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Sample records for scapula

  1. Scapula alata

    DEFF Research Database (Denmark)

    Tibaek, Sigrid; Gadsbøll, Janne

    2015-01-01

    BACKGROUND: To date, there are no published outcomes-based treatment programs to guide clinicians when managing patients with scapula alata. The purposes of this study were to describe a physical therapy program in patients with scapula alata and to evaluate its effect using a shoulder...... to a physical therapy program at a university hospital. The program included (1) physical examination, (2) thoracic brace treatment, and (3) muscular rehabilitation. The treatment frequency and duration were determined individually. The effect was evaluated by a shoulder-specific quality-of-life questionnaire...... Index. CONCLUSIONS: This study described in detail a physical therapy program; the program showed significant benefit. Further research is needed before recommending the program as a potential treatment option....

  2. Arthroscopic treatment for snapping scapula

    DEFF Research Database (Denmark)

    Blønd, Lars; Rechter, Simone

    2014-01-01

    PURPOSE: Painful snapping scapula can be a disabling condition. The object of this prospective study was to assess the efficiency of arthroscopic bone resection of the medial superior corner of scapula, in patients suffering from continuously painful snapping scapula. METHODS: Twenty patients...... with painful snapping scapula underwent arthroscopic scapulothoracic bursectomi and resection of the hook formation at the medial superior margin of the scapular. Preoperatively, all patients reported temporary relief via a local anesthetic injection and had completed a 3-month rehabilitation program......-100) postoperatively. Out of 20 patients, 18 improved and 19 indicated that they would undergo the surgery again. CONCLUSION: In this study, it was found that, among patients troubled by painful snapping scapula and without relief by exercise-based rehabilitation, arthroscopic resection of the medial superior hook...

  3. Meningioma of the scapula

    Energy Technology Data Exchange (ETDEWEB)

    Llauger, Jaume; Aixut, Sonia; Canete, Noemi; Palmer, Jaume; Sola, Marta [Universitat Autonoma de Barcelona, Department of Radiology, Hospital de la Santa Creu I Sant Pau, Barcelona (Spain); Bague, Silvia [Universitat Autonoma de Barcelona, Department of Pathology, Hospital de la Santa Creu I Sant Pau, Barcelona (Spain)

    2008-02-15

    Meningiomas account for approximately 15% of all intracranial tumors and are the most common non-glial primary tumors of the central nervous system. Most meningiomas are benign neoplasms with characteristic imaging features. Primary extradural meningiomas account for only 1-2% of all meningiomas. They must be differentiated from intradural meningiomas with secondary extradural extension and/or metastases. The vast majority of extradural meningiomas are found in the skull or in the head and neck region. We report on an extremely rare case of primary extradural meningioma that was located in the scapula. The lesion was resected. Radiographic findings and pathologic features are discussed. To the best of our knowledge, this form of presentation of an extradural meningioma has not been previously described. (orig.)

  4. Scapulothoracic Anatomy and Snapping Scapula Syndrome

    Directory of Open Access Journals (Sweden)

    Rachel M. Frank

    2013-01-01

    Full Text Available The scapulothoracic articulation is a sliding junction between the deep aspect of the scapula and thoracic rib cage at the levels of ribs 2 through 7. Motion at this articulation is dynamically stabilized by a variety of muscular attachments, allowing for controlled positioning of the glenoid to assist in glenohumeral joint function. A thorough understanding of the complex anatomic relationships, including the various muscles, and bursa, is critical to the evaluation of patients presenting with scapulothoracic disorders. The snapping scapula syndrome is caused by either osseous lesions or scapulothoracic bursitis and can be difficult to recognize and treat. The purpose of this review is to discuss the anatomy of the scapulothoracic articulation with an emphasis on the pathology associated with snapping scapula syndrome.

  5. Scapulothoracic anatomy and snapping scapula syndrome.

    Science.gov (United States)

    Frank, Rachel M; Ramirez, Jose; Chalmers, Peter N; McCormick, Frank M; Romeo, Anthony A

    2013-01-01

    The scapulothoracic articulation is a sliding junction between the deep aspect of the scapula and thoracic rib cage at the levels of ribs 2 through 7. Motion at this articulation is dynamically stabilized by a variety of muscular attachments, allowing for controlled positioning of the glenoid to assist in glenohumeral joint function. A thorough understanding of the complex anatomic relationships, including the various muscles, and bursa, is critical to the evaluation of patients presenting with scapulothoracic disorders. The snapping scapula syndrome is caused by either osseous lesions or scapulothoracic bursitis and can be difficult to recognize and treat. The purpose of this review is to discuss the anatomy of the scapulothoracic articulation with an emphasis on the pathology associated with snapping scapula syndrome.

  6. An unusual cause of an isolated scapula fracture.

    Science.gov (United States)

    Donovan, Megan; Attia, Magdy W

    2018-03-01

    This article reviews an isolated scapula fracture in a teenage athlete. Although rarely reported in professional athletes, scapula fracture should be included in the differential diagnosis of shoulder injuries. Proper imaging is key to effective diagnosis and management.

  7. History of the treatment of scapula fractures.

    Science.gov (United States)

    Bartonícek, Jan; Cronier, Patrick

    2010-01-01

    The history of treatment of scapula fractures is closely connected with the history of the French surgery. Paré (Les œuvres d´Ambroise Paré, conseiller, et premier chirurgien du Roy, Gabriel Buon, Paris, p VCV, 1579), Petit (Traité des maladies des os. Tome second, Charles-Etienne Hochereau, Paris, pp 122–138, 1723), Du Verney (Traité des maladies des os. Tome I, de Burre, Paris, pp 220–231, 1751) and Desault (Œuvres chirurgicales, ou tableau de la doctrine et de la pratique dans le traitement des maladies externes par Xav. Bichat, Desault, Méquignon, Devilliers, Deroi, Paris, pp 98–106, 1798) were the first to point out the existence of these fractures. The first drawing of a scapula fracture was presented by Vogt (Dissertatio de ambarum scapularum dextroeque simul claviculae fractura rara, Dissertatione Universitae Vitembergensi, Wittenberg, 1799). This author was also the first to describe the scapula fracture associated with ipsilateral fracture of the clavicle. The first radiograph of scapula fracture (glenoid fossa fracture) was published by Struthers (Edinburgh Med J 4(3):147–149, 1910). The first internal fixation of scapula fracture using plate was done by Lambotte (1910) who was followed by Lane (The operative treatment of fractures, Medical Publishing Co, London, pp 99–101, 1914) and later by Lenormant (Sur l´ostéosynthèse dans certains fractures de l´omoplate Bulletins et mémoires de la Société de chirgie de Paris, pp 1501–1502, 1923), Dujarier (Fracture du col chirgical de l´omoplate. Ostéosynthèse par plaque en T. Bonne réduction. Bulletin et mémoires de la Société de chirurgie de Paris, pp 1492–1493, 1923) and Basset (Ostéosynthèse d´une fracture de l´omoplate. Bulletin et mémoires de la Société nationale de chirurgie. p 193, 1924). Dupont and Evrard (J Chir (Paris) 39:528–534, 1932) presented the first detailed description of the surgical approach along the lateral border of the scapula including two

  8. Radiation induced fracture of the scapula

    Energy Technology Data Exchange (ETDEWEB)

    Riggs, J.H. III; Schultz, G.D.; Hanes, S.A. (Los Angeles College of Chiropractic, Whittier, CA (USA))

    1990-10-01

    A case of radiation induced osteonecrosis resulting in a fracture of the scapula in a 76-yr-old female patient with a history of breast carcinoma is presented. Diagnostic imaging, laboratory recommendations and clinical findings are discussed along with an algorithm for the safe management of patients with a history of cancer and musculoskeletal complaints. This case demonstrates the necessity of a thorough investigation of musculoskeletal complaints in patients with previous bone-seeking carcinomas.

  9. Scapula Kinematics of Youth Baseball Players

    Directory of Open Access Journals (Sweden)

    Oliver Gretchen

    2015-12-01

    Full Text Available Literature has revealed the importance of quantifying resting scapular posture in overhead athletes as well as quantifying scapular kinematics during dynamic movement. Prior to this project much of the attention in throwing research had been focused on the position of the humerus without description of the positioning of the scapula. Therefore, it was the purpose of this study to present scapular kinematics during pitching in youth baseball players. Twenty-five youth baseball players (age 11.3 + 1.0 years; body height 152.4 + 9.0 cm; body mass 47.5 + 11.3 kg, with no history of injury, participated in the study. Scapular kinematics at the events of maximum humeral external rotation (MER and maximum humeral internal rotation (MIR during the pitching motion were assessed three-dimensionally while pitching fastballs for strikes. Results revealed that at the event of MER, the scapula was in a position of retraction, upward rotation and a posterior tilt. While at the event of MIR, the scapula was protracted, upward rotated and tilted anteriorly.

  10. Scapula fractures: interobserver reliability of classification and treatment.

    NARCIS (Netherlands)

    Neuhaus, V.; Bot, A.G.; Guitton, T.G.; Ring, D.C.; Abdel-Ghany, M.I.; Abrams, J.; Abzug, J.M.; Adolfsson, L.E.; Balfour, G.W.; Bamberger, H.B.; Barquet, A.; Baskies, M.; Batson, W.A.; Baxamusa, T.; Bayne, G.J.; Begue, T.; Behrman, M.; Beingessner, D.; Biert, J.; Bishop, J.; Alves, M.B.; Boyer, M.; Brilej, D.; Brink, P.R.; Brunton, L.M.; Buckley, R.; Cagnone, J.C.; Calfee, R.P.; Campinhos, L.A.; Cassidy, C.; Catalano L, 3.r.d.; Chivers, K.; Choudhari, P.; Cimerman, M.; Conflitti, J.M.; Costanzo, R.M.; Crist, B.D.; Cross, B.J.; Dantuluri, P.; Darowish, M.; Bedout, R. de; DeCoster, T.; Dennison, D.G.; DeNoble, P.H.; DeSilva, G.; Dienstknecht, T.; Duncan, S.F.; Duralde, X.A.; Durchholz, H.; Egol, K.; Ekholm, C.; Elias, N.; Erickson, J.M.; Esparza, J.D.; Fernandes, C.H.; Fischer, T.J.; Fischmeister, M.; origua Jaime, E. F; Getz, C.L.; Gilbert, R.S.; Giordano, V.; Glaser, D.L.; Gosens, T.; Grafe, M.W.; Filho, J.E.; Gray, R.R.; Gulotta, L.V.; Gummerson, N.W.; Hammerberg, E.M.; Harvey, E.; Haverlag, R.; Henry, P.D.; Hobby, J.L.; Hofmeister, E.P.; Hughes, T.; Itamura, J.; Jebson, P.; Jenkinson, R.; Jeray, K.; Jones, C.M.; Jones, J.; Jubel, A.; Kaar, S.G.; Kabir, K.; Kaplan, F.T.; Kennedy, S.A.; Kessler, M.W.; Kimball, H.L.; Kloen, P.; Klostermann, C.; Kohut, G.; Kraan, G.A.; Kristan, A.; Loebenberg, M.I.; Malone, K.J.; Marsh, L.; Martineau, P.A.; McAuliffe, J.; McGraw, I.; Mehta, S.; Merchant, M.; Metzger, C.; Meylaerts, S.A.; Miller, A.N.; Wolf, J.M.; Murachovsky, J.; Murthi, A.; Nancollas, M.; Nolan, B.M.; Omara, T.; Omid, R.; Ortiz, J.A.; Overbeck, J.P.; Castillo, A.P.; Pesantez, R.; Polatsch, D.; Porcellini, G.; Prayson, M.; Quell, M.; Ragsdell, M.M.; Reid, J.G.; Reuver, J.M.; Richard, M.J.; Richardson, M.; Rizzo, M.; Rowinski, S.; Rubio, J.; Guerrero, C.G.; Satora, W.; Schandelmaier, P.; Scheer, J.H.; Schmidt, A.; Schubkegel, T.A.; Schulte, L.M.; Schumer, E.D.; Sears, B.W.; Shafritz, A.B.; Shortt, N.L.; Siff, T.; Silva, D.M.; Smith, R.M.; Spruijt, S.; Stein, J.A.; Pemovska, E.S.; Streubel, P.N.; Swigart, C.; Swiontkowski, M.; Thomas, G; Tolo, E.T.; Turina, M.; Tyllianakis, M.; Bekerom, M.P. van den; Heide, H.; Sande, M.A. van de; Eerten, P.V. van; Verbeek, D.O.; Hoffmann, D.V.; Vochteloo, A.J.; Wagenmakers, R.; Wall, C.J.; Wallensten, R.; Wascher, D.C.; Weiss, L.; Wiater, J.M.; Wills, B.P.; Wint, J.; Wright, T.; Young, J.P.; Zalavras, C.; Zura, R.D.; Zyto, K.

    2014-01-01

    OBJECTIVES: There is substantial variation in the classification and management of scapula fractures. The first purpose of this study was to analyze the interobserver reliability of the OTA/AO classification and the New International Classification for Scapula Fractures. The second purpose was to

  11. Scapula Fractures: Interobserver Reliability of Classification and Treatment

    NARCIS (Netherlands)

    Neuhaus, Valentin; Bot, Arjan G. J.; Guitton, Thierry G.; Ring, David C.; Abdel-Ghany, Mahmoud I.; Abrams, Jeffrey; Abzug, Joshua M.; Adolfsson, Lars E.; Balfour, George W.; Bamberger, H. Brent; Barquet, Antonio; Baskies, Michael; Batson, W. Arnold; Baxamusa, Taizoon; Bayne, Grant J.; Begue, Thierry; Behrman, Michael; Beingessner, Daphne; Biert, Jan; Bishop, Julius; Alves, Mateus Borges Oliveira; Boyer, Martin; Brilej, Drago; Brink, Peter R. G.; Brunton, Lance M.; Buckley, Richard; Cagnone, Juan Carlos; Calfee, Ryan P.; Campinhos, Luiz Augusto B.; Cassidy, Charles; Catalano, Louis; Chivers, Karel; Choudhari, Pradeep; Cimerman, Matej; Conflitti, Joseph M.; Costanzo, Ralph M.; Crist, Brett D.; Cross, Brian J.; Dantuluri, Phani; Darowish, Michael; de Bedout, Ramon; DeCoster, Thomas; Dennison, David G.; DeNoble, Peter H.; DeSilva, Gregory; Dienstknecht, Thomas; Duncan, Scott F.; Duralde, Xavier A.; Durchholz, Holger; Egol, Kenneth; Ekholm, Carl; Elias, Nelson; Erickson, John M.; Esparza, J. Daniel Espinosa; Fernandes, C. H.; Fischer, Thomas J.; Fischmeister, Martin; Forigua Jaime, E.; Getz, Charles L.; GIlbert, Richard S.; Giordano, Vincenzo; Glaser, David L.; Gosens, Taco; Grafe, Michael W.; Filho, Jose Eduardo Grandi Ribeiro; Gray, Robert R. L.; Gulotta, Lawrence V.; Gummerson, Nigel William; Hammerberg, Eric Mark; Harvey, Edward; Haverlag, R.; Henry, Patrick D. G.; Hobby, Jonathan L.; Hofmeister, Eric P.; Hughes, Thomas; Itamura, John; Jebson, Peter; Jenkinson, Richard; Jeray, Kyle; Jones, Christopher M.; Jones, Jedediah; Jubel, Axel; Kaar, Scott G.; Kabir, K.; Kaplan, F. Thomas D.; Kennedy, Stephen A.; Kessler, Michael W.; Kimball, Hervey L.; Kloen, Peter; Klostermann, Cyrus; Kohut, Georges; Kraan, G. A.; Kristan, Anze; Loebenberg, Mark I.; Malone, Kevin J.; Marsh, L.; Martineau, Paul A.; McAuliffe, John; McGraw, Iain; Mehta, Samir; Merchant, Milind; Metzger, Charles; Meylaerts, S. A.; Miller, Anna N.; Wolf, Jennifer Moriatis; Murachovsky, Joel; Murthi, Anand; Nancollas, Michael; Nolan, Betsy M.; Omara, Timothy; Omid, Reza; Ortiz, Jose A.; Overbeck, Joachim P.; Castillo, Alberto Pérez; Pesantez, Rodrigo; Polatsch, Daniel; Porcellini, G.; Prayson, Michael; Quell, M.; Ragsdell, Matthew M.; Reid, James G.; Reuver, J. M.; Richard, Marc J.; Richardson, Martin; Rizzo, Marco; Rowinski, Sergio; Rubio, Jorge; Guerrero, Carlos G. Sánchez; Satora, Wojciech; Schandelmaier, Peter; Scheer, Johan H.; Schmidt, Andrew; Schubkegel, Todd A.; Schulte, Leah M.; Schumer, Evan D.; Sears, Benjamin W.; Shafritz, Adam B.; Shortt, Nicholas L.; Siff, Todd; Silva, Dario Mejia; Smith, Raymond Malcolm; Spruijt, Sander; Stein, Jason A.; Pemovska, Emilija Stojkovska; Streubel, Philipp N.; Swigart, Carrie; Swiontkowski, Marc; Thomas, George; Tolo, Eric T.; Turina, Matthias; Tyllianakis, Minos; van den Bekerom, Michel P. J.; van der Heide, Huub; van de Sande, M. A. J.; van Eerten, P. V.; Verbeek, Diederik O. F.; Hoffmann, David Victoria; Vochteloo, A. J. H.; Wagenmakers, Robert; Wall, Christopher J.; Wallensten, Richard; Wascher, Daniel C.; Weiss, Lawrence; Wiater, J. Michael; Wills, Brian P. D.; Wint, Jeffrey; Wright, Thomas; Young, Jason P.; Zalavras, Charalampos; Zura, Robert D.; Zyto, Karol

    2014-01-01

    Objectives:There is substantial variation in the classification and management of scapula fractures. The first purpose of this study was to analyze the interobserver reliability of the OTA/AO classification and the New International Classification for Scapula Fractures. The second purpose was to

  12. Clinical Assessment of Scapula Motion: Scapula Upward Rotation and Relationship with Injury in Swimmers

    Directory of Open Access Journals (Sweden)

    Jo Brown

    2016-01-01

    Full Text Available Abnormal scapulothoracic mechanics and scapulohumeral rhythm are implicated in shoulder pathologies, including glenohumeral impingement and rotator cuff tears. Upward scapula rotation, specifically asymmetry of scapula motion and associations of patterns through range with injury, was investigated in dominant and non-dominant limbs of nationally ranked junior and Paralympic swimmers during competition season. The static and throughout phases measures of upward scapula rotation were: Phase I (start position, 45°, Phase II (45° to 90°, Phase III (90° to 135° and Phase IV (135° to max. Injury was assessed with a validated questionnaire. Differences between side (dominant and non-dominant, group (junior and Paralympic, and phase were examined. Significant differences (P < 0.05 between groups were identified for dominant side at rest, 45° and 135°, and in phases II and IV (including range. Scapulohumeral rhythm was higher in the non-dominant limb of Paralympic swimmers but in the dominant limb of junior swimmers. Greatest differences in upward rotation between injured and non-injured swimmers were found in Phase 1: 43.6% (3.3° Paralympic; 73.1% (8° junior. Results suggest asymmetry of movement in both limbs, through all phases, and at single points in range, should be investigated for assessing injury and developing preventive strategies and rehabilitation protocols.

  13. Winging of scapula due to serratus anterior tear

    Directory of Open Access Journals (Sweden)

    Varun Singh Kumar

    2014-10-01

    Full Text Available 【Abstract】Winging of scapula occurs most commonly due to injury to long thoracic nerve supplying serratus anterior muscle. Traumatic injury to serratus anterior muscle itself is very rare. We reported a case of traumatic winging of scapula due to tear of serratus anterior muscle in a 19-year-old male. Winging was present in neutral position and in extension of right shoulder joint but not on "push on wall" test. Patient was managed conservatively and achieved satisfactory result. Key words: Serratus anterior tear; Scapula; Wounds and injuries

  14. Giant chondroblastoma of the scapula with pulmonary metastases

    Energy Technology Data Exchange (ETDEWEB)

    Ozkoc, Gurkan; Ozalay, Metin [Baskent University, Department of Orthopedics and Traumatology, Adana Medical Center, School of Medicine, Adana (Turkey); Gonlusen, Gulfiliz [Cukurova University, Department of Pathology, School of Medicine, Adana (Turkey); Kayaselcuk, Fazilet [Baskent University, Department of Pathology, Adana Medical Center, School of Medicine, Adana (Turkey); Pourbagher, Aysin [Baskent University, Department of Radiodiagnostics, Adana Medical Center, School of Medicine, Adana (Turkey); Tandogan, Reha N. [Baskent University, Department of Orthopedics and Traumatology, School of Medicine, Ankara (Turkey)

    2006-01-01

    A 53-year-old man presented with a 12-year history of a progressively growing solid mass at his left shoulder. A 39 x 30 x 18-cm and 14.440-kg mass including the scapula was resected. Pathologic features were specific for chondroblastoma. During the 36-month follow-up, he had multiple inoperable metastatic lesions in his lungs. Histology of the transthoracic needle biopsy showed the metastatic nodules had features specific for chondroblastoma; however, the microscopic features additionally had hyperchromasia and increased mitotic activity in some areas. In the English literature, there are a few cases of chondroblastoma located in the scapula. It is exceptional to see this lesion in the sixth decade of life and with pulmonary metastases. (orig.)

  15. Scapula behavior associates with fast sprinting in first accelerated running

    OpenAIRE

    Otsuka, Mitsuo; Ito, Taisuke; Honjo, Toyoyuki; Isaka, Tadao

    2016-01-01

    The arm-swing motion is important for coordinated lower limb movement during a fast sprint and is composed of three-dimensional scapulothoracic and glenohumeral joint motion. Here, we aimed to clarify the role of the scapula during the initiation of a sprint running when sprinter run with high horizontal acceleration. Ten sports-active students participated in four 5-m dashes, with scapular constraint using non-elastic therapy tape (constraint condition) and without scapular constraint (free ...

  16. Role of development in the evolution of the scapula of the giant sthenurine kangaroos (Macropodidae: Sthenurinae).

    Science.gov (United States)

    Sears, Karen E

    2005-08-01

    Extinct giant sthenurine kangaroos possessed scapulae morphologically distinct from those of all other extant and extinct adult macropodids, but qualitatively resembling those of newborn macropodids. The similarity between adult sthenurine and neonatal macropodid scapulae suggests that a developmental process, such as heterochrony, might have been behind the evolution of the unique sthenurine scapular morphology. By incorporating adult and ontogenetic data, this study examines the evolution and development of the sthenurine scapula. This study quantitatively upholds the previous qualitative morphological observations of macropodid scapulae and finds that ontogenetic and evolutionary morphological changes are correlated in macropodids. The similarity of scapula morphology in sthenurines and newborn macropodids, the correlation between ontogenetic and evolutionary morphological change, and information from other sources (i.e., sthenurine evolutionary history) suggests that pedomorphic shifts in morphology, most likely due to neotenic processes, occurred within the development of the scapula of giant sthenurines. Copyright 2005 Wiley-Liss, Inc.

  17. Scapula fractures: interobserver reliability of classification and treatment.

    Science.gov (United States)

    Neuhaus, Valentin; Bot, Arjan G J; Guitton, Thierry G; Ring, David C; Abdel-Ghany, Mahmoud I; Abrams, Jeffrey; Abzug, Joshua M; Adolfsson, Lars E; Balfour, George W; Bamberger, H Brent; Barquet, Antonio; Baskies, Michael; Batson, W Arnold; Baxamusa, Taizoon; Bayne, Grant J; Begue, Thierry; Behrman, Michael; Beingessner, Daphne; Biert, Jan; Bishop, Julius; Alves, Mateus Borges Oliveira; Boyer, Martin; Brilej, Drago; Brink, Peter R G; Brunton, Lance M; Buckley, Richard; Cagnone, Juan Carlos; Calfee, Ryan P; Campinhos, Luiz Augusto B; Cassidy, Charles; Catalano, Louis; Chivers, Karel; Choudhari, Pradeep; Cimerman, Matej; Conflitti, Joseph M; Costanzo, Ralph M; Crist, Brett D; Cross, Brian J; Dantuluri, Phani; Darowish, Michael; de Bedout, Ramon; DeCoster, Thomas; Dennison, David G; DeNoble, Peter H; DeSilva, Gregory; Dienstknecht, Thomas; Duncan, Scott F; Duralde, Xavier A; Durchholz, Holger; Egol, Kenneth; Ekholm, Carl; Elias, Nelson; Erickson, John M; Esparza, J Daniel Espinosa; Fernandes, C H; Fischer, Thomas J; Fischmeister, Martin; Forigua Jaime, E; Getz, Charles L; Gilbert, Richard S; Giordano, Vincenzo; Glaser, David L; Gosens, Taco; Grafe, Michael W; Filho, Jose Eduardo Grandi Ribeiro; Gray, Robert R L; Gulotta, Lawrence V; Gummerson, Nigel William; Hammerberg, Eric Mark; Harvey, Edward; Haverlag, R; Henry, Patrick D G; Hobby, Jonathan L; Hofmeister, Eric P; Hughes, Thomas; Itamura, John; Jebson, Peter; Jenkinson, Richard; Jeray, Kyle; Jones, Christopher M; Jones, Jedediah; Jubel, Axel; Kaar, Scott G; Kabir, K; Kaplan, F Thomas D; Kennedy, Stephen A; Kessler, Michael W; Kimball, Hervey L; Kloen, Peter; Klostermann, Cyrus; Kohut, Georges; Kraan, G A; Kristan, Anze; Loebenberg, Mark I; Malone, Kevin J; Marsh, L; Martineau, Paul A; McAuliffe, John; McGraw, Iain; Mehta, Samir; Merchant, Milind; Metzger, Charles; Meylaerts, S A; Miller, Anna N; Wolf, Jennifer Moriatis; Murachovsky, Joel; Murthi, Anand; Nancollas, Michael; Nolan, Betsy M; Omara, Timothy; Omid, Reza; Ortiz, Jose A; Overbeck, Joachim P; Castillo, Alberto Pérez; Pesantez, Rodrigo; Polatsch, Daniel; Porcellini, G; Prayson, Michael; Quell, M; Ragsdell, Matthew M; Reid, James G; Reuver, J M; Richard, Marc J; Richardson, Martin; Rizzo, Marco; Rowinski, Sergio; Rubio, Jorge; Guerrero, Carlos G Sánchez; Satora, Wojciech; Schandelmaier, Peter; Scheer, Johan H; Schmidt, Andrew; Schubkegel, Todd A; Schulte, Leah M; Schumer, Evan D; Sears, Benjamin W; Shafritz, Adam B; Shortt, Nicholas L; Siff, Todd; Silva, Dario Mejia; Smith, Raymond Malcolm; Spruijt, Sander; Stein, Jason A; Pemovska, Emilija Stojkovska; Streubel, Philipp N; Swigart, Carrie; Swiontkowski, Marc; Thomas, George; Tolo, Eric T; Turina, Matthias; Tyllianakis, Minos; van den Bekerom, Michel P J; van der Heide, Huub; van de Sande, M A J; van Eerten, P V; Verbeek, Diederik O F; Hoffmann, David Victoria; Vochteloo, A J H; Wagenmakers, Robert; Wall, Christopher J; Wallensten, Richard; Wascher, Daniel C; Weiss, Lawrence; Wiater, J Michael; Wills, Brian P D; Wint, Jeffrey; Wright, Thomas; Young, Jason P; Zalavras, Charalampos; Zura, Robert D; Zyto, Karol

    2014-03-01

    There is substantial variation in the classification and management of scapula fractures. The first purpose of this study was to analyze the interobserver reliability of the OTA/AO classification and the New International Classification for Scapula Fractures. The second purpose was to assess the proportion of agreement among orthopaedic surgeons on operative or nonoperative treatment. Web-based reliability study. Independent orthopaedic surgeons from several countries were invited to classify scapular fractures in an online survey. One hundred three orthopaedic surgeons evaluated 35 movies of three-dimensional computerized tomography reconstruction of selected scapular fractures, representing a full spectrum of fracture patterns. Fleiss kappa (κ) was used to assess the reliability of agreement between the surgeons. The overall agreement on the OTA/AO classification was moderate for the types (A, B, and C, κ = 0.54) with a 71% proportion of rater agreement (PA) and for the 9 groups (A1 to C3, κ = 0.47) with a 57% PA. For the New International Classification, the agreement about the intraarticular extension of the fracture (Fossa (F), κ = 0.79) was substantial and the agreement about a fractured body (Body (B), κ = 0.57) or process was moderate (Process (P), κ = 0.53); however, PAs were more than 81%. The agreement on the treatment recommendation was moderate (κ = 0.57) with a 73% PA. The New International Classification was more reliable. Body and process fractures generated more disagreement than intraarticular fractures and need further clear definitions.

  18. Winging of the Scapula in a Young Athlete.

    Science.gov (United States)

    Patel; Nelson

    1996-10-01

    A 15-year-old high school football player noticed asymmetry of his right shoulder and thought that he was losing muscle mass around his right shoulder over the previous 2-3 weeks. There was no history of pain, recent or past direct trauma or surgery of the neck or thorax. He was diagnosed with serologically confirmed infectious mononucleosis about 2 months earlier, and was recovering clinically. Physical examination was normal, except for significant asymmetry and winging of the right scapula, and electromyographic and nerve conduction studies revealed demyealination and axonal damage to the right long thoracic nerve and paralysis of serratus anterior, most likely caused by Epstein-Barr virus infection. Conservative treatment approach allowing continued activity and strengthening exercises resulted in full functional recovery over the next 6-8 months.

  19. Rehabilitation for Subacromial Impingement Starts at the Scapula

    Directory of Open Access Journals (Sweden)

    Peggy A. Houglum

    2013-12-01

    Full Text Available Subacromial impingement, especially secondary subacromial impingement, is a common malady of athletes and non-athletes alike. Although several pathologies may lead to impingement, they all relate back to poor posture. Over time, postural changes increase stress to soft tissue structures to change both alignment and performance. Injury results as low-level stresses impact weakening tissues to the point of overload. Crucial to effective treatment of secondary subacromial impingement is the identification and correction of all causes. Basic to successful treatment is correction of posture, including scapular posture and muscles which control, stabilize, and move the scapula. An evidence-based approach to not only identifying the causes but also creating a treatment regimen to effectively resolve secondary subacromial impingement is presented.

  20. Scaling and kinematics optimisation of the scapula and thorax in upper limb musculoskeletal models.

    Science.gov (United States)

    Prinold, Joe A I; Bull, Anthony M J

    2014-08-22

    Accurate representation of individual scapula kinematics and subject geometries is vital in musculoskeletal models applied to upper limb pathology and performance. In applying individual kinematics to a model's cadaveric geometry, model constraints are commonly prescriptive. These rely on thorax scaling to effectively define the scapula's path but do not consider the area underneath the scapula in scaling, and assume a fixed conoid ligament length. These constraints may not allow continuous solutions or close agreement with directly measured kinematics. A novel method is presented to scale the thorax based on palpated scapula landmarks. The scapula and clavicle kinematics are optimised with the constraint that the scapula medial border does not penetrate the thorax. Conoid ligament length is not used as a constraint. This method is simulated in the UK National Shoulder Model and compared to four other methods, including the standard technique, during three pull-up techniques (n=11). These are high-performance activities covering a large range of motion. Model solutions without substantial jumps in the joint kinematics data were improved from 23% of trials with the standard method, to 100% of trials with the new method. Agreement with measured kinematics was significantly improved (more than 10° closer at pthorax scaling correction factor were shown to be key. Separation of the medial border of the scapula from the thorax was large, although this may be physiologically correct due to the high loads and high arm elevation angles. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  1. Congenital cleft scapula with type V ulnar longitudinal deficiency: case report.

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    Abdel-Ghani, Hisham

    2010-05-01

    A rare case of malformation of the scapula, a cleft scapula, has been encountered. This case is associated with type V ulnar longitudinal deficiency of the ipsilateral upper limb. The scapular malformation has been treated with fusion of the 2 parts, with good aesthetic and functional outcome. In this report, the clinical, radiological, and surgical findings, as well as the surgical technique, are described. Four cases of similar malformation have been reported in the literature, and they were described as complete scapular duplication. According to the current findings and reinterpretation of the previous reports, this malformation is better called cleft scapula rather than scapular duplication. Copyright 2010. Published by Elsevier Inc.

  2. Solitary Osteochondroma of the Ventral Scapula Associated with Large Bursa Formation and Pseudowinging of the Scapula: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Kiyohisa Ogawa

    2018-01-01

    Full Text Available Osteochondroma (OC is the most common benign bone tumor and may occur on any bone in which endochondral ossification develops. Although scapular OC accounts for less than 5% of the cases of solitary OC, OC is the most common lesion among the tumors and tumor-like lesions of the scapula. OC that develops near the medial scapular border easily causes friction with the ribcage; hence, almost half the number of cases of OC associated with marked bursa formation develops in the ventral scapula. We report a case of a 27-year-old female with a painful OC of the ventral scapular surface associated with large bursa formation and pseudowinging of the scapula. After l2 years of follow-up with magnetic resonance imaging, we confirm that the accompanied bursa left at surgery disappears.

  3. Adaptive scapula bone remodeling computational simulation: Relevance to regenerative medicine

    Energy Technology Data Exchange (ETDEWEB)

    Sharma, Gulshan B., E-mail: gbsharma@ucalgary.ca [Emory University, Department of Radiology and Imaging Sciences, Spine and Orthopaedic Center, Atlanta, Georgia 30329 (United States); University of Pittsburgh, Swanson School of Engineering, Department of Bioengineering, Pittsburgh, Pennsylvania 15213 (United States); University of Calgary, Schulich School of Engineering, Department of Mechanical and Manufacturing Engineering, Calgary, Alberta T2N 1N4 (Canada); Robertson, Douglas D., E-mail: douglas.d.robertson@emory.edu [Emory University, Department of Radiology and Imaging Sciences, Spine and Orthopaedic Center, Atlanta, Georgia 30329 (United States); University of Pittsburgh, Swanson School of Engineering, Department of Bioengineering, Pittsburgh, Pennsylvania 15213 (United States)

    2013-07-01

    Shoulder arthroplasty success has been attributed to many factors including, bone quality, soft tissue balancing, surgeon experience, and implant design. Improved long-term success is primarily limited by glenoid implant loosening. Prosthesis design examines materials and shape and determines whether the design should withstand a lifetime of use. Finite element (FE) analyses have been extensively used to study stresses and strains produced in implants and bone. However, these static analyses only measure a moment in time and not the adaptive response to the altered environment produced by the therapeutic intervention. Computational analyses that integrate remodeling rules predict how bone will respond over time. Recent work has shown that subject-specific two- and three dimensional adaptive bone remodeling models are feasible and valid. Feasibility and validation were achieved computationally, simulating bone remodeling using an intact human scapula, initially resetting the scapular bone material properties to be uniform, numerically simulating sequential loading, and comparing the bone remodeling simulation results to the actual scapula’s material properties. Three-dimensional scapula FE bone model was created using volumetric computed tomography images. Muscle and joint load and boundary conditions were applied based on values reported in the literature. Internal bone remodeling was based on element strain-energy density. Initially, all bone elements were assigned a homogeneous density. All loads were applied for 10 iterations. After every iteration, each bone element’s remodeling stimulus was compared to its corresponding reference stimulus and its material properties modified. The simulation achieved convergence. At the end of the simulation the predicted and actual specimen bone apparent density were plotted and compared. Location of high and low predicted bone density was comparable to the actual specimen. High predicted bone density was greater than

  4. Endoscopically assisted resection of a scapular osteochondroma causing snapping scapula syndrome

    Directory of Open Access Journals (Sweden)

    Futani Hiroyuki

    2007-03-01

    Full Text Available Abstract Background Osteochondroma is the most common benign bone tumor in the scapula. This condition might lead to snapping scapula syndrome, which is characterized by painful, audible, and/or palpable abnormal scapulothoracic motion. In the present case, this syndrome was successfully treated by use of endoscopically assisted resection of the osteochondroma. Case presentation A 41-year-old man had a tolerable pain in his scapular region over a 10 years' period. The pain developed gradually with shoulder motion, in particular with golf swing since he was aiming a professional golf player career. On physical examination, "clunking" was noted once from 90 degrees of abduction to 180 degrees of shoulder motion. A trans-scapular roentgenogram and computed tomography images revealed an osteochondroma located at the anterior and inferior aspect of the scapula. Removal of the tumor was performed by the use of endoscopically assisted resection. One portal was made at the lateral border of the scapula to introduce a 2.7-mm-diameter, 30 degrees Hopkins telescope. The tumor was resected in a piece-by-piece manner by the use of graspers through the same portal. Immediately after the operation pain relief was obtained, and the "clunking" disappeared. CT images showed complete tumor resection. The patient could start playing golf one week after the surgery. Conclusion Endoscopically assisted resection of osteochondroma of the scapula provides a feasible technique to treat snapping scapula syndrome and obtain early functional recovery with a short hospital stay and cosmetic advantage.

  5. Ganglionic cysts related to the scapula: MR findings

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    Jeong, Ae Kyeong; Kim, Sung Moon; Kim, Kyung Sook; Shin, Myung Jin; Chun, Jae Myeung [Ulsan Univ. College of Medicine, Seoul (Korea, Republic of); Ahn, Joong Mo [Sungkyunkwan Univ. College of Medicine, Seoul (Korea, Republic of)

    1999-07-01

    To evaluate the magnetic resonance (MR) imaging characteristics of ganglionic cysts related to the scapula. We retrospectively reviewed 15 ganglionic cysts diagnosed by MR imaging in 14 patients who subsequently underwent surgical excision (n=8) or needle aspiration (n=1). Five other patients whose lesion-related symptoms were not too severe to manage underwent conservative treatment. We analyzed MR findings with regard to the size, shape and presence of internal septa, the location and signal intensity of the lesion, and associated findings such as change of rotator cuff muscle, labral tear and bone erosion. We also evaluated the presence of tear of rotator cuff tendon, tendinosis, and subacromial enthesophyte. The diameter of ganglionic cysts was 0.5-5.5 (mean, 2.8)cm, and they were round (n=2), ovoid (n=6), or elongated (n=7). Where internal septa were present (n=13), cysts were lobulated. Lesions were located in both scapular and spinoglenoid notches (n=9), only in the scapular notch (n=2), only in the spinoglenoid notch (n=2) or within the bone (n=2). In eleven cases they were very close to the superoposterior aspect of the glenoid labrum (n=11). On T1-weighted images, all lesions were seen to be iso- or hypointense to muscle, while on T2-weighted images, they were hyperintense, resembling joint fluid (n=14), except in one patient with hemorrhage. Associated findings were edema of the infraspinatus muscle (n=4), pressure erosion of the scapular neck (n=1), and labral tear (n=1). A torn supraspinatus tendon (n=2), supraspinatus tendinosis (n=3), and subacromial enthesophyte (n=2) were also present. MR imaging was helpful in diagnosing ganglionic cysts and detecting associated lesions.

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

    Science.gov (United States)

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

    2010-03-01

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

  7. Scapula behavior associates with fast sprinting in first accelerated running.

    Science.gov (United States)

    Otsuka, Mitsuo; Ito, Taisuke; Honjo, Toyoyuki; Isaka, Tadao

    2016-01-01

    The arm-swing motion is important for coordinated lower limb movement during a fast sprint and is composed of three-dimensional scapulothoracic and glenohumeral joint motion. Here, we aimed to clarify the role of the scapula during the initiation of a sprint running when sprinter run with high horizontal acceleration. Ten sports-active students participated in four 5-m dashes, with scapular constraint using non-elastic therapy tape (constraint condition) and without scapular constraint (free condition). The sprinting kinematics was assessed by a 16-camera motion capture system. In the constraint condition, the 2-m sprint time was significantly longer than that in the free condition. At the instants of foot-contact and take-off during the first step, no significant difference in the humerothoracic flexion angle was seen between these two conditions. In contrast, at the instants of foot-contact and take-off during the first step, the humerothoracic extension angle in the constraint condition was significantly smaller than that in the free condition. The forward leaning vector angle of center of mass during the first step was significantly greater than that in the constraint condition. Although no significant difference in hip extension and foot forward leaning angles was seen at the instant of foot contact during the first step between the two conditions, at the instant of take-off, the hip extension and foot forward leaning angles in the constraint condition were significantly smaller than those in the free condition. Therefore, scapular behavior in first accelerated running contributes to larger upper- and lower-limb motions and facilitates coordinating whole-body balance for a fast sprint.

  8. Bony structures related to snapping scapula: correlation to gender, side and age.

    Science.gov (United States)

    Totlis, Trifon; Konstantinidis, George A; Karanassos, Marinos T; Sofidis, George; Anastasopoulos, Nikolaos; Natsis, Konstantinos

    2014-01-01

    This study aimed at summarizing the non-pathologic bony structures which are involved in the pathogenesis of snapping scapula and evaluate their incidence, morphology and correlation to gender, side and age. The angulation in the sagittal plane between the supraspinatus and infraspinatus portion of the medial border was measured in 140 dried scapulae. In 264 dried scapulae the medial scapular border morphology was classified into three types and the presence of the Luschka's tubercle and the teres major tubercle or process was recorded. Correlation to gender, side and age was examined using SPSS. The mean angulation between the supraspinatus and infraspinatus portion of the medial border was 154.6° ± 8.8°. Τhe medial scapular border was straight in 99 (37.5 %), convex in 135 (51.1 %) and concave in 30 bones (11.4 %). The Luschka's tubercle was present in eight bones (3 %), while teres major tubercle was found in 114 scapulae (43.2 %). A teres major process was present in 18 bones (6.8 %). The process was curved towards the chest wall in nine bones (3.4 %), while in the other nine scapulae (3.4 %) it had no curvature. The non-pathologic bony structures which predispose to snapping scapula are not rare and include the concave medial scapular border, the Luschka's tubercle and the teres major process curved towards the chest wall. Orthopaedic surgeons should bear in mind these non-pathologic bony structures in order not to be overlooked during the diagnostic procedure of a snapping scapula since they usually require surgical treatment.

  9. The scapula backward tipping test: An inter-rater reliability study.

    Science.gov (United States)

    Sebastian, Deepak; Chovvath, Raghu; Malladi, Ramesh

    2017-01-01

    The purpose of this study was to determine the reliability of the scapula backward tipping test (SBTT) in detecting the presence of pectoralis minor (PM) tightness and subsequently scapula forward tipping, in a symptomatic population. PM tightness with scapula forward tipping has been described to cause pain and dysfunction in the shoulder region. 30 patients with a diagnosis of shoulder pain were randomly assigned and examined by 2 musculoskeletal physical therapists at a time. The procedure consisted of having the individual lay on the stomach in a neutral head position with palms in the anatomical position. The examiner firmly stabilized the inferior angle of the scapula with one hand and the fingers of the other hand hooked the under surface of the coracoid process. A gentle yet firm pull was imparted in an upward direction to sense tightness and to observe movement of the acromion up to the tragus of the ear. A comparison was made with the other side to sense restriction. Inter-rater reliability was determined using the kappa statistic. The SBTT was found to be reproducible between examiners (Kappa = 0.735, SE of kappa = 0.123, 95% confidence interval), with a percentage agreement of 86.67%. The SBTT may be incorporated as a simple yet effective test to determine the presence of PM tightness and subsequently scapula forward tipping. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. The scapula as a window to the diagnosis of skeletal dysplasias

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    Mortier, G.R. [Department of Medical Genetics, University Hospital of Gent, De Pintelaan 185, B-9000 Gent (Belgium); Rimoin, D.L. [Department of Medical Genetics and Pediatrics, Cedars-Sinai Medical Center, University of California Los Angeles, Los Angeles, California (United States); Lachman, R.S. [Department of Medical Genetics and Pediatrics, Cedars-Sinai Medical Center, University of California Los Angeles, Los Angeles, California (United States)]|[Department of Radiology, Harbor/UCLA Medical Center, Torrance, California (United States)]|[International Skeletal Dysplasia Registry, Cedars-Sinai Medical Center, 444 South San Vicente Blvd., Suite 1001, Los Angeles, CA 90048 (United States)

    1997-05-01

    Evaluation of the scapula can be useful in the diagnosis of skeletal dysplasias and helpful for the classification and delineation of new entities. A review of 2100 computerized cases of skeletal dysplasias in the International Skeletal Dysplasia Registry was performed. We found that the Luton type of platyspondylic lethal skeletal dysplasia differed radiographically from the San Diego type and Torrance type by the presence of two spikes at the inferior angle of the scapula. Hypoplasia of the body of the scapula, which is characteristic for campomelic dysplasia but not for kyphomelic dysplasia, is also present in Antley-Bixler syndrome. Radiographic and clinical similarities between campomelic dysplasia and Antley-Bixler syndrome suggest that they might be related disorders and that the latter condition should be included in the bent-bone dysplasia group. Similarity between the metaphyseal regions of the scapula and the metaphyses of the long tubular bones in the different types of short-rib polydactyly syndrome illustrates the importance of evaluation of the scapula in this group as well as in other well-defined or unknown osteochondrodysplasias. (orig.). With 8 figs.

