoneal dialysis, parenteral hyperalimentation, blood or blood product transfusions, etc. Home intravenous self-injection of antibiotics is such an alternative to prolonged and/or repeated hospitalization for patients requiring intravenous antibiotics administration only. This alternative was started as a pilot study and soon became a usual service in the Centre hospitalier de l’Université Laval following receipt of a grant from the National Health Research and Development Program. After careful development of inclusion/exclusion criteria and a teaching manual for patient and health care providers. and the standardization of medical. pharmaceutical and nursing approach, a clinical, psychosocial and economical analysis of patients who agreed to participate in a clinical study comparing the two methods of health care delivery (hospital versus home was started. Patients who met inclusion/exclusion criteria, agreeing to finish their treatment at home instead of staying hospitalized to receive intravenous antibiotics only, were taught the various techniques of intravenous self-injection. Once they were judged to be able to self-administer the antibiotics, they were sent home with the material needed to carry on their treatment, To date, more than 100 patients have participated in the home-treatment, of which 50 were analyzed. The duration of home treatment varied from two days to several months. Most patients had osteomyelitis, septic arthritis, septic bursitis, bacterial cellulitis or lung infections. The therapy allowed some newly defined patients with complicated infections (AIDS patients with cytomegalovirus retinitis to continue their treatment at home. The clinical outcome of patients treated at home was identical to the

  5. Characteristics and importance of the genus Prototheca in human and veterinary medicine

    Directory of Open Access Journals (Sweden)

    Milanov Dubravka S.

    2006-01-01

    Full Text Available Prototheca spp. are strange algae, assigned to the genus Prototheca, family Chlorelaceae. They are ubiquitous in nature, living predominantly in aqueous locales containing decomposing plant material. Prototheca spp. were isolated from skin scarificates, sputum and feces of humans in absence of infection as well as in a variety of domestic and some wild animals. Prototheca spp. are unicellular organisms, oval or spheric in shape. They differ from bacteria and fungi in size, shape and reproductive characteristics. Of the five known species of the genus, only P. wickerhamii and P. zopfii are considered pathogenic, and they are the only known plant causative agents of human and animal infections. Over the past 25 years medical references reported more than 100 cases of human protothecoses, mostly induced by P. wickerhamii and rarely by P. zopfii. A half of the reports on human protothecoses relates to localized cutaneous infections and oleocranon bursitis. The rarest and most severe form of the infection is disseminated or systemic protothecosis, described in patients with durable course of primary disease or immune disfunction. In veterinary medicine, Prototheca zopfii and rarely also P. wickerhamii are reported as causative agents of cutaneous protothecosis in dogs and cats, systemic protothecosis in dogs and mastitis in dairy cows. Protothecal infections are diagnosed by histopathology examination or, more exactly, by isolation of the agent, although the organism cannot be distinguished from the yeasts by its cultural characteristics. Final diagnosis is made by the carbon-hydrate assimilation test. Protothecal infections are easily missed in routine practice. Pharmacological protocol for therapy of this rare infection has not been developed yet either in human or in veterinary medicine. Several antifungal agents are applied for treatment; however, the effects are variable. Where possible, surgical excision is treatment of choice. Prognosis is

  6. Effect of corticosteroid injection for trochanter pain syndrome: design of a randomised clinical trial in general practice

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    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

  8. Central tendon splitting combined with SutureBridge double-row technique as a surgical treatment for insertional Achilles tendinopathy

    Institute of Scientific and Technical Information of China (English)