  11. Delayed presentation of osteochondroma on the ventral surface of the scapula.

    Science.gov (United States)

    Kwon, O S; Kelly, J I V

    2012-04-01

    Osteochondroma is a cartilage-covered bony excrescence that arises from the surface of a bone. It is the most common benign bone tumor in the scapula and can also present as multiple masses in multiple hereditary exostosis. A solitary scapular lesion might lead to "snapping scapula" syndrome, which is characterized by a sometimes audible but usually palpable grinding sensation experienced with scapular abduction. Snapping scapula is usually painless without specific symptoms; however, discomfort may result from the mechanical effects of a ventral scapular mass projecting onto a normally smooth, gliding scapulothoracic joint. Furthermore, malignant transformation of the cartilaginous cap, by virtue of the increased mass, may precipitate symptoms. The visual deformities and interference with major joint function are the most frequent musculoskeletal complaints related by patients. Indications for operative intervention include painful mechanical dysfunction unresponsive to conservative measures and sarcomatous change. Ventral scapular osteochondromas have been reported to cause scapular asymmetry and should be ruled out as part of a differential diagnosis to a "winged" scapula. A solitary osteochondroma can be excised either by arthroscopic or by open means, with the size of the lesion dictating precise management. Scapular osteochondromas usually are detected early during maturation due to mechanical symptoms or gross deformity. Unfortunately, most require surgical excision. Most surgical excisions have been reported in adolescents and young adults. We report an unusual case of osteochondroma from the ventral surface of the scapula in 56-year-old woman who had experienced delayed onset mechanical symptoms which required surgical excision.

  12. Osteochondroma of the scapula associated with winging and large bursa formation.

    Science.gov (United States)

    Mohsen, Mahmoodi Seyed; Moosa, Nooruddin K; Kumar, Pradeep

    2006-01-01

    To report a case of scapular osteochondroma associated with pain and winging that is rarely reported in the medical literature. A 19-year-old male presented with pain and winging of the right scapula. CT scan revealed an osteochondroma of the medial border of the scapula with a large bursa between the chest wall and the tumour. Excision of the tumour relieved the symptoms. Pathological study showed osteochondroma of the scapula. In a follow-up 1 year later he was free of pain with no clinical or radiological sign of recurrence. A case of scapular osteochondroma associated with pain and winging treated by excision and follow-up showed no sign of clinical or radiological recurrence.

  13. A review of 10 years of scapula injuries sustained by UK military personnel on operations.

    Science.gov (United States)

    Roberts, Darren C; Power, D M; Stapley, S A

    2017-09-11

    Scapula fractures are relatively uncommon injuries, mostly occurring due to the effects of high-energy trauma. Rates of scapula fractures are unknown in the military setting. The aim of this study is to analyse the incidence, aetiology, associated injuries, treatment and complications of these fractures occurring in deployed military personnel. All UK military personnel returning with upper limb injuries from Afghanistan and Iraq were retrospectively reviewed using the Royal Centre for Defence Medicine database and case notes (2004-2014). Forty-four scapula fractures out of 572 upper limb fractures (7.7%) were sustained over 10 years. Blast and gunshot wounds (GSW) were leading causative factors in 85%. Over half were open fractures (54%), with open blast fractures often having significant bone and soft tissue loss requiring extensive reconstruction. Multiple injuries were noted including lung, head, vascular and nerve injuries. Injury Severity Scores (ISS) were significantly higher than the average upper limb injury without a scapula fracture (pmilitary personnel with GSW have a favourable chance of nerve recovery, 75% of brachial plexus injuries that are associated with blast have poorer outcomes. Fixation occurred with either glenoid fractures or floating shoulders (10%); these were as a result of high velocity GSW or mounted blast ejections. There were no cases of deep soft tissue infection or osteomyelitis and all scapula fractures united. Scapula fractures have a 20 times higher incidence in military personnel compared with the civilian population, occurring predominantly as a result of blast and GSW, and a higher than average ISS. These fractures are often associated with multiple injuries, including brachial plexus injuries, where those sustained from blast have less favourable outcome. High rates of union following fixation and low rates of infection are expected despite significant contamination and soft tissue loss. © Article author(s) (or their

  14. Static winging of the scapula caused by osteochondroma in adults: a case series

    Directory of Open Access Journals (Sweden)

    Orth Patrick

    2012-10-01

    Full Text Available Abstract Introduction Although palsy of the long thoracic nerve is the classical pathogenesis of winging scapula, it may also be caused by osteochondroma. This rare etiopathology has previously been described in pediatric patients, but it is seldom observed in adults. Case presentation We describe three cases of static scapular winging with pain on movement. Case 1 is a Caucasian woman aged 35 years with a wing-like prominence of the medial margin of her right scapula due to an osteochondroma originating from the ventral omoplate. Histopathological evaluation after surgical resection confirmed the diagnosis. The postoperative course was unremarkable without signs of recurrence on examination at 2 years. Case 2 is a Caucasian woman aged 39 years with painful scapula alata and neuralgic pain projected along the left ribcage caused by an osteochondroma of the left scapula with contact to the 2nd and 3rd rib. Following surgical resection, the neuropathic pain continued, demanding neurolysis of the 3rd and 4th intercostal nerve after 8 months. The patient was free of symptoms 2 years after neurolysis. Case 3 is a Caucasian woman aged 48 years with scapular winging due to a large exostosis of the left ventral scapular surface with a broad cartilaginous cap and a large pseudobursa. Following exclusion of malignancy by an incisional biopsy, exostosis and pseudobursa were resected. The patient had an unremarkable postoperative course without signs of recurrence 1 year postoperatively. Based on these cases, we developed an algorithm for the diagnostic evaluation and therapeutic management of scapula alata due to osteochondroma. Conclusions Orthopedic surgeons should be aware of this uncommon condition in the differential diagnosis of winged scapula not only in children, but also in adult patients.

  15. Osteoid Osteoma in the Neck of the Scapula; A Misleading Case

    Directory of Open Access Journals (Sweden)

    Alireza Rouhani

    2014-09-01

    Full Text Available Osteoid osteoma is a benign bone tumor that when located on the base of the coracoids process of the scapula is very rare and diagnosis and treatment is often delayed because of its rarity. Almost any bone can be involved, but half of cases involve the femur or tibia. The radiologic features of osteoid osteoma are well known, but these tumors may present with unusual features and be easily misdiagnosed. In this report, we present a case of osteoid osteoma of the neck of the left scapula that took almost 27 months to be diagnosed accurately.

  16. Severe ocular alteration associated with fracture of the scapula. Case report

    Directory of Open Access Journals (Sweden)

    Evandro Pereira Palacio

    2013-08-01

    Full Text Available OBJECTIVE: Scapula fractures are rare entities and occur along with severe respiratory complications, usually associated with lung tissue injuries. The authors describe a rare case of eye arteriolar thromboembolism due to scapular body fracture in a patient victim of a car accident.

  17. Sex estimation from the scapula in a contemporary Thai population: Applications for forensic anthropology.

    Science.gov (United States)

    Peckmann, Tanya R; Scott, Shelby; Meek, Susan; Mahakkanukrauh, Pasuk

    2017-07-01

    The impact of climate change is estimated to be particularly severe in Thailand. Overall, the country faces an increase in surface temperatures, severe storms and floods, and a possible increase in the number of mass disasters in the region. It is extremely important that forensic scientists have access to sex estimation methods developed for use on a Thai population. The goal of this project is to evaluate the accuracy of sex estimation discriminant functions, created using contemporary Mexican and Greek populations, when applied to a contemporary Thai sample. The length of the glenoid cavity (LGC) and breadth of the glenoid cavity (BGC) were measured. The sample included 191 individuals (95 males and 96 females) with age ranges from 19 to 96years old. Overall, when the Mexican and Greek discriminant functions were applied to the Thai sample they showed higher accuracy rates for sexing female scapulae (83% to 99%) than for sexing male scapulae (53% to 92%). Size comparisons were made to Chilean, Mexican, Guatemalan, White American, and Greek populations. Overall, in males and females of the Thai sample, the scapulae were smaller than in the Chilean, Mexican, White American, and Greek populations. However, the male and female Thai scapulae were larger than in the Guatemalan sample. Population-specific discriminant functions were created for the Thai population with an overall sex classification accuracy rate of 83% to 88%. Copyright © 2017 The Chartered Society of Forensic Sciences. Published by Elsevier B.V. All rights reserved.

  18. Lump on Back: A Rare Case of Parosteal Lipoma of Scapula

    Directory of Open Access Journals (Sweden)

    Ankit Balani

    2014-01-01

    Full Text Available Lipomas are benign tumors of mature adipose tissue which can occur in subcutaneous, intramuscular, intermuscular, parosteal, and intraosseous compartments. Parosteal lipoma is a rare type of lipoma, accounting for less than 0.1% of primary bone neoplasms and 0.3% of all lipomas. Parosteal lipomas commonly arise in the femur and extremities. Around 150 cases have been reported in English literature with scapula being a rare site of involvement. They are known to be associated with underlying bony changes like focal cortical hyperostosis, pressure erosion of the underlying bone, and bowing deformity or with underlying osteochondroma. We report a rare case of a parosteal lipoma arising in the scapula with a bony excrescence in a 38-year-old male.

  19. 3D Morphometric and posture study of felid scapulae using statistical shape modelling.

    Science.gov (United States)

    Zhang, Kai Yu; Wiktorowicz-Conroy, Alexis; Hutchinson, John R; Doube, Michael; Klosowski, Michal; Shefelbine, Sandra J; Bull, Anthony M J

    2012-01-01

    We present a three dimensional (3D) morphometric modelling study of the scapulae of Felidae, with a focus on the correlations between forelimb postures and extracted scapular shape variations. Our shape modelling results indicate that the scapular infraspinous fossa becomes larger and relatively broader along the craniocaudal axis in larger felids. We infer that this enlargement of the scapular fossa may be a size-related specialization for postural support of the shoulder joint.

  20. Functional and oncological outcome after surgical resection of the scapula and clavicle for primary chondrosarcoma.

    Science.gov (United States)

    Nota, S P F T; Russchen, M J A M; Raskin, K A; Mankin, H J; Hornicek, F J; Schwab, J H

    2017-04-01

    The scapula is a relatively common site for chondrosarcoma to develop in contrary to the clavicle, which is rarely affected by these tumors. The aim of this study is to determine the functional and oncological outcome for patients treated operatively for scapular or clavicular chondrosarcoma. In this single-center retrospective study, we included a sample of 20 patients that received the diagnosis of a primary chondrosarcoma of the scapula or clavicle. Of the surviving patients, the functional function was assessed using the DASH and the PROMIS Physical Function-Upper Extremity. Patients were longitudinally tracked for their oncological outcome. All patients were followed for at least 2 years or until death. The mean age of the cohort was 47 years. Eighteen patients suffered from a chondrosarcoma of the scapula, and in 2 patients, the tumor was located in the clavicle. Metastasis, local recurrence and a higher tumor grade were all associated with a decreased overall survival. For the patients with a chondrosarcoma of the scapula, the average DASH score was 16 ± 16 and the mean PROMIS Physical Function-Upper Extremity score was 48 ± 10. Patients with both an intact rotator cuff and glenoid had a better physical function. Upper extremity function after (partial) scapulectomy varied depending on whether the glenoid was spared and whether a functioning shoulder abductor remained. When the resection spared these structures, then excellent functional outcomes were reported. Oncologic outcomes depended upon the grade of the tumor and whether local recurrence and metastases occurred.

  1. Does Scapula Taping Facilitate Recovery for Shoulder Impingement Symptoms? A Pilot Randomized Controlled Trial

    Science.gov (United States)

    Miller, Peter; Osmotherly, Peter

    2009-01-01

    Scapula taping is a commonly used adjunctive treatment for shoulder impingement pathology. However, this intervention has not previously been subject to formal investigation. A pilot single-blind randomized controlled trial was conducted to evaluate facilitatory taping as an adjunct to routine physiotherapy management. Twenty-two subjects with unilateral shoulder impingement symptoms were randomized into a taping with routine physiotherapy or a routine physiotherapy only group. The intervention group had scapula taping applied three times per week for the first two weeks of their treatment. All subjects were assessed at baseline, then at 2 and 6 weeks after the commencement of treatment. Pain and functional ability were assessed using the Shoulder Pain and Disability Index, range of shoulder elevation, and self-reported pain on elevation. At 2 weeks, the taping group demonstrated a strong trend toward reduced pain both on self-reported activity (SPADI pain subscale mean for taping 27.0 versus 41.5 for control) and pain during measured abduction (mean VAS 22.8 for taped, 46.8 for control), statistical power being limited by small sample size. No similar trend was evident in the SPADI disability subscale. The magnitude of the differences was reduced at 6-week follow-up. This study provides preliminary evidence for a short-term role for scapula taping as an adjunct to routine physiotherapy in the management of shoulder impingement symptoms but also highlights the need for consideration on a case basis relating to risk factors for skin reaction. PMID:20046559

  2. Cadaveric and three-dimensional computed tomography study of the morphology of the scapula with reference to reversed shoulder prosthesis.

    Science.gov (United States)

    Torrens, Carlos; Corrales, Monica; Gonzalez, Gemma; Solano, Alberto; Cáceres, Enrique

    2008-10-10

    The purpose of this study is to analyze the morphology of the scapula with reference to the glenoid component implantation in reversed shoulder prosthesis, in order to improve primary fixation of the component. Seventy-three 3-dimensional computed tomography of the scapula and 108 scapular dry specimens were analyzed to determine the anterior and posterior length of the glenoid neck, the angle between the glenoid surface and the upper posterior column of the scapula and the angle between the major craneo-caudal glenoid axis and the base of the coracoid process and the upper posterior column. The anterior and posterior length of glenoid neck was classified into two groups named "short-neck" and "long-neck" with significant differences between them. The angle between the glenoid surface and the upper posterior column of the scapula was also classified into two different types: type I (mean 50 degrees-52 degrees ) and type II (mean 62.50 degrees-64 degrees ), with significant differences between them (p craneo-caudal glenoid axis and the base of the coracoid process averaged 18,25 degrees while the angle with the upper posterior column of the scapula averaged 8 degrees . Scapular morphological variability advices for individual adjustments of glenoid component implantation in reversed total shoulder prosthesis. Three-dimensional computed tomography of the scapula constitutes an important tool when planning reversed prostheses implantation.

  3. Repositioning the scapula with taping following distal radius fracture: Kinematic analysis using 3-dimensional motion system.

    Science.gov (United States)

    Turgut, Elif; Ayhan, Cigdem; Baltaci, Gul

    2017-08-08

    Cross-sectional and controlled laboratory study using pretest-posttest design. Patients with distal radius fracture (DRfx) report proximal segment problems. Taping is commonly recommended because it provides improved posture and function. This study aimed to investigate the 3-dimensional scapular kinematics and the effect of taping on the kinematics in participants with DRfx. Twenty participants with a unilateral history of DRfx and 20 healthy controls participated. Scapular kinematics was assessed using an electromagnetic system. Three separate strips of elastic taping were applied for participants with DRfx over the arm, scapula, and middle and lower trapezius muscles through the paravertebral muscles. Afterward, the scapular kinematics was reassessed in taped condition. When participants with DRfx and healthy controls compared, the scapula was more downwardly rotated at 120° of humerothoracic elevation (mean difference [MD], 9.06°) and at 120° (MD, 9.04°), 90° (MD, 5.6°) of humerothoracic lowering, more upwardly rotated at 30° of humerothoracic lowering (MD, 5.1°). Taping showed a significant effect on kinematics; specifically, the scapula was more externally rotated (38.9° untaped vs 31.1° taped) and posteriorly tilted (-9.2° untaped vs -4.8° taped) during humerothoracic elevation and lowering for participants with DRfx. Participants with DRfx showed different scapular kinematics and taping resulted in changes on tested kinematic parameters during humeral movements. Differences in scapular motion during elevation with taping showed a specific pattern. Overall, taping maintained a position likely to produce optimal rotator cuff function during early rehabilitation of patients with DRfx. N/A. Copyright © 2017 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

  4. Cadaveric and three-dimensional computed tomography study of the morphology of the scapula with reference to reversed shoulder prosthesis

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    Solano Alberto

    2008-10-01

    Full Text Available Abstract Purpose The purpose of this study is to analyze the morphology of the scapula with reference to the glenoid component implantation in reversed shoulder prosthesis, in order to improve primary fixation of the component. Methods Seventy-three 3-dimensional computed tomography of the scapula and 108 scapular dry specimens were analyzed to determine the anterior and posterior length of the glenoid neck, the angle between the glenoid surface and the upper posterior column of the scapula and the angle between the major craneo-caudal glenoid axis and the base of the coracoid process and the upper posterior column. Results The anterior and posterior length of glenoid neck was classified into two groups named "short-neck" and "long-neck" with significant differences between them. The angle between the glenoid surface and the upper posterior column of the scapula was also classified into two different types: type I (mean 50°–52° and type II (mean 62,50°–64°, with significant differences between them (p Conclusion Scapular morphological variability advices for individual adjustments of glenoid component implantation in reversed total shoulder prosthesis. Three-dimensional computed tomography of the scapula constitutes an important tool when planning reversed prostheses implantation.

  5. A Morphometric Study of the Patterns and Variations of the Acromion and Glenoid Cavity of the Scapulae in Egyptian Population.

    Science.gov (United States)

    El-Din, Wael Amin Nasr; Ali, Mona Hassan Mohammed

    2015-08-01

    Owing to its many variations, scapula became one of the most interesting bones of the human skeleton. To measure acromial and glenoid morphology in to describe their anatomical patterns and variations in Egyptians to establish possible morphofunctional correlations related to race, geographic region and literature data. One hundred and sixty scapulae of unknown age and sex were studied. Morphological shapes of the tip of the acromion; types of acromion; and morphological shapes of the glenoid were evaluated. Length and width of the scapulae, length, breadth and thickness of the acromion process and distances of the acromio-coracoid and acromio-glenoid in addition to glenoid diameters were measured. The morphometric values of the two sides were analysed using an unpaired t-test. Statistical significance was set p≤ 0.05. The intermediate shape of the acromion presented with the highest incidence, while the cobra shaped presented with the lowest distribution in both sides. The oval shaped glenoid cavity presented with the highest incidence while the inverted coma shaped showed the lowest incidence. These results are in match with other population. However, the morphometric values of the scapula, acromion process and glenoid cavity were higher than reported in Turkish and Indians. Our data are important to compare Egyptian scapulae to those from various other races that could contribute to demographic studies of shoulder disease probability and management in Egyptian population.

  6. Incidental finding of unilateral isolated aplasia of serratus anterior muscle and winged scapula on chest radiograph: A case report

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    Choi, Joon Sung; Park, Hyun Jin; Ko, Jeong Min [Dept. of Radiology, St. Vincent' s Hospital, College of Medicine, The Catholic University of Korea, Suwon (Korea, Republic of)

    2014-10-15

    The isolated aplasia of the serratus anterior muscle with winging of scapula is very rare, and only a few cases are reported. Here, we present a case of a 30-year-old Korean male who initially presented with a left flank pain. His physical exam did not show any significant finding in his right shoulder. However, his chest radiograph showed absence of right serratus anterior muscle and slightly elevated and medially rotated right scapula. Subsequent CT scan showed the right serratus anterior muscle aplasia and medial winging of the right scapula. This case is unique in two aspects. First, the combination of abnormalities is different from the typical congenital abnormalities involving shoulder girdle, such as Sprengel deformity or Poland syndrome. Secondly, this was incidentally diagnosed with chest radiograph, without clinical impression. Careful reading of chest radiograph can help the radiologists to detect such clinically silent abnormalities.

  7. Meta-Analysis of Long Thoracic Nerve Decompression and Neurolysis Versus Muscle and Tendon Transfer Operative Treatments of Winging Scapula.

    Science.gov (United States)

    Nath, Rahul K; Somasundaram, Chandra

    2017-08-01

    Injury to long thoracic and the spinal accessory nerves can cause winging scapula as a result of weakness and paralysis of the trapezius and serratus anterior muscles. Although these nerve and muscle operations have been reported to correct winging scapula due to various causes, there is no report on comparing the outcomes of these procedures in peer-reviewed Pubmed-indexed literature. In this article, we compared the improvements in the restoration of shoulder functions in winging scapula patients after long thoracic nerve decompression (LTND) in our present study with outcomes of muscle and tendon transfer operations published in the literature (Aetna cited articles). Twenty-five winging scapula patients met the inclusion criteria, who had LTND and neurolysis at our clinic since 2008. Electromyographic evaluation of the brachial plexus and long thoracic nerve distribution was performed preoperatively for all our patients in this study. Operating surgeon (R.K.N.) examined all patients and measured pre- and postoperative range of motion of the affected shoulder. The mean follow-up was 23 months (range, 13-46 months). Age of our patients in this study at the time of surgery was between 13 and 63 years. These patients had winging scapula between 5 days (tennis injury) and several years before surgery and some were unknown. Shoulder flexion and abduction improved to an average of 163˚ ( P muscle and tendon transfer procedures in the Pubmed-indexed (Aetna cited) literature. This meta-analysis suggests that nerve surgeries such as LTND and neurolysis are effective techniques in correcting winging scapula in comparison with muscle transfer operations.

  8. Clavicles, scapulae and humeri from the Sima de los Huesos site (Sierra de Atapuerca, Spain).

    Science.gov (United States)

    Carretero, J M; Arsuaga, J L; Lorenzo, C

    1997-01-01

    The scapulae, clavicles and humeri recovered from the Sima de los Huesos (SH) site between 1976 and 1994 are studied. All elements are briefly described anatomically with metrics and compared with other fossil hominids in order to establish the morphological pattern of the SH hominids. A minimum of 13 individuals are represented by the humeri in the SH sample. Almost all of them can be classified as adolescents and young adults. The morphology of the SH hominid shoulder girdle and humeri indicates that much of the shoulder morphology recognized in the later true Neandertal was present in Europe long before they appeared. Thus, this morphological pattern is not exclusive to Neandertals alone. The SH clavicles, scapulae and humeri share with the Neandertals many traits usually considered to be Neandertal specializations. The comparative analysis of the SH evidence suggests that most of the SH and Neandertal shared traits are either primitive features within the genus Homo or even for all hominids, or display high variability within different hominid samples. These traits must be used with caution, or not used at all, in phylogenetic analysis. There are, however, traits that to date have only been detected in the SH hominids and the Neanderials, which could be exclusive to the European phyletic lineage (clade) of Homo.

  9. ANATOMY OF BONE AND MUSCLE OF SCAPULA AND ARM OF Chrysocyon Brachyurus (CARNIVORA, CANIDAE

    Directory of Open Access Journals (Sweden)

    Saulo Gonçalves Pereira

    2016-10-01

    Full Text Available The maned wolf, Chrysocyon brachyurus - Illiger, 1815, is the largest canid of South America     and its found in the central region of the continent, preferably in open field biomes. It may reach between 20 and 33 kg and up to 125 cm. It is under threat of extinction. Anatomical knowledge is  of great importance to the completion of information about wild species and clinical, surgical, and conservationist implications. This study aimed to describe the bones and the bone accidents of the cingulate forelimb of brachial region and their respective muscles in maned wolf, through dissection procedures of animals preserved in 10% formalin solution. The animals belong to the didactic collection of the Laboratory of Education and Research on Wild Animals of UFU, and are the result of roadkill. The bones are scapula and humerus. There was no clavicula. The muscles are: M. deltoideus; M. supraspinatus; M. infraspinatus; M. teres major; M. teres minor; M. triceps brachii caput: laterale, accessorium, longum and mediale; M. anconeus; M. biceps; M. subscapularis; M.  coracobrachialis; M. tensor fasciae antebrachii; M. brachial. The scapula and arm have specific accidents; however, they are similar to domestic dogs. The humerus is straight. The muscles have some peculiarities. Keywords: anatomy; canids; maned wolf; muscles; osteology.

  10. Neuromuscular control of scapula muscles during a voluntary task in subjects with Subacromial Impingement Syndrome

    DEFF Research Database (Denmark)

    Larsen, C M; Søgaard, Karen; Chreiteh, S S

    2013-01-01

    Imbalance of neuromuscular activity in the scapula stabilizers in subjects with Subacromial Impingement Syndrome (SIS) is described in restricted tasks and specific populations. Our aim was to compare the scapular muscle activity during a voluntary movement task in a general population with and w......Imbalance of neuromuscular activity in the scapula stabilizers in subjects with Subacromial Impingement Syndrome (SIS) is described in restricted tasks and specific populations. Our aim was to compare the scapular muscle activity during a voluntary movement task in a general population...... with and without SIS (n=16, No-SIS=15). Surface electromyography was measured from Serratus anterior (SA) and Trapezius during bilateral arm elevation (no-load, 1kg, 3kg). Mean relative muscle activity was calculated for SA and the upper (UT) and lower part of trapezius (LWT), in addition to activation ratio...... and time to activity onset. In spite of a tendency to higher activity among SIS 0.10-0.30 between-group differences were not significant neither in ratio of muscle activation 0.80-0.98 nor time to activity onset 0.53-0.98. The hypothesized between-group differences in neuromuscular activity of Trapezius...

  11. Anthropometric measurements of the scapula, humerus, radius and ulna in Labrador dogs with and without elbow dysplasia.

    Science.gov (United States)

    Davidson, P T; Bullock-Saxton, J; Lisle, A

    2008-11-01

    To determine if anthropometric measurements of the Labrador scapula, humerus, ulna and radius, or their ratios, are related to the presence of elbow dysplasia (ED). Digital calliper measurements of the lengths of the left scapula, humerus, radius and ulna, and their ratios, were analysed by gender in 103 volunteer Labradors (41 dogs, 62 bitches) against the ED radiological scores derived by the International Elbow Working Group (IEWG). The IEWG score is an umbrella score used to classify for ED and includes fragmented coronoid process, osteochondritis dessicans, incongruity and ununited anconeal process, the last of which occurs rarely in Labradors. Of the 103 Labradors studied, 31 were diagnosed radiographically with ED (20 bitches (32%), 11 (27%) dogs). Scapula length was significantly shorter for bitches with ED (P = 0.02), but not for dogs with ED. However, dogs showed a trend for a difference in the ulna:radius ratio (P = 0.06), which bitches did not. Although a greater percentage of bitches than dogs had ED in this study, the difference was not statistically significant. Labrador bitches diagnosed with ED have a shorter scapula, which is a new finding associated with this condition. The difference in presentation associated with gender is unexpected and further research is recommended.

  12. A primary inflammatory myofibroblastic tumor of the scapula in a child: imaging findings

    Energy Technology Data Exchange (ETDEWEB)

    Inarejos Clemente, Emilio J.; Riaza Martin, Lucia [University of Barcelona, Hospital Sant Joan de Deu, Barcelona (Spain); Esplugues de Llobregat, Barcelona (Spain); Vilanova, Joan C. [University of Girona, Clinica Girona, Hospital Sta. Caterina, Girona (Spain); Guirao-Marin, Sara [CETIR Clinica Girona-ERESA, Girona (Spain)

    2015-05-01

    Inflammatory myofibroblastic tumor (IMT) is an uncommon tumor characterized by inflammatory cell infiltration and differentiated myofibroblastic spindle cells. IMT was first described in the lung and retroperitoneum. Occurrence in bone has been well described in the maxilla and occasionally in the long bones in the adult population. We present a unique case of IMT arising primarily from the scapula in an 8-year-old patient, not described previously in the pediatric or adult literature. Imaging demonstrated an ill-defined and aggressive osteolytic lesion with cortical bone destruction associated with an important soft tissue component that extended into the adjacent muscles. Histologically, the tumor was composed of spindle and polygonal cells distributed in an inflammatory background with different proportions of plasma cells, lymphocytes, eosinophils and neutrophils. The absence of cellular atypia helped to differentiate this entity from malignant spindle cell tumors, and imaging could differentiate the tumor from the nontumoral inflammatory reaction. (orig.)

  13. Winging of the scapula diagnosed as Parsonage-Turner syndrome: a case report.

    Science.gov (United States)

    Carroll, Christine; Bass, Bill

    2017-01-01

    A 24-year-old active duty female Soldier complained of right shoulder burning, stinging, electrical shock-like pain with radiation to the right hand after completing a ruck march. She also complained of swelling and feelings of her cold right hand. Examination showed a deficit in the deltoid, upper trapezius, supraspinatus, and also right winging of the scapula. She also exhibited weakness to right arm, weak right hand grip, and decreased sensation over the dorsal right hand. The right hand was also noticed to be colder to touch than the left one. She had tenderness to palpation over right paracervical muscles from C3 to C7. A previous magnetic resonance arthrogram of the right shoulder revealed no findings. The cervical magnetic resonance imagery showed mild disc protrusion at C5-C6 without spinal cord impingement. Based on the history and the physical findings, the patient was diagnosed with Parsonage-Turner syndrome.

  14. Functional Outcomes of Operative Management of Scapula Fractures in a Geriatric Cohort.

    Science.gov (United States)

    Cole, Peter A; Gilbertson, Jeffrey A; Cole, Peter A

    2017-01-01

    To analyze functional outcomes, motion, and strength in patients 65 years of age and older who underwent operative management of a scapula fracture. Retrospective review of prospective database. A single level-1 teaching trauma center. Two hundred fifty patients with scapula fractures were operated between January 2002 and March 2014. A review identified 16 geriatric patients 65 years of age and older. All patients underwent operative treatment of a scapular fracture. Disabilities of the Arm, Shoulder, and Hand (DASH), Short-Form Health Survey versions 1 and 2 (SF-36), Range of Motion (ROM), and Strength assessment at final follow-up 1 year or greater. Outcomes were attained on 15/16 patients at a mean follow-up of 40 months (range = 12-114). All fractures were united. Three patients experienced minor perioperative complications (temporary delirium in 2 patients, urinary tract infection in 1). One patient required subsequent removal of an intraarticular screw, and 1 patient required resection of heterotopic ossification and requested implant removal. The mean ROM expressed as a percent of contralateral ROM ranged from 78% to 96%. The mean strength expressed as a percent of contralateral strength ranged from 76% to 92%. The mean DASH score was 8.4. SF-36 scores were comparable with the normal population. All patients returned to activities. Operative treatment for displaced fractures in patients 65 years of age and older is safe and can yield good functional results and return to function. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

  15. An epidemiological survey of tumour or tumour like conditions in the scapula and periscapular region

    Directory of Open Access Journals (Sweden)

    Khan Zeeshan

    2016-01-01

    Full Text Available Introduction: The scapula is not an uncommon site for bone and soft tissue tumours and can be difficult to delineate on examination. Furthermore, these lesions can be potentially challenging to biopsy due to its close anatomical relationship with important structures. We present an epidemiological survey of all the scapular and periscapular lesions presenting to our institution. Methodology: This was a retrospective study with data obtained from a prospectively held electronic database over a 30-year period. Demographic and clinical data was obtained and various subgroup analyses were performed. Results: A total of 418 scapular lesions were included in the study where 132 lesions were found to be of soft tissue origin and 286 were osseous. Fifty-eight percent (n = 241 of all these lesions were malignant, of which 47% (n = 113 were primary sarcomas. The commonest malignant lesions were bone sarcomas (n = 96 followed by metastases (n = 88. The commonest primary bone sarcoma was chondrosarcoma (45%, whereas the commonest soft tissue sarcoma was high grade undifferentiated pleomorphic sarcoma (18%. The most common benign osseous and soft tissue lesions were osteochondroma (70% and lipoma (26%, respectively. We noted that the incidence of malignancy increased with increasing age, however, the incidence of primary bone sarcomas was fairly consistent across different age groups. Conclusion: Based on our findings we recommend that suspicious lesions arising from the scapula should be dealt with in a specialist sarcoma unit with involvement of a multidisciplinary team to offer appropriate management and advice for optimum outcome.

  16. Unusual morphology of scapulae: incidence and dimensions of ossified ligaments and supraspinous bony tunnels for clinical consideration.

    Science.gov (United States)

    Kharay, Sonia Singh; Sharma, Anu; Singh, Poonam

    2016-01-01

    Knowledge of morphological variations of the suprascapular region is important in the management of entrapment neuropathy and interventional procedures. The objective of this study was to collect data on the morphological features and dimensions of ossified ligaments and unusual bony tunnels of scapulae from a North Indian population. A total of 268 adult human scapulae of unknown gender were obtained from the bone bank of the Department of Anatomy, Dayanand Medical College and Hospital, Ludhiana, Punjab, India. The scapulae were evaluated for the incidence of ossified superior transverse scapular ligaments (STSLs), ossified inferior transverse scapular ligaments (ITSLs) and bony tunnels (i.e. the bony canal between the suprascapular notch and spinoglenoid notch), found along the course of the suprascapular nerve (SSN). The dimensions of these structures were measured and noted down. Ossified STSLs were classified based on their shape (i.e. fan- or band-shaped) and the dimensions of the ossified suprascapular openings (SSOs) were measured. Ossified STSLs were present in 26 (9.7%) scapulae. Among the 26 scapulae, 16 (61.5%) were fan-shaped (mean area of SSO 16.6 mm(2)) and 10 (38.5%) were band-shaped (mean area of SSO 34.2 mm(2)). Bony tunnels were observed in 2 (0.75%) specimens, while an ossified ITSL was observed in 1 (0.37%) specimen. The data obtained in the present study augments the reference literature for SSN decompression and the existing anatomical databases, especially those on Indian populations. This data is useful to clinicians, radiologists and orthopaedic surgeons. Copyright © Singapore Medical Association.

  17. Hydatid disease of scapula and upper third of humerus treated by en bloc excision and fibular bone grafting

    Directory of Open Access Journals (Sweden)

    Chari P

    2007-01-01

    Full Text Available 35-year-old male patient presented with gradually increasing painful swelling of the right shoulder, which was incised and drained and wound persisted as a discharging sinus on the anterolateral aspect of the deltoid region with seropurulent discharge. A clinical diagnosis of tuberculosis of the shoulder was made. Plain skiagram of the right shoulder revealed multicystic lesion involving the entire scapula and upper third of the humerus with loss of joint space and pathological fracture at the junction of upper one-third and lower two-thirds of the humerus. A clinico-radiological diagnosis of hydatid disease was made. In view of the extensive involvement of the scapula with stiff shoulder and an active sinus, a two-stage surgical procedure was performed. Stage 1 consisted of en bloc excision of the scapula, upper half of the humerus and lateral end of the clavicle. Stage II surgery, consisting of fibular bone grafting. Tablet albendazole (400 mg, thrice daily was given as systemic scolicidal agent. This case is reported in view of it′s rarity and to highlight the management.

  18. Trial manufacture of subsidiary tool and use of technique for shoulder joint of ''Scapula Y''

    Energy Technology Data Exchange (ETDEWEB)

    Maejima, Hideyuki; Okamoto, Takahide; Yamazaki, Norihito; Hiyoshi, Kan; Tanaka, Tamotsu; Mori, Takeshi; Ako, Toshitaka; Ogawa, Norihisa [Teikyo Univ., Tokyo (Japan). Hospital

    2002-07-01

    The technique of ''Scapula Y'' is effective for capturing forward/backward dislocation of the humeral head and variation in surgical spine fracture. It is also indispensable for describing images of ossification at the tendon plate of the lower lobe of the acrominon and impingement syndrome. However, owing to large individual variations in body shape and position and shape of the scapula, the conventional method does not lend itself to stable reproduction of position or provide adequate diagnostic information. We measured the central angle of entry from scapula m24 pairs of dried bone (Indian) into the spine of the scapula from horizontal and forehead planes to determine the range of variation together with the clinical data referred to in the next paragraph. We then manufactured a trial subsidiary tool to set the angle of the central entering beam base on the acrominon to the spine of the scapula using data on measured angle from 50 clinical radiographs. We identified improvement in radiography of the scapula by using the subsidiary tool designed and manufactured on the basis of the above measured data. (author)

  19. Sex estimation based on scapula analysis in a Japanese population using multidetector computed tomography.

    Science.gov (United States)

    Torimitsu, Suguru; Makino, Yohsuke; Saitoh, Hisako; Sakuma, Ayaka; Ishii, Namiko; Yajima, Daisuke; Inokuchi, Go; Motomura, Ayumi; Chiba, Fumiko; Yamaguchi, Rutsuko; Hashimoto, Mari; Hoshioka, Yumi; Iwase, Hirotaro

    2016-05-01

    Accurate sex estimation based on measurements of dimorphic dimensions in human unknown remains is important as the first step toward making individual identification. The purpose of this study was to assess the sexual dimorphism of the scapula and to quantify the accuracy of sex estimation in a contemporary Japanese forensic sample using scapular measurements based on three-dimensional (3D) computed tomographic (CT) images. A total of 218 cadavers (109 males, 109 females) that underwent postmortem CT and subsequent forensic autopsy were used. Ten scapular measurements were performed on 3D CT reconstructed images that extracted only bone data, and were analyzed using descriptive statistics and discriminant function analyses (DFA). All measurements were dimorphic in terms of sex differences. Univariate DFA provided sex classification accuracy rates of 75.7-91.3%. Stepwise DFA yielded sex prediction accuracy rates of 93.1-94.5%. In conclusion, the scapular measurements using 3D CT images of a contemporary Japanese population may be useful for the estimation of skeletal sex in the field of forensic anthropology. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  20. Evolution of the hominoid scapula and its implications for earliest hominid locomotion.

    Science.gov (United States)

    Selby, Michael S; Lovejoy, C Owen

    2017-04-01

    The higher primate scapula has been subject to many explanations of the putative "adaptive value" of its individual traits. However, the shift from the bone's position in above branch quadrupeds to its more posterolateral position in recent hominoids obviously required fundamental changes to its general form. We hypothesize that most features argued to be individually adaptive are more likely secondary consequences of changes in its fundamental bauplan, a view more consistent with modern developmental biology. We tested this hypothesis with scapular metrics and angles from a broad anthropoid sample. Our results support our hypothesis. Contrary to earlier predictions, vertebral border length differs little relative to body size in anthropoids, inferior angle position primarily reflects mediolateral scapular breadth, and supraspinous and infraspinous fossa sizes largely reflect scapular spine orientation. Suspensory taxa have cranially oriented glenoids, whereas slow clamberers and humans do not. Australopithecus most closely resembles the latter. Most scapular features can be explained by only two primary changes: (1) reduction in mediolateral breadth and (2) change in the glenoid position relative to the vertebral border with increased reliance on suspension, which led to a more cranially angled scapular spine. Virtually all other scapular traits appear to be byproducts of these two changes. Based on fossil morphology, hominids 1 were derived from a last common ancestor primarily adapted for clambering and not for suspension. Scapular form in early hominids such as Australopithecus is therefore primitive and largely reflects the genus's general clambering heritage. © 2017 Wiley Periodicals, Inc.

  1. Análise do SICK Scapula em jogadores de handebol com e sem dor no ombro durante o arremesso

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    Gabriel Peixoto Leão Almeida

    2014-07-01

    Full Text Available INTRODUÇÃO: A discinesia escapular é definida como uma alteração da posição escapular, tanto dinâmica quanto estática, resultante de desequilíbrios da musculatura periescapular secundários à fadiga, trauma ou lesão neurológica. O SICK Scapula avalia e caracteriza as alterações escapulares estaticamente, variando de 0 a 20 pontos (0 = melhor possível. No exame, a escápula é avaliada em três aspectos: dor objetiva, dor subjetiva e mau posicionamento escapular. OBJETIVO: Comparar o SICK Scapula entre jogadores de handebol sintomáticos e assintomáticos. MÉTODOS: A amostra foi composta por 57 atletas de handebol divididos em dois grupos, de acordo com a presença de dor no ombro: grupo assintomático (GA (N = 27 e grupo sintomático (GS (N = 30. O SICK Scapula foi avaliado entre os atletas, tanto em relação à sua pontuação final como às subescalas. O GS apresentou maior pontuação no SICK Scapula em relação ao GA (8 ± 2,3 vs 2,7 ± 1,8; p<0,001. RESULTADOS: Nas subescalas, os GA e GS também apresentaram diferenças significantes quanto à dor subjetiva (0 vs. 1,73 ± 0,83; p < 0,001, dor objetiva (0,41 ± 0,64 vs. 2,5 ±0,86; p < 0,001 e mau posicionamento escapular (2,3 ± 1,9 vs. 3,7 ± 1,5; p = 0,002. CONCLUSÃO: Os atletas de handebol com dor relacionada ao arremesso apresentam maior pontuação com relação à dor e às alterações de posicionamento escapular, segundo avaliação pelo SICK Scapula, em comparação com os que não apresentam sintomatologia.

  2. Isolated metastasis of colon cancer to the scapula: is surgical resection warranted?

    Directory of Open Access Journals (Sweden)

    Onesti Jill K

    2011-10-01

    Full Text Available Abstract Background Distant metastases from colon cancer spread most frequently to the liver and the lung. Risk factors include positive lymph nodes and high grade tumors. Isolated metastases to the appendicular skeleton are very rare, particularly in the absence of identifiable risk factors. Case report The patient was a 55 year old male with no previous personal or family history of colon cancer. Routine screening revealed a sigmoid adenocarcinoma. He underwent resection with primary anastomosis and was found to have Stage IIA colon cancer. He declined chemotherapy as part of a clinical trial, and eight months later was found to have an isolated metastasis in his right scapula. This was treated medically, but grew to 12 × 15 cm. The patient underwent a curative forequarter amputation and is now more than four years from his original colon surgery. Discussion Stage IIA colon cancers are associated with a high five year survival rate, and chemotherapy is not automatically given. If metastases occur, they are likely to arise from local recurrence or follow lymphatic dissemination to the liver or lungs. Isolated skeletal metastases are quite rare and are usually confined to the axial skeleton. To our knowledge, this is the first reported case of an isolated scapular metastasis in a patient with node negative disease. The decision to treat the recurrence with radiation and chemotherapy did not reduce the tumor, and a forequarter amputation was eventually required. Conclusion This case highlights the importance of adequately analyzing the stage of colon cancer and offering appropriate treatment. Equally important is the early involvement of a surgeon in discussing the timing of the treatment for recurrence. Perhaps if the patient had received chemotherapy or earlier resection, he could have been spared the forequarter amputation. The physician must also be aware of the remote possibility of an unusual presentation of metastasis in order to pursue

  3. The effect of middle and lower trapezius strength exercises and levator scapulae and upper trapezius stretching exercises in upper crossed syndrome.

    Science.gov (United States)

    Bae, Won-Sik; Lee, Hyun-Ok; Shin, Jae-Wook; Lee, Keon-Cheol

    2016-05-01

    [Purpose] The purpose of this study was to determine the effectiveness of strength and stretching exercises on upper crossed syndrome. [Subjects and Methods] After measuring cervical alignment using the Global Posture System, 30 students with forward head posture were selected and divided into two groups. The experimental group (n=15) participated in strength and stretching exercises, three times per week for 4 weeks. The control group (n=15) did not participate in the exercises. The exercise program comprised middle and lower trapezius strength exercises and levator scapulae and upper trapezius stretching exercises. The temperature of the posterior neck was then measured using digital infrared thermographic imaging. [Results] There was a significant difference between the pretest and posttest results in the experimental group, and a significant difference in posterior neck temperature between the two groups. [Conclusion] This study showed that middle and lower trapezius strength exercises and levator scapulae and upper trapezius stretching exercises are more effective for upper crossed syndrome.

  4. A geometric morphometric study of sex differences in the scapula, humerus and ulna of Chaetophractus villosus (Xenarthra, Dasypodidae

    Directory of Open Access Journals (Sweden)

    Francisco Acuña

    Full Text Available ABSTRACT Sexual differences in some of the components of the pectoral girdle and forelimb of Chaetophractus villosus (Desmarest, 1804 were investigated by means of geometric morphometrics. A total of 15 scapulae (7 males, 8 females and 50 humeri-ulnae complexes (24 males, 26 females were examined. No size differences were detected between sexes for any of the bones, but shape differences were found for the humerus and the ulna that enhance the in-forces or the related in-levers. Females had a more robust humerus, with an enlarged deltoid tuberosity, a more spherical head, higher tubercular and epicondylar widths, and more developed supracondylar crests. The ulna of the females was characterised by a more pronounced curvature along its main axis, a caudal displacement of the lateral fossa, a longer olecranon, and a deeper trochlear notch. For both bones, the discriminant analysis classified correctly all the specimens according to their sex. A small percentage of the variance (5.2% for the humerus; 6.8% for the ulna was explained by allometry. The morphological traits found for the humerus and ulna of the females suggest an increased structural strength that could result in powerful digging strokes while keeping shoulder and elbow stabilisation, suggesting a fossorial advantage over males.

  5. Resting Orientations of Dinosaur Scapulae and Forelimbs: A Numerical Analysis, with Implications for Reconstructions and Museum Mounts.

    Science.gov (United States)

    Senter, Phil; Robins, James H

    2015-01-01

    The inclination of the scapular blade and the resting pose of the forelimb in dinosaurs differ among reconstructions and among skeletal mounts. For most dinosaurian taxa, no attempt has previously been made to quantify the correct resting positions of these elements. Here, we used data from skeletons preserved in articulation to quantify the resting orientations of the scapula and forelimb in dinosaurs. Specimens were included in the study only if they were preserved lying on their sides; for each specimen the angle between forelimb bones at a given joint was included in the analysis only if the joint was preserved in articulation. Using correlation analyses of the angles between the long axis of the sacrum, the first dorsal centrum, and the scapular blade in theropods and Eoraptor, we found that vertebral hyperextension does not influence scapular orientation in saurischians. Among examined taxa, the long axis of the scapular blade was found to be most horizontal in bipedal saurischians, most vertical in basal ornithopods, and intermediate in hadrosauroids. We found that in bipedal dinosaurs other than theropods with semilunate carpals, the resting orientation of the elbow is close to a right angle and the resting orientation of the wrist is such that the hand exhibits only slight ulnar deviation from the antebrachium. In theropods with semilunate carpals the elbow and wrist are more flexed at rest, with the elbow at a strongly acute angle and with the wrist approximately at a right angle. The results of our study have important implications for correct orientations of bones in reconstructions and skeletal mounts. Here, we provide recommendations on bone orientations based on our results.

  6. Optimal Normalization Tests for Muscle Activation of the Levator Scapulae, Pectoralis Minor, and Rhomboid Major: An Electromyography Study Using Maximum Voluntary Isometric Contractions.

    Science.gov (United States)

    Castelein, Birgit; Cagnie, Barbara; Parlevliet, Thierry; Danneels, Lieven; Cools, Ann

    2015-10-01

    To identify maximum voluntary isometric contraction (MVIC) test positions for the deeper-lying scapulothoracic muscles (ie, levator scapulae, pectoralis minor, rhomboid major), and to provide a standard set of a limited number of test positions that generate an MVIC in all scapulothoracic muscles. Cross-sectional study. Physical and rehabilitation medicine department. Healthy subjects (N=21). Not applicable. Mean peak electromyographic activity from levator scapulae, pectoralis minor, and rhomboid major (investigated with fine-wire electromyography) and from upper trapezius, middle trapezius, lower trapezius, and serratus anterior (investigated with surface electromyography) during the performance of 12 different MVICs. The results indicated that various test positions generated similar high mean electromyographic activity and that no single test generated maximum activity for a specific muscle in all subjects. The results of this study support using a series of test positions for normalization procedures rather than a single exercise to increase the likelihood of recruiting the highest activity in the scapulothoracic muscles. A standard set of 5 test positions was identified as being sufficient for generating an MVIC of all scapulothoracic muscles: seated T, seated U 135°, prone T-thumbs up, prone V-thumbs up, and supine V-thumbs up. A standard set of test positions for normalization of scapulothoracic electromyographic data that also incorporates the levator scapulae, pectoralis minor, and rhomboid major muscles is 1 step toward a more comprehensive understanding of normal and abnormal muscle function of these muscles and will help to standardize the presentation of scapulothoracic electromyographic muscle activity. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  7. Brief communication: Morphological effects of captivity: A geometric morphometric analysis of the dorsal side of the scapula in captive-bred and wild-caught Hominoidea.

    Science.gov (United States)

    Bello-Hellegouarch, Gaëlle; Potau, Josep Maria; Arias-Martorell, Julia; Pastor, Juan Francisco; Pérez-Pérez, Alejandro

    2013-10-01

    Many osteological collections from museums and research institutions consist mainly of remains from captive-bred animals. The restrictions related to the space of their enclosures and the nature of its substrate are likely to affect the locomotor and postural behaviors of captive-bred animals, which are widely considered uninformative regarding bone morphology and anatomical adaptations of wild animals, especially so in the case of extant great apes. We made a landmark-based geometric morphometrics analysis of the dorsal side of the scapular bone of both wild-caught and captive-bred great apes to clarify the effect of captivity on the morphology of a bone greatly involved in locomotion. The comparison suggested that captivity did not have a significant effect on the landmark configuration used, neither on average scapular shape nor shape variability, being impossible to distinguish the scapulae of a captive-bred animal from that of a wild-caught one. This indicates that the analyzed scapulae from captive Hominoidea specimens may be used in morphological or taxonomic analyses since they show no atypical morphological traits caused by living conditions in captivity. Copyright © 2013 Wiley Periodicals, Inc.

  8. Prevalence of shoulder pain in Swedish flatwater kayakers and its relation to range of motion and scapula stability of the shoulder joint.

    Science.gov (United States)

    Johansson, Anette; Svantesson, Ulla; Tannerstedt, Jörgen; Alricsson, Marie

    2016-01-01

    Few studies have investigated the incidence of injuries in kayakers. The aim was to study the prevalence of shoulder pain in competitive flatwater kayakers and to evaluate any differences in range of motion or scapula stability of the shoulder joint among kayakers with or without the history of shoulder pain. Thirty-one kayakers were participated in the study, and a questionnaire including background data was used. Shoulder range of motion was measured with a goniometer, and the participants were observed for scapula dyskinesis in flexion and abduction. Of the participating kayakers, 54.8% (n = 17) had experienced shoulder pain. Kayakers who had experienced shoulder pain showed a significantly lower degree of internal rotational range of motion versus kayakers with no reported shoulder pain, with a mean degree of internal rotation in the right shoulder 49.3 vs. 60.0 (P = 0.017) and the left shoulder 51.9 vs. 66.0 (P = 0.000). Kayakers who had experienced shoulder pain were also observed with a scapular dyskinesis (n = 15 of 17 kayakers) to a significantly higher degree (P = 0.001) than kayakers with no reported shoulder pain. Findings suggest that screening for scapular dyskinesis and testing for rotational range of motion in the shoulder joint is essential in order to treat and maybe prevent shoulder pain in kayakers.

  9. Stabilisation dynamique d'un winging scapula (à propos d'un cas avec revue de la littérature)

    Science.gov (United States)

    Boukhris, Jalal; Boussouga, Mostapha; Jaafar, Abdelouahab; Bouslmame, Nabil

    2014-01-01

    Décrit pour la première fois par Velpeau en 1937, le winging scapula reste une affection rare, encore peu connue aussi bien du grand public que des professionnels de santé. Il s'agit en fait de la paralysie isolée du nerf thoracique long, responsable de l'innervation unique du muscle serratus antérieur, laquelle paralysie génère un décollement du bord spinal et de la pointe de l'omoplate, particulièrement visible lors des mouvements d'abduction et d'antépulsion du bras. Evoluant habituellement vers la récupération spontanée, le diagnostic de cette affection est essentiellement clinique, l'exploration électromyographique, peut appuyer le diagnostic et surtout servir d’élément de surveillance. Le traitement est avant tout conservateur; la chirurgie n’étant envisagée que dans les formes chroniques qui ne répondent pas à la rééducation, le cas d'ailleurs de notre patient. Le choix du type d'intervention devra obéir à des critères précis. La stabilisation dynamique de la scapula est une intervention séduisante et donne entre des mains entraînées des résultats très satisfaisants, beaucoup de critiques sont faites sur la récupération de la force musculaire, ce qui en limite l'indication quand les exigences professionnelles des patients sont importantes. Néanmoins, certaines séries en font la méthode de choix avec des résultats excellents. PMID:25918571

  10. Effects of polyvinyl chloride overwrap film, high-oxygen modified atmosphere packaging, or ultra-low-oxygen modified atmosphere packaging on bone marrow discoloration in beef humerus, rib, thoracic vertebra, and scapula.

    Science.gov (United States)

    Grobbel, J P; Dikeman, M E; Smith, J S; Kropf, D H; Milliken, G A

    2006-03-01

    Meat retailers have reported bone marrow discoloration to be a problem, especially in modified atmosphere packages (MAP). Therefore, it is important to determine the prevalence and cause(s) of bone marrow discoloration in different beef bones and packaging systems. Thirty-six beef humeri, ribs, scapulas, and thoracic vertebrae from USDA Select and Choice carcasses were obtained from a commercial abattoir, cut into 2.54-cm-thick sections at 4 d postmortem, and packaged into 1 of 3 systems: 1) polyvinyl chloride film (PVC) overwrap; 2) high-oxygen (80% O2, 20% CO2) MAP; and 3) ultra-low-oxygen (70% N2, 30% CO2) MAP. Instrumental reflectance and visual color scores were taken on d 0, 2, and 4, and on d 0 to 4 of display, respectively. Bone marrow was extracted from humeri, ribs, and thoracic vertebrae for analysis but not from scapulas. Ribs, scapulas, and thoracic vertebrae packaged in PVC and high-oxygen MAP developed undesirable gray or black discoloration. In ultra-low-oxygen MAP, mean visual color scores were acceptable throughout the entire display period. Discoloration (darkening) was more extensive for ribs, scapulas, and thoracic vertebrae than for humeri, especially for bones packaged in PVC and high-oxygen MAP. Humeri had lower (P packaged in ultra-low-oxygen MAP and for humeri in PVC and high-oxygen MAP. Humeri marrow had lower (P packaging systems. Myoglobin was undetectable in humeri marrow. The much larger amounts of Fe and hemoglobin in ribs and thoracic vertebrae likely contribute to marrow discoloration. Bone marrow discoloration was distinct in ribs, scapulas, and thoracic vertebrae packaged in PVC or high-oxygen MAP. Bones packaged in ultra-low-oxygen MAP had minimal discoloration.

  11. Stretching position can affect levator scapular muscle activity, length, and cervical range of motion in people with a shortened levator scapulae.

    Science.gov (United States)

    Jeong, Hyo-Jung; Cynn, Heon-Seock; Yi, Chung-Hwi; Yoon, Jang-Whon; Lee, Ji-Hyun; Yoon, Tae-Lim; Kim, Bo-Been

    2017-07-01

    Levator scapulae (LS) muscle stretching exercises are a common method of lengthening a shortened muscle; however, the appropriate stretching position for lengthening the LS in people with a shortened LS remains unclear. The purpose of this study was to compare the effects of different stretching exercise positions on the LS and introduce effective stretching exercise methods to clinicians. Twenty-four university students (12 men, 12 women) with a shortened LS were recruited. LS muscle activity, LS index (LSI), and cervical range of motion (ROM) were measured pre (baseline) and post three different stretching exercise positions (sitting, quadruped, and prone). The LSI and cervical ROM exceeded the minimal detectable change and had significant changes. The LSI was greater in the sitting position than at the baseline (p = 0.01), quadruped position (p Stretching the LS in the sitting position was the most effective exercise for improving LS muscle length and cervical ROM. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. Fratura da escápula: resultados do tratamento cirúrgico em 15 pacientes Scapula fractures: outcomes after surgical treatment in 15 patients

    Directory of Open Access Journals (Sweden)

    Vincenzo Giordano

    2011-01-01

    Full Text Available OBJETIVO: Apresentar os resultados do tratamento cirúrgico de 15 pacientes com fratura da escápula. MÉTODOS: Avaliação retrospectiva dos resultados clinicos e radiográficos do tratamento cirurgico de fraturas da escápula, em um periodo de dez anos. A avaliação clínica baseou-se tanto no escore de Schofer et al. quanto no Constant-Murley. Na avaliação radiográfica, pesquisou-se a existência de perda da redução, pseudartrose ou alterações póstraumáticas. A análise estatística foi puramente descritiva, por meio de cálculo percentual dos achados. RESULTADOS: Todas as fraturas consolidaram em um período médio de 90 dias, confor- me documentação radiográfica. Na última consulta ambulatorial, o tempo médio de seguimento foi de 45,6 meses (variando de 14 a 109,2 meses. Nenhum paciente referiu dor constante e incapacitante no ombro operado. O escore médio de Constant- Murley foi de 84 pontos (variando de 76 a 90 pontos. Dos 15 pacientes, 13 (86,7% retornaram ao nível funcional prévio sem restrição (atividades profissional e recreacionais. Não forma detectados sinais de perda de redução, pseudartrose ou osteo- artrose pós-traumática. Não ocorreram penetração ou impacto articular pela presença do material de osteossíntese. CONCLUSÃO: Em pacientes com fraturas da escápula, que se enquadrem nos critérios para tratamento cirúrgico, os resultados são bons desde que sejam respeitados os tecidos moles periarticulares e realizado o devido planejamento da via de acesso e do protocolo de reabilitação.OBJECTIVE: To evaluate the clinical and radiographic outcomes on 15 unstable scapula fractures treated by open reduction and internal fixation. METHODS: A retrospective study to evaluate the results of scapula fracture fixation in 15 patients, managed at our Institution during a 10-year period. Shoulder function was recorded in both upper extremities with both the Schofer et al. and the Constant-Murley score

  13. Scapula alata in early breast cancer patients enrolled in a randomized clinical trial of post-surgery short-course image-guided radiotherapy

    Directory of Open Access Journals (Sweden)

    Adriaenssens Nele

    2012-05-01

    Full Text Available Abstract Background Scapula alata (SA is a known complication of breast surgery associated with palsy of the serratus anterior, but it is seldom mentioned. We evaluated the risk factors associated with SA and the relationship of SA with ipsilateral shoulder/arm morbidity in a series of patients enrolled in a trial of post-surgery radiotherapy (RT. Methods The trial randomized women with completely resected stage I-II breast cancer to short-course image-guided RT, versus conventional RT. SA, arm volume and shoulder-arm mobility were measured prior to RT and at one to three months post-RT. Shoulder/arm morbidities were computed as a post-RT percentage change relative to pre-RT measurements. Results Of 119 evaluable patients, 13 (= 10.9% had pre-RT SA. Age younger than 50 years old, a body mass index less than 25 kg/m2, and axillary lymph node dissection were significant risk factors, with odds ratios of 4.8 (P = 0.009, 6.1 (P = 0.016, and 6.1 (P = 0.005, respectively. Randomization group was not significant. At one to three months’ post-RT, mean arm volume increased by 4.1% (P = 0.036 and abduction decreased by 8.6% (P = 0.046 among SA patients, but not among non-SA patients. SA resolved in eight, persisted in five, and appeared in one patient. Conclusion The relationship of SA with lower body mass index suggests that SA might have been underestimated in overweight patients. Despite apparent resolution of SA in most patients, pre-RT SA portended an increased risk of shoulder/arm morbidity. We argue that SA warrants further investigation. Incidentally, the observation of SA occurring after RT in one patient represents the second case of post-RT SA reported in the literature.

  14. Isolated scapula fracture: Ice hockey player without trauma

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    Serdar Memişoğlu

    2015-09-01

    Conclusion: Scapular fractures are generally seen along with other injuries, but in this case we wanted to emphasize that care has to been taken to diagnose an isolated scapular fracture while assessing shoulder pain.

  15. Avaliação dos resultados da artrodese da articulação escapulotorácica no tratamento da escápula alada na distrofia fascioescapulumeral Evaluation of scapulothoracic arthrodesis results in the treatment of winged scapula in facioscapulohumeral dystrophy

    Directory of Open Access Journals (Sweden)

    Luciano Antonio Nassar Pellegrino

    2008-02-01

    deficit of the limb involved, muscular fatigue, and esthetic deformity. The surgical technique used for the arthrodesis fixated the scapula to the thoracic wall by tying a narrow, slim plate with No. 5 polyester threads and placing an autologous cancellous bone graft. RESULTS: Mean follow-up of the patients was of 124 months. Comparing the range of movement before and after surgery, the authors observed an improvement in raising, lateral rotation being kept, with the pre-op UCLA ranging from 7 to 11, and the post-op UCLA ranging from 29 to 33. Complications included two cases of pneumothorax; one case of the detachment of synthesis material, and one case of lack of bone fusion. COMMENT: Arthrodesis fusion was achieved in six cases, besides improvement in pain and raising. Two cases were reoperated on, one of them due to breakage of the material and another one due to lack of fusion. All cases evolved on to fusion.

  16. Stature Estimation from Measurement of Scapula of Igbos of South-East Nigeria

    Directory of Open Access Journals (Sweden)

    2016-11-01

    Full Text Available The study investigated the correlation between stature and different radiographic scapular measurements. An also estimated stature using linear regression formula derived for the population of Igbos of south-east Nigeria. 90 scapular radiographic films comprising 45 males and 45 females with ages ranging between 25 to 65 were used for the study. Six different radiographic scapular variables were measured with spreading calliper. Height of the subjects was measured with standard height measuring instrument with the subject standing erect, in anatomical position. The result obtained was analyzed and used to derive a formula between different radiographic scapular measurements and the total height of an individual.

  17. Neoplasias of the scapula - rare causes of a chronic shoulder-hand syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Grobovschek, M.; Bone, G.

    1986-03-01

    The diseases most frequently resulting in a chronic shoulder-hand syndrome are definitely of a post-traumatic nature and are later - after a varying period - often combined with degenerative changes. The tendency to injury is enhanced by the particularly great mobility of the shoulder joint. Inflammatory changes - e.g. of bacterial, rheumatic origin - are much rarer. The authors present two patients with rare neoplastic lesions in the region of the shoulder-blade and show how the disease was identified via various differential diagnostic methods.

  18. 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

  19. Rare case of the fracture of the lateral border of the scapula ...

    African Journals Online (AJOL)

    A 38-year-old man injured his left shoulder in a traffic accident. In his physical ... By 4 months after the injury there was further improvement in both sensory and motor function, and by 8 months there was sensation in the autonomous zones of both median and ulnar nerves and good return of muscle power. Pan African ...

  20. Idiopathic snapping scapula in a Moroccan patient: A rare cause of shoulder pain

    Directory of Open Access Journals (Sweden)

    Kona Kaut Irène

    2017-04-01

    Conclusion: Our case illustrates a new case of a jumped shoulder blade of unknown origin after completion of all etiological imaging. Further analysis of clinical events is needed to better understand this type of jumped shoulder blade.

  1. The inferior angle of the scapula as a landmark to locate the seventh thoracic spinous process

    OpenAIRE

    2012-01-01

    M. Tech. Although Chiropractors rely on palpation as a clinical tool, its reliability still remains to be proven (O‟Haire and Gibbons, 2000). Motion palpation is based on the assumption that Chiropractors‟ and other manual medicine practitioners‟ static palpation is performed correctly to identify bony anatomical landmarks (O‟Haire and Gibbons, 2000). The most common method taught to chiropractic students on the location of the seventh thoracic spinous process, is to place the patient‟s ha...

  2. Prominent scapulae mimicking an inherited myopathy expands the phenotype of CHD7-related disease

    NARCIS (Netherlands)

    O'Grady, Gina L.; Ma, Alan; Sival, Deborah; Wong, Monica T. Y.; Peduto, Tony; Menezes, Manoj P.; Young, Helen; Waddell, Leigh; Ghaoui, Roula; Needham, Merrilee; Lek, Monkol; North, Kathryn N.; MacArthur, Daniel G.; van Ravenswaaij-Arts, Conny M. A.; Clarke, Nigel F.

    CHD7 variants are a well-established cause of CHARGE syndrome, a disabling multi-system malformation disorder that is often associated with deafness, visual impairment and intellectual disability. Less severe forms of CHD7-related disease are known to exist, but the full spectrum of phenotypes

  3. Scapular Malunion in a Vietnam War Veteran: Superior Medial Angle of the Scapula Impinging on the Clavicle: A Case Report.

    Science.gov (United States)

    Sorenson, Scott M; Armstrong, April D

    2015-01-01

    Scapular malunion can be overlooked as a source of substantial upper-extremity pain and dysfunction and can generate unnecessary studies or treatments. We present the case of a Vietnam War veteran who sustained a projectile injury in the left shoulder and had persistent symptoms limiting his activity and quality of life for a number of years until surgical resection was performed. Scapular malunion should be considered in the differential diagnosis of a patient presenting with persistent upper-extremity pain and weakness following scapular fracture. Making the correct diagnosis based on the history, examination, and imaging will prevent unnecessary studies and invasive procedures.

  4. Scapula insufficiency fractures after reverse total shoulder arthroplasty in rotator cuff arthropathy: What is their functional impact?

    Science.gov (United States)

    Lópiz, Yaiza; Rodríguez-González, Alberto; García-Fernández, Carlos; Marco, Fernando

    2015-01-01

    To describe the incidence, etiological factors, functional impairment and therapeutic management of scapular fractures after reverse shoulder arthroplasty (RSA) in rotator cuff arthropathy. A retrospective study was conducted on 126 RSA between 2009 and 2011, in which 4 fractures were identified that were compared with a control group of 40 patients. An analysis was performed on the variables related to the surgical technique, functional results, and quality of life (Constant scale, EQ-5D). The fracture incidence was 3.28% with a mean age of 74.7 years. The mean time until diagnosis was 11.9 months. The preoperative Constant score in the control group was 37.3%, and 34.7% in the fracture group (P>.05); postoperative Constant score: 81.2 and 66.5%, respectively (P>.001). Forward elevation and abduction in fracture patients decreased by 39° (P=.02), and 34° (P=.057) respectively. The perceived quality of life (EQ-VAS) was lower in the fracture group (60 vs. 76) (P=.002). There were no instability cases, and no revision surgery was required. The union rate was 50% after a mean follow-up 39.6 months. Scapular fracture after RSA is a rare complication. Despite its presence, the functional outcomes and quality of life of these patients are higher than preoperatively; however, they are lower than that obtained in patients with RSA without this complication. More prospective studies are needed to define guidelines for therapeutic action against this complication. Copyright © 2014 SECOT. Published by Elsevier Espana. All rights reserved.

  5. Cyclic loading comparison of Bio-SutureTak-#2 FiberWire and Bio Mini-Revo-#2 Hi-Fi suture anchor-sutures in cadaveric scapulae.

    Science.gov (United States)

    Sparks, Brad S; Nyland, John; Nawab, Akbar; Blackburn, Ethan; Krupp, Ryan; Burden, Robert

    2008-03-01

    This study compared tap-in Bio-SutureTak suture anchor-#2 FiberWire suture (Group 1) and screw-in Bio Mini-Revo suture anchor-#2 Hi-Fi suture (Group 2) fixation in the glenoid region of interest for Bankart repair, in addition to evaluation of isolated suture loop biomechanical properties under progressive incremental cyclic loads. With knowledge of glenoid apparent bone mineral density (BMD), implant preparation and fit characteristics, and following application of a light manual tensile load, the primary investigator scored each specimen for perceived within group biomechanical test performance using a 0-10 point modified visual analog scale. After scoring, 12 paired constructs were placed in a servo hydraulic device clamp, preloaded to 25 N, and cycled between 25 and 50 Hz with a 25 N load increase every 25 cycles. Group 2 withstood greater load (104.1 +/- 56 vs. 70 +/- 36.9 N, P = 0.04) and displaced more at failure (13 +/- 4.5 vs. 8.6 +/- 3.3 mm, P = 0.04). All Group 1 specimens failed prior to reaching 150 N, whereas 25% of Group 2 specimens (n = 3) failed at 200 N. All specimens failed by anchor pullout except for three Group 2 specimens that failed by eyelet breakage at 200 N. Isolated suture testing revealed that Group 1 sutures displaced less at each cyclic load (P = 0.028) and withstood greater failure loads (P = 0.028) than that of Group 2 sutures. Group 2 constructs displayed moderately strong relationships between perceived within group biomechanical test performance and ultimate load (r (2) = 0.55) and displacement at failure (r (2) = 0.67). Group 1 did not display significant relationships. Similar biomechanical performance between 50 and 125 N, greater load at failure, and superior biomechanical test prediction accuracy suggest that the screw-in type Bio Mini-Revo suture anchor-#2 Hi-Fi suture combination may be preferred for Bankart lesion repair in low apparent BMD glenoid processes. The #2 Hi-Fi suture, however, allowed significantly greater displacement than the #2 FiberWire suture at each progressive cyclic load interval.

  6. The effect of middle and lower trapezius strength exercises and levator scapulae and upper trapezius stretching exercises in upper crossed syndrome

    OpenAIRE

    Bae, Won-Sik; Lee, Hyun-Ok; Shin, Jae-Wook; Lee, Keon-Cheol

    2016-01-01

    [Purpose] The purpose of this study was to determine the effectiveness of strength and stretching exercises on upper crossed syndrome. [Subjects and Methods] After measuring cervical alignment using the Global Posture System, 30 students with forward head posture were selected and divided into two groups. The experimental group (n=15) participated in strength and stretching exercises, three times per week for 4 weeks. The control group (n=15) did not participate in the exercises. The exercise...

  7. Download this PDF file

    African Journals Online (AJOL)

    age of seventeen years and was managed by the Woodward's procedure. INTRODUCTION. Congenital elevation of the scapula is a complex congenital deformity of the shoulder girdle. Other names attributed to it include undescended scapula, elevated scapula, Congenital high scapula and congenital undescended ...

  8. [Extended surgical indications in combined shoulder girdle fracture].

    Science.gov (United States)

    Kohler, A; Käch, K; Platz, A; Friedl, H P; Trentz, O

    1992-01-01

    The combination of an ipsilateral clavicule and scapula fracture causes a double instability of the shoulder. In opposite to an isolated clavicule or scapula fracture this injury should be treated operatively. Diagnosis of the scapula fracture in polytrauma can be difficult. If there is a clinical or radiologic suspicion, the indication for a CT scan is given. Osteosynthesis with plates from separated approaches, first the scapula from dorsal then the calvicule from ventral has proven good. The nervus suprascapularis must be treated carefully and, if necessary, liberated from the fracture. The optimal treatment of this injury is not always possible in polytraumatised patient.

  9. Disease: H00873 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available characterized by scapular and pelvic hypoplasia along with epiphyseal abnormalities, congenital dwarfism, an...TBX15 mutations cause craniofacial dysmorphism, hypoplasia of scapula and pelvis,

  10. Assessment of scapular position in patients suffering from shoulder ...

    African Journals Online (AJOL)

    Measurements of the distance between T4 and the root of the scapula were made and the relationship of the distance and the function of trapezius middle fibres at resting length was tested. A Vernier caliper® ... for further studies. Keywords: Scapula position, shoulder dysfunction, trapezius muscle, competitive swimming ...

  11. Simultaneous Fractures of Acromion, Coracoid Process and Inferior ...

    African Journals Online (AJOL)

    Shoulder dislocations are the most frequent among all articular dislocations. They can lead to major shoulder instability especially when they are associated with scapula fractures. We report an unusual case of antero- inferior shoulder dislocation associated with a triple fracture of the scapula. It is a twenty eight-year old ...

  12. Influence of body composition on the prevalence of postural ...

    African Journals Online (AJOL)

    Correlations demonstrated a statistical significant association (p<0.05) between BMI and percentage body fat with winged scapulae, protruding abdomen and flat feet. A large practical significant difference (d≈.8) in BMI was demonstrated between the different categories of winged scapulae and flat feet and also in ...

  13. Diagnostic accuracy of scapular physical examination tests for shoulder disorders: a systematic review.

    Science.gov (United States)

    Wright, Alexis A; Wassinger, Craig A; Frank, Mason; Michener, Lori A; Hegedus, Eric J

    2013-09-01

    To systematically review and critique the evidence regarding the diagnostic accuracy of physical examination tests for the scapula in patients with shoulder disorders. A systematic, computerised literature search of PubMED, EMBASE, CINAHL and the Cochrane Library databases (from database inception through January 2012) using keywords related to diagnostic accuracy of physical examination tests of the scapula. The Quality Assessment of Diagnostic Accuracy Studies tool was used to critique the quality of each paper. Eight articles met the inclusion criteria; three were considered to be of high quality. Of the three high-quality studies, two were in reference to a 'diagnosis' of shoulder pain. Only one high-quality article referenced specific shoulder pathology of acromioclavicular dislocation with reported sensitivity of 71% and 41% for the scapular dyskinesis and SICK scapula test, respectively. Overall, no physical examination test of the scapula was found to be useful in differentially diagnosing pathologies of the shoulder.

  14. Download this PDF file

    African Journals Online (AJOL)

    Administrator

    muscle wasting prevalent in HIV patients10. Nutritional assessment tools that can accurately predict risk ... nutrition impact symptoms, dietary intake, function and physical exam) were rated as severely malnourished. ... clavicles (pectoralis and deltoids), shoulders (deltoids), interosseous muscles, scapula (latissimus dorsi,.

  15. Shoulder Fractures

    Science.gov (United States)

    ... arm bone), the scapula (shoulder blade) and the clavicle (collarbone) (Figure 1). The upper end of the humerus ... age. Most fractures in children occur in the clavicle bone. In adults, the most common fracture is ...

  16. Hypertrophy in the cervical muscles and thoracic discs in bed rest?

    National Research Council Canada - National Science Library

    Daniel L. Belavý; Tanja Miokovic; Gabriele Armbrecht; Dieter Felsenberg

    2013-01-01

    .... Subjects were followed for 2 yr after bed rest. On axial cervical magnetic resonance images from the skull to T3, the volumes of the semispinalis capitis, splenius capitis, spinalis cervicis, longus capitis, longus colli, levator scapulae...

  17. Main component of soft tissue artifact of the upper-limbs with respect to different functional, daily life and sports movements.

    OpenAIRE

    Blache, Yoann; Dumas, Raphaël; LUNDBERG, Arian; Begon, Mickaël

    2017-01-01

    Abstract Soft tissue artifact (STA) is the main source of error in kinematic estimation of human movements based on skin markers. Our objective was to determine the components of marker displacements that best describe STA of the shoulder and arm (i.e. clavicle, scapula and humerus). Four participants performed arm flexion and rotation, a daily-life and a sports movement. Three pins with reflective markers were inserted into the clavicle, scapula and humerus. In addition, up to seven skin mar...

  18. The human acromion viewed from an evolutionary perspective.

    Science.gov (United States)

    Voisin, J-L; Ropars, M; Thomazeau, H

    2014-12-01

    The high prevalence of rotator cuff tendinopathy in modern humans may be partly related to the shape acquired by the scapula as species changed throughout evolution. Here, we compared the anatomic features of the scapula across members of the Hominoid group. The results support the hypothesis that the scapula of Homo sapiens sapiens exhibits distinctive anatomic characteristics compared to that of other Hominoids. We studied 89 scapulae from five species. For each scapula, we measured eight parameters and determined six index. We then compared the results across species. We identified two distinctive characteristics of the lateral aspect of the human scapula, namely, a lateral orientation of the glenoid cavity and a narrow coraco-acromial arch. Similar to the gorilla acromion, the human one is steeply sloped and, above all, larger and squarer than the acromion of other Hominoids. These features may explain, in part at least, the pathogenesis of rotator cuff tendinopathy in modern man. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  19. Effect of sitting posture on 3-dimensional scapular kinematics measured by skin-mounted electromagnetic tracking sensors.

    Science.gov (United States)

    Finley, Margaret A; Lee, Raymond Y

    2003-04-01

    To determine the effect of trunk sitting posture on scapular kinematics during humeral elevation by using skin-mounted electromagnetic tracking sensors. Repeated-measures design contrasting scapular kinematics in 2 different sitting postures. A biomechanics laboratory in Hong Kong with a real-time, 3-dimensional electromagnetic tracking device for measuring movements of the scapula. A sample of 16 healthy adults (12 women, 4 men; age, 21.6+/-3.92y) with full, pain-free shoulder range of motion and no history of shoulder pathology. Not applicable. Movements of the scapula were measured while each subject performed humeral elevation in an upright seated position and a slouched seated position. In both postures, posterior tip, lateral and upward rotation of the scapula, and lateral rotation of the humerus were observed during humeral elevation. When the slouched posture was adopted, there were significant decreases in the posterior tip and lateral rotation of the scapula, but there was no significant change in the magnitude of the upward rotation of the scapula. Increased thoracic kyphosis significantly alters the kinematics of the scapula during humeral elevation.

  20. Complete Absence of Suprascapular Notch: A Case Report

    Directory of Open Access Journals (Sweden)

    Rohini Mohan Pawar

    2015-10-01

    Full Text Available Suprascapular Nerve Entrapment (SSNE is an acquired neuropathy secondary to compression of suprascapular nerve in the Suprascapular Notch (SSN. Complete ossification of superior transverse scapular ligament may be a cause for suprascapular nerve entrapment. The absence of suprascapular notch is not very common condition, though its prevalence was quoted by Indian authors to be varying from 1.36% to 32.46% in different parts of the country. It is considered to be a predisposing factor for suprascapular nerve entrapment neuropathy. We noticed a male scapula without suprascapular notch in osteology section of Forensic Medicine department. In this case we observed costal and dorsal surfaces of the left scapula of a male without suprascapular notch at its superior border. The details of the said scapula are discussed in this report.

  1. Microvascular free flaps for mandibular reconstruction in Goldenhar syndrome.

    Science.gov (United States)

    Mueller, Cornelia Katharina; Bader, Rolf-Dieter; Schultze-Mosgau, Stefan

    2011-05-01

    Although Goldenhar syndrome is a relatively common craniofacial malformation, there is some debate regarding the ideal treatment of severe mandibular hypoplasia. Traditionally, patients with severe mandibular deficits have been treated with iliac or costochondral bone grafts followed by distraction osteogenesis, with mixed results. The authors present their experience with the use of the osteocutaneous fibula and scapula free flap for mandibular reconstruction in patients with severe mandibular hypoplasia. The cases of 4 patients who underwent free-flap reconstruction of a severely hypoplastic mandible due to Goldenhar syndrome are presented. Microvascular reconstruction of the severely hypoplastic mandible is possible with the osteocutaneous scapula and the fibula flap. Minimal donor-site morbidity is elicited. Furthermore, the vertical relationship can be restored adequately, and breathing is facilitated. The microvascular fibula and scapula flap are a viable option for reconstruction of the severely hypoplastic mandible in patients with Goldenhar syndrome.

  2. A Biomechanical Model of the Scapulothoracic Joint to Accurately Capture Scapular Kinematics during Shoulder Movements.

    Science.gov (United States)

    Seth, Ajay; Matias, Ricardo; Veloso, António P; Delp, Scott L

    2016-01-01

    The complexity of shoulder mechanics combined with the movement of skin relative to the scapula makes it difficult to measure shoulder kinematics with sufficient accuracy to distinguish between symptomatic and asymptomatic individuals. Multibody skeletal models can improve motion capture accuracy by reducing the space of possible joint movements, and models are used widely to improve measurement of lower limb kinematics. In this study, we developed a rigid-body model of a scapulothoracic joint to describe the kinematics of the scapula relative to the thorax. This model describes scapular kinematics with four degrees of freedom: 1) elevation and 2) abduction of the scapula on an ellipsoidal thoracic surface, 3) upward rotation of the scapula normal to the thoracic surface, and 4) internal rotation of the scapula to lift the medial border of the scapula off the surface of the thorax. The surface dimensions and joint axes can be customized to match an individual's anthropometry. We compared the model to "gold standard" bone-pin kinematics collected during three shoulder tasks and found modeled scapular kinematics to be accurate to within 2 mm root-mean-squared error for individual bone-pin markers across all markers and movement tasks. As an additional test, we added random and systematic noise to the bone-pin marker data and found that the model reduced kinematic variability due to noise by 65% compared to Euler angles computed without the model. Our scapulothoracic joint model can be used for inverse and forward dynamics analyses and to compute joint reaction loads. The computational performance of the scapulothoracic joint model is well suited for real-time applications; it is freely available for use with OpenSim 3.2, and is customizable and usable with other OpenSim models.

  3. Scapular dyskinesis and SICK syndrome in patients with a chronic type III acromioclavicular dislocation. Results of rehabilitation.

    Science.gov (United States)

    Carbone, Stefano; Postacchini, Roberto; Gumina, Stefano

    2015-05-01

    Scapular dyskinesis has been related to acromioclavicular injuries. A rehabilitation protocol has been studied in order to treat scapular dyskinesis, but it has not yet been evaluated. This rehabilitation programme was adopted to improve the shoulder function, thereby improving the scapular dyskinesis in patients with chronic acromioclavicular dislocation. Twenty-four patients diagnosed with chronic type III acromioclavicular dislocation and scapular dyskinesis that have already been conservatively treated were enrolled in the rehabilitation protocol and analysed. Fourteen of these patients had a Scapular Inferior Coracoid dysKinesis (SICK) Syndrome. The adopted rehabilitation protocol consisted of 12 strengthening and stretching exercises of the scapulae. The final follow-ups were performed after 6 weeks, 6 months and 12 months using clinical measurements of scapular position and clinical evaluation of the scapular motion. In order to evaluate the SICK scapula syndrome, we used the SICK Scapula Rating Scale. The shoulder function was evaluated with a Constant Score and a Subjective Shoulder Value. After 12 months, the follow-up concluded that the scapular dyskinesis was no longer present in 18/23 patients (78.2 %). SICK scapula syndrome was observed in 4/8 patients with a scapular malposition. The Scapula Rating Scale score in 4 patients with SICK scapula was 7.5 points. After 12 months of rehabilitation, the mean Constant Score and Subjective Shoulder Value grew up to 85 points. The scapular dyskinesis and SICK syndrome secondary to chronic type III AC dislocation can be treated with the proposed rehabilitation protocol resulting in positive improvements of the shoulder function within 6 weeks; however, patients that do not respond to the rehabilitation programme will not improve with extended rehabilitation time. It is important to advise patients of the specific exercises for the prevention/treatment of scapular dyskinesis in the rehabilitation programme after

  4. Scapuloplasty alleviates scapular pain resulting from lung cancer metastasis.

    Science.gov (United States)

    Choi, Hey-Ran; Lee, Pyung-Bok; Kim, Kyung-Hoon

    2010-01-01

    Osteoplasty, a highly effective minimally invasive procedure that alleviates the painful effects of metastatic bone disease by injecting bone cement to support weakened bones, provides immediate and substantial pain relief. However, it is rarely performed in non-weight bearing flat bones such as the scapula. Fractures of the body of the scapula are rarely treated surgically, except for cases of marked displacement of fragments that limit the function of the scapula. According to the reported incidences of operative treatment of different scapula fracture types, 99% of all isolated scapula body fractures are treated nonoperatively A 54-year-old man had been experiencing metastatic bone pain in the lateral border, medial border, and medial infraspinatus fossa of the left scapula for the past 2 months; this pain originated from adenocarcinoma of the right lung. He could not sleep on his back even after completion of radiation therapy. We decided to perform scapuloplasty. The patient was placed in the prone position on a radiolucent table with an inflatable adjustable axillary pillow. Three 13-gauge, 10-cm long bone biopsy needles were simultaneously inserted from the 3 different entry points to fill the osteolytic lesion with the bone cement with fluoroscopic guidance under local anesthesia and intravenous analgesia. After confirming needle placement and ensuring that no contrast medium was extravasated, a total of 8 mL of the cement was injected. Immediately after the operation, the patient could lie on his back without pain. Scapuloplasty is a new variant of osteoplasty used to alleviate the painful effects of metastatic bone disease. It may be an option of shoulder motion-preserving minimally invasive procedure for alleviating intractable pain induced by lying on the back.

  5. Shoulder Duplication in Constriction Band Syndrome: a Case Report

    Directory of Open Access Journals (Sweden)

    Davod Jafari

    2011-11-01

    Full Text Available A 2.5 year old girl is presented with both hands constriction bands leading to distal amputations and the rare deformity of shoulder duplication in the right side accompanying constriction skin marking over the affected shoulder. The cephalomedial scapula articulated with the clavicle and the caudolateral scapula articulated with humeral head. The most important physical finding which could explain the pathophysiology of this rare anomaly, was constriction band marking over the right shoulder. Shoulder range of motion was limited but still functional and no surgical intervention was required for the scapular duplication.

  6. Syndrome of fascial incarceration of the long thoracic nerve: winged scapula☆

    Science.gov (United States)

    Silva, Jefferson Braga; Gerhardt, Samanta; Pacheco, Ivan

    2015-01-01

    Objective To analyze the results from early intervention surgery in patients with the syndrome of fascial incarceration of the long thoracic nerve and consequent winged scapula. Methods Six patients with a syndrome of nerve trapping without specific nerve strain limitations were followed up. Results The patients achieved improvement of their symptoms 6–20 months after the procedure. The motor symptoms completely disappeared, without any persistent pain. The medial deformity of the winged scapula improved in all cases, without any residual esthetic disorders. Conclusion The approach of early surgical release seems to be a better predictor for recovery from non-traumatic paralysis of the anterior serratus muscle. PMID:26535205

  7. Sprengel's deformity and spinal dysraphism : connecting the shoulder and the spine

    NARCIS (Netherlands)

    van Aalst, J.; Vles, J. S. H.; Cuppen, I.; Sival, D. A.; Niks, E. H.; Van Rhijn, L. W.; Van Steensel, M. A. M.; Cornips, E. M. J.

    Sprengel's deformity, a rare congenital malformation of the scapula, may be observed in combination with spinal dysraphism. The co-occurrence of these malformations suggests an unknown shared etiology. Therefore, we reviewed the medical records of eight children presenting with both malformations

  8. 1978 Archeological Investigations at ELK City Lake, Kansas,

    Science.gov (United States)

    1978-01-01

    contained the most significant data. In addition, plane table maps were made for all tested sites and are on file at the Society. 14MY342 14MY342...Family Leporidae - rabbits 11 mandible; four left, one right 3 maxilla; one right 2 palatine 9 vertebra; all lumbar 1 sacrum 3 scapula; two

  9. 76 FR 36152 - Notice of Inventory Completion: Western Michigan University, Anthropology Department, Kalamazoo...

    Science.gov (United States)

    2011-06-21

    ... funerary objects are 8 black bear scapula and fragments, 1 black bear atlas, 1 black bear proximal femur head, 1 large bird long bone shaft, 1 possible black bear phalanx, 1 possible crane carpometacarpus, 1... placed with or near individual human remains at the time of death or later as part of the death rite or...

  10. 75 FR 67998 - Notice of Inventory Completion: Western Michigan University, Anthropology Department, Kalamazoo, MI

    Science.gov (United States)

    2010-11-04

    ... associated funerary objects are 8 black bear scapula and fragments, 1 black bear atlas, 1 black bear proximal femur head, 1 large bird long bone shaft, 1 possible black bear phalanx, 1 possible crane... human remains at the time of death or later as part of the death rite or ceremony. Lastly, officials of...