    LIN Yuan; WANG Zhi-wei; ZHANG Bo; PAN Jiang; QU Tie-bing; HAI Yong

    2013-01-01

    Background Surgical treatment of insertional Achilles tendinopathy should be considered when a variety of conservative measures fail.To achieve a satisfactory outcome,thorough debridement of the Achilles tendon is critical,besides excision of the bursitis and the calcaneal exostosis.Central tendon-splitting provides straightforward access to the calcified or degenerative tissue within the Achilles tendon.For Achilles tendon reconstruction if detachment is present,several surgical techniques have been reported.Controversy surrounds the technique can provide maximum security for reattachment of the Achilles tendon.The SutureBridge double-row construct,initially used in rotator cuff repair,is probably a good choice.Methods Ten consecutive patients with insertional Achilles tendinopathy underwent tendon reattachment using the SutureBridge technique through a central tendon-splitting approach.We retrospectively evaluated the surgical outcomes,which included pre-and postoperative visual analog scale (VAS),postoperative Maryland Foot Score (MFS),postoperative range of motion of the affected ankle,and related complications.Follow-up was performed in the outpatient department.Results One patient was lost to follow-up.Nine patients (two male and seven female; 12 feet) were reviewed with a minimum follow-up of six months (range 6-30 months).The postoperative VAS pain scores were markedly lower than the preoperative scores.Postoperative MFS was 92.1±8.0 (range 74-100).No intra-or postoperative complications were found,except for one case of delayed healing incision.At last follow-up,all affected ankles achieved their normal range of motion,and patients were able to resume daily activities without any assistive device.Conclusions Although a randomized control trial with a larger sample may be necessary to compare the central tendonsplitting combined with the SutureBridge technique with other techniques,our results confirmed that it was a promising alternative for treatment of

  9. Reliability of diagnostic tests in rotator cuff muscle pathology

    Directory of Open Access Journals (Sweden)

    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

  10. Bloqueo tricompartimental del hombro doloroso: estudio preliminar Tricompartmental blockade of painful shoulder: A preliminary study

    Directory of Open Access Journals (Sweden)

    D. Abejón

    2009-10-01

    Full Text Available Introducción: El hombro doloroso constituye una de las consultas más frecuentes en atención primaria, y afecta entre el 7 y el 34% de la población general adulta. La etiología más frecuente es la disfunción del manguito de los rotadores, que supone más del 70% de los casos, incluyendo aquí la tendinitis, la bursitis y la rotura de éste o de alguno de sus componentes. Se han postulado diversos tratamientos para el hombro doloroso. El objetivo del estudio es exponer una nueva técnica para los pacientes que son resistentes a los tratamientos convencionales. Material y métodos: Se analizó la eficacia de la técnica mediante una escala analógica visual (EVA que se pasó a los pacientes en el momento basal y al mes posterior a su realización. En el mismo período se valoró el grado de satisfacción de los pacientes y el porcentaje de mejoría de éstos. Por último, se analizaron las complicaciones, si existieron, y se preguntó a los pacientes si repetirían la técnica o no. Resultados: La técnica se realizó en 12 pacientes. La EVA basal media fue de 8,5 ± 1 y descendió a 5,5 ± 3 tras el procedimiento. Cuando se analizan los pacientes en los que se obtuvo beneficio, el descenso de la EVA fue cercano a 5 puntos con respecto al basal. Cuando se analizan estos datos se podría decir que en patología artrósica el valor de la técnica es mayor que en los pacientes en los que predomina la patología de partes blandas. El porcentaje medio de mejoría en la muestra completa fue de 45,83 ± 42,05. Los pacientes en los que se realizó la técnica, ante la pregunta de si repetirían o no la técnica, 7 repetirían frente a 5 que no lo harían. No se recogió ninguna complicación derivada del procedimiento. Conclusiones: El bloqueo tricompartimental del hombro parece una técnica prometedora en el tratamiento del hombro doloroso, principalmente en los casos en los que la patología subyacente es de origen artrósico.Introduction: Painful

  11. 超声观察英夫利西单抗治疗强直性脊柱炎患者骨质改变的研究%Study of therapeutic effects of infliximab on bone in patients with ankylosing spondylitis using ultrasonography

    Institute of Scientific and Technical Information of China (English)