  11. 38 CFR 4.73 - Schedule of ratings-muscle injuries.

    Science.gov (United States)

    2010-07-01

    ... scapula; elevation of arm above shoulder level. Extrinsic muscles of shoulder girdle: (1) Trapezius; (2.... Function: Elevation and abduction of arm to level of shoulder; act with 1 and 2 of Group II in forward and... 20 Moderate 10 Slight 0 The Pelvic Girdle and Thigh Rating 5313Group XIII. Function: Extension of hip...

  12. Aneurysmal bone cyst of the acromion: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Ruggieri, M. [Div. of Pediatric Neurology, Inst. of Pediatrics, Univ. of Catania (Italy); Milone, P. [Inst. of Radiology, Univ. of Catania (Italy); Smilari, P. [Div. of Pediatric Neurology, Inst. of Pediatrics, Univ. of Catania (Italy); Sessa, G. [Orthopedic Clinic, Univ. of Catania (Italy); Pavone, V. [Orthopedic Clinic, Univ. of Catania (Italy); Vasquez, E. [Inst. of Anatomical Pathology, Univ. of Catania (Italy)

    1995-11-01

    The case of 6-year-old girl with an asymptomatic aneurysmal bone cyst of the acromion is reported. Such tumors are rarely located in the scapula and are especially rare in the acromion. The diagnosis was confirmed by biopsy and surgical resection of the lesion. Roentgenographic, CT and histologic features of the cyst are discussed. (orig.)

  13. Food choice and diet of the bearded vulture Gypaetus barbatus in ...

    African Journals Online (AJOL)

    1990-04-17

    Apr 17, 1990 ... carcass. Mountain reedbuck lamb. Grey rhebok carcass. Small antelope limb. Small ungulate scapula. Bones-long. Ribs. Vertebrae. Red meat. Dog carcass. Unidentified. Totals. Number of food items. Lesotho Giant's KwaZulu N.E. high- Castle Game and Natal Cape lands. Reserve farms farms Totals %. 2.

  14. ISSN 2073 East Cent. Afr. j. surg.

    African Journals Online (AJOL)

    DELL

    sarcomas of the shoulder girdle particularly osteosarcomas of the proximal humerus and scapula3, 4, 5. With the increase in ... This was a 20 year old woman who presented with gradual onset of shoulder swelling, ulceration and pain of ... After resuscitation further examination under general anaesthesia revealed that the.

  15. Geo(Im)pulseBite marks on early Holocene Tursiops truncatus fossils from the North Sea indicate scavenging by rays (Chondrichthyes, Rajidae)

    NARCIS (Netherlands)

    Netten, H.H. van; Reumer, J.W.F.

    A number of Tursiops truncatus mandibles in the collection of fossil marine mammals in the Rotterdam Natural History Museum have marks consisting of several parallel linear grooves. These marks are also found on four atlas complexes, a scapula and on one vertebra. The hypothesis that they are bite

  16. Download this PDF file

    African Journals Online (AJOL)

    enlarged processes on the scapula, humerus and ulna for greater muscle attachment; enlarged neck muscles and a dip in the spine in the cervical region to accommodate these and the enlarged shoulder muscles; an enlarged occiput for insertion of the ... of the shoulder and forelimb anatomy and function in C. asiatica.

  17. Images in medicine

    African Journals Online (AJOL)

    ebutamanya

    sensory and motor function, and by 8 months there was sensation in the autonomous zones of both median and ulnar nerves and good return of muscle power. Figure 1: A) radiograph of the left shoulder demonstrating fracture of the lateral border of the scapula; B and C) tomography scan with 3D reconstruction confirmed ...

  18. Bilateral Additional Slips of Triceps Brachii Forming Osseo‑Musculo ...

    African Journals Online (AJOL)

    Triceps brachii is a muscle of posterior compartment of the arm having medial, long and lateral heads and is an extensor of forearm at elbow joint. Its long head originates from the infraglenoid tubercle of the scapula, the lateral head from the area above to the radial groove of the humerus along with lateral intermuscular ...

  19. Secondary chondrosarcoma: Malignant transformation of pre ...

    African Journals Online (AJOL)

    2014-12-15

    Dec 15, 2014 ... 2Department of Anatomical. Pathology, Stellenbosch. University and Tygerberg ... osteochondromas (in particular, those involving the pelvis or scapula which are known to have an increased ... and lesions localised to the spine, pelvis, sacrum, ribs and sternum. Distinguishing enchondromas from low- ...

  20. ISSN 2073 East Cent. Afr. j. surg.

    African Journals Online (AJOL)

    DELL

    sarcomas of the shoulder girdle particularly osteosarcomas of the proximal humerus and scapula3, 4, 5. With the increase in traumatic severe injuries, it is also indicated for unsalvageable injuries around the shoulder joint6. Five patients who underwent forequarter amputation at Muhimbili Orthopaedic Institute are.

  1. Differences in body composition and occurrence of postural ...

    African Journals Online (AJOL)

    The African group had higher occurrence in most of the deformities with winged scapulae, protruding abdomen and lordosis demonstrating a statistical significance (p<0.05) and a practical significance (large effect) with regard to the Caucasian group. The higher occurrence of kyphosis and pronated feet in the African group ...

  2. Life-Threatening and Suspicious Lesions Caused by Mechanical Cardiopulmonary Resuscitation

    DEFF Research Database (Denmark)

    Milling, Louise; Leth, Peter Mygind; Astrup, Birgitte Schmidt

    2017-01-01

    , between the scapulae, and in the lumbar region. Investigation of internal organs showed injuries to the lung, spleen, and kidney. The extension of the injuries gave rise to suspicion of homicide by smothering, which police investigation subsequently did not support. The pattern of injury could...

  3. Kinematics of the contralateral and ipsilateral shoulder: A possible relationship with post-stroke shoulder pain

    NARCIS (Netherlands)

    Niessen, M.H.M.; Janssen, T.W.J.; Meskers, C.G.M.; Koppe, P.; Konijnenbelt, M.; Veeger, H.E.J.

    2008-01-01

    Objective: Post-stroke shoulder pain is a common phenomenon in hemiplegia and impedes rehabilitation. The aim of this study was to identify a possible relationship between post-stroke shoulder pain, scapula resting position and shoulder motion. Methods: Shoulder kinematics of 27 patients after

  4. The scapular glenopolar angle: standard values and side differences

    Energy Technology Data Exchange (ETDEWEB)

    Tucek, Michal; Bartonicek, Jan [Charles University and Military University Hospital Prague, Department of Orthopaedic Trauma, 1st Faculty of Medicine, Prague 6 (Czech Republic); Nanka, Ondrej [Charles University, Institute of Anatomy, 1st Faculty of Medicine, Prague 2 (Czech Republic); Malik, Jozef [Military University Hospital Prague, Department of Radiology, Prague 6 (Czech Republic)

    2014-11-15

    The aim of this study is to determine normal glenopolar angle (GPA) values on bone specimens of the scapula and compare them with various radiological views and CT examination. GPA values were measured on 100 mature, dry, non-paired scapulae, 20 pairs of dry scapulae, 50 AP radiographs of the shoulder, 50 Neer I views, 50 AP chest radiographs and 20 3D CT reconstructions of the scapula. Measurements made on bone specimens of the scapula showed an average GPA value of 42.3 ; the mean absolute side-to-side difference was on average 1.6 . The average GPA measured on 50 AP shoulder radiographs was 35.9 , on Neer I views 40.6 and AP chest radiographs 37.1 , with the mean absolute side-to-side difference on average 4.9 ; on 3D CT the average GPA was 43.0 and the mean absolute side-to-side difference on average 1.4 . GPA values depend on the method of measurement used. Measurements made on 3D CT reconstructions and Neer I views showed almost the same values as those measured on bone specimens. The values measured on AP shoulder views and AP chest radiographs were statistically significantly lower. Side-to-side variability (right and left) measured on 3D CT reconstructions was insignificant, and the obtained values corresponded to the values from bone specimens. Therefore, the best method to measure the GPA is a 3D CT reconstruction and an exact Neer I projection. (orig.)

  5. EFFECT OF SCAPULAR STABILISATION EXERCISES FOR TYPE 2 SCAPULAR DYSKINESIS IN SUBJECTS WITH SHOULDER IMPINGEMENT

    Directory of Open Access Journals (Sweden)

    Pradeep Shankar

    2016-02-01

    Full Text Available Background: Abnormal altered scapular position during rest or motion have been termed as Scapular Dyskinesia. Scapula Dyskinesia Type-2 is one type of dyskinesia in which there is a visual prominence of entire medial border of scapula that occurs due to weakness of the serratus anterior and tightness of posterior shoulder joint capsule that results in reduction in glenohumeral flexion and abduction, resulting in decreased acromial elevation. This type of dyskinesia is commonly seen in Secondary impingement of shoulder. Rehabilitation generally begins and focused on axio-humeral and scapula- humeral than axio-scapular muscle. Early application of closed kinetic exercises on scapular stabilization and its effect of application on scapular dyskinesia type 2 is unknown. The study was proposed to find the effect of scapular stabilization exercise for type 2 Scapular Dyskinesia in subjects with shoulder impingement. Methods: An experimental study design, 7 male patients with mean age 37 years diagnosed with Shoulder impingement associated with Type 2 scapular dyskinesia were included in the study. The protocol includes closed kinematic chain exercises (scapula clock, Black burn exercises, Sleepers stretch, and thera band exercises aimed to balance force couple of upper, lower trapezius and serratus anterior. Duration of intervention was 3 sessions per week for 2 weeks. Outcome measurements such as Lateral scapular slide test and SPADI were measured pre and post interventions. Results: Analysis using Paired ‘t’ test as a parametric test found that there is statistically significant difference p<0.000 when pre to post interventions means were compared within the groups showing significant improvement in post SPADI and lateral scapular slide test. Conclusion: It is concluded that Scapula stabilization exercise protocol found to be effective in Scapular type-2 Dyskinesia.

  6. Effect of scapular external rotation on the axillary nerve during the arthroscopic Latarjet procedure: an anatomical investigation.

    Science.gov (United States)

    Reinares, Felipe; Werthel, Jean-David; Moraiti, Constantina; Valenti, Philippe

    2017-10-01

    The first purpose of this study is to measure the distance between the axillary nerve and the exit point of K-wires placed retrograde through the glenoid in the setting of an arthroscopic Latarjet procedure. The second objective is to evaluate whether manual external rotation of the scapula alters that distance. In seven fresh-frozen specimens, two 2.0-mm K-wires were drilled through the glenoid using an arthroscopic Latarjet retrograde glenoid guide. These were drilled into the glenoid at the 7- and 8-o'clock positions (right shoulders) and at the 4- and 5-o'clock positions (left). K-wires were oriented parallel to the glenoid articular surface and perpendicular to the long superoinferior axis of the glenoid, 7 mm medial to the joint surface. Two independent evaluators measured the distances between the axillary nerve and the exit point of the K-wires in the horizontal plane (AKHS for the superior K-wire and AKHI for the inferior K-wire) and in the vertical plane (AKV). Measurements were taken with the scapula left free and were repeated with the scapula placed at 15° and 30° of external rotation. With the scapula left free, scapular external rotation was 34° ± 2.3°. In this position, the AKHS was 2.5 ± 1.6, 6.3 ± 1.2 mm at 15° of external rotation (ER) and 11.4 ± 1.4 mm at 30° ER. The AKHI distance was 0.37 ± 1.6, 3.4 ± 1.4 and 10.6 ± 2.1 mm, respectively, for the scapula left free, at 15° ER and 30° of ER. The AKV distances were, respectively, 0.12 ± 0.2, 4.9 ± 1.6 and 9.9 ± 1.7 mm. The increase in all distances was statistically significant (p < 0.001). Increasing scapular external rotation significantly increases the distance between the axillary nerve and the exit point of the K-wires, increasing the margin of safety during this procedure. Therefore, increased external rotation of the scapula could be an effective tool to decrease the risk of iatrogenic axillary nerve injury. Cadaveric study, Level V.

  7. 18F-NaF and 18F-FDG PET/CT in Gorham-Stout Disease.

    Science.gov (United States)

    Papadakis, Georgios Z; Millo, Corina; Bagci, Ulas; Blau, Jenny; Collins, Michael T

    2016-11-01

    Gorham-Stout disease (GSD) is an extremely rare skeletal disorder of unknown etiology characterized by benign proliferation of vascular or lymphatic channels, leading to progressive bone resorption. We report on a patient diagnosed with GSD affecting the right scapula and the right ribs, who underwent PET/CT scans using F-FDG and F-NaF. The remnant upper portion of the affected scapula did not show F-FDG uptake but demonstrated markedly increased F-NaF activity. Furthermore, intense F-NaF activity was seen on the right posterior ribs, which were actively being resorbed, suggesting the potential application of F-NaF-PET/CT imaging in GSD diagnosis and follow-up.

  8. 18F-NaF and 18F-FDG PET/CT in Gorham-Stout disease

    Science.gov (United States)

    Papadakis, Georgios Z.; Millo, Corina; Bagci, Ulas; Blau, Jenny; Collins, Michael T.

    2016-01-01

    Gorham-Stout disease (GSD) is an extremely rare skeletal disorder of unknown etiology characterized by benign proliferation of vascular or lymphatic channels, leading to progressive bone resorption. We report on a patient diagnosed with GSD affecting the right scapula and the right ribs, who underwent PET/CT scans using 18F-FDG and 18F-NaF. The remnant upper portion of the affected scapula did not show 18F-FDG uptake, but demonstrated markedly increased 18F-NaF activity. Furthermore, intense 18F-NaF activity was seen on the right posterior ribs which were actively being resorbed, suggesting the potential application of 18F-NaF-PET/CT imaging in GSD diagnosis and follow-up. PMID:27648707

  9. A Giant Scapular Aneurysmal Bone Cyst in a Child

    Directory of Open Access Journals (Sweden)

    Theodoros Beslikas

    2012-01-01

    Full Text Available Aneurysmal bone cysts (ABCs are rare benign bone tumours. Scapula is a very rare location, and the relative literature is sparse. The purpose of this study is to present a case of a giant aggressive scapular aneurysmal bone cyst in a child. A 7-year-old boy presented to our hospital with pain and a palpated mass on the right scapula. Imaging studies (radiographs computed tomography scintigraphy were indicative of aneurysmal bone cyst. We performed curettage and bone grafting after the diagnosis was set by pathological examination through a posterior shoulder approach. Five years later, the patient has only residual signs of the lesion on radiographic control without signs of recurrence.

  10. A Giant Scapular Aneurysmal Bone Cyst in a Child

    Science.gov (United States)

    Beslikas, Theodoros; Chytas, Anastasios; Christodoulou, Andreas; Gigis, Ioannis; Christoforidis, Ioannis

    2012-01-01

    Aneurysmal bone cysts (ABCs) are rare benign bone tumours. Scapula is a very rare location, and the relative literature is sparse. The purpose of this study is to present a case of a giant aggressive scapular aneurysmal bone cyst in a child. A 7-year-old boy presented to our hospital with pain and a palpated mass on the right scapula. Imaging studies (radiographs computed tomography scintigraphy) were indicative of aneurysmal bone cyst. We performed curettage and bone grafting after the diagnosis was set by pathological examination through a posterior shoulder approach. Five years later, the patient has only residual signs of the lesion on radiographic control without signs of recurrence. PMID:23259119

  11. Tumoral calcinosis in a dog with chronic renal failure : clinical communication

    Directory of Open Access Journals (Sweden)

    T.C. Spotswood

    2003-06-01

    Full Text Available A 2-year-old male German shepherd dog in poor bodily condition was evaluated for thoracic limb lameness due to a large, firm mass medial to the left cranial scapula. Radiography revealed several large cauliflower-like mineralized masses in the craniomedial left scapula musculature, pectoral region and bilaterally in the biceps tendon sheaths. Urinalysis, haematology and serum biochemistry showed that the dog was severely anaemic, hyperphosphataemic and in chronic renal failure. The dog was euthanased and a full post mortem performed. A diagnosis of chronic renal failure with secondary hyperparathyroidism was confirmed. The mineralized masses were grossly and histopathologically consistent with a diagnosis of tumoral calcinosis. Tumoral calcinosis associated with chronic renal failure that does not involve the foot pads is rarely seen.

  12. Effect of exams period on prevalence of Myofascial Trigger points and head posture in undergraduate students: Repeated measurements study.

    Science.gov (United States)

    Kalichman, Leonid; Bulanov, Natalie; Friedman, Aryeh

    2017-01-01

    Myofascial Trigger points (MTrPs) may be caused or aggravated by many factors, such as mental stress associated with exams and impaired posture. To compare the prevalence and sensitivity of MTrPs, and forward head position (FHP) during exam period vs. mid-semester among physical therapy students. 39 physical therapy students were palpated for MTrPs in neck and shoulder muscles and were photographed laterally for FHP measurement during the academic semester and during the academic examination period. The subjects showed higher prevalence of active MTrPs in the right Trapezius and Levator Scapula muscles, and higher prevalence of latent MTrPs in the left Sternocleidomastoideus and Levator Scapula muscles during exams, as well as a higher rate of tenderness in suboccipital musculature. Physical therapy students show greater prevalence of MTrPs during exams. The authors recommend implementing preventative programs towards the examination period. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. The Flail and Pulseless Upper Limb: an Extreme Case of Traumatic Scapulo-thoracic Dissociation

    Directory of Open Access Journals (Sweden)

    Maria SW

    2015-07-01

    Full Text Available Scapulo-thoracic dissociation is an infrequent injury resulting from high energy trauma which is often associated with severe neurological and vascular injuries which may be unrecognised at the time of presentation. A 24 year-old female presented with bilateral rib fractures, pneumothorax, liver and kidney injuries following a road traffic accident. She also sustained fractures of her right scapula, odontoid, right transverse processes of the thoracic and lumbar vertebrae and a closed fracture of her right femur. Her right upper limb was later noted to be flail and pulseless, due to complete right brachial plexus injury, scapula-thoracic dissociation and subclavian artery avulsion. We managed the upper limb injuries non-operatively, and focused on resuscitation of the patient. Early exploration of the complete brachial plexus injury was not undertaken in spite of the possible associated poor functional outcome as there was no life-threatening indication.

  14. [Pseudoarthrosis of acromion due to politraumatism. Treatment with autologus graffting intercalar of iliac crest].

    Science.gov (United States)

    Lumbreras, Ruth; Castro, Angel; Val, Sami; Palanca, Daniel; Bueno, Antonio L; Modrego, Francisco J

    2006-01-01

    The fractures of the scapula are not very frequent, an incidence around the 0,4 and 1% of the fractures that affect the upper limb. The acromion fracture means the 7% of the fractures that affect to the scapula. They usually appear in politraumatized patients with more serious lesions that can mask them and postpose this way their diagnosis and treatment. We present a clinical case of a 56 year-old patient with the antecedent of politraumatism that presented a clear atrophic pseudoartrosis of the acromion of their right shoulder with painful clinic and movement limitation. It was treated with surgery by intercalary bone grafting fixed by osteosynthesis plate obtaining good clinical and radiological results. Actually the painful clinic has disappeared completely.

  15.  Soft Tissue Swelling at the Subscapular Region

    Directory of Open Access Journals (Sweden)

    Masoud Al Kindi

    2012-03-01

    Full Text Available A 38-year-old female presented with a longstanding painless swelling overlying the scapula on the right side and has been gradually increasing in size with occasional episodes of pain radiating to the right arm. The clinical diagnosis was a soft tissue tumor. MRI was reported as suggestive of irregular fibro-fatty tissue with muscular infiltration and inflammation. Fine needle aspiration (FNA retrieved a paucicellular aspirate with a few clusters of adipocytes. The diagnosis was a lipomatous lesion and excision was advised for histopathological examination. The intraoperative findings showed the tumor located deep into the rhomboids and latissimus dorsi and extending deep into the right scapula. The excised specimen was sent for histopathological examination. 

  16. Subacromial osteochondroma: A rare cause of impingement syndrome

    OpenAIRE

    Çıtlak, Atilla; Akgün, Ulaş; Bulut, Tugrul; Aslan, Cihan; Mete, Berna Dirim; Şener, Muhittin

    2014-01-01

    Introduction Subacromial impingement syndrome is one of the most common disorders of shoulder. Scapula is a very rare site for osteochondromas, and osteochondromas arising under the acromion cause impingement syndrome. Presentation of case We presented 34-year old female patient with subacromial impingement syndrome secondary to osteochondroma. She had received conservative treatment several times in other clinics. The osteochondroma causing impingement was not diagnosed. Physical examination...

  17. FORWARD HEAD POSTURE CORRECTION VERSUS SHOULDER STABILIZATION EXERCISES EFFECT ON SCAPULAR DYSKINESIA AND SHOULDER PROPRIOCEPTION IN ATHLETES AN EXPERIMENTAL STUDY

    OpenAIRE

    Deepmala Thakur; Basavraj Motimath; Raghavendra M

    2016-01-01

    Background: Forward head posture (FHP), the most common deviation from the normal curvature in cervical spine. Craniocervical flexor muscle strengthening is frequently used treatment for FHP. Scapular dykinesia (SD) is the alteration in the normal static or dynamic motion of the scapula during coupled scapulohumeral movements. Shoulder stabilization exercises are an effective treatment for SD. As both FHP and SD are related to each other, the objective of the study was to find and compare the...

  18. AcEST: DK952596 [AcEST

    Lifescience Database Archive (English)

    Full Text Available |Q4PM04|RL18_IXOSC 60S ribosomal protein L18 OS=Ixodes scapula... 160 4e-39 sp|Q4GXG7|RL18_TIMBA 60S ribosomal protein L18 OS=Timarch...ribosomal protein L18 OS=Timarcha balearica GN=RpL18 PE=2 SV=1 Length = 188 Score = 153 bits (386), Expect =

  19. Three-dimensional kinematic analysis of the pectoral girdle during upside-down locomotion of two-toed sloths (Choloepus didactylus, Linné 1758

    Directory of Open Access Journals (Sweden)

    Nyakatura John A

    2010-07-01

    Full Text Available Abstract Background Theria (marsupials and placental mammals are characterized by a highly mobile pectoral girdle in which the scapula has been shown to be an important propulsive element during locomotion. Shoulder function and kinematics are highly conservative during locomotion within quadrupedal therian mammals. In order to gain insight into the functional morphology and evolution of the pectoral girdle of the two-toed sloth we here analyze the anatomy and the three-dimensional (3D pattern of shoulder kinematics during quadrupedal suspensory ('upside-down' locomotion. Methods We use scientific rotoscoping, a new, non-invasive, markerless approach for x-ray reconstruction of moving morphology (XROMM, to quantify in vivo the 3D movements of all constituent skeletal elements of the shoulder girdle. Additionally we use histologic staining to analyze the configuration of the sterno-clavicular articulation (SCA. Results Despite the inverse orientation of the body towards gravity, sloths display a 3D kinematic pattern and an orientation of the scapula relative to the thorax similar to pronograde claviculate mammalian species that differs from that of aclaviculate as well as brachiating mammals. Reduction of the relative length of the scapula alters its displacing effect on limb excursions. The configuration of the SCA maximizes mobility at this joint and demonstrates a tensile loading regime between thorax and limbs. Conclusions The morphological characteristics of the scapula and the SCA allow maximal mobility of the forelimb to facilitate effective locomotion within a discontinuous habitat. These evolutionary changes associated with the adoption of the suspensory posture emphasized humeral influence on forelimb motion, but allowed the retention of the plesiomorphic 3D kinematic pattern.

  20. Çocuk skapula cisim kırığı (Parsiyel skapulotorasik dissosiasyon) (Bir olgu sunumu)

    OpenAIRE

    Tezer, Mehmet; Kabukcuoglu, Yavuz; Kockesen, T. Caglar; Ordueri, Mehmet; Kuzgun, Unal

    2004-01-01

    Scapular fractures are rarely seen lesions and they are even rarely seen in children. Scapular fractures generally result from direct trauma. In the presence of scapular fractures pathologies involving other systems must be carefully looked for and mechanism of trauma must be meticiously assessed. In this study we present a greenstick type scapular body fracture with displacement and 90 degrees of angulation of lower pole of scapula from thoracic wall which we treated conservatively in a 7 ye...

  1. Development of forelimb bones in indigenous sheep fetuses

    OpenAIRE

    N. S. Ahmed

    2008-01-01

    The study included detection of the sites of ossification centers and their sequence of appearance in the forelimb bones of indigenous sheep fetuses by using double staining method with younger specimens and radiography or maceration methods with old specimens, as well as, histological study with some ages. The results showed that the primary ossification centers of the forelimb in indigenous sheep fetuses appeared firstly in the diaphyses of radius and ulna, humerus, scapula, metacarpus, pha...

  2. Muscle Energy Technique and Static Stretching for Treatment of Mechanical Neck Pain 16 July 2012 International Journal of Health and Rehabilitation Sciences Volume 1 Number 1 O RIGINAL R ESEARCH Comparative Effectiveness of Muscle Energy Technique and Static Stretching for Treatment of Subacute Mechanical N eck Pain

    OpenAIRE

    Richa Mahajan; Chitra Kataria; Kshitija Bansal,

    2012-01-01

    Background: Neck pain is a common problem within our society. Upper trapezius and the levator scapulae are the most common postural muscles that tends to get shorten leading to restricted neck mobility. If these group of muscles are treated it may provide with best results. There is lack of evidence to allow conclusions to be drawn about the effectiveness of Muscle energy technique (MET) when compared with stretching exercises for relieving mechanical nec...

  3. Cervical Spinal Injury from Repeated Exposures to Sustained Acceleration.

    Science.gov (United States)

    1999-02-01

    load (51). Also, with arm movements the upper trapezius and the levator scapulae become involved and resist neck movement, thus directly and...proper diet and weight control; 2. Regular strength and aerobic training with stretching and functional respiration training; 3. Massage, sauna and...physical warm-up including stretching neck muscles immediately before taking off while the pilot is in the cockpit. 39 CHAPTER 10 CERVICAL INJURY AND

  4. EFFICACY OF POST ISOMETRIC RELAXATION VERSUS STATIC STRECHING IN SUBJECTS WITH CHRONIC NON SPECIFIC NECK PAIN

    OpenAIRE

    P Haritha; Shanthi, C; Madhavi, K.

    2015-01-01

    Background: Neck pain is a common problem within our society. Upper trapezius sternocleidomastoid and the levator scapulae are the most common postural muscles that tends to get shorten leading to restricted neck mobility. There is lack of evidence to allow conclusions to be drawn about the effectiveness of post isometric relaxation when compared with static stretching exercises. The aim is to find out the effectiveness of Post isometric relaxation Versus Static stretching in the subjects wit...

  5. Computer Aided Multi-Data Fusion Dismount Modeling

    Science.gov (United States)

    2012-03-22

    based methods is that they ignore homology. A famous example of this problem is that it mistakes a scapula for a potato chip [24]. Such a comparison...appearance (shape, structure, color , pattern). The analysis of the dismount shape aims to extract features such as body landmarks, skeletal structure...Common standard color cameras take images at three different wavelengths of light, corresponding to red, green and blue (RGB). The visible region of the

  6. Spontaneous Fibrosarcoma in a Djungarian Hamster (Phodopus sungorus)

    OpenAIRE

    Kondo, Hirotaka; ONUMA, Mamoru; Ito, Hidetoshi; Shibuya, Hisashi; Sato, Tsuneo

    2008-01-01

    A 1.5-y-old female Djungarian hamster (Phodopus sungorus) presented with a large subcutaneous mass surrounding the right shoulder. Radiography revealed dislocation of the right humeral articulation and osteolytic lesions of the right scapula. Histologically, the mass was composed of spindle to stellate cells arranged in fascicles interwoven with delicate collagen fibers, and neoplastic cells infiltrated the bone, skeletal muscle, and subcutaneous tissues. Neoplastic cells stained intensely po...

  7. A Literature Review of Musculoskeletal Injuries to the Human Neck and the Effects of Head-Supported Mass Worn by Soldier

    Science.gov (United States)

    2005-10-01

    hypothesis is that this caused a stretching of posterior neck muscles and ligaments, which may be linked to sub-occipital pain. Then, as the head response...neck (splenius capitus and trapezius ) showed bursts of activity synchronized with head and neck flexion. The anterior muscles of the neck showed...The outer-most muscles, the levator scapulae, sternocleidomastoid, and trapezius muscles responded between 73 ms and 83 ms (measured from sled

  8. Malawer limb salvage surgery for the treatment of scapular chondrosarcoma.

    Science.gov (United States)

    Chang, Fei; Liu, Guang-Yao; Zhang, Qiao; Lin, Gang; Huang, Hong; Duan, De-Sheng; Wang, Jin-Cheng

    2014-06-30

    Chondrosarcoma is a common malignant bone tumor, which accounts for 20% of all malignant bone tumors. It often occurs in the long bones, but the incidence of scapular chondrosarcoma is rare. Here, we describe a case of a large chondrosarcoma occurring in the scapula which was treated with Malawer limb salvage surgery. The patient retained considerable limb function after complete removal of the tumor tissue as assessed at the follow-up visit two years and ten months following surgery.

  9. Fatal Overdose due to Confusion of an Transdermal Fentanyl Delivery System

    OpenAIRE

    Ingo Voigt

    2013-01-01

    Background. The use of transdermal fentanyl systems has increased over recent years, especially in patients with chronic pain. Large misuse potential and fatal outcomes have been described. Case Presentation. A 58-year-old patient presenting with clinical signs of opioid poisoning (hypoventilation, bradycardia, hypotension, and miosis) was admitted to our ICU. The first body check revealed a 75 mcg per hour fentanyl patch at the patient's right scapula. Some months ago, patient's aunt died af...

  10. A Trial of the Ponderax Skinfold Caliper*

    African Journals Online (AJOL)

    laterally, at an angle of about 30· to vertical from the inferior angle of the scapula: In young women the sites of choice are triceps and supra-iliac, the latter being a vertical fold in the midaxillary line just .... Sloan, A. W. (1967): Ibid., 23. 311. . 4. Sloan, A. W., Burt, 1. J. and Blyth, C. S. (1962): Ibld., 17, 967. 5. Davidson, A. and.

  11. Three-dimensional kinematic analysis of the pectoral girdle during upside-down locomotion of two-toed sloths (Choloepus didactylus, Linné 1758)

    Science.gov (United States)

    2010-01-01

    Background Theria (marsupials and placental mammals) are characterized by a highly mobile pectoral girdle in which the scapula has been shown to be an important propulsive element during locomotion. Shoulder function and kinematics are highly conservative during locomotion within quadrupedal therian mammals. In order to gain insight into the functional morphology and evolution of the pectoral girdle of the two-toed sloth we here analyze the anatomy and the three-dimensional (3D) pattern of shoulder kinematics during quadrupedal suspensory ('upside-down') locomotion. Methods We use scientific rotoscoping, a new, non-invasive, markerless approach for x-ray reconstruction of moving morphology (XROMM), to quantify in vivo the 3D movements of all constituent skeletal elements of the shoulder girdle. Additionally we use histologic staining to analyze the configuration of the sterno-clavicular articulation (SCA). Results Despite the inverse orientation of the body towards gravity, sloths display a 3D kinematic pattern and an orientation of the scapula relative to the thorax similar to pronograde claviculate mammalian species that differs from that of aclaviculate as well as brachiating mammals. Reduction of the relative length of the scapula alters its displacing effect on limb excursions. The configuration of the SCA maximizes mobility at this joint and demonstrates a tensile loading regime between thorax and limbs. Conclusions The morphological characteristics of the scapula and the SCA allow maximal mobility of the forelimb to facilitate effective locomotion within a discontinuous habitat. These evolutionary changes associated with the adoption of the suspensory posture emphasized humeral influence on forelimb motion, but allowed the retention of the plesiomorphic 3D kinematic pattern. PMID:20619000

  12. Combat Injury Coding: A Review and Reconfiguration

    Science.gov (United States)

    2013-01-01

    the clavicle, scapula, and pelvic girdle were grouped with the torso where they are anatomically located rather than in the upper and lower extremities...follows: 1. Head and neck: injuries to the head, face, and neck 2. Torso: injuries to the chest and abdomen, including the pel- vic girdle and...parasymphysis, or mandible avulsion) Open wound with loss of e10% muscle mass of trunk, buttocks, or pelvic girdle Amputation or crush hands, bilateral Open

  13. Arthroscopic arthrodesis of the shoulder: Fourteen-year follow-up

    OpenAIRE

    Antonio Jiménez-Martín; Santiago Pérez-Hidalgo

    2011-01-01

    Shoulder arthrodesis is indicated in infections, brachial paralysis, irreparable rotator cuff tears, osteoarthritis without indication of prosthesis, rescue after arthroplasty, or after surgery for cancer. Arthroscopic arthrodesis is exceptional. Our aim is presenting our result after 14 years of follow-up of one patient. We present a case report of a 17-year-old male patient. He suffered fracture of left scapula (type V, Ideberg), fracture of left clavicle (type I, Craig), and fracture of le...

  14. Thoracic limb morphology of the red panda (Ailurus fulgens) evidenced by osteology and radiography

    OpenAIRE

    Modesta Makungu; Hermanus B. Groenewald; Wencke M. du Plessis; Michelle Barrows; Katja N. Koeppel

    2015-01-01

    The red panda (Ailurus fulgens) is distributed primarily in the Himalayas and southern China. It is classified as a vulnerable species by the International Union for Conservation of Nature. The aim of this study was to describe the normal osteology and radiographic anatomy of the thoracic limb of the red panda. Radiography of the right thoracic limb was performed in seven captive adult red pandas. Radiographic findings were correlated with bone specimens from three adult animals. The scapula ...

  15. Unusual exercise-related stress fractures. Two case reports

    Energy Technology Data Exchange (ETDEWEB)

    Fink-Bennett, D.M.; Benson, M.T.

    1984-08-01

    We describe two unusual exercise-related stress fractures, one in the sacroiliac joint of a long distance runner, the other in the body of the scapulae of an above-knee amputee. Each were detected on a 2-hour delay bone scan. To our knowledge, neither have been described scintigraphically. The bilateral scapular fracture is an unreported entity, and the fractured SI joint is a very uncommon site for an overuse injury.

  16. Elastofibrome dorsal: étude rétrospective de 21 cas et revue de ...

    African Journals Online (AJOL)

    L'élastofibrome est une tumeur bénigne du tissu mou survient essentiellement chez les personnes âgées de plus de 55 ans avec une prédominance féminine. Il survient électivement à l'angle caudal de la scapula (99%). Il est bilatéral dans 10% à 66% des cas. L'etiopathogenie de l'EF reste encore non élucidée.

  17. Kinematic analysis of the shoulder complex after anatomic and reverse total shoulder arthroplasty: A cross-sectional study.

    Science.gov (United States)

    Roren, Alexandra; Nguyen, Christelle; Palazzo, Clémence; Fayad, Fouad; Revel, Michel; Gregory, Thomas; Poiraudeau, Serge; Roby-Brami, Agnès; Lefèvre-Colau, Marie-Martine

    2017-06-01

    The movement of the arm relative to the trunk results from coordinated 3D glenohumeral and scapulothoracic movements. Changes in scapula kinematics may occur after total shoulder arthroplasty and could affect clinical and functional outcomes. To assess the 3D movement of the scapula during arm elevation after anatomic and reverse total shoulder arthroplasty. This was a single-centre, non-randomized, controlled cross-sectional study. Patients with anatomic (n = 14) and reverse total shoulder arthroplasty (n = 9) were prospectively enrolled and were compared to age-matched asymptomatic controls (n = 23). 3D scapular kinematics were assessed by a non-invasive, electromagnetic method during arm abduction and flexion. 3D scapular rotations and 3D linear displacements of the barycentre (geometrical centre) at rest and at 30°, 60° and 90° arm elevation; as well as scapulohumeral rhythm were analysed. Participant groups were compared using one-way ANOVA and Bonferroni post-hoc testing for normally distributed data, and Mann-Whitney U test for non-normally distributed data. Total range of scapular lateral rotation and barycentre displacement were increased, and scapulohumeral rhythm was reduced, in patients with anatomic and reverse total shoulder arthroplasty compared with age-matched controls; however, the global scapular kinematic pattern was preserved. For patients after total shoulder arthroplasty, the increased contribution of the scapula to arm elevation is consistent with a compensatory mechanism for the reduced glenohumeral mobility. The stability of the global scapula kinematic pattern reflects its mechanical and neuromotor strength. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. Kinematics of the contralateral and ipsilateral shoulder: A possible relationship with post-stroke shoulder pain

    OpenAIRE

    Niessen, M.H.M.; Janssen, T.W.J.; Meskers, C.G.M.; Koppe, P.; Konijnenbelt, M.; Veeger, H.E.J.

    2008-01-01

    Objective: Post-stroke shoulder pain is a common phenomenon in hemiplegia and impedes rehabilitation. The aim of this study was to identify a possible relationship between post-stroke shoulder pain, scapula resting position and shoulder motion. Methods: Shoulder kinematics of 27 patients after stroke (17 men) were compared with 10 healthy age-matched control subjects. Using an electromagnetic tracking device, the kinematics of both the contralateral and ipsilateral (i.e. paretic and non-paret...

  19. Shang Oracle Bones

    Science.gov (United States)

    Pankenier, David W.

    Astronomical observations first appear in China's archaeological record on turtle plastrons and ox scapulae from the reigns of the last few kings of the Shang Dynasty (1250-1046 BCE). A variety of meteorological and astronomical phenomena were divined about and recorded by scribes in formulaic language that is recognizably archaic Chinese. The oracle bone inscriptions record sacrifices to celestial bodies and the proper ritual response to anomalous phenomena like eclipses.

  20. Réflexion sur le processus coracoïde des hominoïdes et des atèles ; application à quelques hominidés fossilesRemark on the coracoid process of hominoids and spider monkeys, application to some hominid fossils

    Science.gov (United States)

    Voisin, Jean-Luc

    2001-02-01

    The orientation of the coracoid process, in relation to the scapula, is different in man on one hand and other hominoids ( Pan, Gorilla, Pongo, Hylobates), spider and colobus monkeys on the other hand. On the contrary, the orientation of the coracoid process is similar in all hominoids and spider monkeys when it is taken in relation to the axial skeleton. Morphology of the coracoid process reveals the pattern of arm movements and some differences between modern human, Neandertal man and Homoergaster.

  1. Anthropological analysis of projectile trauma to the bony regions of the trunk

    Directory of Open Access Journals (Sweden)

    Humphrey Caitlin

    2017-06-01

    Full Text Available Ballistics literature often focuses on soft tissue injures and projectile trauma to the cranium. Minimal details on the bony characteristics of projectile trauma to the thorax/abdomen regions have been published. This study aims to analyse projectile trauma to the bony trunk region including the ribs, vertebrae, scapula, sternum and the hip bone to form a better understanding of the characteristics and biomechanics of skeletal trauma caused by a projectile and contribute to the existing database on skeletal trauma caused by projectiles. Fourteen cases of documented projectile trauma to the bony regions of the trunk from the Hamman-Todd Human Osteological Collection at the Cleveland Natural History Museum, Ohio were analysed. Of the 14 individuals with gunshot wounds examined, 40 wounds occurred to the bones. Twenty- four injuries to the ribs, 1 ilium, 11 vertebrae, 3 scapulae, and 1 sternum. Fracture patterns, heaving and bevelling can be used to determine the direction of travel of the projectile which can be evident on the ribs, sternum, scapula and ilium. It is critical to understand the wounding patterns associated with projectile trauma to the torso region as this is often targeted, due to being the centre of mass.

  2. Three-dimensional inverse dynamics of the forelimb of Beagles at a walk and trot.

    Science.gov (United States)

    Andrada, Emanuel; Reinhardt, Lars; Lucas, Karin; Fischer, Martin S

    2017-07-01

    OBJECTIVE To perform 3-D inverse dynamics analysis of the entire forelimb of healthy dogs during a walk and trot. ANIMALS 5 healthy adult Beagles. PROCEDURES The left forelimb of each dog was instrumented with 19 anatomic markers. X-ray fluoroscopy was used to optimize marker positions and perform scientific rotoscoping for 1 dog. Inverse dynamics were computed for each dog during a walk and trot on the basis of data obtained from an infrared motion-capture system and instrumented quad-band treadmill. Morphometric data were obtained from a virtual reconstruction of the left forelimb generated from a CT scan of the same dog that underwent scientific rotoscoping. RESULTS Segmental angles, torque, and power patterns were described for the scapula, humerus, ulna, and carpus segments in body frame. For the scapula and humerus, the kinematics and dynamics determined from fluoroscopy-based data varied substantially from those determined from the marker-based data. The dominant action of scapular rotation for forelimb kinematics was confirmed. Directional changes in the torque and power patterns for each segment were fairly consistent between the 2 gaits, but the amplitude of those changes was often greater at a trot than at a walk. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that control of the forelimb joints of dogs is similar for both a walk and trot. Rotation of the forelimb around its longitudinal axis and motion of the scapula should be reconsidered in the evaluation of musculoskeletal diseases, especially before and after treatment or rehabilitation.

  3. Scapular asymmetry in participants with and without shoulder impingement syndrome; a three-dimensional motion analysis.

    Science.gov (United States)

    Turgut, Elif; Duzgun, Irem; Baltaci, Gul

    2016-11-01

    This study analyzed the dynamic three-dimensional scapular kinematics and scapular asymmetry in participants with and without shoulder impingement syndrome. Twenty-nine participants with shoulder impingement syndrome, have been suffering from unilateral shoulder pain at the dominant arm lasting more than six weeks and thirty-seven healthy controls participated in the study. Scapular kinematics was measured with an electromagnetic tracking device during shoulder elevation in the sagittal plane. Data for bilateral scapular orientation were analyzed at 30°, 60°, 90°, and 120° of humerothoracic elevation and lowering. The symmetry angle was calculated to quantify scapular asymmetry throughout shoulder elevation. Statistical comparisons indicated that the scapula was more downwardly rotated (pshoulder impingement syndrome compared to healthy controls. Side-to-side comparisons revealed that the scapula was more anteriorly tilted on the involved side of participants with shoulder impingement syndrome (p=0.01), and the scapula was rotated more internally (p=0.02) and downwardly (p=0.01) on the dominant side of healthy controls. Although there were side-to-side differences in both groups, symmetry angle calculation revealed that the scapular movement was more asymmetrical for scapular internal and upward rotation in individuals with shoulder impingement syndrome when compared with healthy controls (pshoulder assessment and rehabilitation. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. Determination of a new computed tomography method for measuring the glenoid version and comparing with a reference method. Radio-anatomical and retrospective study.

    Science.gov (United States)

    Andrin, Julien; Macaron, Charbel; Pottecher, Pierre; Martz, Pierre; Baulot, Emmanuel; Trouilloud, Pierre; Viard, Brice

    2016-03-01

    In the literature, there are several techniques for measuring the glenoidal version of the scapula. The superiority of the scannographic measurement over the standard radiologic measures seems evident. The main problems are the evaluation and the reproducibility of these methods, which are dependent on the quality of the CT scan and the orientation of its sections. We pinpoint a simple method of the "scapular triangle", the reliability of which deserves special consideration. The aim of this study is to report a simple and reproducible computed tomography method to measure the glenoidal version. Thrity-one shoulder CT scans, performed on patients attending the emergency department of the University Hospital of Dijon between January 2012 and April 2013 for shoulder trauma, were evaluated retrospectively. The CT scan must include the entire body of scapula to allow measurements to be made with both methods: the conventional method of Friedman and our new method of the "scapular triangle". Two independent operators performed inter-observer and intra-observer reproducibility. We compared both techniques with Pearson's test. Pearson's test showed a trend line according to a linear correlation between the two methods with a p value of 7.791(-10) and a correlation coefficient of 0.85 with the 95% confidence interval (0.7213; 0.929). The method of the "scapular triangle" is easily applicable on most sections of the CT scan of scapula whether or not it takes the whole body. It is more reliable and reproducible and could be used by any radiologist.

  5. Infraspinatus strength assessment before and after scapular muscles rehabilitation in professional volleyball players with scapular dyskinesis.

    Science.gov (United States)

    Merolla, Giovanni; De Santis, Elisa; Sperling, John W; Campi, Fabrizio; Paladini, Paolo; Porcellini, Giuseppe

    2010-12-01

    This study tested the hypothesis that infraspinatus strength in professional volleyball players can be assessed with the scapula free (infraspinatus strength test, IST) and with the scapula retracted (infraspinatus scapula retraction test, ISRT) before and after scapular musculature training. A prospective study was performed in 31 professional volleyball players. Isometric strength (kg) of the infraspinatus with IST and with ISRT was recorded by a handheld dynamometer and compared with the values found after 3 and 6 months of rehabilitation. Magnetic resonance imaging was performed to exclude articular and cuff pathology. Pain scores were assessed using a visual analog scale. The mean increase in the force values of IST was statistically significant after 3 months (P biomechanic effect of scapular dyskinesis results in specific infraspinatus dysfunction that arise with the ISRT. ISRT is practical and consistent to assess the infraspinatus strength in overhead athletes with scapular dyskinesis. A functional rehabilitation protocol, designed to restore scapular muscles balance and shoulder mobility, is essential in the training program to prevent shoulder dysfunction and improve sports performance. Copyright © 2010 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

  6. [Neuromuscular dynamic scapular winging: Clinical, electromyographic and magnetic resonance imaging diagnosis].

    Science.gov (United States)

    Nguyen, Christelle; Guérini, Henri; Roren, Alexandra; Zauderer, Jennifer; Vuillemin, Valérie; Seror, Paul; Ouaknine, Michaël; Palazzo, Clémence; Bourdet, Christopher; Pluot, Étienne; Roby-Brami, Agnès; Drapé, Jean-Luc; Rannou, François; Poiraudeau, Serge; Lefèvre-Colau, Marie-Martine

    2015-12-01

    Dyskinesia of the scapula is a clinical diagnosis and includes all disorders affecting scapula positioning and movement whatever its etiology. Scapular winging is a subtype of scapular dyskinesia due to a dynamic prominence of the medial border of the scapula (DSW) secondary to neuromuscular imbalance in the scapulothoracic stabilizer muscles. The two most common causes of DSW are microtraumatic or idiopathic lesions of the long thoracic nerve (that innerves the serratus anterior) or the accessory nerve (that innerves the trapezius). Diagnosis of DSW is clinical and electromyographic. Use of magnetic resonance imaging (MRI) could be of interest to distinguish lesion secondary to a long thoracic nerve from accessory nerve and to rule out scapular dyskinesia related to other shoulder disorders. Causal neuromuscular lesion diagnosis in DSW is challenging. Clinical examinations, combined with scapular MRI, could help to their specific diagnosis, determining their stage, ruling out differential diagnosis and thus give raise to more targeted treatment. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  7. Sex determination using discriminant analysis of upper and lower extremity bones: New approach using the volume and surface area of digital model.

    Science.gov (United States)

    Lee, U-Young; Kim, In-Beom; Kwak, Dai-Soon

    2015-08-01

    This study used 110 CT images taken from donated Korean cadavers to create 3-D models of the following upper and lower limb bones: the clavicle, scapula, humerus, radius, ulna, hip bone (os coxa), femur, patella (knee cap), tibia, talus, and calcaneus. In addition, the bone volume and surface area were calculated to determine sex differences using discriminant analysis. Significant sex differences were found in all bones with respect to volume and surface area (phip bone>tibia>humerus>scapula), although the order of surface area was different. The largest surface area in men was the femur and in women was the hip bone (pdiscriminant equation of surface area; female<0scapula+0.045×humerus+(-0.049)×radius+0.093×ulna+(-0.023)×hip bone+0.091×patella+(-0.052)×fibula+0.043×talus-11.548. These results show that bone volume and surface area of extremity bones can be used for sex determination. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  8. Treatment of a brachial plexus injury using kinesiotape and exercise.

    Science.gov (United States)

    Walsh, Sharon Fleming

    2010-10-01

    This describes a child whose neonatal brachial plexus injury was treated with kinesiotape and exercise. The subject was a two-year-old female whose X-rays demonstrated severe inferior subluxation of the humeral head and winging of the scapula on the left. She was fitted with a shoulder brace with surgery scheduled in six months. The initial PT exam noted 80 degrees of shoulder abduction (trumpet sign), significant asymmetry, and nonuse. Mallet score was 15/25. Treatment consisted of d/c of the brace and E-stimulation, parent education on exercise and taping, and kinesiotape to facilitate rotator cuff and scapular stabilizers. Typical wear time was 2-3 days on, 1-2 days off. After 2 weeks, there was prominent deltoid definition. The shoulder was in 20 degrees of abduction, shoulders level with less scapular winging. Scapular stabilizers were then taped. At 4 weeks, her arm was held to her side displaying a stable symmetrical scapula. The arm displayed increased fine motor use and initiation of activities. At 10 weeks there was a forced d/c, and a decline toward baseline levels. After 2 weeks of reinstatement, function returned to prior level. At 20 weeks (12 total visits) she displayed full ROM, symmetrical shoulders, Mallet score of 20/25, rare trumpet sign, and was hanging by arms during play. X-rays displayed significant improvement in humeral head position, rib cage rotation, angle of scapula and clavicle, and size and mineralization of humerus. Reconstructive surgery was cancelled. Kinesiotape and parent education made a significant difference in this child's function.

  9. Prevalence and anatomical location of muscle tenderness in adults with nonspecific neck/shoulder pain.

    Science.gov (United States)

    Andersen, Lars L; Hansen, Klaus; Mortensen, Ole S; Zebis, Mette K

    2011-07-22

    Many adults experience bothersome neck/shoulder pain. While research and treatment strategies often focus on the upper trapezius, other neck/shoulder muscles may be affected as well. The aim of the present study is to evaluate the prevalence and anatomical location of muscle tenderness in adults with nonspecific neck/shoulder pain. Clinical neck/shoulder examination at two large office workplaces in Copenhagen, Denmark. 174 women and 24 men (aged 25-65 years) with nonspecific neck/shoulder pain for a duration of at least 30 days during the previous year and a pain intensity of at least 2 on a modified VAS-scale of 0-10 participated. Exclusion criteria were traumatic injuries or other serious chronic disease. Using a standardized finger pressure of 2 kg, palpable tenderness were performed of eight anatomical neck/shoulder locations in the left and right side on a scale of 'no tenderness', 'some tenderness' and 'severe tenderness'. In women, the levator scapulae, neck extensors and infraspinatus showed the highest prevalence of severe tenderness (18-30%). In comparison, the prevalence of severe tenderness in the upper trapezius, occipital border and supraspinatus was 13-19%. Severe tenderness of the medial deltoid was least prevalent (0-1%). In men, the prevalence of severe tenderness in the levator scapulae was 13-21%, and ranged between 0-8% in the remainder of the examined anatomical locations. A high prevalence of tenderness exists in several anatomical locations of the neck/shoulder complex among adults with nonspecific neck/shoulder pain. Future research should focus on several neck/shoulder muscles, including the levator scapulae, neck extensors and infraspinatus, and not only the upper trapezius. ISRCTN60264809.

  10. Scapular Resting Position and Gleno-Humeral Movement Dysfunction in Asymptomatic Racquet Players: A Case-Control Study.

    Science.gov (United States)

    Shimpi, Apurv P; Bhakti, Shah; Roshni, Karnik; Rairikar, Savita A; Shyam, Ashok; Sancheti, Parag K

    2015-12-01

    Racquet sports, especially lawn tennis and badminton have been gaining popularity in Asian countries like India. With this increase in popularity, the injury rate in the sport has also increased. The study will help detect the presence of gleno-humeral movement dysfunction and scapular resting position abnormality in asymptomatic racquet players, thus providing basis for screening the players and allow the clinician to determine if the asymmetry is a normal adaptation in the player or an abnormal change associated with injury. 46 asymptomatic professional players were divided into a study group of 23 players (16 tennis and 7 badminton) and control group of 23 football players. Assessment of passive gleno-humeral range of motion and distance of spine and inferior angle of scapula from corresponding spinous process were measured bilaterally and between groups. There was statistically significant reduction in range of internal rotation (62.17 ± 8.09), extension (39.78 ± 4.12) and an increase in the external rotation (106.95 ± 7.49) of dominant compared to non-dominant arm of racquet players and a statistically significant decrease in internal rotation (78.69 ± 10.24), extension (44.78 ± 3.19), adduction (37.39 ± 6.54) and an increase in external rotation (102.6 ± 5.19) of dominant arm of racquet players compared to football players. Study also showed statistically significant increase in the spino-scapular distance at the level of inferior angle of scapula (10.23 ± 1.43) on dominant side compared to non-dominant. The dominant side scapula of asymptomatic racquet players showed increased external rotation and elevation as compared to the non-dominant side. Also, reduced shoulder internal rotation, extension and adduction and gain in shoulder external rotation was observed on the dominant side of racquet players when compared to the control group.

  11. A novel cadaveric study of the morphometry of the serratus anterior muscle: one part, two parts, three parts, four?

    Science.gov (United States)

    Webb, Alexandra Louise; O'Sullivan, Elizabeth; Stokes, Maria; Mottram, Sarah

    2018-01-01

    The serratus anterior is portrayed as a homogeneous muscle in textbooks and during functional activities and rehabilitation exercises. It is unclear whether the serratus anterior is composed of subdivisions with distinctive morphology and functions. The purpose of this study was to determine whether the serratus anterior could be subdivided into different structural parts on the basis of its segmental architectural parameters. Eight formalin-embalmed serratus anterior muscles were dissected and the attachments of each fascicle documented. Orientation and size of each fascicle were measured and the physiological cross-sectional area (PCSA) calculated. Three subdivisions of the serratus anterior were identified. A new finding was the discovery of two distinctive fascicles attached to the superior and inferior aspects of rib 2. The rib 2 inferior fascicle had the largest PCSA (mean 1.6 cm 2 ) and attached, with the rib 3 fascicle, along the medial border of the scapula to form the middle division. The rib 2 superior and rib 1 fascicles attached to the superior angle of the scapula (upper division). Fascicles from ribs 4-8/9 attached to the inferior angle of the scapula (lower division). Mean fascicle angle relative to a vertical midline reference and PCSA for each division were 29° and 1.3 cm 2 (upper), 90° and 2.2 cm 2 (middle) and 59° and 3.0 cm 2 (lower). This novel study demonstrated the presence of morphologically distinct serratus anterior subdivisions. The results of this study will inform the development of optimal techniques for the assessment, treatment and rehabilitation of this architecturally complex muscle in shoulder and neck pain.

  12. Prevalence and anatomical location of muscle tenderness in adults with nonspecific neck/shoulder pain

    Science.gov (United States)

    2011-01-01

    Background Many adults experience bothersome neck/shoulder pain. While research and treatment strategies often focus on the upper trapezius, other neck/shoulder muscles may be affected as well. The aim of the present study is to evaluate the prevalence and anatomical location of muscle tenderness in adults with nonspecific neck/shoulder pain. Methods Clinical neck/shoulder examination at two large office workplaces in Copenhagen, Denmark. 174 women and 24 men (aged 25-65 years) with nonspecific neck/shoulder pain for a duration of at least 30 days during the previous year and a pain intensity of at least 2 on a modified VAS-scale of 0-10 participated. Exclusion criteria were traumatic injuries or other serious chronic disease. Using a standardized finger pressure of 2 kg, palpable tenderness were performed of eight anatomical neck/shoulder locations in the left and right side on a scale of 'no tenderness', 'some tenderness' and 'severe tenderness'. Results In women, the levator scapulae, neck extensors and infraspinatus showed the highest prevalence of severe tenderness (18-30%). In comparison, the prevalence of severe tenderness in the upper trapezius, occipital border and supraspinatus was 13-19%. Severe tenderness of the medial deltoid was least prevalent (0-1%). In men, the prevalence of severe tenderness in the levator scapulae was 13-21%, and ranged between 0-8% in the remainder of the examined anatomical locations. Conclusions A high prevalence of tenderness exists in several anatomical locations of the neck/shoulder complex among adults with nonspecific neck/shoulder pain. Future research should focus on several neck/shoulder muscles, including the levator scapulae, neck extensors and infraspinatus, and not only the upper trapezius. Trial Registration ISRCTN60264809 PMID:21777478

  13. EFFICACY OF POST ISOMETRIC RELAXATION VERSUS STATIC STRECHING IN SUBJECTS WITH CHRONIC NON SPECIFIC NECK PAIN

    Directory of Open Access Journals (Sweden)

    P.Haritha

    2015-12-01

    Full Text Available Background: Neck pain is a common problem within our society. Upper trapezius sternocleidomastoid and the levator scapulae are the most common postural muscles that tends to get shorten leading to restricted neck mobility. There is lack of evidence to allow conclusions to be drawn about the effectiveness of post isometric relaxation when compared with static stretching exercises. The aim is to find out the effectiveness of Post isometric relaxation Versus Static stretching in the subjects with chronic nonspecific neck pain. To evaluate the effectiveness of post isometric relaxation technique on pain by using Visual analoge scale, range of motion by using Universal Goniometry, and functional disability by using Neck Disability Index in chronic nonspecific neck pain. Methods: A convenient sample of thirty seven subjects was diagnosed with nonspecific neck pain was randomly allocated to one of the two treatment groups on the basis of the inclusion criteria. The experimental group (n=15 received three sessions of post isometric relaxation technique for trapezius, sternocleidomastoid and the levator scapulae and control group (n=15 received the three sessions of static stretching for trapezius, sternocliedomastiod and levator scapulae for four weeks. Results: Non parametric tests demonstrated a statistically significant difference with experimental group showing greater improvement in ROM, VAS, and NDI than the control group and significant difference within the group also. Conclusion: This study concluded and the results reflected that post isometric relaxation technique group had better improvement in reduction of pain, improvement in the range of motion, and increased neck functional activities than the static stretching group.

  14. Prevalence and anatomical location of muscle tenderness in adults with nonspecific neck/shoulder pain

    Directory of Open Access Journals (Sweden)

    Mortensen Ole S

    2011-07-01

    Full Text Available Abstract Background Many adults experience bothersome neck/shoulder pain. While research and treatment strategies often focus on the upper trapezius, other neck/shoulder muscles may be affected as well. The aim of the present study is to evaluate the prevalence and anatomical location of muscle tenderness in adults with nonspecific neck/shoulder pain. Methods Clinical neck/shoulder examination at two large office workplaces in Copenhagen, Denmark. 174 women and 24 men (aged 25-65 years with nonspecific neck/shoulder pain for a duration of at least 30 days during the previous year and a pain intensity of at least 2 on a modified VAS-scale of 0-10 participated. Exclusion criteria were traumatic injuries or other serious chronic disease. Using a standardized finger pressure of 2 kg, palpable tenderness were performed of eight anatomical neck/shoulder locations in the left and right side on a scale of 'no tenderness', 'some tenderness' and 'severe tenderness'. Results In women, the levator scapulae, neck extensors and infraspinatus showed the highest prevalence of severe tenderness (18-30%. In comparison, the prevalence of severe tenderness in the upper trapezius, occipital border and supraspinatus was 13-19%. Severe tenderness of the medial deltoid was least prevalent (0-1%. In men, the prevalence of severe tenderness in the levator scapulae was 13-21%, and ranged between 0-8% in the remainder of the examined anatomical locations. Conclusions A high prevalence of tenderness exists in several anatomical locations of the neck/shoulder complex among adults with nonspecific neck/shoulder pain. Future research should focus on several neck/shoulder muscles, including the levator scapulae, neck extensors and infraspinatus, and not only the upper trapezius. Trial Registration ISRCTN60264809

  15. ARTHROSCOPIC TECHNIQUE OF BONE AUTOGRAFTING OF GLENOID CAVITY DEFECTS IN PATIENTS WITH RECURRENT ANTERIOR INSTABILITY OF THE SHOULDER

    Directory of Open Access Journals (Sweden)

    S. Y. Dokolin

    2012-01-01

    Full Text Available Injuries of the bone anterior edge of the glenoid cavity of scapula is noted in 90% of patients with recurrent shoulder instability and it is the cause of recurrent dislocation in 67% of cases. The authors have presented a description of techniques and benefits of arthroscopic autoplasty (autografting of scapula glenoid. A total of 10 operations were performed in 9 men and 1 woman. The average age of operated patients was 27,1±4,7 years. All patients were injured during contact sports. In the preoperative and immediate postoperative period computer tomography of damaged shoulder was performed in all patients with reconstruction in 3D images. The size of the bone defect was evaluated by 3D scans and averaged 29.7%. During the first stage free bicortical grafts with varying sizes from the wing of the ilium were harvested. Preartroscopic stage permits to avoid swelling of paraarticular structures during arthroscopy and allows to correct positioning and fixation autografts in the joint. The arthroscopic signs of defect and the technique of immersing of previously prepared free fragment through a wide 10 mm cannula and subsequent minimally invasive fixation with cannulated screws in scapula neck were described. This operation is an alternative to the transposition of coracoid process, does not require special tools and a long operating time (average 60-80 min, excludes injuries of brachial plexus branches and surgical trauma of subscapularis muscle, does not disturb the normal anatomy of the shoulder joint. There were no neurological complications, recurrences of instability in the immediate postoperative period.

  16. Radiology of postnatal skeletal development. Pt. 7

    Energy Technology Data Exchange (ETDEWEB)

    Ogden, J.A.; Phillips, S.B.

    1983-02-01

    Twenty-four pairs of scapulae from fetal specimens and 35 pairs of scapulae from postnatal cadavers ranging in age from full-term neonates to 14 years, were studied morphologically and roentgenographically. Air-cartilage interfacing was used to demonstrate both the osseous and cartilaginous contours. When the entire chondro-osseous dimensions, rather than just the osseous dimensions, were measured, the scapula had a height-width ratio ranging from 1.36 to 1.52 (average 1.44) during most of fetal development. The exceptions were three stillborns with camptomelic, thanatophoric, and achondrogenic dwarfism in which the ratio averaged 0.6. At no time during fetal development was the glenoid cavity convex; it always had a concave articular surface. However, the osseous subchrondral countour was often flat or slightly convex. In the postnatal period the height-width ratio averaged 1.49. The ratio remained virtually unchanged throughout skeletal growth and maturation. In a patient with unilateral Sprengel's deformity the ratio for the normal side was 1.5, while the abnormal was 1.0. The cartilaginous glenoid cavity was always concave during postnatal development, even in the specimens with major structural deformities, although the subchondral osseous contour was usually flat or convex during the first few years of postnatal development. Ossification of the coracoid process began with the development of a primary center at three to four months. A bipolar physis was present between the primary coracoid center and the primary scapular center until late adolescence.

  17. Can clinical observation differentiate individuals with and without scapular dyskinesis?

    Science.gov (United States)

    Miachiro, Newton Y; Camarini, Paula M F; Tucci, Helga T; McQuade, Kevin J; Oliveira, Anamaria S

    2014-01-01

    Altered scapular rotation and position have been named scapular dyskinesis. Visual dynamic assessment could be applied to classify this alteration based on the clinical observation of the winging of the inferior medial scapular border (Type I) or of the prominence of the entire medial border (Type II), or by the excessive superior translation of the scapula (Type III). The aim of this study was to determine if there were differences in scapular rotations (Type I and II) and position (Type III) between a group of subjects with scapular dyskinesis, diagnosed by the clinical observation of an expert physical therapist, using a group of healthy individuals (Type IV). Twenty-six asymptomatic subjects volunteered for this study. After a fatigue protocol for the periscapular muscles, the dynamic scapular dyskinesis tests were conducted to visually classify each scapula into one of the four categories (Type IV dyskinesis-free). The kinematic variables studied were the differences between the maximum rotational dysfunctions and the minimum value that represented both normal function and a small dysfunctional movement. Only scapular anterior tilt was significantly greater in the type I dyskinesis group (clinical observation of the posterior projection of the inferior angle of the scapula) when compared to the scapular dyskinesis-free group (p=0.037 scapular and p=0.001 sagittal plane). Clinical observation was considered appropriate only in the diagnoses of dyskinesis type I. Considering the lower prevalence and sample sizes for types II and III, further studies are necessary to validate the clinical observation as a tool to diagnose scapular dyskinesis.

  18. Dorsal scapular nerve neuropathy: a narrative review of the literature.

    Science.gov (United States)

    Muir, Brad

    2017-08-01

    The purpose of this paper is to elucidate this little known cause of upper back pain through a narrative review of the literature and to discuss the possible role of the dorsal scapular nerve (DSN) in the etiopathology of other similar diagnoses in this area including cervicogenic dorsalgia (CD), notalgia paresthetica (NP), SICK scapula and a posterolateral arm pain pattern. Dorsal scapular nerve (DSN) neuropathy has been a rarely thought of differential diagnosis for mid scapular, upper to mid back and costovertebral pain. These are common conditions presenting to chiropractic, physiotherapy, massage therapy and medical offices. The methods used to gather articles for this paper included: searching electronic databases; and hand searching relevant references from journal articles and textbook chapters. One hundred-fourteen articles were retrieved. After removing duplicates, there were 57 articles of which 29 were retrieved. There were 26 articles and textbook chapters retrieved by hand searching equaling 55 articles retrieved of which 47 relevant articles were used in this report. The anatomy, pathway and function of the dorsal scapular nerve can be varied and exceptionally rarely may include a sensory component. The signs and symptoms, therefore, may include pain, atrophy, scapular winging, and dysesthesia. The mechanism of injury to the DSN is also quite varied ranging from postural to overuse in overhead work and sport. Other conditions in this area, including CD, NP, SICK scapula and a posterolateral arm pain pattern bear a striking resemblance to DSN neuropathy. DSN neuropathy should be included in the list of common differential diagnoses of upper and mid-thoracic pain, stiffness, dysesthesia and dysfunction. The study also brings forward interesting connections between DSN neuropathy, CD, NP, SICK scapula and a posterolateral arm pain pattern.

  19. Glenohumeral internal rotation measurements differ depending on stabilization techniques.

    Science.gov (United States)

    Wilk, Kevin E; Reinold, Michael M; Macrina, Leonard C; Porterfield, Ron; Devine, Kathleen M; Suarez, Kim; Andrews, James R

    2009-03-01

    The loss of glenohumeral internal rotation range of motion in overhead athletes has been well documented in the literature. Several different methods of assessing this measurement have been described, making comparison between the results of studies difficult. Significant differences in the amount of internal rotation range of motion exist when using different methods of stabilization. Descriptive laboratory study. THREE TECHNIQUES WERE USED BILATERALLY IN RANDOM FASHION TO MEASURE GLENOHUMERAL INTERNAL ROTATION RANGE OF MOTION: stabilization of the humeral head, stabilization of the scapula, and visual inspection without stabilization. An initial study on 20 asymptomatic participants was performed to determine the intrarater and interrater reliability for each measurement technique. Once complete, measurements were performed on 39 asymptomatic professional baseball players to determine if a difference existed in measurement techniques and if there was a significant side-to-side difference. A 2-way repeated-measures analysis of variance was used. While interrater reliability was fair between all 3 methods, scapular stabilization provided the best intrarater reliability. A statistically significant difference was observed between all 3 methods (P < .001). Internal rotation was significantly less in the dominant shoulder than in the nondominant shoulder (P < .001). Differences in internal rotation range of motion measurements exist when using different methods. The scapula stabilization method displayed the highest intrarater reproducibility and should be considered when evaluating internal rotation passive range of motion of the glenohumeral joint. A standardized method of measuring internal rotation range of motion is required to accurately compare physical examinations of patients. The authors recommend the use of the scapula stabilization method to assess internal rotation range of motion by allowing normal glenohumeral arthrokinematics while stabilizing the

  20. An Application of the Multivariate Linear Mixed Model to the Analysis of Shoulder Complexity in Breast Cancer Patients

    Directory of Open Access Journals (Sweden)

    Gholamreza Oskrochi

    2016-03-01

    Full Text Available In this study, four major muscles acting on the scapula were investigated in patients who had been treated in the last six years for unilateral carcinoma of the breast. Muscle activity was assessed by electromyography during abduction and adduction of the affected and unaffected arms. The main principal aim of the study was to compare shoulder muscle activity in the affected and unaffected shoulder during elevation of the arm. A multivariate linear mixed model was introduced and applied to address the principal aims. The result of fitting this model to the data shows a huge improvement as compared to the alternatives.

  1. Superior sulcus (Pancoast) tumors: current evidence on diagnosis and radical treatment

    OpenAIRE

    Foroulis, Christophoros N.; Zarogoulidis, Paul; Darwiche, Kaid; Katsikogiannis, Nikolaos; Machairiotis, Nikolaos; Karapantzos, Ilias; Tsakiridis, Kosmas; Huang, Haidong; Zarogoulidis, Konstantinos

    2013-01-01

    Pancoast tumors account for less than 5% of all bronchogenic carcinomas. These tumors are located in the apex of the lung and involve through tissue contiguity the apical chest wall and/or the structures of the thoracic inlet. The tumors become clinically evident with the characteristic symptoms of the “Pancoast-Tobias syndrome” which includes Claude-Bernard-Horner syndrome, severe pain in the shoulder radiating toward the axilla and/or scapula and along the ulnar distribution of the upper ar...

  2. Isolated Rhabdomyolysis of the Infraspinatus Muscle Following the CrossFit "Sissy Test": A Report of Two Cases.

    Science.gov (United States)

    Routman, Howard D; Triplet, Jacob J; Kurowicki, Jennifer; Singh, Neil

    2018-01-10

    Following the completion of a CrossFit-style challenge (the "Sissy Test"), 2 patients presented with severe pain and swelling over the posterior aspect of the scapula. Magnetic resonance imaging demonstrated isolated edema of the infraspinatus muscle in both patients; the compartments were compressible. Neurovascular checks and observation of range of motion were performed. The patients were treated nonoperatively and were discharged with the diagnosis of overuse syndrome with rhabdomyolysis of the infraspinatus muscle. With marked increase in the popularity of extreme fitness, monitoring for rhabdomyolysis and potential renal dysfunction is essential.

  3. Bilateral Directional Asymmetry of the Appendicular Skeleton of the White-Beaked Dolphin (Lagenorhynchus albirostris)

    DEFF Research Database (Denmark)

    Galatius, Anders

    2006-01-01

    Bilateral directional asymmetry of the lengths and diameters of the scapula, humerus, radius, and ulna were analyzed on a sample of 38 white-beaked dolphins (Lagenorhynchus albirostris) from Danish waters. The levels of asymmetry were consistent between the sexes and between physically mature...... of lateralized use of the flippers in the white-beaked dolphin and possibly other delphinid and cetacean species. Although some evidence exists for flipper preference in the baleen humpback whale (Megaptera novaengliae) and turning preferences in other species, this needs to be confirmed through further...

  4. A Unique Case of Melorheostosis Presenting with Two Radiologically Distinct Lesions in the Shoulder

    Directory of Open Access Journals (Sweden)

    Ahmed A. Elsheikh

    2017-01-01

    Full Text Available Melorheostosis is a rare, nonhereditary, benign, mesenchymal condition of unknown aetiology affecting the bones and surrounding tissues. A male patient complaining of left shoulder pain, swelling, and mildly limited range of motion has an exclusive combination of the classic dripping wax lesion in the scapula and the myositis ossificans-like lesion in the deltoid muscle; this combination is the first to be reported in the shoulder. Both lesions showed typical findings of melorheostosis in radiographs, CT, MRI, and bone scan. This case has a stationary course over the follow-up period, and no specific treatment is needed in due course.

  5. An unusually medial axillary arch muscle.

    OpenAIRE

    Dharap, A

    1994-01-01

    In the left upper limb of an adult male cadaver a triangular muscular slip, 3.5 cm long and 2.5 cm wide, arose from the lower border of latissimus dorsi just proximal to its tendon of insertion. It was inserted by a slender 6 cm long tendon mainly into the coracoid process of the scapula. Three short fibrous strands radiated from this slender tendon to gain attachments to pectoralis minor and the common tendon of origin of the short head of biceps brachii and coracobrachialis. In addition 2 f...

  6. Conservative management of thoracic outlet syndrome.

    Science.gov (United States)

    Novak, C B

    1996-04-01

    Conservative management of thoracic outlet syndrome requires accurate evaluation of the peripheral nervous system, posture, and the cervico-scapular muscles. Patients should be instructed in postural correction in sitting, standing and sleeping, stretching exercises (ie, upper trapezius, levator scapulae, suboccipitals, scalenes, sternocleidomastoid and pectoral muscles), and strengthening exercises of the lower scapular stabilizers beginning in gravity-assisted positions to regain normal movement patterns in the cervico-scapular region. Patient education, compliance to an exercise program, and behavioral modification at home and work are critical to successful conservative management.

  7. Case report

    African Journals Online (AJOL)

    abp

    14 avr. 2016 ... avec deux branches une sur le bord supérieur et l'autre sur le bord spinal avec hémostase du pédicule supéro-interne de la scapula. La tumeur été enveloppée par les muscles alentour et occupant la fosse sus-épineuse. Une large résection complète de la lésion a été réalisée emportant une partie de ...

  8. Giant Chest Wall Hematoma Mimicking Elastofibroma Dorsi: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Yeon Soo; Park, Kuhn; Kim, Jong Ok; Choi, Eun Seok; Kang, Si Won [Daejeon St. Mary' s Hospital, The Catholic University of Korea, Daejeon (Korea, Republic of)

    2011-02-15

    Hematoma on the thoracic wall is very rare. We describe here a 63-year-old man with a huge chest wall hematoma and the man had no history of trauma. The patient was found to have a large mass located subjacent to the inferior angle of the right scapula area and the CT and MRI findings were similar to those of an elastofibroma dorsi. We describe the CT and MRI findings of this hematoma and how to make the differential diagnosis from elastofibroma dorsi

  9. Lung metastasis 21 years after initial diagnosis of osteosarcoma: a case report

    Directory of Open Access Journals (Sweden)

    Montgomery Sam

    2009-11-01

    Full Text Available Abstract Introduction To the best of our knowledge, this case report describes the longest disease-free interval between primary diagnosis and metastatic recurrence of an osteosarcoma. Case presentation A 35-year-old Caucasian American man presented with asymptomatic lung metastases 21 years after being diagnosed and treated for lower extremity osteosarcoma. He underwent curative lung resection, but 2 years thereafter developed metastatic disease in the scapula and tibia and, after resection and chemotherapy, is in remission 1 year later. Conclusion This case highlights the importance of long follow-up periods and continued surveillance of osteosarcoma patients after initial curative treatment.

  10. Functional Analysis of the Primate Shoulder.

    Science.gov (United States)

    Preuschoft, Holger; Hohn, Bianca; Scherf, Heike; Schmidt, Manuela; Krause, Cornelia; Witzel, Ulrich

    2010-04-01

    Studies of the shoulder girdle are in most cases restricted to morphological comparisons and rarely aim at elucidating function in a strictly biomechanical sense. To fill this gap, we investigated the basic functional conditions that occur in the shoulder joint and shoulder girdle of primates by means of mechanics. Because most of nonhuman primate locomotion is essentially quadrupedal walking-although on very variable substrates-our analysis started with quadrupedal postures. We identified the mechanical situation at the beginning, middle, and end of the load-bearing stance phase by constructing force parallelograms in the shoulder joint and the scapulo-thoracal connection. The resulting postulates concerning muscle activities are in agreement with electromyographical data in the literature. We determined the magnitude and directions of the internal forces and explored mechanically optimal shapes of proximal humerus, scapula, and clavicula using the Finite Element Method. Next we considered mechanical functions other than quadrupedal walking, such as suspension and brachiation. Quadrupedal walking entails muscle activities and joint forces that require a long scapula, the cranial margin of which has about the same length as the axillary margin. Loading of the hand in positions above the head and suspensory behaviors lead to force flows along the axillary margin and so necessitate a scapula with an extended axillary and a shorter cranial margin. In all cases, the facies glenoidalis is nearly normal to the calculated joint forces. In anterior view, terrestrial monkeys chose a direction of the ground reaction force requiring (moderate) activity of the abductors of the shoulder joint, whereas more arboreal monkeys prefer postures that necessitate activity of the adductors of the forelimb even when walking along branches. The same adducting and retracting muscles are recruited in various forms of suspension. As a mechanical consequence, the scapula is in a more frontal

  11. Measuring Three-Dimensional Thorax Motion Via Biplane Radiographic Imaging: Technique and Preliminary Results.

    Science.gov (United States)

    Baumer, Timothy G; Giles, Joshua W; Drake, Anne; Zauel, Roger; Bey, Michael J

    2016-01-01

    Measures of scapulothoracic motion are dependent on accurate imaging of the scapula and thorax. Advanced radiographic techniques can provide accurate measures of scapular motion, but the limited 3D imaging volume of these techniques often precludes measurement of thorax motion. To overcome this, a thorax coordinate system was defined based on the position of rib pairs and then compared to a conventional sternum/spine-based thorax coordinate system. Alignment of the rib-based coordinate system was dependent on the rib pairs used, with the rib3:rib4 pairing aligned to within 4.4 ± 2.1 deg of the conventional thorax coordinate system.

  12. Sprengel's Deformity Associated with Musculoskeletal Dysfunctions and Renal Anomalies: A Case Report

    Directory of Open Access Journals (Sweden)

    Mohammad Hossein Kariminasab

    2012-01-01

    Full Text Available Background. Sprengel's deformity is a rare congenital anomaly of the shoulder girdle. The deformity is due to failure of descent of the scapula in intrauterine life. Case Presentation. We report a case of unilateral Sprengel's deformity associated with several other musculoskeletal and renal disorders consisting of absence of pectoralis major, weakness of trapezius and serratus anterior muscles, one kidney agenesis, and severe hydronephrosis of the other kidney in a 7-year-old boy. Conclusion. Sprengel's deformity can be associated with other musculoskeletal abnormalities and it is much more than a cosmetic problem.

  13. New insights into the lifestyle of Allosaurus (Dinosauria: Theropoda based on another specimen with multiple pathologies

    Directory of Open Access Journals (Sweden)

    Christian Foth

    2015-05-01

    Full Text Available Adult large-bodied theropods are often found with numerous pathologies. A large, almost complete, probably adult Allosaurus specimen from the Howe Stephens Quarry, Morrison Formation (Late Kimmeridgian–Early Tithonian, Wyoming, exhibits multiple pathologies. Pathologic bones include the left dentary, two cervical vertebrae, one cervical and several dorsal ribs, the left scapula, the left humerus, the right ischium, and two left pedal phalanges. These pathologies can be classified as follows: the fifth cervical vertebra, the scapula, several ribs and the ischium are probably traumatic, and a callus on the shaft of the left pedal phalanx II-2 is probably traumatic-infectious. Traumatically fractured elements exposed to frequent movement (e.g., the scapula and the ribs show a tendency to develop pseudarthroses instead of a callus. The pathologies in the lower jaw and a reduced extensor tubercle of the left pedal phalanx II-2 are most likely traumatic or developmental in origin. The pathologies on the fourth cervical are most likely developmental in origin or idiopathic, that on the left humerus could be traumatic, developmental, infectious or idiopathic, whereas the left pedal phalanx IV-1 is classified as idiopathic. With exception of the ischium, all as traumatic/traumatic-infectious classified pathologic elements show unambiguous evidences of healing, indicating that the respective pathologies did not cause the death of this individual. Alignment of the scapula and rib pathologies from the left side suggests that all may have been caused by a single traumatic event. The ischial fracture may have been fatal. The occurrence of multiple lesions interpreted as traumatic pathologies again underlines that large-bodied theropods experienced frequent injuries during life, indicating an active predatory lifestyle, and their survival perhaps supports a gregarious behavior for Allosaurus. Alternatively, the frequent survival of traumatic events could be

  14. Bilateral directional asymmetry of the appendicular skeleton of the harbor porpoise (Phocoena phocoena)

    DEFF Research Database (Denmark)

    Galatius, Anders; Jespersen, Åse

    2005-01-01

    from 2.8% SE 0.5 (humerus) to 4.3% SE 0.7 (ulna). The humerus and ulna had significantly larger mean diameter/ length ratios on the right side than the left, making them more robust. The large DA of scapula length indicates larger muscle mass associated with the right flipper, while the generally more...... robust right humerii and ulnae may be designed for higher levels of mechanical stress. These DAs and the examples of lateralized behavior recorded in cetaceans, point to the existence of lateralized use of the flippers at the population level in harbor porpoises and possibly other cetacean species....

  15. Propensity for Acute Supraspinatus Injury in Low-Speed Rear-End Automobile Collisions: A Biomechanical Perspective

    OpenAIRE

    Hunter, Ross Craig

    2017-01-01

    Automobile drivers with a diagnosed supraspinatus (SSP) tendon tear following a low-speed rear-end collision often allege the collision is responsible for causing their shoulder injury. The goal was to determine the propensity for acute tear of a healthy SSP tendon during a low-speed rear-end automobile collision. To accomplish this, first the scapula and humerus positions were measured in twenty-one volunteers while in a driver seat. Then these positions were averaged and simulated in a cada...

  16. [Multiple brown tumors in a female hemodialyzed patient with severe secondary hyperparathyroidism].

    Science.gov (United States)

    Peces, R; Gil, F; González, F; Ablanedo, P

    2002-01-01

    Skeletal brown tumours are relatively uncommon, and brown tumours that involve multiple bones are considered very rare. We describe a 29-year-old woman with chronic renal failure (CRF) who had undergone hemodialysis for 21 years and developed multiple brown tumours associated with severe secondary hyperparathyroidism. Computed tomography (CT) revealed multiple brown tumours involving scapula, ribs, spine and sacroiliac bone. Microscopic analysis of the brown tumour showed dense infiltration of the marrow space by reactive fibroblastic tissue with irregularly distributed multinucleated osteoclastic giants cells and marked increase in hematopoietic elements.

  17. Optimization of a therapeutic electromagnetic field (EMF) to retard breast cancer tumor growth and vascularity

    OpenAIRE

    Cameron, Ivan L.; Markov, Marko S; Hardman, W Elaine

    2014-01-01

    Background This study provided additional data on the effects of a therapeutic electromagnetic field (EMF) device on growth and vascularization of murine 16/C mammary adenocarcinoma cells implanted in C3H/HeJ mice. Methods The therapeutic EMF device generated a defined 120 Hz semi sine wave pulse signal of variable intensity. Murine 16/C mammary adenocarcinoma tumor fragments were implanted subcutaneously between the scapulae of syngeneic C3H mice. Once the tumor grew to 100 mm3, daily EMF tr...

  18. Traumatic axillary artery pseudoaneurysm treated with intravascular balloon occlusion and percutaneous thrombin injection

    Directory of Open Access Journals (Sweden)

    Maria Carratola, BS

    2014-01-01

    Full Text Available Axillary artery pseudoaneurysms are relatively rare, with few reported cases found in the literature. Furthermore, treatment with percutaneous thrombin injection has not yet been reported. We report the case of a 59-year-old man with a large (10 cm post-traumatic pseudoaneurysm of the left axillary artery found five weeks after a motorcycle crash. The patient sustained multiple injuries, including fractures of the left scapula and clavicle. Edema was observed at the time of diagnosis. Arteriography with successful ultrasound-guided percutaneous thrombin injection was undertaken. The patient experienced no complications after the procedure.

  19. Defining Platelet Function During Polytrauma

    Science.gov (United States)

    2014-04-01

    Facial Fx Acetabulum Knee Lac 0 0 0 0 jury to Fron R Femur Fx Flail Chest Pulm Hemorrhage 0 0 0 0 ulmonary CoForehead Laabdominal bstric wall hematom...skull base and frontal bone skull fracture , right front Facial TraumResp. Distresachnoid hemLeft C2 pedicle Fx Blunt Cardiac In ck w acute b...FxSternum Fx Scapula Fx ricothyroto l Fx Acetabulum Fx Nasal Bone Fx Xervical Injury Flail Chest Pulm Cont Ptx ulti Muscle Hematoma Pulm Cont Flail Chest

  20. Measurement properties of existing clinical assessment methods evaluating scapular positioning and function. A systematic review

    DEFF Research Database (Denmark)

    Larsen, Camilla Marie; Juul-Kristensen, B; Lund, H

    2014-01-01

    Therapy, Physiotherapy and Radiography, Bergen University College, Bergen, Norway Purpose From a biomechanical perspective, the scapula plays a key role in the shoulder and arm function as a stable base for optimal muscle activation both at rest and during functional tasks.There is evidence suggesting...... that scapular positioning are altered in patients with musculoskeletal shoulder disorders, e.g in shoulder impingement syndrome and in patients with glenohumeral osteoarthritis. Rehabilitation exercises are aiming at altering abnormal/asymmetric scapular positioning and/or function. Numerous assessment methods...

  1. Measurement properties of existing clinical assessment methods evaluating scapular positioning and function. A systematic review

    DEFF Research Database (Denmark)

    Larsen, Camilla Marie; Juul-Kristensen, Birgit; Lund, Hans

    of Occupational Therapy, Physiotherapy and Radiography, Bergen University College, Bergen, Norway PurposeFrom a biomechanical perspective, the scapula plays a key role in the shoulder and arm function as a stable base for optimal muscle activation both at rest and during functional tasks.There is evidence...... suggesting that scapular positioning are altered in patients with musculoskeletal shoulder disorders, e.g in shoulder impingement syndrome and in patients with glenohumeral osteoarthritis. Rehabilitation exercises are aiming at altering abnormal/asymmetric scapular positioning and/or function. Numerous...

  2. Camptomelic dysplasia: prenatal diagnosis by ultrasound.

    Science.gov (United States)

    Natasha, Gupta; Ghai, Rajeev; Shah, Dheeraj; Kiran, P S

    2006-09-01

    We report a case of camptomelic dysplasia, an extremely rare lethal congenital bony dysplasia with an incidence of about 2 per million live births. Diagnosis was made antenatally at a gestational age of about 25 weeks by sonographic demonstration of anterior bowing of long bones, hypoplastic scapulae, bilateral talipes equinovarus, and normally ossified unfractured ribs. The mother elected to terminate the pregnancy, and the diagnosis was confirmed on clinical and radiographic examination of the fetus. Radiological features and differential diagnoses of this entity are discussed.

  3. Assessment of cervical range of motion, cervical core strength and scapular dyskinesia in violin players.

    Science.gov (United States)

    Tawde, Pooja; Dabadghav, Rachana; Bedekar, Nilima; Shyam, Ashok; Sancheti, Parag

    2016-12-01

    Playing the violin can lead to asymmetric postures which can affect the cervical range of motion, cervical core strength and scapular stability. The objective of the study was to assess the cervical range of motion, cervical core strength and scapular dyskinesia in violin players and non-players of the same age group. An inclinometer was used to assess the cervical range of motion, pressure biofeedback was used to assess cervical core strength and scapular dyskinesia was also assessed in 30 professional violin players (18-40 years) compared with 30 age-matched non-players. Analysis was done using an unpaired t test. Significant change was seen with respect to extension (p = 0.051), cervical core strength (p = 0.005), right (Rt) superior angle 0° (p = 0.004), Rt superior angle 45° (p = 0.015) and Rt inferior angle 90° (p = 0.013). This study shows a significant difference in extension range of motion and cervical core strength of violin players. Also, there was scapular dyskinesia seen at 0° and 45° right-side superior angle of the scapula and 90° right-side inferior angle of the scapula.

  4. [Effectiveness of an individualised physiotherapy program versus group therapy on neck pain and disability in patients with acute and subacute mechanical neck pain].