    薛勤; 汪年松; 吴燕; 朱家安; 程东生

    2015-01-01

    Objective To observe the bone change before and after infliximab treatment in patients with ankylosing spondylitis ( AS) using ultrasonography, and to explore its clinical significance.Methods All the 48 cases of active AS patients met the modified New York criteria (1984), signed informed consent forms, and received 6 times of intravenous infusion of infliximab 5 mg/kg.Bone change on lower limb joints and tendon insertion sites in terms of morphology and blood flow after infliximab treatment was observed using high-resolution B ultrasonography and energy Doppler ultrasonography.Back pain VAS scores, joint swelling and pain, CRP, ESR, BASDAI, DASFI, and BASMI were recorded on week 0 and week 30, respectively.Results Forty-eight cases of AS patients completed the trial, and 31 of them had recheck using ultrasonography.Before the treatment, 37 sites of bone erosion, 2 sites of osteophyte, 17 sites of tendon thickening, 15 sites of bursitis, 1 site of tendon calcification, 22 sites of abnormal blood flow, 11 sites of joint effusion, and 1 site of synovial proliferation were found among the 48 cases using ultrasonography.Thirty weeks after infliximab treatment, 8 sites of bone erosion and 1 site of abnormal blood flow were found among the 31 patients who underwent recheck using ultrasonography.The difference was statistically significant ( P 0.05 ) .All the clinical indicators improved after the treatment, and the difference was statistically significant ( P<0.01 ) compared to those before the treatment.Conclusion Ultrasonography can clearly show the formation of bone erosion and osteophyte on tendon insertion sites and joints, and indentify abnormities such as tendon thickening, bursitis, synovial proliferation, and abnormal blood flow. Particularly, it can reflect bone change in AS patients in a real-time manner and monitor the treatment efficacy.%目的:应用超声观察英夫利西单抗治疗前、后强直性脊柱炎患者骨质改变的情况,并

  12. Patellofemoral pain syndrome: a review of current issues.

    Science.gov (United States)

    Thomeé, R; Augustsson, J; Karlsson, J

    1999-10-01

    There is no clear consensus in the literature concerning the terminology, aetiology and treatment for pain in the anterior part of the knee. The term 'anterior knee pain' is suggested to encompass all pain-related problems. By excluding anterior knee pain due to intra-articular pathology, peripatellar tendinitis or bursitis, plica syndromes, Sinding Larsen's disease, Osgood Schlatter's disease, neuromas and other rarely occurring pathologies, it is suggested that remaining patients with a clinical presentation of anterior knee pain could be diagnosed with patello-femoral pain syndrome (PFPS). Three major contributing factors of PFPS are discussed: (i) malalignment of the lower extremity and/or the patella; (ii) muscular imbalance of the lower extremity; and (iii) overactivity. The significance of lower extremity alignment factors and pathological limits needs further investigation. It is possible that the definitions used for malalignment should be re-evaluated, as the scientific support is very weak for determining when alignment is normal and when there is malalignment. Consequently, pathological limits must be clarified, along with evaluation of risk factors for acquiring PFPS. Muscle tightness and muscular imbalance of the lower extremity muscles with decreased strength due to hypotrophy or inhibition have been suggested, but remain unclear as potential causes of PFPS. Decreased knee extensor strength is a common finding in patients with PFPS. Various patterns of weaknesses have been reported, with selective weakness in eccentric muscle strength, within the quadriceps muscle and in terminal knee extension. The significance of muscle function in a closed versus open kinetic chain has been discussed, but is far from well investigated. It is clear that further studies are necessary in order to establish the significance of various strength deficits and muscular imbalances, and to clarify whether a specific disturbance in muscular activation is a cause or an effect

  13. Role of ultrasonography in diagnosis of peripheral entheseal involvement in patients with spondyloarthritis%超声检查脊柱关节炎患者外周附着点病变的诊断价值

    Institute of Scientific and Technical Information of China (English)

    周博; 张红; 张琰; 朱剑; 黄烽

    2013-01-01

    bone erosion was severer in clinical entheseal involvement than in none entheseal involvement group (P<0.05). Of the enthesis in lower extremities, bursitis was the most common lesion, accounting for 64%. Conclusion US can detect more enthesopathy at distal patellar ligament, sternoclavicular joint and symphysis pubis, except for distal Achille tendon than clinical examination.