    Science.gov (United States)

    Antúnez Sánchez, Leonardo Gregorio; de la Casa Almeida, María; Rebollo Roldán, Jesús; Ramírez Manzano, Antonio; Martín Valero, Rocío; Suárez Serrano, Carmen

    To compare the efficacy in reducing neck pain and disability in an individualised physiotherapy treatment with group treatment in acute and subacute mechanical neck pain. Randomised clinical trial. Health Area of University Hospital Virgen del Rocío, Seville, Spain. A total of 90 patients diagnosed with mechanical neck pain of up to one month onset, distributed randomly into two groups: (i)individualised treatment; (ii)group treatment. The treatment consisted of 15 sessions of about 60minutes for both groups. Individual treatment consisted of 15minutes of infrared heat therapy, 17minutes of massage, and analytical passive stretching of the trapezius muscles and angle of the scapula. The group treatment consisted of a program of active mobilisation, isometric contractions, self-stretching, and postural recommendations. Pain was measured at the beginning and end of treatment pain using a Visual Analogue Scale (VAS) and an algometer applied on the trapezius muscles and angle of the scapula, and neck disability using the Neck Disability Index. Both treatments were statistically significant (P<.001) in improving all variables. Statistically significant differences (P<.001) were found for all of them in favour of individualised treatment compared to group treatment. Patients with acute or subacute mechanical neck pain experienced an improvement in pain and neck disability after receiving either of the physiotherapy treatments used in our study, with the individual treatment being more effective than collective. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  5. Finite element modeling for predicting the contact pressure between a foam mattress and the human body in a supine position.

    Science.gov (United States)

    Lee, Wookjin; Won, Byeong Hee; Cho, Seong Wook

    2017-01-01

    In this paper, we generated finite element (FE) models to predict the contact pressure between a foam mattress and the human body in a supine position. Twenty-year-old males were used for three-dimensional scanning to produce the FE human models, which was composed of skin and muscle tissue. A linear elastic isotropic material model was used for the skin, and the Mooney-Rivlin model was used for the muscle tissue because it can effectively represent the nonlinear behavior of muscle. The contact pressure between the human model and the mattress was predicted by numerical simulation. The human models were validated by comparing the body pressure distribution obtained from the same human subject when he was lying on two different mattress types. The experimental results showed that the slope of the lower part of the mattress caused a decrease in the contact pressure at the heels, and the effect of bone structure was most pronounced in the scapula. After inserting a simple structure to function as the scapula, the contact pressure predicted by the FE human models was consistent with the experimental body pressure distribution for all body parts. These results suggest that the models proposed in this paper will be useful to researchers and designers of products related to the prevention of pressure ulcers.

  6. Rapid recovery of serratus anterior muscle function after microneurolysis of long thoracic nerve injury

    Directory of Open Access Journals (Sweden)

    Melcher Sonya E

    2007-02-01

    Full Text Available Abstract Background Injury to the long thoracic nerve is a common cause of winging scapula. When the serratus anterior muscle is unable to function, patients often lose the ability to raise their arm overhead on the affected side. Methods Serratus anterior function was restored through decompression, neurolysis, and tetanic electrical stimulation of the long thoracic nerve. This included partial release of constricting middle scalene fibers and microneurolysis of epineurium and perineurium of the long thoracic nerve under magnification. Abduction angle was measured on the day before and the day following surgery. Results In this retrospective study of 13 neurolysis procedures of the long thoracic nerve, abduction is improved by 10% or greater within one day of surgery. The average improvement was 59° (p Conclusion In a notable number of cases, decompression and neurolysis of the long thoracic nerve leads to rapid improvements in winging scapula and the associated limitations on shoulder movement. The duration of the injury and the speed of improvement lead us to conclude that axonal channel defects can potentially exist that do not lead to Wallerian degeneration and yet cause a clear decrease in function.

  7. Can scapular and humeral head position predict shoulder pain in adolescent swimmers and non-swimmers?

    Science.gov (United States)

    McKenna, Leanda; Straker, Leon; Smith, Anne

    2012-12-01

    The aims of this study were to determine whether scapular and humeral head position can predict the development of shoulder pain in swimmers, whether those predictors were applicable to non-swimmers and the annual rate of shoulder pain in adolescent swimmers and non-swimmers. Forty-six adolescent swimmers and 43 adolescent non-swimmers were examined prospectively with a questionnaire and anthropometric measures. The questionnaire examined demographic and training variables. Anthropometric measures examined the distances between the T7 spinous process and the inferior scapula (Inferior Kibler) and T3 spinous process and the medial spine of the scapula (Superior Kibler), humeral head position in relation to the acromion using palpation, BMI and chest width. Shoulder pain was re-assessed 12 months later by questionnaire. Shoulder pain in swimmers was best predicted by a larger BMI (OR = 1.48, P = 0.049), a smaller Inferior Kibler distance in abduction (e.g. OR = 0.90, P = 0.009) and a smaller horizontal distance between the anterior humeral head and the anterior acromion (OR = 0.76, P = 0.035). These variables were not significantly predictive of shoulder pain in non-swimmers. Annual prevalence of shoulder pain was 23.9% in swimmers and 30.8% in non-swimmers (χ(2) = 0.50, P = 0.478).

  8. Development of forelimb bones in indigenous sheep fetuses

    Directory of Open Access Journals (Sweden)

    N. S. Ahmed

    2008-01-01

    Full Text Available The study included detection of the sites of ossification centers and their sequence of appearance in the forelimb bones of indigenous sheep fetuses by using double staining method with younger specimens and radiography or maceration methods with old specimens, as well as, histological study with some ages. The results showed that the primary ossification centers of the forelimb in indigenous sheep fetuses appeared firstly in the diaphyses of radius and ulna, humerus, scapula, metacarpus, phalanges and lastly in the carpal bone at an estimated age of 43, 45, 46, 47, 49 - 56 and 90-118 days old respectively. The results of statistical analysis of the total lengths of scapula, humerus, radius, ulna and metacarpus with the lengths of their ossified parts through the 7th – 15th weeks of fetus age, showed presence of significant differences in the average of these measurements among most of studied weeks. Also there was a significant differences in the average of relative increase in the total length and length of ossified part of diaphysis of studied bones during the 7th week in comparison to the same average in the other studied weeks (8th-15th week of indigenous sheep fetuses age.

  9. Effect of a worktable position on head and shoulder posture and shoulder muscles in manual material handling.

    Science.gov (United States)

    Kim, Min-Hee; Yoo, Won-Gyu

    2015-06-05

    According to a recent research, manual working with high levels of static contraction, repetitive loads, or extreme working postures involving the neck and shoulder muscles causes an increased risk of neck and shoulder musculoskeletal disorders. We investigated the effects of the forwardly worktable position on head and shoulder angles and shoulder muscle activity in manual material handling tasks. The forward head and shoulder angles and the activity of upper trapezius, levator scapulae, and middle deltoid muscle activities of 15 workers were measured during performing of manual material handling in two tasks that required different forward head and shoulder angles. The second manual material task required a significantly increased forward head and shoulder angle. The upper trapezius and levator scapulae muscle activity in second manual material task was increased significantly compared with first manual material task. The middle deltoid muscle activity in second manual material task was not significantly different compared with first manual material task. Based on this result, the forward head and shoulder angles while performing manual work need to be considered in selection of the forward distance of a worktable form the body. The high level contractions of the neck and shoulder muscles correlated with neck and shoulder pain. Therefore, the forward distance of a worktable can be an important factor in preventing neck and shoulder pain in manual material handling workers.

  10. Stature estimation from scapular measurements by CT scan evaluation in an Italian population.

    Science.gov (United States)

    Giurazza, Francesco; Del Vescovo, Riccardo; Schena, Emilano; Cazzato, Roberto Luigi; D'Agostino, Francesco; Grasso, Rosario Francesco; Silvestri, Sergio; Zobel, Bruno Beomonte

    2013-07-01

    This study evaluated the correlation between scapula size and stature and developed standard equations in order to estimate stature by CT scan evaluation. A total of 200 healthy Italian subjects (100 men and 100 women, mean age 64.2±12.8years) underwent thoracic CT scan evaluation during pulmonary screening in our department; we measured the stature of each patient with standard anthropometric instruments and then analyzed images to calculate the longitudinal scapular length (LSL) and the transverse scapular length (TSL). The correlation between stature and each parameter measured was analyzed by dividing the population into two groups, males and females, and was examined by simple regression analysis using Pearson's correlation coefficient (r). Each anthropometric variable showed a significant difference between males and females (p value stature and LSL. Our study demonstrates that scapulae can be used for stature estimation; in our sample LSL was found to have a better correlation with stature then TSL. hm=4.247*LSL+93.74 and hf=4.031*LSL+92.38 are the formulae that provide the most accurate stature assessment in males and females respectively. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  11. Shoulder kinematics is not influenced by external load during elevation in the scapular plane.

    Science.gov (United States)

    de Castro, Marcelo P; Ribeiro, Daniel Cury; Forte, Felipe de C; de Toledo, Joelly M; Aldabe, Daniela; Loss, Jefferson F

    2014-02-01

    The current study aimed to compare the shoulder kinematics (3D scapular orientation, scapular angular displacement and scapulohumeral rhythm) of asymptomatic participants under unloaded and loaded conditions during unilateral shoulder elevation in the scapular plane. We used a repeated-measures design with a convenience sample. Eleven male participants with an age range of 21-28 years with no recent history of shoulder injury participated in the study. The participants performed isometric shoulder elevation from a neutral position to approximately 150 degrees of elevation in the scapular plane in intervals of approximately 30 degrees during unloaded and loaded conditions. Shoulder kinematic data were obtained with videogrammetry. During shoulder elevation, the scapula rotated upwardly and externally, and tilted posteriorly. The addition of an external load did not affect 3D scapular orientation, scapular angular displacement, or scapulohumeral rhythm throughout shoulder elevation (P > .05). In clinical practice, clinicians should expect to observe upward and external rotation and posterior tilt of the scapula during their assessments of shoulder elevation. Such behavior was not influenced by an external load normalized to 5% of body weight when performed in an asymptomatic population.

  12. Sex determination from scapular length measurements by CT scans images in a Caucasian population.

    Science.gov (United States)

    Giurazza, F; Schena, E; Del Vescovo, R; Cazzato, R L; Mortato, L; Saccomandi, P; Paternostro, F; Onofri, L; Zobel, B Beomonte

    2013-01-01

    Together with race, stature and age, sex is a main component of the biological identity. Thanks to its proportional correlation with parts of the human body, sex can be evaluated form the skeleton. The most accurate approach to determine sex by bone size is based on os coxae or skull. After natural disaster their presence can never be guaranteed, therefore the development of methods of sex determination using other skeletal elements can result crucial. Herein, sexual dimorphism in the human scapula is used to develop a two-variable discriminant function for sex estimation. We have enrolled 100 males and 100 females who underwent thoracic CT scan evaluation and we have estimated two scapular diameters. The estimation has been carried out by analyzing images of the scapulae of each patient after three dimensional post-processing reconstructions. The two-variable function allows to obtain an overall accuracy of 88% on the calibration sample. Furthermore, we have employed the mentioned function on a collection of 10 individual test sample from the collection of the "Museo di Anatomia Umana di Firenze" of the Università degli Studi di Firenze; sex has been correctly predicted on 9 skeletons.

  13. Initial development and testing of a novel foam-based pressure sensor for wearable sensing

    Directory of Open Access Journals (Sweden)

    Smyth Barry

    2005-03-01

    Full Text Available Abstract Background This paper provides an overview of initial research conducted in the development of pressure-sensitive foam and its application in wearable sensing. The foam sensor is composed of polypyrrole-coated polyurethane foam, which exhibits a piezo-resistive reaction when exposed to electrical current. The use of this polymer-coated foam is attractive for wearable sensing due to the sensor's retention of desirable mechanical properties similar to those exhibited by textile structures. Methods The development of the foam sensor is described, as well as the development of a prototype sensing garment with sensors in several areas on the torso to measure breathing, shoulder movement, neck movement, and scapula pressure. Sensor properties were characterized, and data from pilot tests was examined visually. Results The foam exhibits a positive linear conductance response to increased pressure. Torso tests show that it responds in a predictable and measurable manner to breathing, shoulder movement, neck movement, and scapula pressure. Conclusion The polypyrrole foam shows considerable promise as a sensor for medical, wearable, and ubiquitous computing applications. Further investigation of the foam's consistency of response, durability over time, and specificity of response is necessary.

  14. Maxillofacial osseous reconstruction using the angular branch of the thoracodorsal vessels.

    LENUS (Irish Health Repository)

    Dolderer, Jürgen H

    2010-09-01

    Mandibular and maxillary resections can produce complex three-dimensional defects requiring skeletal, soft tissue, and epithelial reconstruction. The subscapular vascular axis offers a source of skin, bone, and muscle on a single pedicle for microvascular flap transfer. We reviewed four cases where the subscapular vascular pedicle was used as a source of tissue for complex facial reconstructions in maxillofacial defects. Reconstruction of these complex defects was performed with a latissimus dorsi muscle or myocutaneous flap in combination with the lateral border of the scapula, harvested on the angular branch of the thoracodorsal vessels. There were three cases of maxillectomy and one case of partial mandibulectomy for malignant tumors. In each case, the angular branch of the thoracodorsal artery supplied 6 to 8 cm of the lateral border of the scapula and a latissimus dorsi myocutaneous flap was used for soft tissue reconstruction. Follow-up ranged from 9 months to 3 years and in all cases there was successful bony union. Shoulder movement was normal. This series encourages the further use of subscapular axis flaps as flexible sources of combined myocutaneous and osseous flaps on a single vascular pedicle in cases of complex maxillofacial reconstruction.

  15. A new basal sauropodiform dinosaur from the Lower Jurassic of Yunnan Province, China.

    Science.gov (United States)

    Wang, Ya-Ming; You, Hai-Lu; Wang, Tao

    2017-02-16

    The Lufeng Formation in Lufeng Basin of Yunnan Province, southwestern China preserves one of the richest terrestrial Lower Jurassic vertebrate faunas globally, especially for its basal sauropodomorphs, such as Lufengosaurus and Yunnanosaurus. Here we report a new taxon, Xingxiulong chengi gen. et sp. nov. represented by three partial skeletons with overlapping elements. Xingxiulong possesses a number of autapomorphies, such as transversely expanded plate-like summit on top of the neural spine of posterior dorsal vertebrae, four sacral vertebrae, robust scapula, and elongated pubic plate approximately 40% of the total length of the pubis. Phylogenetic analysis resolves Xingxiulong as a basal member of Sauropodiformes, and together with another two Lufeng basal sauropodiforms Jingshanosaurus and Yunnanosaurus, they represent the basalmost lineages of this clade, indicating its Asian origin. Although being relatively primitive, Xingxiulong displays some derived features normally occurred in advanced sauropodiforms including sauropods, such as a four sacral-sacrum, a robust scapula, and a pubis with elongated pubic plate. The discovery of Xingxiulong increases the diversity of basal sauropodomorphs from the Lufeng Formation and indicates a more complicated scenario in the early evolution of sauropodiforms.

  16. Early history of scapular fractures.

    Science.gov (United States)

    Bartoníček, Jan; Kozánek, Michal; Jupiter, Jesse B

    2016-01-01

    The first to use the term Scapula was Vesalius (1514-1564) and thus it has remained ever since. Probably the oldest injured scapula, from 250 million years ago, was described by Chinese authors of a skeletal examination of a fossilised remains of a dinosaur Yangchuanosaurus hepingensis. In humans, the oldest known scapular fractures date back to the prehistoric and early historic times. In ancient times, a fracture of acromion was described in the treatises of Hippocrates. Early modern history of the treatment of scapular fractures is closely interlinked with the history of the French surgery. The first to point out the existence of these fractures were Petit, Du Verney and Desault in the 18th century. The first study devoted solely to scapular fractures was published by Traugott Karl August Vogt in 1799. Thomas Callaway published in 1849 an extensive dissertation on injuries to the shoulder girdle, in which he discussed a number of cases known at that time. The first radiograph of a scapular fracture was published by Petty in 1907. Mayo Robson (1884), Lambotte (1913) and Lane (1914) were pioneers in the surgical treatment of these fractures, followed in 1923 by the French surgeons Lenormat, Dujarrier and Basset. The first internal fixation of the glenoid fossa, including a radiograph, was published by Fischer in 1939.

  17. Rigid and Elastic taping changes scapular kinematics and pain in subjects with shoulder impingement syndrome; an experimental study.

    Science.gov (United States)

    Shaheen, Aliah F; Bull, Anthony M J; Alexander, Caroline M

    2015-02-01

    Rigid and Elastic scapular taping is used in physical rehabilitation of shoulder impingement syndrome (SIS). It is believed to reduce pain and normalise scapular movement patterns. However, there is insufficient evidence to support its use. The aim of the study was to investigate the effect of Rigid and Elastic taping techniques on the scapular kinematics and pain in patients with SIS. Eleven patients with SIS participated in the study. They performed elevation and lowering of the arm in the scapular and sagittal planes under three conditions: Baseline, Rigid taping and Elastic taping. The movements of the thorax, humerus and scapula were tracked. Scapular displacements and scapulothoracic joint rotations were calculated. Subjects used a visual analogue scale to rate the intensity of pain at rest and during movements in both planes. Both taping techniques externally rotated the scapula in sagittal plane movements (ppain. In the scapular plane, Elastic taping increased the scapular retraction (ppain in this plane. In conclusion, both taping techniques had an effect on scapular kinematics and pain in movements occurring in the sagittal plane. Elastic taping also affected scapular kinematics in scapular plane movements, but without the concomitant decrease in pain. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. Adaptive patterns of movement during arm elevation test in patients with shoulder impingement syndrome.

    Science.gov (United States)

    Lin, Jiu-jenq; Hsieh, Shih-Chang; Cheng, Wei-Cheng; Chen, Wei Chun; Lai, Yuta

    2011-05-01

    The purpose of this study was to determine if a distinctive characteristic exists in the pattern of movement (scapular elevation and upward rotation to reduce impingement) and associated muscular activities during arm elevation in subjects with shoulder impingement (SI) that is associated with the severity of the disease. Fourteen subjects (7 amateur athletes and 7 student athletes) with SI and 7 controls performed arm elevation in the scapular plane. Scapular kinematics (upward rotation, elevation, tipping, and scapulohumeral rhythm) and muscular activity [upper trapezius (UT), lower trapezius (LT), serratus anterior (SA), and deltoid] were measured by an electromagnetic motion tracking system and surface electromyography, respectively. Subjects with SI had greater elevation of the scapula (11.9 mm, p < 0.005) and less peak scapular posterior tipping (10.6°, p < 0.02) than controls. In more severe subjects (amateur athletes), the elevation and posterior tipping of the scapula were correlated with an increase in the UT (R = -0.818, p = 0.025) and a decrease in SA (R = 0.772, p = 0.040) activity, respectively. Our results identified a characteristic compensatory scapular elevation to reduce impingement during arm elevation in subjects with SI. Assessing scapular elevation during arm elevation may be a useful functional marker for evaluating impingement status and associated muscle function. Additionally, SA and LT muscle strengthening may improve SI. Copyright © 2010 Orthopaedic Research Society.

  19. 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.

  20. Vascularized scapular grafting for treatment of osteonecrosis of the humeral head.

    Science.gov (United States)

    Kawamura, Kenji; Kawate, Kenji; Yajima, Hiroshi; Kobata, Yasunori; Takakura, Yoshinori

    2008-11-01

    Eight dissections in four embalmed cadavers were performed to investigate the possibility of vascularized scapular grafting for osteonecrosis of the humeral head. When the angular branch was used as the nutrient vessel, the mean length of the vascular pedicle was 12.4 cm, which was sufficient for transferring the scapula into the humeral head. Based on the anatomical study, a 27-year-old man with corticosteroid-induced osteonecrosis of the right humeral head was treated by vascularized scapular grafting. The pedicled vascularized scapula was successfully transferred into the humeral head using the angular branch. The patient's right shoulder pain disappeared following surgical recovery. He had no limitations of right shoulder motion 3 years after the surgery. Magnetic resonance imaging at 1 year after the surgery indicated revascularization of the humeral head. The humeral head did not collapse during a 3-year follow-up with radiographic evaluation. This procedure has the potential to be a new joint-preserving procedure for osteonecrosis of the humeral head.

  1. A new basal sauropodiform dinosaur from the Lower Jurassic of Yunnan Province, China

    Science.gov (United States)

    Wang, Ya-Ming; You, Hai-Lu; Wang, Tao

    2017-02-01

    The Lufeng Formation in Lufeng Basin of Yunnan Province, southwestern China preserves one of the richest terrestrial Lower Jurassic vertebrate faunas globally, especially for its basal sauropodomorphs, such as Lufengosaurus and Yunnanosaurus. Here we report a new taxon, Xingxiulong chengi gen. et sp. nov. represented by three partial skeletons with overlapping elements. Xingxiulong possesses a number of autapomorphies, such as transversely expanded plate-like summit on top of the neural spine of posterior dorsal vertebrae, four sacral vertebrae, robust scapula, and elongated pubic plate approximately 40% of the total length of the pubis. Phylogenetic analysis resolves Xingxiulong as a basal member of Sauropodiformes, and together with another two Lufeng basal sauropodiforms Jingshanosaurus and Yunnanosaurus, they represent the basalmost lineages of this clade, indicating its Asian origin. Although being relatively primitive, Xingxiulong displays some derived features normally occurred in advanced sauropodiforms including sauropods, such as a four sacral-sacrum, a robust scapula, and a pubis with elongated pubic plate. The discovery of Xingxiulong increases the diversity of basal sauropodomorphs from the Lufeng Formation and indicates a more complicated scenario in the early evolution of sauropodiforms.

  2. Elite swimmers with and without unilateral shoulder pain: mechanical hyperalgesia and active/latent muscle trigger points in neck-shoulder muscles.

    Science.gov (United States)

    Hidalgo-Lozano, A; Fernández-de-las-Peñas, C; Calderón-Soto, C; Domingo-Camara, A; Madeleine, P; Arroyo-Morales, M

    2013-02-01

    Our aim was to investigate the presence of mechanical hypersensitivity and active trigger points (TrPs) in the neck-shoulder muscles in elite swimmers with/without unilateral shoulder pain. Seventeen elite swimmers with shoulder pain; 18 swimmers without shoulder pain; and 15 elite athletes matched controls were recruited. Pressure pain thresholds (PPT) were assessed over the levator scapulae, sternocleidomastoid, upper trapezius, infraspinatus, scalene, subscapularis and tibialis anterior muscles. TrPs in the levator scapulae, upper trapezius, infraspinatus, scalene, sternocleidomastoid and subscapularis muscles were also explored. Swimmers with shoulder pain showed significant lower PPT in all muscles compared with controls (Pactive; 2.6 ± 1.4 latent) and 4.7 ± 1.3 (1.3 ± 1.3 active; 3.4 ± 1.5 latent), whereas healthy athletes only showed latent TrPs (2.4 ± 1.2). Elite swimmers with shoulder pain showed higher number of active TrPs than swimmers without pain, whereas it was the opposite for the number of latent muscle TrP (Pactive TrPs play a role in the development of shoulder pain in elite swimmers. © 2011 John Wiley & Sons A/S.

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

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    Morita, Wataru; Tasaki, Atsushi [St. Luke' s International Hospital, Department of Orthopaedic Surgery, Tokyo (Japan); Nozaki, Taiki [St. Luke' s International Hospital, Department of Radiology, Tokyo (Japan)

    2017-02-15

    Scapular dyskinesis describes the altered position of the scapula and/or abnormal movements of the scapulothoracic joint. It is caused by bony anatomical variations, bursitis, tumors, and muscular pathological conditions including loss of innervation and fibrosis. Scapular dyskinesis is just as often subclinical as it is symptomatic, and as the periscapular anatomical changes may not result in patient symptoms, a precise diagnosis of the etiology and pathophysiology has been a challenge. Scapular bony prominence is a common etiology of scapular dyskinesis, but does not always result in morbidity. We report a case of a 39-year-old man in whom an extensive MRI with fluid-sensitive imaging sequences covering the whole of the scapula was beneficial in diagnosing the inflammation adjacent to the bony deformity, which confirmed the etiology of scapular dyskinesis. Furthermore, in a 41-year old man without any anatomical variances, a similar MRI showed inflammation at the subscapular fossa that suggested altered scapular kinematics. An arthroscopic debridement of the lesion improved the symptoms. MRI in conjunction with plain radiographs, CT and physical examination enabled a precise diagnosis of the etiology. Fluid-sensitive MR images are important in defining the presence of inflammation, and are beneficial in determining the pathological significance of findings through other diagnostic measures. (orig.)

  4. Main component of soft tissue artifact of the upper-limbs with respect to different functional, daily life and sports movements.

    Science.gov (United States)

    Blache, Y; Dumas, R; Lundberg, A; Begon, M

    2017-09-06

    Soft tissue artifact (STA) is the main source of error in kinematic estimation of human movements based on skin markers. Our objective was to determine the components of marker displacements that best describe STA of the shoulder and arm (i.e. clavicle, scapula and humerus). Four participants performed arm flexion and rotation, a daily-life and a sports movement. Three pins with reflective markers were inserted into the clavicle, scapula and humerus. In addition, up to seven skin markers were stuck on each segment. STA was described with a modal approach: individual marker displacements or marker-cluster (i.e. translations, rotations, homotheties and stretches) relative to the local segment coordinate system defined by markers secured to the pins. The modes were then ranked according to the percentage of total STA energy that they explained. Both individual skin marker displacements and marker-cluster geometrical transformations were task-, location-, segment- and subject-specific. However, 85% of the total STA energy was systematically explained by the rigid transformations (i.e. translations and rotations of the marker-cluster). In conclusion, large joint dislocations and limited efficiency of least squares bone pose estimators are expected for the computation of upper limb joint kinematics from skin markers. Future developments shall consider the rigid transformations of marker-clusters in the implementation of an STA model to reduce its effects on kinematics estimation. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. Skinfold Thickness at 8 Common Cryotherapy Sites in Various Athletic Populations

    Science.gov (United States)

    Jutte, Lisa S.; Hawkins, Jeremy; Miller, Kevin C.; Long, Blaine C.; Knight, Kenneth L.

    2012-01-01

    Context: Researchers have observed slower cooling rates in thigh muscle with greater overlying adipose tissue, suggesting that cryotherapy duration should be based on the adipose thickness of the treatment site. Skinfold data do not exist for other common cryotherapy sites, and no one has reported how those skinfolds might vary because of physical activity level or sex. Objective: To determine the variability in skinfold thickness among common cryotherapy sites relative to sex and activity level (National Collegiate Athletic Association Division I athletes, recreationally active college athletes). Design: Descriptive laboratory study. Setting: Field. Patients or Other Participants: Three hundred eighty-nine college students participated; 196 Division I athletes (157 men, 39 women) were recruited during preseason physicals, and 193 recreationally active college athletes (108 men, 85 women) were recruited from physical education classes. Intervention(s): Three skinfold measurements to within 1 mm were taken at 8 sites (inferior angle of the scapula, middle deltoid, ulnar groove, midforearm, midthigh, medial collateral ligament, midcalf, and anterior talofibular ligament [ATF]) using Lange skinfold calipers. Main Outcome Measure(s): Skinfold thickness in millimeters. Results: We noted interactions among sex, activity level, and skinfold site. Male athletes had smaller skinfold measurements than female athletes at all sites except the ATF, scapula, and ulnar groove (F7,2702 = 69.85, P cryotherapy treatment sites varied based on level of physical activity and sex. Therefore, clinicians should measure skinfold thickness to determine an appropriate cryotherapy duration. PMID:22488282

  6. Assessment of body parameters' symmetry in child violinists.

    Science.gov (United States)

    Cygańska, Anna; Truszczyńska-Baszak, Aleksandra; Drzał-Grabiec, Justyna; Tarnowski, Adam

    2017-09-22

    Playing violin may lead to overload of the locomotor system. The aim of this study was to assess body parameters for trunk symmetry in child violinists and compare with the control group. We analyzed body posture of 101 children aged 7-12 years, mean age 11.09 ± 9.46, 49 child violinists and control group of 52 children. We found statistically significant differences for the difference in depth of the lower corners of scapulae and upper posterior spina iliaca, though greater asymmetries were found in the clinical control group. The remaining parameter values are close to significance, which may suggest that the process of postural change among the children had just started and that the existing asymmetries were easy to correct. We found positive correlation between body height and the difference in distance of the lower corners of scapulae from the spine: OL (p= 0.029, correlation coefficient value was 0.167) and the Thales triangle height: (p= 0.018, correlation coefficient was 0.214). Position maintained while playing the violin changed some parameters characterizing the curvature of the spine in frontal plane. We found the importance of detailed analysis of children body posture and its critical assessment.

  7. Sensory Feedback Plays a Significant Role in Generating Walking Gait and in Gait Transition in Salamanders: A Simulation Study

    Science.gov (United States)

    Harischandra, Nalin; Knuesel, Jeremie; Kozlov, Alexander; Bicanski, Andrej; Cabelguen, Jean-Marie; Ijspeert, Auke; Ekeberg, Örjan

    2011-01-01

    Here, we investigate the role of sensory feedback in gait generation and transition by using a three-dimensional, neuro-musculo-mechanical model of a salamander with realistic physical parameters. Activation of limb and axial muscles were driven by neural output patterns obtained from a central pattern generator (CPG) which is composed of simulated spiking neurons with adaptation. The CPG consists of a body-CPG and four limb-CPGs that are interconnected via synapses both ipsilaterally and contralaterally. We use the model both with and without sensory modulation and four different combinations of ipsilateral and contralateral coupling between the limb-CPGs. We found that the proprioceptive sensory inputs are essential in obtaining a coordinated lateral sequence walking gait (walking). The sensory feedback includes the signals coming from the stretch receptor like intraspinal neurons located in the girdle regions and the limb stretch receptors residing in the hip and scapula regions of the salamander. On the other hand, walking trot gait (trotting) is more under central (CPG) influence compared to that of the peripheral or sensory feedback. We found that the gait transition from walking to trotting can be induced by increased activity of the descending drive coming from the mesencephalic locomotor region and is helped by the sensory inputs at the hip and scapula regions detecting the late stance phase. More neurophysiological experiments are required to identify the precise type of mechanoreceptors in the salamander and the neural mechanisms mediating the sensory modulation. PMID:22069388

  8. Sensory feedback plays a significant role in generating walking gait and in gait transition in salamanders: A simulation study

    Directory of Open Access Journals (Sweden)

    Nalin eHarischandra

    2011-11-01

    Full Text Available Here, we use a three-dimensional, neuro-musculo-mechanical model of a salamander with realistic physical parameters in order to investigate the role of sensory feedback in gait generation and transition. Activation of limb and axial muscles were driven by neural output patterns obtained from a central pattern generator (CPG which is composed of simulated spiking neurons with adaptation. The CPG consists of a body CPG and four limb CPGs that are interconnected via synapses both ipsilateraly and contralaterally. We use the model both with and without sensory modulation and for different combinations of ipsilateral and contralateral coupling between the limb CPGs. We found that the proprioceptive sensory inputs are essential in obtaining a coordinated walking gait. The sensory feedback includes the signals coming from the stretch receptor like intraspinal neurons located in the girdle regions and the limb stretch receptors residing in the hip and scapula regions of the salamander. On the other hand, coordinated motor output patterns for the trotting gait were obtainable without the sensory inputs. We found that the gait transition from walking to trotting can be induced by increased activity of the descending drive coming from the mesencephalic locomotor region (MLR and is helped by the sensory inputs at the hip and scapula regions detecting the late stance phase. More neurophysiological experiments are required to identify the precise type of mechanoreceptors in the salamander and the neural mechanisms mediating the sensory modulation.

  9. Safety screw fixation technique in a case of coracoid base fracture with acromioclavicular dislocation and coracoid base cross-sectional size data from a computed axial tomography study.

    Science.gov (United States)

    Kawasaki, Yoshiteru; Hirano, Tetsuya; Miyatake, Katsutoshi; Fujii, Koji; Takeda, Yoshitsugu

    2014-07-01

    Coracoid base fracture accompanied by acromioclavicular joint dislocation with intact coracoclavicular ligaments is a rare injury. Generally, an open reduction with screw fixation is the first treatment choice, as it protects the important structures around the coracoid process. This report presents a new technique of screw fixation for coracoid base fracture and provides anatomic information on cross-sectional size of the coracoid base obtained by computed tomography (CT). An axial image of the coracoid base was visualized over the neck of the scapula, and a guidewire was inserted into this circle under fluoroscopic guidance. The wire was inserted easily into the neck of scapula across the coracoid base fracture with imaging in only 1 plane. In addition, 25 measurements of the coracoid base were made in 25 subjects on axial CT images. Average length of the long and short axes at the thinnest part of the coracoid base was 13.9 ± 2.0 mm (range 10.6-17.0) and 10.5 ± 2.2 mm (6.6-15.1), respectively. This new screw fixation technique and measurement data on the coracoid base may be beneficial for safety screw fixation of coracoid base fracture.

  10. An Atypical Path of a Bullet in Thorax in a Firearm Injury Case Report

    Directory of Open Access Journals (Sweden)

    Ufuk Çobanoğlu

    2008-08-01

    Full Text Available Various weapons have been used in the history of mankind for defence and attack. With the progression of new technologies numerous types and greater destroying effects accompanied these weapons. Bullets of gunshots can be localised in different regions from the entry point due to its high kinetic energy and tissue contact. Fourty eight years old male was admitted to emergency unit due to gun shot injury on the chest. Bullet entered thorax from 4. intercostal space. It passed through upper lobe by causing injure paranchyme and toward sternum. It entered to right hemithorax by pericardial laceration and rupture of internal mammary artery and then changed its direction downward. Following right lower lobe laseration and 7. rib fracture, it directed upward and left thorax from 5.intercostal space. It injured medial border of scapula and setteled down to posterior of scapula. This case was discussed for its interesting outcome due to an atipical route in the chest with a gunshot bullet. Key words: Gunshot bullet core, atipical route, chest cavity, forensic case

  11. Influence of the positioning of a cementless glenoid prosthesis on its interface micromotions.

    Science.gov (United States)

    Suárez, D R; van der Linden, J C; Valstar, E R; Broomans, P; Poort, G; Rozing, P M; van Keulen, F

    2009-10-01

    The positioning of the glenoid component in total shoulder arthroplasty is complicated by the limited view during operation. Malalignment and/or motion of the glenoid component with respect to the bone can be a cause of, or contribute to, failure of the implant. The aim of this paper is to determine the effect of the positioning of a cementless glenoid component on the micromotions between the implant and the bone during normal loading after surgery. For this study a three-dimensional finite element model of a complete scapula with a cementless glenoid component was used. In total, eight positions of the upper arm in both abduction and anteflexion were chosen to represent the patient's arm movement postoperatively. A previously published musculoskeletal model was used to determine the joint and muscle forces on the scapula with implant in each arm position. Five different alignments of the glenoid component (neutral, anterior, inferior, posterior, and superior inclinations), two different implantation depths ('optimal' and 'deeper' implantations), and two bone qualities (healthy and rheumatoid arthritis (RA) bone) were considered. Inclinations of 10 degrees with respect to a neutral alignment did not affect the overall interface micromotions in the optimal implantation depth. However, when the implantation depth was 3 mm deeper, anterior and inferior inclinations were more favourable than a neutral alignment and other inclinations. Micromotions in RA bone were always larger than in healthy bone.

  12. ANATOMIA ÓSSEA E MUSCULAR DO CÍNGULO ESCAPULAR E BRAÇO DE Tapirus terrestris (PERISSODACTYLA: TAPIRIDAE

    Directory of Open Access Journals (Sweden)

    Saulo Gonçalves Pereira

    2015-04-01

    Full Text Available Tapirus terrestris (Linneaus, 1758 is a mammal found in South America and in almost all Brazilian biomes. The aim of this study was to describe the anatomy of bone and muscle of the scapular cingulum and arm of Tapirus terrestris and compare it with other species of mammals, especially equines. We used four animals donated to the Laboratory of Education and Research of Wild Animals of the Federal University of Uberlândia, after their death with no trauma. The bones were carefully analyzed, described and the muscles were dissected, analyzed and described in accordance with the usual techniques of gross anatomy. The skeleton of the scapular cingulum and arm of Tapirus terrestris is formed by scapula and humerus bones, the lateral muscles of the scapula are subclavian m., deltoid m. supraspinatus m. and infraspinatus, teres minor m., subscapularis m., teres major m., coracobrachialis m., shoulder joint m., biceps brachii m., brachial m. triceps, forearm tensor fasciae m., anconeus m. The muscular and bone standard found is similar to the horse (Equus caballus T. terrestris has bone and muscle characteristics of a suitable animal to displacement and eventual swimming with obvious bone accidents and developed muscles .

  13. Anatomy of Shoulder Girdle Muscle Modifications and Walking Adaptation in the Scaly Chinese Pangolin (Manis Pentadactyla Pentadactyla: Pholidota) Compared with the Partially Osteoderm-Clad Armadillos (Dasypodidae).

    Science.gov (United States)

    Kawashima, Tomokazu; Thorington, Richard W; Bohaska, Paula W; Chen, Yen-Jean; Sato, Fumi

    2015-07-01

    Because pangolins are unique mammals with a body and limbs almost entirely sheathed in hard keratinous overlapping scales and with digging and climbing abilities, the shoulder girdle muscles may differ significantly from those of other mammals including the partially osteoderm-clad armadillos. Therefore, we conducted a functional anatomical study of the shoulder girdle muscles in Chinese pangolins (Manis pentadactyla pentadactyla, Pholidota) and some armadillo species (Dasypodidae). Our CT scans revealed that the pangolin's overlapping scales are hard structures completely encasing the limbs. The armadillo's limbs, however, are covered with small relatively soft non-overlapping scales embedded in the skin, and articulate completely free of the hard osteodermal carapace. The attachments of some shoulder girdle muscles in the pangolin have moved from the surrounding edges of the scapula to the spine, and they, therefore, fully cover the scapula. In addition, some pangolin shoulder girdle muscles cross the shoulder joint to insert on the distal humerus, but this does not occur in armadillos. We cannot rule out the possibility that these muscle modifications represent adaptations for digging and/or climbing in pangolins. Our results and previous literature do not establish specific links between them and locomotive modes. However, we propose that the Chinese pangolin may use its derived muscular features when walking to move its armor-restricted forelimbs more effectively by swinging its head from side to side. © 2015 Wiley Periodicals, Inc.

  14. Are chronic neck pain, scapular dyskinesis and altered scapulothoracic muscle activity interrelated?: A case-control study with surface and fine-wire EMG.

    Science.gov (United States)

    Castelein, Birgit; Cools, Ann; Parlevliet, Thierry; Cagnie, Barbara

    2016-12-01

    The function of the scapula is important in normal neck function and might be disturbed in patients with neck pain. The surrounding muscular system is important for the function of the scapula. To date, it is not clear if patients with idiopathic neck pain show altered activity of these scapulothoracic muscles. Therefore, the objective of this study was to investigate differences in deeper and superficial lying scapulothoracic muscle activity between patients with idiopathic neck pain and healthy controls during arm elevation, and to identify the influence of scapular dyskinesis on muscle activity. Scapular dyskinesis was rated with the yes/no method. The deeper lying (Levator Scapulae, Pectoralis Minor (Pm) and Rhomboid major) and superficial lying (Trapezius and Serratus Anterior) scapulothoracic muscles' activity was investigated with fine-wire and surface EMG, respectively, in 19 female subjects with idiopathic neck pain (age 28.3±10.1years, average duration of neck pain 45.6±36.3months) and 19 female healthy control subjects (age 29.3±11.7years) while performing scaption and towel wall slide. Possible interactions or differences between subject groups, scapular dyskinesis groups or phases of the task were studied with a linear mixed model. Higher Pm activity during the towel wallslide (p=0.024, mean difference 8.8±3.3% MVIC) was shown in patients with idiopathic neck pain in comparison with healthy controls. For the MT, a significant group∗dyskinesis interaction effect was found during scaption which revealed that patients with neck pain and scapular dyskinesis showed lower Middle Trapezius (MT) activity in comparison with healthy controls with scapular dyskinesis (p=0.029, mean difference 5.1±2.2% MVIC). In the presence of idiopathic neck pain, higher Pm activity during the towel wallslide was found. Patients with neck pain and scapular dyskinesis showed lower MT activity in comparison with healthy controls with scapular dyskinesis during scaption

  15. [Anatomy of fractures of the inferior scapular angle].

    Science.gov (United States)

    Bartoníček, J; Tuček, M; Malík, J

    2018-01-01

    The aim of this study is to describe the anatomy of fractures of the inferior angle and the adjacent part of the scapular body, based on 3D CT reconstructions. In a series of 375 scapular fractures, we identified a total of 20 fractures of the inferior angle of the scapular body (13 men, 7 women), with a mean patient age of 50 years (range 3373). In all fractures, 3D CT reconstructions were obtained, allowing an objective evaluation of the fracture pattern with a focus on the size and shape of the inferior angle fragment, propagation of the fracture line to the lateral and medial borders of the infraspinous part of the scapular body, fragment displacement and any additional fracture of the ipsilateral scapula and the shoulder girdle. We identified a total of 5 types of fracture involving the distal half of the infraspinous part of the scapular body. The first type, recorded in 5 cases, affected only the apex of the inferior angle, with a small part of the adjacent medial border. The second type, occurring in 4 cases, involved fractures separating the entire inferior angle. The third type, represented by 4 cases, was characterized by a fracture line starting medially close above the inferior angle and passing proximolaterally. The separated fragment had a shape of a big drop, carrying also the distal half of the lateral pillar in addition to the inferior angle. In the fourth type identified in 5 fractures, the separated fragment was formed both by the inferior angle and a variable part of the medial border. The fifth type, being by its nature a transition to the fracture of the infraspinous part of the body, was recorded in 2 cases, with the same V-shaped fragment. Fractures of the inferior angle and the adjacent part of the scapular body are groups of fractures differing from other infraspinous fractures of the scapular body. Although these fractures are highly variable in terms of shape, they have the same course of fracture line and the manner of displacement

  16. The cat vertebral column: stance configuration and range of motion

    Science.gov (United States)

    Macpherson, J. M.; Ye, Y.; Peterson, B. W. (Principal Investigator)

    1998-01-01

    This study examined the configuration of the vertebral column of the cat during independent stance and in various flexed positions. The range of motion in the sagittal plane is similar across most thoracic and lumbar joints, with the exception of a lesser range at the transition region from thoracic-type to lumbar-type vertebrae. The upper thoracic column exhibits most of its range in dorsiflexion and the lower thoracic and lumbar in ventroflexion. Lateral flexion is limited to less than 5 degrees at all segments. The range in torsion is almost 180 degrees and occurs primarily in the midthoracic region, T4-T11. Contrary to the depiction in most atlases, the standing cat exhibits several curvatures, including a mild dorsiflexion in the lower lumbar segments, a marked ventroflexion in the lower thoracic and upper lumbar segments, and a profound dorsiflexion in the upper thoracic (above T9) and cervical segments. The curvatures are not significantly changed by altering stance distance but are affected by head posture. During stance, the top of the scapula lies well above the spines of the thoracic vertebrae, and the glenohumeral joint is just below the bodies of vertebrae T3-T5. Using a simple static model of the vertebral column in the sagittal plane, it was estimated that the bending moment due to gravity is bimodal with a dorsiflexion moment in the lower thoracic and lumbar region and a ventroflexion moment in the upper thoracic and cervical region. Given the bending moments and the position of the scapula during stance, it is proposed that two groups of scapular muscles provide the major antigravity support for the head and anterior trunk. Levator scapulae and serratus ventralis form the lateral group, inserting on the lateral processes of cervical vertebrae and on the ribs. The major and minor rhomboids form the medial group, inserting on the spinous tips of vertebrae from C4 to T4. It is also proposed that the hypaxial muscles, psoas major, minor, and quadratus

  17. Head kinematics and shoulder biomechanics in shoulder impacts similar to pedestrian crashes--a THUMS study.

    Science.gov (United States)

    Paas, Ruth; Davidsson, Johan; Brolin, Karin

    2015-01-01

    Head injuries account for the largest percentage of fatalities among pedestrians in car crashes. To prevent or mitigate such injuries, safety systems that reduce head linear and rotational acceleration should be introduced. Human body models (HBMs) are valuable safety system evaluation tools for assessing both head injury risk and head kinematics prior to head contact. This article aims to evaluate the suitability of the Total Human Model for Safety (THUMS) version 4.0 for studying shoulder impacts, similar to pedestrian crashes, investigating head, spine, and shoulder kinematics as well as shoulder biomechanics. Shoulder impact experiments including volunteers and postmortem human subjects (PMHSs) were simulated with THUMS. Head linear and angular and vertebral linear displacements of THUMS were compared with volunteers and shoulder deflections with both volunteers and PMHSs. A parameter variation study was conducted to assess head response to shoulder impacts, by varying shoulder posture and impact directions mimicking shoulder-to-vehicle contacts. Functional biomechanics literature was compared with THUMS responses in view of pedestrian-like shoulder impacts. THUMS head linear displacement compared better with tensed than with relaxed volunteers. Head lateral rotation was comparable with volunteer responses up to 120 ms; head twist was greater in THUMS than in the volunteers. The THUMS spine appeared to be stiffer than in the volunteers. Shoulder deflections were smaller than in the relaxed volunteers but matched the PMHSs. Raised shoulder postures decreased the THUMS shoulder deflections and increased head lateral displacements. When the impactor surface orientation or the impact velocity angle was changed from lateral to superolateral, THUMS head lateral displacement decreased. THUMS scapula and clavicle kinematics compared well with previous experimental studies. The shoulder impact conditions influenced the scapula motion over the thorax, which had

  18. PREVALENCE OF UPPER CROSS SYNDROME AMONG THE MEDICAL STUDENTS OF UNIVERSITY OF LAHORE

    Directory of Open Access Journals (Sweden)

    Iqra Mubeen

    2016-06-01

    Full Text Available Background: Upper cross syndrome is becoming more prevalent in today’s population. The syndrome is expressed as a postural disorder presenting with over active pectoralis musculature and upper trapezius musculature. Also there is inhibition of lower and middle trapezius musculature, which results in winging of scapula, elevated and abducted scapula. This scapulardyskinesia there by resulted inrounding of shoulders. The syndrome is often associated with bad posture in routine life oroccupation of a person.The purpose of the study is to determine the prevalence of upper cross syndrome in medical students of Lahore. Methods: A convenience sample of 384 medical students was selected from university of Lahore, based on inclusion and exclusion criteria. Medical students of age between 17 to 2 years with sound physical and mental state were included. Students with any trauma, recent injury, recent fracture or surgery and any serious underlying pathology that may interfere with mobility of upper limb were excluded from the study. The research was a cross sectional observational study and self-administered questionnaires were circulated among participants and the data was analyzed using SPSS version 21. Reed-co scale was used to analyze the proper alignment of head, neck and shoulder; where as wall push test was used to assess the abnormal protrusion of scapula. Results: The study have revealed that48.7% population of the students haveneck pain;and the results have concluded that high prevalence of upper cross syndrome in medical students of university of Lahore and a 66.8% of population was found to have poor studying posture. Conclusion: In this study relation between upper cross syndrome and bad posture were seen and it was found that the individuals suffering with upper cross syndrome were somehow related to bad posture or indulge in activities which make individual to adopt a posture of high physiologic cost there by leading to muscular imbalance

  19. Posterosuperior and anterosuperior impingement of the shoulder in overhead athletes—evolving concepts

    Science.gov (United States)

    Kirchhoff, Chlodwig

    2010-01-01

    During throwing motion the athlete puts enormous stress on both the dynamic and the static stabilisers of the shoulder. Repetitive forces cause adaptive soft tissue and bone changes that initially improve performance but ultimately may lead to shoulder pathologies. Although a broad range of theories have been suggested for the pathophysiology of internal impingement, the reasons are obviously multifactorial. This review aims to critically analyse the current literature and to summarise clinically important information. The cardinal lesions of internal impingement, articular-sided rotator cuff tears and posterosuperior labral lesions, have been shown to occur in association with a number of other findings, most importantly glenohumeral internal rotation deficit and SICK scapula syndrome, but also with posterior humeral head lesions, posterior glenoid bony injury and, rarely, with Bankart and inferior glenohumeral ligament lesions. Extensive biomechanical and clinical research is necessary before a complete understanding and reconciliation of the varying theories of the pathomechanisms of injury can be developed. PMID:20490792

  20. Biomechanical comparison of screw-in suture anchor-suture combinations used for Bankart repair.

    Science.gov (United States)

    Sparks, Brad S; Nyland, John; Nawab, Akbar; Blackburn, Ethan; Krupp, Ryan; Caborn, David N M

    2010-03-01

    Bankart repair laxity may contribute to pathologic joint instability. This biomechanical study compared two screw-in suture anchor-suture combinations under tensile loads. Twelve pairs of scapulae were implanted with either a 3 mm diameter, 14 mm long poly-L/D-lactide suture anchor with a suture eyelet (Group 1) or a 3.1 mm diameter, 11 mm long polylactide suture anchor with a molded eyelet (Group 2). Constructs were cyclically loaded between 25 and 50 N with a 25 N load increase every 25 cycles. Group 2 displayed greater displacement at failure, had more specimens with > or =2 mm displacement by the 50 N interval (P = 0.014), and had displaced more by 100 N (P suture anchor-suture loops, the rehabilitation timetable, and the timing of return to unrestricted activities.

  1. Analysis and Modeling of Motor Vehicle Crashes Involving Air Force Military Personnel

    Science.gov (United States)

    2009-09-01

    Fracture patella , tibia or fibula 26.9 7.8 Fractured femur (short-termc) 26.1 7.5 Internal injuries 21.9 6.3 Fractured ulna...or radius 19.2 5.5 Fractured clavicle, scapula or humerus 16.7 4.8 Fractured facial bones 11.4 3.3 Fractured rib or sternum 11.1 3.2 Fractured ...ankle 10.8 3.1 Fractured vertebral column 9.4 2.7 Fractured pelvis 8.8 2.6 Sprains 8.3 2.4 Fractured skull (short-termc) 7.9 2.3 Fractured

  2. Sprengel's deformity and spinal dysraphism: connecting the shoulder and the spine.

    Science.gov (United States)

    van Aalst, J; Vles, J S H; Cuppen, I; Sival, D A; Niks, E H; Van Rhijn, L W; Van Steensel, M A M; Cornips, E M J

    2013-07-01

    Sprengel's deformity, a rare congenital malformation of the scapula, may be observed in combination with spinal dysraphism. The co-occurrence of these malformations suggests an unknown shared etiology. Therefore, we reviewed the medical records of eight children presenting with both malformations and performed a review of the literature. Databases from four university medical centers were searched for children presenting between 1992 and 2012 with spinal dysraphism and a Sprengel's deformity. The combination of spinal dysraphism and Sprengel's deformity is rare, and is associated with segmentation defects of the spine and ribs. Although the etiology of both spinal dysraphism and Sprengel's deformity remains unclear, all deformities of the spine, ribs, and shoulder might result from a common genetic defect affecting somitogenesis.

  3. Postmortem noninvasive virtual autopsy: extrapleural hemorrhage after blunt thoracic trauma.

    Science.gov (United States)

    Bolliger, Stephan A; Thali, Michael J; Aghayev, Emin; Jackowski, Christian; Vock, Peter; Dirnhofer, Richard; Christe, Andreas

    2007-03-01

    A 19-year-old man speeding recklessly along a highway caused a left-frontal crash with another car. After his vehicle came to a standstill, he climbed out of the wreck and crawled across the tarmac to the other side of the road, where he died several minutes after the accident and before the arrival of an ambulance. Postmortem multislice computed tomography (MSCT) demonstrated fractures of the first, second, and third ribs and scapula on the left, an extrapleural hemorrhage in the apical region of the left thorax, as well as a large amount of blood in the left thoracic cavity. These radiologic findings were indicative of a delayed rupture of a traumatic extrapleural hematoma into the pleural space. A traditional autopsy confirmed the very rare diagnosis of a traumatic extrapleural hemorrhage with a delayed rupture.

  4. Morel-Lavallee Lesion (MLL) Mimicking A Soft Tissue Neoplasm.

    Science.gov (United States)

    Kumar, Sandeep; Hasan, Roumina; Kadavigere, Rajagopal; Maddukuri, Satish Babu; Puppala, Radha

    2015-04-01

    Morel-lavallee lesion (MLL) represents post traumatic subcutaneous cyst generally overlying bony prominences like greater trochanter, lower back, knee and scapula. A 51-year-old man presented with a swelling in left thigh since six years which was insidious in onset, gradually progressive in size and not associated with pain, fever or discharge. There was no history of trauma or any associated constitutional symptoms. Since there was no history of trauma recalled by the patient the clinical dilemma was between soft tissue sarcoma and cold abscess. We report a case of slow growing painless mass lesion of thigh, diagnosed on Magnetic Resonance Imaging (MRI) as morel lavallee lesion and describe its salient imaging features with treatment options.

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

    Science.gov (United States)

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

    2017-04-01

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

  6. Bone Scintigraphic Findings in Leukemic Patients

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Hyo Sun; Park, Jeong Mi; Shon, Hyeong Seon; Chang, Soo Kyo; Kim, Choon Yul; Bahk, Yong Hee; Shinn, Kyung Sub [Catholic University College of Medicine, Seoul (Korea, Republic of)

    1992-03-15

    The leukemias represent diffuse lesions of the bone marrow and significant bony abnormalities are associated with the more aggressive varieties of leukemias and with the younger age groups. On plain film, several roentgenographic findings are observed such as diffuse osteopenia, radiolucent metaphyseal bands, osteolytic lesions and periostitis. We evaluated bone scintigraphic findings using {sup 99m}Tc-methylene diphosphonate ({sup 99m}Tc-MDP) in ten patients with proven leukemia. The scan is abnormal in 90%. We classified abnormal scintigraphic findings to 3 types and these are increased diffuse juxta-articular uptake, focal increase of uptake and combined type. The common sites of focal uptake were femur, humerus, tibia, spine, ribs, calvarium, scapula and mandible. We concluded that {sup 99m}Tc-MDP bone scintigraphy is sensitive imaging modality in leukemic patients with bone pain.

  7. OSTEOCONDROSARCOMA IN DOG - STUDY OF A CASE OSTEOCONDROSARCOMA EM CÃO, RELATO DE UM CASO

    Directory of Open Access Journals (Sweden)

    Peter Fisher

    2007-09-01

    Full Text Available

    In this present paper the authors report one case of osteocondrosarcoma in a male Fox Terrier 15 years old. The primary lesion was found in the left scapula with two mouth evolution and there was lung methastasis. The macro and microscopical features as well as the classification are presented in the paper.

    O presente trabalho relata o achado de um caso de osteocondrosarcoma em cão macho da raça Fox Terrier com 15 anos de idade, localizado na escápula esquerda com evolução de dois meses e com metástases pulmonares. Os aspectos macro e microscópicos, bem como a nomenclatura empregada, são discutidos no trabalho.

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

    Science.gov (United States)

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

    2013-07-01

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

  9. Extended long-term (5 years) outcomes of triangle tilt surgery in obstetric brachial plexus injury.

    Science.gov (United States)

    Nath, Rahul K; Somasundaram, Chandra

    2013-01-01

    We evaluated the "extended" long-term (5 years) functional outcomes in obstetric brachial plexus injury (OBPI) patients, who underwent triangle tilt surgery between February 2005 and January 2008. Twenty two children (9 girls and 13 boys, mean age at surgery was 5.8 years; ranging 2.1-11.8 years old), who initially presented with medial rotation contracture and scapula deformity secondary to obstetric brachial plexus injury were included in this study. Functional movements were evaluated pre-operatively, and 5 years following triangle tilt surgery by modified Mallet scale. Here, we report long-term (5 years) follow-up of triangle tilt surgery for 22 OBPI patients. Upper extremity functional movements such as, external rotation (2.5±0.6 to 4.1±0.8, ptriangle tilt surgery improved all shoulder functions significantly, and maintained over the extended long-term (5 years) in these patients.

  10. Andreas Vesalius' five hundreth anniversary: initiation of the rotator cuff concept.

    Science.gov (United States)

    Brinkman, Romy J; Hage, J Joris

    2015-12-01

    The rotator cuff concept refers to the four scapulohumeral muscles that stabilize and rotate the humerus relative to the scapula. To date, the first description of the rotator cuff remained unidentified. In light of the 500th birthday of Andreas Vesalius (1515-1564) we searched his 1543 masterwork "Fabrica Corporis Humani Libri Septem" for references to the morphology and function of the rotator cuff muscles. Even though he distinguished three rather than four scapulohumeral muscles, Vesalius recognized the need for structures that prevent dislocation of the shoulder inherent to the morphology of the humeral caput and scapular socket. He recorded "three strong ligaments" and the "three muscles that rotate the arm" of which the tendons completely "embrace the ligaments of the joint" as such structures. Vesalius defined the rotator cuff concept avant la lettre.

  11. Differences in standing and sitting postures of youth with idiopathic scoliosis from quantitative analysis of digital photographs.

    Science.gov (United States)

    Fortin, Carole; Ehrmann Feldman, Debbie; Cheriet, Farida; Labelle, Hubert

    2013-08-01

    The objective of this study was to explore whether differences in standing and sitting postures of youth with idiopathic scoliosis could be detected from quantitative analysis of digital photographs. Standing and sitting postures of 50 participants aged 10-20-years-old with idiopathic scoliosis (Cobb angle: 15° to 60°) were assessed from digital photographs using a posture evaluation software program. Based on the XY coordinates of markers, 13 angular and linear posture indices were calculated in both positions. Paired t-tests were used to compare values of standing and sitting posture indices. Significant differences between standing and sitting positions (p elevation, scapula asymmetry, trunk list, scoliosis angle, waist angles, and frontal and sagittal plane pelvic tilt. Quantitative analysis of digital photographs is a clinically feasible method to measure standing and sitting postures among youth with scoliosis and to assist in decisions on therapeutic interventions.

  12. Camurati-Engelmann's Disease on {sup 99m}Tc-MDP Bone Scan

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    Yoon, Hai Jeon; Oh, So Won; Paeng, Jin Chul; Lee, You Kyung; Choi, In Ho; Lee, Dong Soo [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2009-12-15

    A 24 year-old female presented for a {sup 99m}Tc-methylene diphosphonate (MDP) whole body bone scan due to chronic pain in the bilateral lower extremities that has aggravated since 2002. She was diagnosed with Camurati-Engelmann disease (CED) based on the clinical and radiological findings in 2002, and she re-visited our institute to evaluate disease status at this time. CED is a rare autosomal dominant type of bone dysplasia characterized by progressive cortical thickening of long bones, and narrowing of medullary cavity, and thus presents with typical clinical symptoms and signs such as chronic pain in the extremities, muscle weakness, and waddling gait. On the {sup 99m}Tc-MDP bone scan performed to evaluate disease status, intense increased uptake was seen in the skull, facial bones, bilateral scapulae, bilateral long bones, and bilateral pelvic bones, which clearly demonstrated the extent of CED involvement.

  13. Biomechanical analysis of the circular friction hand massage.

    Science.gov (United States)

    Ryu, Jeseong; Son, Jongsang; Ahn, Soonjae; Shin, Isu; Kim, Youngho

    2015-01-01

    A massage can be beneficial to relieve muscle tension on the neck and shoulder area. Various massage systems have been developed, but their motions are not uniform throughout different body parts nor specifically targeted to the neck and shoulder areas. Pressure pattern and finger movement trajectories of the circular friction hand massage on trapezius, levator scapulae, and deltoid muscles were determined to develop a massage system that can mimic the motion and the pressure of the circular friction massage. During the massage, finger movement trajectories were measured using a 3D motion capture system, and finger pressures were simultaneously obtained using a grip pressure sensor. Results showed that each muscle had different finger movement trajectory and pressure pattern. The trapezius muscle experienced a higher pressure, longer massage time (duration of pressurization), and larger pressure-time integral than the other muscles. These results could be useful to design a better massage system simulating human finger movements.

  14. Intraoperative CT navigation for glenoid component fixation in reverse shoulder arthroplasty

    Directory of Open Access Journals (Sweden)

    Ashok S Gavaskar

    2013-01-01

    Full Text Available CT navigation has been shown to improve component positioning in total shoulder arthroplasty. The technique can be useful in achieving strong initial fixation of the metal backed glenoid in reverse shoulder arthroplasty. We report a 61 years male patient who underwent reverse shoulder arthroplasty for rotator cuff arthropathy. CT navigation was used intraoperatively to identify best possible glenoid bone and to maximize the depth of the fixation screws that anchor the metaglene portion of the metal backed glenoid component. Satisfactory positioning of screws and component was achieved without any perforation or iatrogenic fracture in the scapula. CT navigation can help in maximizing the purchase of the fixation screws that dictate the initial stability of the glenoid component in reverse shoulder arthroplasty. The technique can be extended to improve glenoid component position [version and tilt] with the availability of appropriate software.

  15. Scapulothoracic Bursitis in a Patient With Quadriparesis

    Science.gov (United States)

    Seol, Seung Jun; Han, Seung Hoon

    2015-01-01

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

  16. Spontaneous fibrosarcoma in a Djungarian hamster (phodopus sungorus).

    Science.gov (United States)

    Kondo, Hirotaka; Onuma, Mamoru; Ito, Hidetoshi; Shibuya, Hisashi; Sato, Tsuneo

    2008-06-01

    A 1.5-y-old female Djungarian hamster (Phodopus sungorus) presented with a large subcutaneous mass surrounding the right shoulder. Radiography revealed dislocation of the right humeral articulation and osteolytic lesions of the right scapula. Histologically, the mass was composed of spindle to stellate cells arranged in fascicles interwoven with delicate collagen fibers, and neoplastic cells infiltrated the bone, skeletal muscle, and subcutaneous tissues. Neoplastic cells stained intensely positive for vimentin and negative for S100 protein, neurofilament, and desmin. A minority of neoplastic cells (10% to 20%) stained moderately for smooth muscle actin. The mass was diagnosed as a fibrosarcoma. Although fibrosarcomas are relatively common in dogs and cats, this is the first report of fibrosarcoma in a domestic Djungarian hamster.

  17. Imaging of human vertebral surface using ultrasound RF data received at each element of probe for thoracic anesthesia

    Science.gov (United States)

    Takahashi, Kazuki; Taki, Hirofumi; Onishi, Eiko; Yamauchi, Masanori; Kanai, Hiroshi

    2017-07-01

    Epidural anesthesia is a common technique for perioperative analgesia and chronic pain treatment. Since ultrasonography is insufficient for depicting the human vertebral surface, most examiners apply epidural puncture by body surface landmarks on the back such as the spinous process and scapulae without any imaging, including ultrasonography. The puncture route to the epidural space at thoracic vertebrae is much narrower than that at lumber vertebrae, and therefore, epidural anesthesia at thoracic vertebrae is difficult, especially for a beginner. Herein, a novel imaging method is proposed based on a bi-static imaging technique by making use of the transmit beam width and direction. In an in vivo experimental study on human thoracic vertebrae, the proposed method succeeded in depicting the vertebral surface clearly as compared with conventional B-mode imaging and the conventional envelope method. This indicates the potential of the proposed method in visualizing the vertebral surface for the proper and safe execution of epidural anesthesia.

  18. Implant mandibular rehabilitation postoncologic segmental resection: a clinical report.

    Science.gov (United States)

    Cuesta Gil, Matias; Bucci, Tommaso; Ruiz, Blanca Duarte; Vila, Carlos Navarro; Marenzi, Gaetano; Sammartino, Gilberto

    2012-04-01

    In cases of reconstruction of a discontinuity defect of the mandible, the surgeon has a major responsibility to maximize function as well as cosmetics and to preserve quality of life, restoring mastication, speech, and appearance. Treatment of mandibular discontinuity defects is a complex process and, among other methods, includes the use of free vascularized flaps. A variety of donor sites have been used for this purpose, including the iliac crest, radius, scapula, and fibula.At this time, the iliac crest free flap represents a versatile reconstruction method after mandibular ablation. This article reports a clinical case using the iliac crest free flap for comprehensive reconstruction of discontinuity defects in the mandible after resections of an aggressive odontogenic tumor. The immediate implant positioning reduced the number of surgical procedures and the rehabilitation time.

  19. Active myofascial trigger points might be more frequent in patients with cervical radiculopathy.

    Science.gov (United States)

    Sari, H; Akarirmak, U; Uludag, M

    2012-06-01

    Myofascial trigger points (MTrPs) are commonly observed in the neck, parascapular region, and upper back muscles of patients with cervical pathology. To assess the frequency of latent and active myofascial trigger point (aMTrP) in the neck and upper back muscles in patients with cervical radiculopathy and healthy subjects. Controlled clinical trials. Outpatients and controls. Two hundred and forty four patients and 122 controls The patients clinically diagnosed as cervical radiculopathy with positive Spurling's test and confirmed by MRI, were enrolled in this study. All subjects were examined for active and latent MTrP. In patients with cervical radiculopathy, an aMTrP was distinguished from a latent one when the referred pain elicited by exploration of the MTrP is recognized as familiar. The patients comprised of 128 female (52.5%) and 116 male (47.5%) patients. Mean age was 44.58(20-65 years). In 125 (51.2%) of patients with cervical radiculopathy were found an aMTrP at least one muscle from upper trapezius, multifidus, splenius capitis, levator scapulae, rhomboid major, minor and deep paraspinal muscles. Number and distribution of MTrPs in patients with 244 cervical radiculopathy and in healthy controls. aMTrPs were detected most common in levator scapula (16.3%), splenius capitis (14.7%), rhomboid minor (14.3%), upper part of trapezius (13.5%), rhomboid major (10.2%) and multifidus (8.6%) muscles. Patients with cervical radiculopathy showed latent MTrP in levator scapula (27%), splenius capitis (16.8%), rhomboid minor (24.6%), upper part of trapezius (33.2%), rhomboid major (9%) and multifidus (8.2%) muscles. There was significant difference in terms of distribution of active and latent MTrPs in patients with cervical radiculopathy (P=0.019). Number of latent MTrPs in upper trapezius muscles in patients with cervical radiculopathy was more than the expected distribution. None of the subjects of control group had aMTrP. However, healthy controls showed latent

  20. Isolated and painless (? atrophy of the infraspinatus muscle: left handed versus right handed volleyball players

    Directory of Open Access Journals (Sweden)

    Thiago D. Gonçalves Côelho

    1994-12-01

    Full Text Available The suprascapular nerve originates from the upper trunk of the brachial plexus or less frequently from the root of C5. It runs a short way and crosses the suprascapular notch. It innervates the supraspinatus muscle and the acromioclavicular and glenohumeral joints. Then, it crosses the lateral edge of the spine of the scapula passing through the spinoglenoid notch, and innervates the infraspinatus muscle. These are potential sites of injury to the suprascapular nerve. Three cases of suprascapular nerve entrapment causing an isolated infraspinatus muscle atrophy in volleyball players were studied. It is suggested the hypothesis that the nature of the smash, in which the athlete uses the arm violently, more than does in volleyball service or in the art of reception, is the key to the pathogenesis of the lesion in volleyball players.

  1. Unusual inferior dislocation of shoulder: reduction by two-step maneuver: a case report

    Science.gov (United States)

    Saseendar, S; Agarwal, Dinesh K; Patro, Dilip K; Menon, Jagdish

    2009-01-01

    Dislocation of the shoulder is the commonest of all large joint dislocations. Inferior dislocation constitutes 0.5% of all shoulder dislocations. It characteristically presents with overhead abduction of the arm, the humerus being parallel to the spine of scapula. We present an unusual case of recurrent luxatio erecta in which the arm transformed later into an adducted position resembling the more common anterior shoulder dislocation. Such a case has not been described before in English literature. Closed reduction by the two-step maneuver was successful with a single attempt. MRI revealed posterior labral tear and a Hill-Sachs variant lesion on the superolateral aspect of humeral head. Immobilisation in a chest-arm bandage followed by physiotherapy yielded excellent results. The case is first of its kind; the unusual mechanism, unique radiological findings and alternate method of treatment are discussed. PMID:19883514

  2. Unusual inferior dislocation of shoulder: reduction by two-step maneuver: a case report

    Directory of Open Access Journals (Sweden)

    Patro Dilip K

    2009-11-01

    Full Text Available Abstract Dislocation of the shoulder is the commonest of all large joint dislocations. Inferior dislocation constitutes 0.5% of all shoulder dislocations. It characteristically presents with overhead abduction of the arm, the humerus being parallel to the spine of scapula. We present an unusual case of recurrent luxatio erecta in which the arm transformed later into an adducted position resembling the more common anterior shoulder dislocation. Such a case has not been described before in English literature. Closed reduction by the two-step maneuver was successful with a single attempt. MRI revealed posterior labral tear and a Hill-Sachs variant lesion on the superolateral aspect of humeral head. Immobilisation in a chest-arm bandage followed by physiotherapy yielded excellent results. The case is first of its kind; the unusual mechanism, unique radiological findings and alternate method of treatment are discussed.

  3. Nail-Patella Syndrome: clinical and molecular data in 55 families raising the hypothesis of a genetic heterogeneity.

    Science.gov (United States)

    Ghoumid, Jamal; Petit, Florence; Holder-Espinasse, Muriel; Jourdain, Anne-Sophie; Guerra, José; Dieux-Coeslier, Anne; Figeac, Martin; Porchet, Nicole; Manouvrier-Hanu, Sylvie; Escande, Fabienne

    2016-01-01

    Nail-Patella Syndrome (NPS) is a rare autosomal dominant condition comprising nail and skeletal anomalies. Skeletal features include dysplastic patellae and iliac horns, as well as scapula and elbow dysplasia. Nephropathy and glaucoma or intra-ocular hypertension can sometimes be present. NPS is due to variants affecting function in LMX1B, which encodes a LIM-homeodomain protein critical for limb, kidney and eye development. We describe the phenotype and the molecular data of 55 index patients and their 39 relatives presenting with typical NPS. We identified 38 different LMX1B anomalies, 19 of which were not reported before. In our series, 9% of families are not carriers of a LMX1B genomic alteration after extensive study of the coding and non-coding regions of the gene. One of the families showed no linkage to the LMX1B locus, raising the hypothesis of a genetic heterogeneity.

  4. Computed tomography of deep fat masses in multiple symmetrical lipomatosis

    Energy Technology Data Exchange (ETDEWEB)

    Enzi, G.; Biondetti, P.R.; Fiore, D.; Mazzoleni, F.

    1982-07-01

    Deep fat masses were evaluated by computed tomography (CT) in 15 patients with multiple symmetrical lipomatosis. In 4 patients, peritracheal accumulations of fat were observed. In 3 of them, tracheal compression by lipomatous tissue was demonstrated: 2 were asymptomatic and the third severe respiratory insufficiency secondary to blockage of the air was by the vocal cords as the result of recurrent nerve palsy. In 6 patients, lipomatous tissue occupied the potential space between the spina scapulae and the trapezius, supraspinatus, and infraspinatus muscles. In 2, calcification of lipomatous masses was observed. There was no relationship between extension of subcutaneous fat and accumulation at deep sites. CT facilitates early detection of peritracheal lipomatous tissue and is helpful in follow-up when deep fat accumulation is responsible for space-occupying lesions requiring surgery.

  5. Revisiting the application of integrated physiotherapy in degenerative-dystrophic diseases of the musculoskeletal system

    Directory of Open Access Journals (Sweden)

    Kotenko K.V.

    2014-12-01

    Full Text Available Aim. The authors described a comprehensive program of frozen shoulder treatment, including extracorporeal shock wave therapy and pelotherapy. Objective: To evaluate the effectiveness of the inclusion of extracorporeal shock wave therapy and pelotherapy in rehabilitation of patients with degenerative diseases of the musculoskeletal system. Materials and Methods: there had been examined 120 patients during the study. Results: The result of the application of complex physiotherapy normalized indicators of metabolic and electrolyte imbalances that are important in the formation of a therapeutic effect. Conclusion: The application of extracorporeal shock wave therapy and in combination with pelotherapy in patients with scapula-humeral periarthritis is the elimination of metabolic and electrolyte imbalance, which is important in degenerative diseases of the musculoskeletal system

  6. On the validity and phylogenetic position of Eubrachiosaurus browni, a kannemeyeriiform dicynodont (Anomodontia from Triassic North America.

    Directory of Open Access Journals (Sweden)

    Christian F Kammerer

    Full Text Available The large dicynodont Eubrachiosaurus browni from the Upper Triassic Popo Agie Formation of Wyoming is redescribed. Eubrachiosaurus is a valid taxon that differs from Placerias hesternus, with which it was previously synonymized, by greater anteroposterior expansion of the scapula dorsally and a very large, nearly rectangular humeral ectepicondyle with a broad supinator process. Inclusion of Eubrachiosaurus in a revised phylogenetic analysis of anomodont therapsids indicates that it is a stahleckeriid closely related to the South American genera Ischigualastia and Jachaleria. The recognition of Eubrachiosaurus as a distinct lineage of North American dicynodonts, combined with other recent discoveries in the eastern USA and Europe, alters our perception of Late Triassic dicynodont diversity in the northern hemisphere. Rather than being isolated relicts in previously therapsid-dominated regions, Late Triassic stahleckeriid dicynodonts were continuing to disperse and diversify, even in areas like western North America that were otherwise uninhabited by coeval therapsids (i.e., cynodonts.

  7. Possible cases of tuberculosis and brucellosis in Argaric villages in Galera (Granada

    Directory of Open Access Journals (Sweden)

    Ángel Rubio

    2017-07-01

    Full Text Available One of the main characteristics of Bronze Age Argaric populations of Granada is an agricultural and livestock economy in which animals were present within the settlements. Such presence is a factor in the increase of the risk of contagious diseases. In this study we present some cases that could be linked to animal-transmitted infectious diseases due that have been documented at the sites of Castellón Alto and Fuente Amarga, both located in Galera (province of Granada. At these sites four individuals have been identified with new bone formations in the thorax (scapulae and ribs that can indicate the presence of tuberculosis. At Fuente Amarga another individual presents a characteristic lesion in the vertebral column linked to brucellosis (vertebral epiphysitis. These features are not uncommon in populations that have close contact with animals.

  8. Bilateral bony fusion around the supraspinatus muscle inducing muscle hypoplasia and shoulder pain

    Energy Technology Data Exchange (ETDEWEB)

    Son, YeNa; Jin, Wook; Park, So Young [Kyung Hee University Hospital at Gangdong, Department of Radiology, 892, Dongnam-ro, Gangdong-gu, Seoul (Korea, Republic of); Ryu, Kyung Nam; Park, Ji Seon [Kyung Hee University Hospital, Department of Radiology, 23 Kyunghee-daero, Dongdaemun-gu, Seoul (Korea, Republic of)

    2017-03-15

    We describe the case of a 30-year-old man who developed chronic bilateral shoulder pain that relapsed and remitted over the course of 1 year. The patient was diagnosed with congenital shoulder fusion anomalies. The right shoulder showed anomalous accessory articulation between the distal third of the clavicle and the acromion along with normal articulation of the shoulder on CT. At the left shoulder, bony fusions were present between the distal portion of the clavicle, the acromion, and the coracoid process, and between the coracoid process, upper portion of the glenoid, and upper body of the scapula, which formed a bony canal and was responsible for hypoplasia of the supraspinatus muscle on CT and MRI. To our knowledge, this is the first description of such congenital shoulder anomalies with extreme bony fusion and is an illustrative example of how imaging may be used to differentiate fusion from other congenital abnormalities of the shoulder to aid diagnosis. (orig.)

  9. The use of EMG biofeedback for learning of selective activation of intra-muscular parts within the serratus anterior muscle

    DEFF Research Database (Denmark)

    Holtermann, A; Mork, P J; Andersen, L L

    2010-01-01

    Motor control and learning possibilities of scapular muscles are of clinical interest for restoring scapular muscle balance in patients with neck and shoulder disorders. The aim of the study was to investigate whether selective voluntary activation of intra-muscular parts within the serratus...... anterior can be learned with electromyographical (EMG) biofeedback, and whether the lower serratus anterior and the lower trapezius muscle comprise the lower scapula rotation force couple by synergistic activation. Nine healthy males practiced selective activation of intra-muscular parts within...... the serratus anterior with visual EMG biofeedback, while the activity of four parts of the serratus anterior and four parts of the trapezius muscle was recorded. One subject was able to selectively activate both the upper and the lower serratus anterior respectively. Moreover, three subjects managed...

  10. Anterior Coracoscapular Ligament as a Factor Predisposing to or Protective for Suprascapular Neuropathy

    Directory of Open Access Journals (Sweden)

    Michał Polguj

    2016-01-01

    Full Text Available Suprascapular neuropathy is a pathology caused by injury or compression of the suprascapular nerve. As the nerve runs from the anterior to posterior side of the scapula, the hot point where it is most susceptible to both injury and compression is the suprascapular notch. A literature search reveals several potential predisposing morphological factors in this area. However the most recent reports indicate that the structures at the suprascapular notch region may also prevent nerve injury and compression. The role of the anterior coracoscapular ligament (ACSL remains unclear. While some studies indicate that it may predispose to suprascapular neuropathy, the newest study proposes a protective function. The aim of the article was to review the function of the anterior coracoscapular ligament in the light of the most recent studies. An understanding of the role of the ligament is essential for arthroscopic and other surgical procedures of this area in order to avoid iatrogenic injury of the suprascapular nerve.

  11. [Planned reconstruction after broad carcinological demolition of the face: case report].

    Science.gov (United States)

    Norat, F; Poissonnet, G; Dassonville, O; Dreant, N; Lebreton, E

    2009-01-01

    The authors present their approach in face reconstruction after carcinological demolition. A 40-years-old patient presented an epidermoid carcinoma starting at the level of the right jawbone, few differentiated, massively destroying the roof of the maxillary sinus with subcutaneous and cutaneous infiltration in front and extension to the orbit. A broad right hemifacial right amputation was decided with ocular exenteration, cutaneo-palpebral sacrifice, parotidectomy with conservation of the facial nerve and standard cervical neck. After study and 3D simulation the reconstruction was carried out by an osteocutaneous parascapular flap using the external columna of the scapula for the repair of the lower orbital edge in order to accomodate an epithesis. We think that the planning step and preoperative three-dimensional measurement is of primary importance. It defines the size and type of flap to be taken in order to rebuild as well as possible the face while respecting the aesthetic units.

  12. Method for locating a small magnetic object in the human body

    Energy Technology Data Exchange (ETDEWEB)

    Kaufman, L.; Williamson, S.J.; Ilmoniemi, R.J.; Weinberg, H.; Boyd, A.D.

    1988-02-29

    A piece of a thin acupuncture needle lodged under the right scapula of a patient could not be found in surgical procedures accompanied by studies of 30 standard x-ray images. To locate it, the authors mapped the magnetic-field component normal to a plane lying above the object, using a superconducting quantum interference device (SQUID). Assuming that the needle could be modeled as a magnetic dipole, the authors were able to infer its lateral position, depth, orientation, and magnetic moment. With this information, directed CT scans, high-resolution x-ray films, and the subsequent surgical removal of the needle proved that it could be located in the body with an accuracy of about three millimeters.

  13. A collation of recently published Western European formulae for age estimation of subadult skeletal remains: recommendations for forensic anthropology and osteoarchaeology.

    Science.gov (United States)

    Rissech, Carme; Márquez-Grant, Nicholas; Turbón, Daniel

    2013-01-01

    The aim of this study is to provide an effective and quick reference guide based on the most useful European formulae recently published for subadult age estimation. All of these formulae derive from studies on postnatal growth of the scapula, innominate, femur, and tibia, based on modern skeletal data (173 ♂, 173 ♀) from five documented collections from Spain, Portugal, and Britain. The formulae were calculated from Inverse Regression. For this reason, these formulae are especially useful for modern samples from Western Europe and in particular on 20th century human remains from the Iberian Peninsula. Eleven formulae were selected as the most useful because they can be applied to individuals from within a wide age range and in individuals of unknown sex. Due to their high reliability and because they derive from documented European skeletal samples, we recommend these formulae be used on individuals of Caucasoid ancestry from Western Europe. © 2012 American Academy of Forensic Sciences.

  14. On the validity and phylogenetic position of Eubrachiosaurus browni, a kannemeyeriiform dicynodont (Anomodontia) from Triassic North America.

    Science.gov (United States)

    Kammerer, Christian F; Fröbisch, Jörg; Angielczyk, Kenneth D

    2013-01-01

    The large dicynodont Eubrachiosaurus browni from the Upper Triassic Popo Agie Formation of Wyoming is redescribed. Eubrachiosaurus is a valid taxon that differs from Placerias hesternus, with which it was previously synonymized, by greater anteroposterior expansion of the scapula dorsally and a very large, nearly rectangular humeral ectepicondyle with a broad supinator process. Inclusion of Eubrachiosaurus in a revised phylogenetic analysis of anomodont therapsids indicates that it is a stahleckeriid closely related to the South American genera Ischigualastia and Jachaleria. The recognition of Eubrachiosaurus as a distinct lineage of North American dicynodonts, combined with other recent discoveries in the eastern USA and Europe, alters our perception of Late Triassic dicynodont diversity in the northern hemisphere. Rather than being isolated relicts in previously therapsid-dominated regions, Late Triassic stahleckeriid dicynodonts were continuing to disperse and diversify, even in areas like western North America that were otherwise uninhabited by coeval therapsids (i.e., cynodonts).

  15. Neglected anterior dislocation of shoulder with large Hillsach's lesion & deficient glenoid: Treated by autogenous bone graft & modified Latarjet procedure.

    Science.gov (United States)

    Peshin, Chetan; Jangira, Vivek; Gupta, Ravi Kumar; Jindal, Rohit

    2015-12-01

    Neglected anterior dislocation of shoulder is rare in spite of the fact that the anterior dislocation of the shoulder is seen in around 90% of the acute cases. Most of the series of neglected dislocation describe posterior dislocation to be far more common.(1) (,2) We hereby report a case of the neglected anterior shoulder dislocation in a 15 year old boy who had a history of epilepsy. There was a large Hill Sachs lesion in humeral head which was impacted in glenoid inferiorly and glenoid was eburnated at that margin. The humeral head was reconstructed with a tricortical iliac graft. Glenoid was reconstructed by transfer of coracoids process of scapula to antero-inferior glenoid (modified Latarjet procedure). This case is unique because management of humeral head defect with bone graft is not mentioned in anterior dislocation.

  16. Neglected anterior dislocation of shoulder with large Hillsach's lesion & deficient glenoid: Treated by autogenous bone graft & modified Latarjet procedure☆

    Science.gov (United States)

    Peshin, Chetan; Jangira, Vivek; Gupta, Ravi Kumar; Jindal, Rohit

    2015-01-01

    Neglected anterior dislocation of shoulder is rare in spite of the fact that the anterior dislocation of the shoulder is seen in around 90% of the acute cases. Most of the series of neglected dislocation describe posterior dislocation to be far more common.1,2 We hereby report a case of the neglected anterior shoulder dislocation in a 15 year old boy who had a history of epilepsy. There was a large Hill Sachs lesion in humeral head which was impacted in glenoid inferiorly and glenoid was eburnated at that margin. The humeral head was reconstructed with a tricortical iliac graft. Glenoid was reconstructed by transfer of coracoids process of scapula to antero-inferior glenoid (modified Latarjet procedure). This case is unique because management of humeral head defect with bone graft is not mentioned in anterior dislocation. PMID:26566343

  17. Lesiones del nervio torácico largo de Bell. Revisión de conceptos terapéuticos

    Directory of Open Access Journals (Sweden)

    Sebastián E. Valbuena

    2014-03-01

    Full Text Available Re­su­men las lesiones del nervio torácico producen parálisis del serrato anterior y originan una deformidad característica (escápula alata, que genera debilidad y alteraciones importantes en la movilidad del hombro. En esta revisión, se analizan conceptos sobre anatomía, etiología, presentación clínica y alternativas terapéuticas. Long­ thoracic ­nerve ­of ­Bell. ­Review­ of­ therapeutic ­management Abstract The long thoracic nerve injuries are manifested by a characteristic deformity called scapula alata, causing weakness, and impaired shoulder mobility. in this review current concepts of the anatomy, etiology, clinical presentation and therapeutic management are analyzed.

  18. Nutritional secondary hyperparathyroidism in a white lion cub (Panthera leo, with concomitant radiographic double cortical line : clinical communication

    Directory of Open Access Journals (Sweden)

    V. Herz

    2004-06-01

    Full Text Available A captive-bred white lion cub was presented with hindquarter pain, lameness and reluctance to move. Radiographs revealed generalised osteoapenia, multiple fractures, a severely collapsed pelvic girdle, bilateral lateral bowing of the scapulae and mild kyphosis of the caudal vertebrae.Adouble cortical line, a distinct sign of osteopaenia, was repeatedly seen on the pelvic limbs, most strikingly along both femurs. Based on radiographic findings and a history of an exclusive meat diet since weaning, a diagnosis of nutritional secondary hyperparathyroidism was made. The diet was changed to a commercial kitten food and the cub was given cage rest for 6 weeks. Signs of pain abated and the cub became more active.A guarded prognosis was given for full recovery, as changes to the pelvis were considered potentially irreversible.

  19. Variation of the latissimus dorsi

    Directory of Open Access Journals (Sweden)

    Ishani P Shah

    2014-01-01

    Full Text Available A typical muscle variation of latissimus dorsi - the axillary arch is represented by the muscular or fibromuscular slip detached from the anteroinferior border of the musculus latissimus dorsi passing over the axilla under the axillary fascia crossing the medial side of the brachial plexus to continue as a septum intermusculare mediale brachii distally to the medial epicondyle of humerus. The full extent of the muscle is rarely present. Slips of muscle extend from the latissimus dorsi at the inferior angle of scapula to insert into pectoralis major (Langer, coracobrachilis, biceps or coracoid process forming what is described as a common variant - the muscular axillary arch. We report three cases of variants of latissimus dorsi, one of which has not been reported in the literature before.

  20. Cloverleaf skull associated with unusual skeletal anomalies

    Energy Technology Data Exchange (ETDEWEB)

    Say, B.; Poznanski, A.K.

    1987-02-01

    A male infant which cloverleaf skull and multiple other birth defects born to unrelated, healthy, young parents is presented. Radiologic findings in addition to the cloverleaf skull configuration included short, wide clavicles, winged scapulae, unusual shapes of ribs with abnormal spacing between them and with prominent costovertebral junctions, and widely separated ischia. Ulnae appeared angular with probable fusion to the midportion of the radial bones bilaterally. There was polydactyly of the hands and feet with grossly abnormal metacarpal and metatarsal bones. Skeletal maturation was normal. Computed tomography of the skull showed dilated lateral and third ventricles as well as agenesis of the corpus callosum. The mother denies any teratogenic exposure during the pregnancy. The findings in this infant do not seem to fit into any previously described syndrome.

  1. RESULTS OF SHOULDER STABILIZATION BY A MODIFIED BRISTOW - LATARJET PROCEDURE WITH ARTHROSCOPY

    Directory of Open Access Journals (Sweden)

    R. V. Gladkov

    2014-01-01

    Full Text Available The authors describe the minimally invasive technique for Bristow-Latarjet bone unfree autoplasty with arthroscopy in patients with bone loss more than 25% of anterior-posterior diameter of the glenoid, the poor quality of the capsule or deep defects of Hill-Sachs. The analysis of the early results of treatment in 19 patients and midterm results - in 13 soldiers operated in 2011-2014. Features of the proposed technique are the shortening of surgical approach and the reduction of subscapularis muscle damage. In addition, arthroscopic support allows to attain the precision location of the graft relative to the articular surface of scapula, at the same time restoring the damaged anatomy SLAP, rotator cuff tendons and posterior labrum and restore shoulder ligaments tension and isolate bone graft from the joint cavity, contributing to a better articulation of the humeral head and reducing the risk of nonunion and resorption.