  14. Ultrasonographic contrast analysis between shoulder joint soft tissue inflammation and healthy shoulder peripheral soft tissue%肩关节软组织炎症与正常肩部周围软组织的声像图比较

    Institute of Scientific and Technical Information of China (English)

    赵亚平; 陈建权; 胡文江; 文莉

    2013-01-01

    Objective To comprehend the ultrasonic appearance of shouder joint soft tissue inflammation and healthy shoulder peripheral soft tissue,and to explore the value of high frequency ultrasound in diagnosing shoulder joint soft tissue inflammation .Methods High—frequency ultrasound was performed in 80 healthy adult, shoulders and 40 shoulders with soft tissue inflammation.Sonographic features of rotator cuff, muscular fasciae, shoulder burs a mucosa, joint capsule and other structures were evaluated.The differences between the two groups were compared.Results In case group,the main performance of various abnormal image in lesion area of shoulder joint consisted of increaseing, thickening and wide effusion area ,with tendon and tendon sheath echo—enhanced,edema,calcification and muscular fasciae rough,hyperplasia,echo disorder and so on.Compared with control group.affected tendon thickened obviously in case group ( P < 0.05).In lesion area of myofascitis.bursitis around shoulder and adhesive synovitis, myofascial thickness, bursal effusion depth and shoulder joint capsule wall thickness were significantly higher than the control group (P< 0.05).Conclusion Ultrasonography can display clearly the pathological changes of shoulder joint soft tissue inflammation , and their ultrasonic appearance have certain characteristic.%目的 比较肩关节软组织炎症患者和正常肩部周围软组织的声像图表现,探讨超声在诊断肩关节软组织炎症性病变中的价值.方法 对40例肩关节软组织炎症患者(病例组)肩袖、肌筋膜、肩滑膜囊及关节囊等部位进行超声检查,另选80正常成人(对照组)检测其相同部位,结果进行对比分析.结果 病例组肩部的各型异常图像以病变区受累部位测值的增大、增厚、积液区范围广泛等为主要表现,同时伴随肌腱、腱鞘回声增强,水肿、钙化,肌筋膜毛糙、增生、回声紊乱等多种异常声像.与正常对照组比较,病例组受

  15. Achados em ressonância magnética artrográfica de indivíduos com lesão do labrum acetabular Magnetic resonance arthrographic findings in subjects with acetabular labral tears

    Directory of Open Access Journals (Sweden)

    André Luiz Almeida Pizzolatti

    2011-01-01

    Full Text Available OBJETIVO: Descrever os achados em artro RM de sujeitos com suspeita de lesão do labrum acetabular. MÉTODO: Foram analisadas 108 artro RM de quadris em 2007/2008. Dois radiologistas independentemente analisaram as imagens e foi considerada a resposta comum entre eles. Com base em seus pareceres observou-se o local e estadiamento das lesões labrais e condrais, as alterações anatômicas, e a presença de tendinite e bursite trocantérica. RESULTADO: As lesões labrais grau I ocorreram em 41% dos casos, grau II em 31%, e grau III em 29%. O IFA tipo cam foi frequente em 36% dos casos, tipo pincer em 11%, e IFA misto em 13%, nestes casos 57% apresentaram lesão labral grau III, A lesão condral grau I foi observada em 51% acetábulos, as de grau II em 13%, e grau III em 18%. CONCLUSÃO: As alterações morfológicas que provocam IFA do tipo cam foram as mais prevalentes. Em relação ao grau de lesão labral e condral foram predominantes as lesões grau I independente da presença ou do tipo de IFA, exceto em IFAs mistos onde houve predomínio de lesão labral grau III. Não foi observada uma relação entre o grau de lesão labral e condral.OBJECTIVE: To describe the MR arthrographic findings in subjects with suspected acetabular labral tears of the hip. METHOD: 108 hip MRa results were analyzed in 2007-2008. Two radiologists independently interpreted the images, and the consensual answers between them were considered for analysis. Based on their opinions, information was obtained on the location, staging of the chondral and labral lesions, anatomic alterations, and the presence of trochanteric bursitis and tendonitis. RESULTS: 1st degree labral lesions occurred in 41% of cases, 2nd degree in 31%, and 3rd degree in 29%. The cam type FAI was common in 36% of cases, pincer FAI in 11%, and mixed cam-pincer FAI in 13%; in these cases 57% had grade III labral lesions. 1st degree chondral lesions were observed in 51% of acetabulum, 2nd degree in 13

  16. 肩峰下间隙药物注射治疗肩关节撞击综合征疗效%Analysis on the curative effects of subacromial space drug injection therapy on shoulder impingement syndrome

    Institute of Scientific and Technical Information of China (English)

    郁凯; 杨剑; 刘敏; 杨杰; 杨人军; 张殿英

    2015-01-01

    目的:比较曲安奈德、派瑞昔布钠肩峰下间隙注射治疗肩关节撞击综合征的疗效。方法59例确诊为肩关节撞击综合征患者随机分为激素组和非甾体消炎药(NSAID)组,激素组注射曲安奈德40 mg,NSAID 组注射派瑞昔布钠40 mg,每位患者注射前后分别进行疼痛(VAS 评分)和肩关节功能评价(HSS 评分、外展度)。结果37例最终获得随访,3周后随访,两组患者活动度与疼痛均明显改善。肩关节 HSS 评分 NSAID 组和激素组注射后30 min 均明显优于注射前,3周随访时NSAID 组优于注射前,激素组与注射前比较差异无统计学意义。肩关节外展,NSAID 组和激素组注射后30 min 均明显优于注射前,3周随访时 NSAID 组优于激素组,差异有统计学意义。结论肩峰下注射激素和 NSAID 药物均有助于减轻肩关节撞击综合征患者的疼痛,NSAID 组肩关节活动度和HSS 评分优于激素组。%Background The common symptoms of shoulder impingement syndrome include shoulder pain and shoulder activity limitation,and shoulder pain is the chief complaint of majority of patients.There are many causes for shoulder pain,and the common causes include bursitis and tendon degeneration which are resulted from the impingement between subacromial bursa/rotator cuff and humerus/ acromion in the abduction activity of shoulder.The abnormal activity of humeral head and scapula which is resulted from rotator cuff injury may also cause shoulder impingement and generate symptoms.To alleviate pain and increase joint range of motion,such methods as no-load rest,cold compress,physical therapy,oral administration of nonsteroidalanti-inflammatory drugs (NSAID)and injection of cortical hormone are adopted for non-operational treatment of shoulder impingement.An international multicenter study shows that,injection of cortical hormone is an effective means for the patients for whom the other methods such as rest are ineffective without

  17. Avaliação ultra-sonográfica da articulação do ombro em nadadores de nível competitivo Sonographic evaluation of the shoulder joint in competitive swimmers

    Directory of Open Access Journals (Sweden)

    Guilherme Moura da Cunha

    2007-12-01

    s lesões do manguito rotador.OBJECTIVE: To evaluate the shoulders of symptomatic or asymptomatic competitive swimmers, quantifying the incidence of rotator cuff lesions in these athletes MATERIALS AND METHODS: Eleven (eight male and three female symptomatic and asymptomatic, competitive swimmers (master category in the age range between 28 and 52 years, had both shoulders prospectively evaluated by ultrasonography for determining the prevalence of injuries in correlation with clinical findings. The studies included at least two orthogonal planes of rotator cuff tendons, as well as non-tendinous components of the shoulder joint. Tendinous findings were classified into tendinosis, probable full-thickness tears and partial-thickness tears. Non-tendinous findings were classified into present or absent. Additionally to the sonographic studies results, the analysis has taken the presence or absence of symptoms and the patients' age into consideration. RESULTS: Overall, the prevalence of symptomatic patients was higher (63.6%; seven athletes, with 75% of patients with bursitis, and 100% of those with partial-thickness tendon tears. Among isolated tendinous findings, the supraspinatus tendon was the most frequently involved, showing echographic pattern alteration in 36.36% of cases. Tendinosis was the most prevalent finding, present in at least one tendon in 50% of the studied shoulders. The incidence of partial-thickness tendon tears was similar to the incidence reported for non-athlete individuals (13%, always present in individuals above 40 years of age. CONCLUSION: Swimmers do not seem to present a higher incidence of tendon tears or degeneration when compared with the general population. Individuals' age is the most relevant determining factor, as far as rotator cuff lesions are concerned, no matter these individuals practice or not activities involving an overload of the shoulder joint.

  18. 脑卒中早期患者肩部病变损伤及其与肢体功能的相关性研究%The study of shoulder lesion and injury in stroke patients of early stage and its correlation with the function of hemiplegic extremity

    Institute of Scientific and Technical Information of China (English)

    李涛; 宫萍; 周谋望

    2013-01-01

    Objective:To clarify the shoulder lesion and injury using sonography and to evaluate the relationship between sonographic findings and function of hemiplegic extremity in stroke patients of early stage.Method:Sixty patients were divided into two groups according to Brunnstrom stage of hemiplegic extremity.Of which,44 patients were in the poor function group and 16 patients were in the good function group.All the patients received ultrasound examination and passive range of motion(PROM)measurement of their hemiplegic shoulder.Result:The total occurrence rate of shoulder lesion and injury was 76.7%(n=46).The occurrence rate of subacromial-subdeltoid bursal hydrops or bursitis was 41.7%(n=25).The occurrence rate of hydrops or inflammation of long head of biceps tendon sheath was 30%(n=18).The occurrence rate of tendinitis of rotator cuff was 16.7% (n=10).The occurrence rate of tear leision and injury (partial or complete) of rotator cuff was 21.7%(n=13).There was no statistical correlation between motor function stage of hemiplegic extremity and severity of leision and injury sonographic findings(P>0.05).There were significant differences in PROM of hemiplegic shoulder among patients with different severities of shoulder lesion and injury(P<0.05).Conclusion:The occurrence rate of shoulder lesion and injury after stroke of early stage was very high.There was no correlation between the severity of shoulder lesion and injury and the motor function stage of hemiplegic extremity.The shoulder lesion and injury can affect PROM of hemiplegic shoulder.For the function rehabilitation of upper extremity of stroke hemiplegic patients it is beneficial to find the shoulder lesion and injury earlier and administer effective therapy.%目的:通过超声检查的方法对脑卒中早期的肩部病变和损伤进行分析,并研究其与脑卒中患者患侧上肢功能状态之间的相关性.方法:60例脑卒中早期肩痛患者根据

  19. Biological characteristics of stemless hip arthroplasty and the recovery of hip joint function in young patients:A follow-up of medium- and short-term outcome%无柄解剖型人工髋关节生物学特征与青年髋关节置换者髋关节功能的恢复:短中期随访结果

    Institute of Scientific and Technical Information of China (English)

    詹新立; 肖增明; 李世德; 陈前芬; 罗高斌

    2007-01-01

    necrosis. In the postoperative 5-year follow up, 1 patient had radiolucency. Because the range of radiolucency was very small, progression was not quick and clinical symptoms were not severe, so revision operation was not conducted;In the postoperative 6th month, the inclination angle averaged (135.2±6.8)° on the untreated side and (132.2±6.5)° on the treat side. One patient with congenital hip dysplasia and a previous varus derotational osteotomy had a postoperative inclination angle below 120°. Patients with postoperative inclination angles between 125° and 140° had significantly less hip pain than the rest of the series. Heterotopic ossifications classification: Three patients had postoperative heterotopic ossifications, one hip had grade 1 heterotopic ossification, 1 hip had grade 2 heterotopic ossification, and 1 hip had grade 3 heterotopic ossification.③ Revision operation: one patient (5.9%,1/17)required a revision total hip arthroplasty due to pain. Good bone stock of the proximal femur was found in the patient which allowed implantation of a conventional medullary anchored prosthesis. This revision surgery and postoperative rehabilitation were uncomplicated.④ Adverse events and complications: Hip dislocation occurred postoperatively in one patient (5.9%,1/17). Other complications included trochanter bursitis (n=1), fistula (n =1), and seroma (n =1).CONCLUSION: ① NSHP provides biological fixation for femoral prothesis by bone proliferation through the windows with connective tissues surrounding the prothesis and has the characteristics of low stress and deformation, high intensity and rigidity, and anti-loosening, thus, may prolong its live lime. ②Revision surgeries are facilitated by the good bone stock remaining in the proximal femur. ③ The short- and medium-term therapeutic effects of total hip arthroplasty are satisfying in young patients.