  2. Split calvarium cranioplasty.

    Science.gov (United States)

    Weber, R S; Kearns, D B; Smith, R J

    1987-01-01

    Fronto-orbital deformities secondary to trauma, infection, or surgery create a difficult problem for the reconstructive surgeon. The location of the deformity is particularly critical because it involves the most visible part of the face. Since the skull is rarely able to produce bony regeneration over large areas, numerous alloplastic materials have been used to repair these defects. Complications with these materials are commonplace. Autogenous bone has been used with good results and avoids many of the problems inherent to the use of foreign materials. Rib, scapula, and iliac crest may be used, but they require a separate incision and often provide less than satisfactory cosmetic results. We describe a technique of cranioplasty utilizing split calvarium for repair of frontal bone defects. Cosmesis is excellent, morbidity is minimal, and only one incision is necessary.

  3. Inverse Dynamics and the Immeasurable Motions

    DEFF Research Database (Denmark)

    Rasmussen, John; Andersen, Michael Skipper; Damsgaard, Michael

    remains extremely computationally challenging. In this paper, we attempt prediction of forces as well as small movements in the knee based upon knowledge of large movements, i.e. flexion/extension, from camera-based motion capture. The applied method, force-dependent kinematics, is rooted....../adduction in the knee as a function of the knee flexion angle. Benoit, D.L., Ramsey, D.K., Lamontagne, M., Xu, L., Wretenberg, P. & Renström, P. 2006, "Effect of skin movement artifact on knee kinematics during gait and cutting motions measured in vivo", Gait & posture, vol. 24, no. 2, pp. 152-164....... the precise 3-D marker locations, certain movements are inherently difficult to register, for instance the movement of the scapula relative to the thorax or glenohumeral superior migration. This paper, however, focuses on the knee. Knee flexion/extension is a large articulation in most practical cases...

  4. Relationship between posterior crossbite and postural alterations in children

    Directory of Open Access Journals (Sweden)

    Juliana Jaqueline de Matos Lopes

    2009-12-01

    Full Text Available Objective: To evaluate the posture of individuals with functional posterior crossbite, malocclusion is one of the most in need of orthodontic treatment. Methods: This work presents an analysis of postural among children 6 to 12 years who present functional posterior cross bite of both genders who are in mixed dentition or no intervention prior orthodontic and orthopedic. Was obtained images in the plans: front and back where it was analyzed the asymmetry or symmetry of the individual in the image and in the lateral, anterior, a posterior or normality. Results: 100% had some kind of postural change, and the asymmetry between the scapulae (shoulder found the greatest change, as one of extreme importance in this age group represents a growing skeletal muscle. Conclusion: analyzes all of the children showed postural abnormalities and malocclusion are also of great importance not only to be treating the problem orally, but the postural problem with the help of a multidisciplinary team.

  5. Improved comfort and function of arm prosthesis after implantation of a Humerus-T-Prosthesis in trans-humeral amputees.

    Science.gov (United States)

    Witsø, Eivind; Kristensen, Tomm; Benum, Pål; Sivertsen, Svein; Persen, Leif; Funderud, Are; Magne, Tordis; Aursand, Hans Petter; Aamodt, Arild

    2006-12-01

    The use of arm prosthesis in trans-humeral amputees is limited; due to the cone form of the amputation stump. A Humerus-T-Prosthesis was implanted in three patients to create artificial humerus condyles. Two of the patients were successfully rehabilitated with the application of a new type trans-humeral arm prosthesis. This arm prosthesis had a socket which is suspended and stabilized by the humerus and implant only. Traction and rotational stability were secured by adjustable pressure adaptation around the artificial condyles. The third patient developed a pressure wound over the lateral part of the artificial condyle that later healed. He also was subject to a new trauma with a fracture of the ipsilateral scapula and until now has had limited the use of his new arm prosthesis. It was concluded that this new concept for prosthesis fitting of trans-humeral amputees looks promising, but alternative designs of the implant should be tested.

  6. Measurement properties of exsisting clinical assessment methods evaluating scapular positioning and function. A systematic review

    DEFF Research Database (Denmark)

    Larsen, Camilla Marie; Juul-Kristensen, B; Lund, H

    base for optimal muscle activation both at rest and during functional tasks. There is evidence suggesting that scapular positioning are altered in patients with musculoskeletal shoulder disorders, e.g. in shoulder impingement syndrome and in patients with glenohumeral osteoarthritis [1......Department of Research and Innovation, University College Lillebaelt, Denmark3Institute of Occupational Therapy, Physiotherapy and Radiography, Bergen University College, Bergen, Norway INTRODUCTION From a biomechanical perspective, the scapula plays a key role in the shoulder and arm function as a stable...... with glenohumeral osteoarthritis or frozen shoulder. Journal of biomechanics, 41:326-332, 2008.2.Ludewig PM & Reynolds JF. The Association of Scapular Kinematics and Glenohumeral Joint Pathologies. Journal of orthopaedic & sports physical therapy, 39(2):91-104, 2009.3.Shaheen AF, et al., Scapular taping alters...

  7. A Funny Thing Happened On The Way To . . .

    Science.gov (United States)

    Gaskill, Jack D.

    1985-08-01

    Ii had been struggling with this, my first editorial, for some time, and had just about arrived at a version that suited me. However, before attempting to put the finishing touches on it, I decided to get in the proper frame of mind by taking one of my frequent early morning bicycle rides. That ride was never completed. While cranking along a bike lane just outside Tucson, I was crunched from the rear by-of all things-a pickup truck belonging to a porta-potty company. My beautiful gold bike was completely trashed, and ended up with a fractured left scapula, multiple contusions and abrasions, and a lot of road rash. In addition, I was pretty badly bruised and scraped. I do seem to be mending, though, and hope to be riding again within a couple of months. So much for the war stories.

  8. Limb Girdle Muscular Dystrophy (LGMD): Case Report.

    Science.gov (United States)

    Kanitkar, Shubhangi A; Kalyan, Meenakshi; Gaikwad, Anu N; Makadia, Ankit; Shah, Harshad

    2015-01-01

    We report a young male of autosomal recessive limb girdle muscular dystrophy (LGMD) with positive family history presented with gradual onset proximal muscle weakness in all four limbs since eight years and thinning of shoulders, arms and thighs. Neurological examination revealed atrophy of both shoulders with wasting of both deltoids thinning of thighs and pseudo hypertrophy of both calves, hypotonia in all four limbs. Gower's sign was positive. Winging of scapula was present. Power was 3/5 at both shoulders, 4/5 at both elbows, 5/5 at both wrists, 3/5 at both hip joints, 3/5 at both knees, 5/5 at both ankles. All deep tendon reflexes and superficial reflexes were present with plantars bilateral flexors. Electromyography (EMG) showed myopathic pattern. He had elevated creatinine phosphokinase levels and muscle biopsy findings consistent with muscular dystrophy.

  9. Elastofibroma dorsi – differential diagnosis in chest wall tumours

    Directory of Open Access Journals (Sweden)

    Steinau Hans-Ulrich

    2007-02-01

    Full Text Available Abstract Background Elastofibromas are benign soft tissue tumours mostly of the infrascapular region between the thoracic wall, the serratus anterior and the latissimus dorsi muscle with a prevalence of up to 24% in the elderly. The pathogenesis of the lesion is still unclear, but repetitive microtrauma by friction between the scapula and the thoracic wall may cause the reactive hyperproliferation of fibroelastic tissue. Methods We present a series of seven cases with elastofibroma dorsi with reference to clinical findings, further clinical course and functional results after resection, as well as recurrence. Data were obtained retrospectively by clinical examination, phone calls to the patients' general practitioners and charts review. Follow-up time ranged from four months to nine years and averaged 53 months. Results The patients presented with swelling of the infrascapular region or snapping scapula. In three cases, the lesion was painful. The ratio men/women was 2/5 with a mean age of 64 years. The tumor sizes ranged from 3 to 13 cm. The typical macroscopic aspect was characterized as poorly defined fibroelastic soft tissue lesion with a white and yellow cut surface caused by intermingled remnants of fatty tissue. Microscopically, the lesions consisted of broad collagenous strands and densely packed enlarged and fragmented elastic fibres with mostly round shapes. In all patients but one, postoperative seroma (which had to be punctuated occurred after resection; however, at follow-up time, no patient reported any decrease of function or sensation at the shoulder or the arm of the operated side. None of the patients experienced a relapse. Conclusion In differential diagnosis of soft tissue tumors located at this specific site, elastofibroma should be considered as likely diagnosis. Due to its benign behaviour, the tumor should be resected only in symptomatic patients.

  10. MR neurography (MRN) of the long thoracic nerve: retrospective review of clinical findings and imaging results at our institution over 4 years

    Energy Technology Data Exchange (ETDEWEB)

    Deshmukh, Swati [Northwestern University, Chicago, IL (United States); Fayad, Laura M. [The Johns Hopkins Medical Institutions, The Russell H. Morgan Department of Radiology and Radiological Science, Baltimore, MD (United States); The Johns Hopkins Medical Institutions, Department of Oncology, Baltimore, MD (United States); The Johns Hopkins Medical Institutions, Department of Orthopaedic Surgery, Baltimore, MD (United States); Ahlawat, Shivani [The Johns Hopkins Medical Institutions, The Russell H. Morgan Department of Radiology and Radiological Science, Baltimore, MD (United States)

    2017-11-15

    Long thoracic nerve (LTN) injury can result in ipsilateral serratus anterior palsy and scapular winging. Traditional means of evaluating patients with suspected LTN injury include physical examination and electrodiagnostic studies. The purpose of our study is to describe high-resolution magnetic resonance (MR) findings in patients with clinical suspicion of LTN neuropathy. In this HIPAA-compliant, IRB-approved, retrospective study, two radiologists reviewed MR imaging performed for long thoracic neuropathy. Clinical presentation, electrodiagnostic studies and MR imaging of 20 subjects [mean age 37 ± 13 years; 25% (5/20) female] were reviewed. Observers reviewed MR imaging for LTN signal intensity, size, course, presence or absence of mass and secondary findings [skeletal muscle denervation (serratus anterior, trapezius, rhomboid) and scapular winging]. Descriptive statistics were reported. Clinical indications included trauma (n = 5), hereditary neuropathy (n = 1), pain (n = 8), winged scapula (n = 6), brachial plexitis (n = 4) and mass (n = 1). Electrodiagnostic testing (n = 7) was positive for serratus anterior denervation in three subjects. Abnormal LTN signal intensity, size, course or mass was present in 0/20. Secondary findings included skeletal muscle denervation in the serratus anterior in 40% (8/20), trapezius in 20% (4/20) and rhomboid in 20% (4/20). In 5% (1/20), an osteochondroma simulated a winged scapula, and in 2/20 (10%) MR showed scapular winging. High-resolution MR imaging is limited in its ability to visualize the long thoracic nerve directly, but does reveal secondary signs that can confirm a clinical suspicion of LTN injury. (orig.)

  11. Local bone pain and osseous scintigraphic findings in patients with metastatic bone tumor

    Energy Technology Data Exchange (ETDEWEB)

    Imaeda, Takeyoshi; Iinuma, Gen; Hirota, Keiichi; Inoue, Akemi; Sone, Yasuhiro; Seki, Matsuzo; Suzuki, Masao; Doi, Hidetaka

    1988-12-01

    Local bone pain and osseous scintigraphic findings were evaluated in patients with cancer of the lung, breast or prostate. (1) In 77-92% out of the patients with local pain, metastatic bone lesions were detected. (2) The sacrum and scapulae were the frequent sites of pain as estimated from the metastatic bone lesions. On the other hand, the incidence of pain was low in the ribs, cervical vertebrae, skull and femurs. (3) When calculated by the weight of red bone marrow, the most likely sites for bone metastases consisted of the scapulae, clavicles, sternum, humeri, ribs and cervical vertebrae, somewhat different from previous reports. Those bones involved were all proximate to the heart. (4) Extensive bone metastases were already detected in more than 50% of patients who complain of pain in the metastatic bone lesion. On the other hand, extensive bone metastases occurred in less than 6% of patients who didn't complain of pain. (5) The appearance of pain in the metastatic bone lesion was earlier in only 3% and was later in 71% than the detection of abnormal radioisotope accumulation on scintigram. (6) Majority of the patients with pain in the metastatic bone lesion showed a high degree of abnormal radioisotope accumulation which measured more than 5 cm in diameter on scintigram. On the other hand, the abnormal radioisotope accumulation in most of patients without pain was mild and mostly measured less than 5 cm in diameter. (7) The positive rate of bone metastasis amounted to 29% by plain X-ray and 41% by local bone pain as compaired to positive bone scintigram.

  12. Effect of a Home Based Exercise Program on Postmenopausal Women’s Shoulder Girdle Muscle Strength for Women with Breast Cancer

    Directory of Open Access Journals (Sweden)

    M. Akoochakian

    2014-10-01

    Full Text Available Introduction & Objective: Reducing in muscle strength of the shoulder girdle is a side effect of breast cancer treatment. The aim of this study was to determine the effect of 4 weeks of resistance and mobility training on the shoulder girdle strength of women with breast cancer. Materials & Methods: In this randomized clinical trial study twenty-seven postmenopausal women with breast cancer (mean age, 51±5.96 years, (mean height, 158.08±7.2 cm, (mean weight, 63.08±11.06 kg who underwent surgery, chemotherapy and radiation therapy, were purposefully selected and divided into two groups of intervention and control. Intervention group performed 4 weeks (4 sessions per week of resistance training with flex-band and stretch training at home, but the control group did not participate in any sports or physical program. Muscle strength before and after intervention was measured using a handheld dynamometer. The data were analyzed using ANCOVA. Results: Significant differences were seen between intervention and control groups in shoulder flexion, scapula abduction and upward rotation, shoulder internal rotation, shoulder external rotation, shoulder horizontal adduction and scapula depression and adduction strength, as all strength variables increased after 4 weeks exercise. Conclusion: Since strength plays an important role in ADL performance and shoulder girdle function in breast cancer survivors, it seems that muscle strength improvement following combined home based exercise program can help patients after treatment to easier and faster rehabilitation. (Sci J Hamadan Univ Med Sci 2014; 21 (3: 185-195

  13. Surgical Release of the Pectoralis Minor Tendon for Scapular Dyskinesia and Shoulder Pain.

    Science.gov (United States)

    Provencher, Matthew T; Kirby, Hannah; McDonald, Lucas S; Golijanin, Petar; Gross, Daniel; Campbell, Kevin J; LeClere, Lance; Sanchez, George; Anthony, Shawn; Romeo, Anthony A

    2017-01-01

    Pectoralis minor (PM) tightness has been linked to pain and dysfunction of the shoulder joint secondary to anterior tilt and internal rotation of the scapula, thus causing secondary impingement of the subacromial space. To describe outcomes pertaining to nonoperative and operative treatment via surgical release of the PM tendon for pathologic PM tightness in an active population. Case series; Level of evidence, 4. Over a 3-year period, a total of 46 patients were enrolled (mean age, 25.5 years; range, 18-33 years). Inclusion criteria consisted of symptomatic shoulder pain, limited range of overhead motion, inability to participate in overhead lifting activities, and examination findings consistent with scapular dysfunction secondary to a tight PM with tenderness to palpation of the PM tendon. All patients underwent a lengthy physical therapy and stretching program (mean, 11.4 months; range, 3-23 months), which was followed by serial examinations for resolution of symptoms and scapular tilt. Of the 46 patients, 6 (13%) were unable to adequately stretch the PM and underwent isolated mini-open PM release. Outcomes were assessed with scapula protraction measurements and pain scales as well as American Shoulder and Elbow Surgeons (ASES), Single Assessment Numeric Evaluation (SANE), and visual analog scale (VAS) scores. Forty of the 46 patients (87%) resolved the tight PM and scapular-mediated symptoms with a dedicated therapy program (pre- and posttreatment mean outcome scores: 58 and 91 [ASES], 50 and 90 [SANE], 4.9 and 0.8 [VAS]; P shoulder symptoms after surgical release of the PM. Additional research is necessary to evaluate the long-term efficacy of isolated PM treatment.

  14. Referred pain from myofascial trigger points in head, neck, shoulder, and arm muscles reproduces pain symptoms in blue-collar (manual) and white-collar (office) workers.

    Science.gov (United States)

    Fernández-de-las-Peñas, César; Gröbli, Christian; Ortega-Santiago, Ricardo; Fischer, Christine Stebler; Boesch, Daniel; Froidevaux, Philippe; Stocker, Lilian; Weissmann, Richard; González-Iglesias, Javier

    2012-07-01

    To describe the prevalence and referred pain area of trigger points (TrPs) in blue-collar (manual) and white-collar (office) workers, and to analyze if the referred pain pattern elicited from TrPs completely reproduces the overall spontaneous pain pattern. Sixteen (62% women) blue-collar and 19 (75% women) white-collar workers were included in this study. TrPs in the temporalis, masseter, upper trapezius, sternocleidomastoid, splenius capitis, oblique capitis inferior, levator scapulae, scalene, pectoralis major, deltoid, infraspinatus, extensor carpi radialis brevis and longus, extensor digitorum communis, and supinator muscles were examined bilaterally (hyper-sensible tender spot within a palpable taut band, local twitch response with snapping palpation, and elicited referred pain pattern with palpation) by experienced assessors blinded to the participants' condition. TrPs were considered active when the local and referred pain reproduced any symptom and the patient recognized the pain as familiar. The referred pain areas were drawn on anatomic maps, digitized, and measured. Blue-collar workers had a mean of 6 (SD: 3) active and 10 (SD: 5) latent TrPs, whereas white-collar workers had a mean of 6 (SD: 4) active and 11 (SD: 6) latent TrPs (P>0.548). No significant differences in the distribution of active and latent TrPs in the analyzed muscles between groups were found. Active TrPs in the upper trapezius, infraspinatus, levator scapulae, and extensor carpi radialis brevis muscles were the most prevalent in both groups. Significant differences in referred pain areas between muscles (Pactive TrPs reproduced the overall pain pattern. The distribution of TrPs was not significantly different between groups. Clinicians should examine for the presence of muscle TrPs in blue-collar and white-collar workers.

  15. Muscle trigger points and pressure pain hyperalgesia in the shoulder muscles in patients with unilateral shoulder impingement: a blinded, controlled study.

    Science.gov (United States)

    Hidalgo-Lozano, Amparo; Fernández-de-las-Peñas, César; Alonso-Blanco, Cristina; Ge, Hong-You; Arendt-Nielsen, Lars; Arroyo-Morales, Manuel

    2010-05-01

    Our aim was to describe the differences in the presence of trigger points (TrPs) in the shoulder muscles and to investigate the presence of mechanical hypersensitivity in patients with unilateral shoulder impingement and healthy controls. Twelve patients with strictly unilateral shoulder impingement and 10 matched controls were recruited. TrPs in the levator scapula, supraspinatus, infraspinatus, subscapularis, pectoralis major, and biceps brachii muscles were explored. TrPs were considered active if the local and referred pain reproduced the pain symptoms and the patient recognized the pain as a familiar pain. Pressure pain thresholds (PPT) were assessed over the levator scapulae, supraspinatus, infraspinatus, pectoralis major, biceps brachii, and tibialis anterior muscles. Both explorations were randomly done by an assessor blinded to the subjects' condition. Patients with shoulder impingement have a greater number of active (mean +/- SD: 2.5 +/- 1; P latent (mean +/- SD: 2 +/- 1; P = 0.003) TrPs when compared to controls (only latent TrPs, mean +/- SD: 1 +/- 1). Active TrPs in the supraspinatus (67%), infraspinatus (42%), and subscapularis (42%) muscles were the most prevalent in the patient group. Patients showed a significant lower PPT in all muscles when compared to controls (P Active TrPs in some muscles were associated to greater pain intensity and lower PPTs when compared to those with latent TrPs in the same muscles (P active TrPs in the shoulder muscles, which reproduce their clinical pain symptoms. Our results suggest both peripheral and central sensitisation mechanisms in patients with shoulder impingement syndrome.

  16. Quantitative Anatomy of the Trapezius Muscle in the Human Fetus.

    Science.gov (United States)

    Badura, Mateusz; Grzonkowska, Magdalena; Baumgart, Mariusz; Szpinda, Michał

    2016-01-01

    The trapezius muscle consists of three parts that are capable of functioning independently. Its superior part together with the levator scapulae and rhomboids elevate the shoulder, the middle part retracts the scapula, while the inferior part lowers the shoulder. The present study aimed to supplement numerical data and to provide growth dynamics of the trapezius in the human fetus. Using methods of anatomical dissection, digital image analysis (NIS Elements AR 3.0), and statistics (Student's t-test, regression analysis), we measured the length, the width and the surface area of the trapezius in 30 fetuses of both sexes (13™ k,17™ … ) aged 13-19 weeks. Neither sex nor laterality differences were found. All the studied parameters of the trapezius increased proportionately with age. The linear functions were computed as follows: y = -103.288 + 10.514 × age (r = 0.957) for total length of the trapezius muscle, y = -67.439 + 6.689 × age (r = 0.856) for length of its descending part, y = -8.493 + 1.033 × age (r = 0.53) for length of its transverse part, y = -27.545 + 2.802 × age (r = 0.791) for length of its ascending part, y = -19.970 + 2.505 × age (r = 0.875) for width of the trapezius muscle, and y = -2670.458 + 212.029 × age (r = 0.915) for its surface area. Neither sex nor laterality differences exist in the numerical data of the trapezius muscle in the human fetus. The descending part of trapezius is the longest, while its transverse part is the shortest. The growth dynamics of the fetal trapezius muscle follows proportionately.

  17. Length of winter coat in horses depending on husbandry conditions.

    Science.gov (United States)

    Bocian, Krzysztof; Strzelec, Katarzyna; Janczarek, Iwona; Jabłecki, Zygmunt; Kolstrung, Ryszard

    2017-02-01

    This paper analyzes changes in the length of coat on selected body areas in horses and ponies kept under different husbandry (stable) conditions during the winter-spring period. The study included 12 Małpolski geldings and 12 geldings of Felin ponies aged 10-15 years. Horses were kept in two stables (six horses and six ponies in each stable). The type of performance, husbandry conditions and feeding of the studied animals were comparable. As of December 1, samples of hair coat from the scapula, sternum, back and abdomen areas of both body sides were collected seven times. The lengths of 20 randomly selected hair fibers were measured. Daily measurements of air temperature in the stables were also taken. An analysis of variance (ANOVA) was performed using the following factors: the body part from where the coat was sampled, the subsequent examination and the stable as well as the interaction between these factors. The significance of differences between means was determined with a t-Tukey test. The relations between air temperature in the stable and hair length were calculated using Pearson's correlation. It was found that air temperature in the stable impacts the length of winter coat in horses and ponies. The effect of this factor is more pronounced in ponies; as in the stables with lower temperatures it produces a longer hair coat which is more evenly distributed over the body in comparison with horses. Keeping horses and ponies in stables with a low air temperature accelerates coat shedding by approximately 25 days. Coat shedding begins from the scapula area. © 2016 Japanese Society of Animal Science.

  18. Scapular dyskinesis after Latarjet procedure.

    Science.gov (United States)

    Carbone, Stefano; Moroder, Philipp; Runer, Armin; Resch, Herbert; Gumina, Stefano; Hertel, Ralph

    2016-03-01

    Because of detachment of the pectoralis minor and variation of the vector of the conjoint tendons, we hypothesized that the Latarjet procedure may alter scapular position and motion. The purpose of this study was to evaluate scapular position and motion in patients who underwent a Latarjet or a modified iliac crest bone graft transfer (ICBGT) procedure (J-bone graft). Forty-six consecutive patients treated for recurrent anterior shoulder dislocation between 2010 and 2012 were retrospectively enrolled. Twenty-three were treated with a Latarjet and 23 with an ICBGT procedure. Twenty Latarjet and 20 ICBGT patients were available at a mean follow-up of 20 months (min, 12; max, 60). We recorded the Western Ontario Instability Index, the Rowe Score, and the Subjective Shoulder Value. Scapulothoracic position was studied according to the dyskinesis yes/no method. Intraobserver and interobserver reliability of the dyskinesis assessment was assessed. Intraobserver and interobserver reliability of scapula dyskinesis assessment was high (Latarjet: intratester, κ = 0.84; intertester, κ = 0.75; ICBGT: intratester, κ = 0.78; intertester, κ = 0.71). Scapular dyskinesis was observed after 5 of 20 Latarjet and after 0 of 20 ICBGT procedures (P = .047). Patients with dyskinesis had lower scores (Western Ontario Instability Index, P = .043; Rowe, P = .047; Subjective Shoulder Value, P = .046), but no statistically significant difference was found between the Latarjet and ICBGT groups. Two of the 5 scapular dyskinesis patients reached the SICK (Scapular malposition, Inferior medial scapular winging, Coracoid tenderness, and scapular dysKinesis) scapula syndrome definition. Scapular dyskinesis was found in 5 of 20 patients who underwent a Latarjet procedure. Dyskinesis may be related to the detachment of the pectoralis minor, and variation of the vector and the working length of the coracobrachialis and the short head of the biceps. Copyright © 2016 Journal of Shoulder and Elbow

  19. The anterior tilt of the acromion: radiographic evaluation and correlation with shoulder diseases

    Energy Technology Data Exchange (ETDEWEB)

    Prato, N.; Peloso, D.; Franconeri, A. [Department of Radiology, San Carlo Hospital, Genoa (Italy); Tegaldo, G. [Dept. of Orthopaedic Surgery, San Carlo Hospital, Genoa (Italy); Ravera, G.B. [Inst. of Medical Statistics and Biometry, University of Genoa (Italy); Silvestri, E.; Derchi, L.E. [Inst. of Radiology, University of Genoa (Italy)

    1998-12-01

    The aim of this study was to test whether the anterior tilt of the acromion can be objectively evaluated on lateral radiographs, and whether there is a relation between this anatomical feature and the most common shoulder diseases. Lateral radiographs of 15 dried scapulas were performed in neutral position and with 5 of caudal, cranial, anterior and posterior angulations. Two hundred and forty-three shoulders, both asymptomatic and affected by chronic and post-traumatic impingement, calcific tendinitis and instability, were examined by conventional radiography. The presence of rotator-cuff tears was investigated by sonography. A method was elaborated to obtain reproducible lateral radiographs and to determine the acromial tilt angle. Inter- and intraobserver and inter- and intraoperator variations in measurements were evaluated. Variations in tube angulation produced changes in tilt-angle values on dried scapulas. The average tilt angle for the chronic impingement and the instability groups were significantly different from the post-traumatic, calcific tendinitis and control groups. Rotator-cuff tears were significantly more frequent in the chronic impingement group and related to a more acute tilt angle. The inter- and intraobserver variability coefficients were 0.95 and 0.98, whereas the inter- and intraoperator variability coefficients were 0.94 and 0.96, respectively. Conventional radiography using fluoroscopy for positioning is a well-reproducible method for the evaluation of acromial tilt. There is a significant difference in tilt-angle values between some groups of subjects examined, but the lack of specificity limits the clinical importance of such measurement. (orig.) With 6 figs., 3 tabs., 34 refs.

  20. Ossification of coracoclavicular ligament in complete paraplegia: a case report.

    Science.gov (United States)

    Qureshi, A Z; AlSaleh, A J; AlHalemi, A A

    2015-01-01

    A case report. The objective of this study was to highlight the possible etiological factors and functional implications of coracoclavicular ligament ossification in a man with paraplegia. This study was conducted in King Fahad Medical City, Riyadh, Saudi Arabia. A 25-year-old man was admitted as a case of complete traumatic spinal cord injury (SCI) at the T3 level for comprehensive rehabilitation after 4 months of injury. He also had a right clavicular fracture, which was managed conservatively. During his rehabilitation course, he complained of chronic right shoulder pain, which limited his activities of daily living, transfers and wheelchair mobility. His shoulder examination was unremarkable for impingement but range of motion was restricted, which rendered the need for imaging. A computed tomography scan showed ossification of coracoclavicular ligament, illustrating a rare synostosis between the clavicle and scapula. In addition to pain management, the patient was trained on shoulder conservation techniques for performing functional tasks and showed enhanced independence in various activities of daily living. SCI has an association with neurogenic heterotropic ossification (HO), which usually develops below the level of injury. A low threshold for investigating HO may be considered at fracture sites even if they are above the level of SCI, for early prevention and treatment of this disabling complication. The abnormal cross-union between the clavicle and the scapula owing to HO can alter the mechanics of the shoulder girdle along with soft tissue injuries and early degenerative changes. Formation of shoulder HO can be particularly accelerated in SCI patients due to excessive use of upper limbs and to the neurogenic nature of the injury.

  1. Scapular kinematic and shoulder muscle activity alterations after serratus anterior muscle fatigue.

    Science.gov (United States)

    Umehara, Jun; Kusano, Ken; Nakamura, Masatoshi; Morishita, Katsuyuki; Nishishita, Satoru; Tanaka, Hiroki; Shimizu, Itsuroh; Ichihashi, Noriaki

    2018-02-23

    Although the serratus anterior muscle has an important role in scapular movement, no study to date has investigated the effect of serratus anterior fatigue on scapular kinematics and shoulder muscle activity. The purpose of this study was to clarify the effect of serratus anterior fatigue on scapular movement and shoulder muscle activity. The study participants were 16 healthy men. Electrical muscle stimulation was used to fatigue the serratus anterior muscle. Shoulder muscle strength and endurance, scapular movement, and muscle activity were measured before and after the fatigue task. The muscle activity of the serratus anterior, upper and lower trapezius, anterior and middle deltoid, and infraspinatus muscles was recorded, and the median power frequency of these muscles was calculated to examine the degree of muscle fatigue. The muscle endurance and median power frequency of the serratus anterior muscle decreased after the fatigue tasks, whereas the muscle activities of the serratus anterior, upper trapezius, and infraspinatus muscles increased. External rotation of the scapula at the shoulder elevated position increased after the fatigue task. Selective serratus anterior fatigue due to electric muscle stimulation decreased the serratus anterior endurance at the flexed shoulder position. Furthermore, the muscle activities of the serratus anterior, upper trapezius, and infraspinatus increased and the scapular external rotation was greater after serratus anterior fatigue. These results suggest that the rotator cuff and scapular muscle compensated to avoid the increase in internal rotation of the scapula caused by the dysfunction of the serratus anterior muscle. Copyright © 2018 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  2. The effect of experimental shortening of the clavicle on shoulder kinematics.

    Science.gov (United States)

    Hillen, Robert J; Burger, Bart J; Pöll, Rudolf G; van Dijk, C Niek; Veeger, Dirkjan H E J

    2012-10-01

    Malunion after mid shaft clavicle fractures has recently been recognized as a cause of pain and dysfunction of the shoulder. The mechanism that causes these complaints is however yet unclear. In this study we describe the kinematic changes that occur in the shoulder girdle due to clavicle shortening. An experimental cadaveric study was performed on five shoulders of three fresh frozen specimens. The specimens were fixed in an upright position that allowed free motion of the shoulder girdle. We measured position of the bony structures with an opto-electronic system (Northern Digital Inc., Waterloo, Ontario Canada) in rest and during in a series of motions. Measurements were done with a normal clavicle and after shortening of the clavicle by 1.2, 2.4 and 3.6 cm. The shoulders were moved manually by one of the researchers. We examined for changes in resting position and during movement that resulted from the experimental shortening of the clavicle. In the resting position, winging of the scapula increased with resultant changes in the orientation of the glenoid, acromio-clavicular and sterno-clavicular joints and an altered position of the clavicle. On average protraction increased by 20°, lateral rotation changed 12° and posterior tilt decreased by 7°. Clavicle shortening affected sterno-clavicular joint rotations but did not do so in the acromio-clavicular joint. In arm elevation the offset in scapula orientation at resting position stayed relatively constant over the full range of motion but the amount of disposition is progressive in relation to the amount of shortening. Shortening of the clavicle leads to significant changes in the shoulder girdle in resting position and in movement. Copyright © 2012 Elsevier Ltd. All rights reserved.

  3. Trigger point dry needling as an adjunct treatment for a patient with adhesive capsulitis of the shoulder.

    Science.gov (United States)

    Clewley, Derek; Flynn, Timothy W; Koppenhaver, Shane

    2014-02-01

    Case report. Prognosis for adhesive capsulitis has been described as self-limiting and can persist for 1 to 3 years. Conservative treatment that includes physical therapy is commonly advised. The patient was a 54-year-old woman with primary symptoms of shoulder pain and loss of motion consistent with adhesive capsulitis. Manual physical therapy intervention initially consisted of joint mobilizations of the shoulder region and thrust manipulation of the cervicothoracic region. Although manual techniques seemed to result in some early functional improvement, continued progression was limited by pain. Subsequent examination identified trigger points in the upper trapezius, levator scapula, deltoid, and infraspinatus muscles, which were treated with dry needling to decrease pain and allow for higher grades of manual intervention. The patient was treated for a total of 13 visits over a 6-week period. After trigger point dry needling was introduced on the third visit, improvements in pain-free shoulder range of motion and functional outcome measures, assessed with the Shoulder Pain and Disability Index and the shortened form of the Disabilities of the Arm, Shoulder and Hand questionnaire, exceeded the minimal clinically important difference after 2 treatment sessions. At discharge, the patient had achieved significant improvements in shoulder range of motion in all planes, and outcome measures were significantly improved. This case report describes the clinical reasoning behind the use of trigger point dry needling in the treatment of a patient with adhesive capsulitis. The rapid improvement seen in this patient following the initiation of dry needling to the upper trapezius, levator scapula, deltoid, and infraspinatus muscles suggests that surrounding muscles may be a significant source of pain in this condition.

  4. Inter-observer agreement of CT measurement of the glenoid bone surface by the CT Pico method: Comparison with laser in a cadaveric model

    Energy Technology Data Exchange (ETDEWEB)

    De Filippo, Massimo; Saba, Luca; Negrini, Giulio; Silva, Mario [University of Parma, Department of Radiology, Parma (Italy); Pedrazzi, Giuseppe [Universita di Parma, Department of Neuroscience. Unita di Biofisica e Fisica Medica - Plesso Biotecnologico Integrato, Parma (Italy); Pogliacomi, Francesco [University of Parma, Department of Orthopedic Surgery, Parma (Italy); Castagna, Alessandro [Istituto Clinico Humanitas, Section of Orthopedic Surgery, Rozzano, MI (Italy)

    2015-10-15

    The aim of this study was to test reproducibility of the CT Pico method in a cadaveric model and to compare CT Pico measurements with a high-precision laser probe for optical scanning. The glenoid surface of ten dried cadaveric scapulae (with intact surface) was measured by and high-precision laser probe for optical scanning, the latter being assumed as a reference standard. Measurements were done according to the Pico technique, using a circle-shaped region of interest (ROI) that was placed on the inferior glenoid rim. Measurements obtained using the CT Pico method (three readers) and with laser were compared to assess differences between radiological assessment and the reference standard. Each observer performed two repeated measurements from each scapulae (20 for each observer). Mean differences between laser measurements and each CT reader were 18.4 % (range, -4 to 61 %) for reader 1, 12.4 % (range, -15 to 64 %) for reader 2, and 11 % (range, -14 to 58 %) for reader 3. Considering all the 60 measurements made by the three readers, 39 measurements out of 60 (65 %) were outside the range [-5 %; +5 %] while 26 measurements (43 %) are outside the range [-10 %; +10 %]. The largest differences (positive and negative) were +64 and -14 %, respectively. Intra-operator reproducibility was high in most cases intraclass correlation coefficient (ICC) =0.93, ICC = 0.91, ICC = 0.93 and Lin's Concordance correlation coefficient (CCC) = 0.92, CCC = 0.90, CCC = 0.92 for reader 1 to 3, respectively. However, in five cases the CT Pico measurements showed absolute differences between the first and second measurements that exceeded 10 %. The inter-observer variability for CT measurement of the glenoid surface using the CT Pico method was high when compared with laser, in the assessment of glenoid surface in cadaveric specimens, thus the CT Pico method is not reliable and could cause errors in the clinical management of the patient. Level of evidence. Level II, Development of

  5. Application of synthetic photostable retinoids induces novel limb and facial phenotypes during chick embryogenesis in vivo.

    Science.gov (United States)

    Lopez-Real, R E; Budge, J J R; Marder, T B; Whiting, A; Hunt, P N; Przyborski, S A

    2014-04-01

    We have recently developed a range of synthetic retinoid analogues which include the compounds EC23 and EC19. They are stable on exposure to light and are predicted to be resistant to the normal metabolic processes involved in the inactivation of retinoids in vivo. Based on the position of the terminal carboxylic acid groups in the compounds we suggest that EC23 is a structural analogue of all-trans retinoic acid (ATRA), and EC19 is an analogue of 13-cis retinoic acid. Their effects on the differentiation of pluripotent stem cells has been previously described in vitro and are consistent with this hypothesis. We present herein the first description of the effects of these molecules in vivo. Retinoids were applied to the anterior limb buds of chicken embryos in ovo via ion-exchange beads. We found that retinoid EC23 produces effects on the wing digits similar to ATRA, but does so at two orders of magnitude lower concentration. When larger quantities of EC23 are applied, a novel phenotype is obtained involving production of multiple digit 1s on the anterior limb. This corresponds to differential effects of ATRA and EC23 on sonic hedgehog (shh) expression in the developing limb bud. With EC23 application we also find digit 1 phenotypes similar to thumb duplications described in the clinical literature. EC23 and ATRA are shown to have effects on the entire proximal-distal axis of the limb, including hitherto undescribed effects on the scapula. This includes suppression of expression of the scapula marker Pax1. EC23 also produces effects similar to those of ATRA on the developing face, producing reductions of the upper beak at concentrations two orders of magnitude lower than ATRA. In contrast, EC19, which is structurally very similar to EC23, has novel, less severe effects on the face and rarely alters limb development. EC19 and ATRA are effective at similar concentrations. These results further demonstrate the ability of retinoids to influence embryonic development

  6. Thoracic Vertebral Body Irradiation Contributes to Acute Hematologic Toxicity During Chemoradiation Therapy for Non-Small Cell Lung Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Deek, Matthew P.; Benenati, Brian [Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, New Jersey (United States); Kim, Sinae [Department of Biostatistics, School of Public Health, Rutgers University, Piscataway, New Jersey (United States); Biometrics Division, Rutgers Cancer Institute of New Jersey, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, New Jersey (United States); Chen, Ting; Ahmed, Inaya; Zou, Wei [Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, New Jersey (United States); Aisner, Joseph [Division of Medical Oncology, Rutgers Cancer Institute of New Jersey, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, New Jersey (United States); Jabbour, Salma K., E-mail: jabbousk@cinj.rutgers.edu [Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, New Jersey (United States)

    2016-01-01

    Purpose: To determine the relationships between radiation doses to the thoracic bone marrow and declines in blood cell counts in non-small cell lung cancer (NSCLC) patients treated with chemoradiation therapy (CRT). Methods and Materials: We included 52 patients with NSCLC treated with definitive concurrent carboplatin–paclitaxel and RT. Dose-volume histogram (DVH) parameters for the thoracic vertebrae (TV), sternum, scapulae, clavicles, and ribs were assessed for associations with changes in blood counts during the course of CRT. Linear and logistic regression analyses were performed to identify associations between hematologic nadirs and DVH parameters. A DVH parameter of Vx was the percentage of the total organ volume exceeding x radiation dose. Results: Grade ≥3 hematologic toxicity including neutropenia developed in 21% (n=11), leukopenia in 42% (n=22), anemia in 6% (n=3), and throbocytopenia in 2% (n=1) of patients. Greater RT dose to the TV was associated with higher risk of grade ≥3 leukopenia across multiple DVH parameters, including TV V{sub 20} (TVV) (odds ratio [OR] 1.06; P=.025), TVV{sub 30} (OR 1.07; P=.013), and mean vertebral dose (MVD) (OR 1.13; P=.026). On multiple regression analysis, TVV{sub 30} (β = −0.004; P=.018) and TVV{sub 20} (β = −0.003; P=.048) were associated with white blood cell nadir. Additional bone marrow sites (scapulae, clavicles, and ribs) did not affect hematologic toxicity. A 20% chance of grade ≥3 leukopenia was associated with a MVD of 13.5 Gy and a TTV{sub 30} of 28%. Cutoff values to avoid grade ≥3 leukopenia were MVD ≤23.9 Gy, TVV{sub 20} ≤56.0%, and TVV{sub 30} ≤52.1%. Conclusions: Hematologic toxicity is associated with greater RT doses to the TV during CRT for NSCLC. Sparing of the TV using advanced radiation techniques may improve tolerance of CRT and result in improved tolerance of concurrent chemotherapy.

  7. Glenoid morphology in light of anatomical and reverse total shoulder arthroplasty: a dissection- and 3D-CT-based study in male and female body donors.

    Science.gov (United States)

    Mathews, Sandra; Burkhard, Marco; Serrano, Nabil; Link, Karl; Häusler, Martin; Frater, Nakita; Franke, Ingeborg; Bischofberger, Helena; Buck, Florian M; Gascho, Dominic; Thali, Michael; Serowy, Steffen; Müller-Gerbl, Magdalena; Harper, Gareth; Qureshi, Ford; Böni, Thomas; Bloch, Hans-Rudolf; Ullrich, Oliver; Rühli, Frank-Jakobus; Eppler, Elisabeth

    2017-01-10

    Placement of the glenoid baseplate is of paramount importance for the outcome of anatomical and reverse total shoulder arthroplasty. However, the database around glenoid size is poor, particularly regarding small scapulae, for example, in women and smaller individuals, and is derived from different methodological approaches. In this multimodality cadaver study, we systematically examined the glenoid using morphological and 3D-CT measurements. Measurements of the glenoid and drill hole tunnel length for superior baseplate screw placement were recorded to define size of the glenoid and the distance to the scapular notch on cadaveric specimens. Glenoid angles were determined on both, 3D-CT-scans of the thoraxes using the Friedman method and on subsequently isolated scapulae from 18 male and female donors (average 84 years, range 60-98 years). Mean glenoid height was 36.6 mm ± 3.6, and width 27.8 mm ± 3.1 with a significant sex dimorphism (p ≤ 0.001): in males, glenoid height 39.5 mm ± 3.5, and width 30.3 mm ± 3.3, and in females, glenoid height 34.8 mm ± 2.2, and width 26.2 mm ± 1.6. The average distance from the superior screw entry to its exit in the scapular notch measured by calliper was 27.2 mm ± 6.0 with a sex difference: in males, 29.4 mm ± 5.7, and in females, 25.8 mm ± 5.9 mm with a minimum recorded distance of 15 mm. Measured by CT, the mean inclination angle for male and female donors combined was 13.0° ± 7.0, and the ante-/retroversion angle -1.0° ± 4.0°. This study is one of the first to combine dissection, including drill holes, with anatomical measurements and radiological data. In some women and smaller individuals, smaller baseplates should be selected. The published safe zone of 20 mm is generally feasible for superior screw placement, however, in small patients this distance may be substantially shorter than expected and start as of 13 and 15 mm, respectively. No

  8. Muscle trigger points, pressure pain threshold, and cervical range of motion in patients with high level of disability related to acute whiplash injury.

    Science.gov (United States)

    Fernández-Pérez, Antonio Manuel; Villaverde-Gutiérrez, Carmen; Mora-Sánchez, Aurora; Alonso-Blanco, Cristina; Sterling, Michele; Fernández-de-Las-Peñas, César

    2012-07-01

    Cross sectional cohort study. To analyze the differences in the prevalence of trigger points (TrPs) between patients with acute whiplash-associated disorders (WADs) and healthy controls, and to determine if widespread pressure hypersensitivity and reduced cervical range of motion are related to the presence of TrPs in patients with acute WADs. The relationship between active TrPs and central sensitization is not well understood in patients with acute WADs. Twenty individuals with a high level of disability related to acute WAD and 20 age- and sex-matched controls participated in the study. TrPs in the temporalis, masseter, upper trapezius, levator scapulae, sternocleidomastoid, suboccipital, and scalene muscles were examined. TrPs are defined as hypersensitive spots in a palpable taut band, producing a local twitch response and referred pain when palpated. Pressure pain threshold (PPT) was assessed bilaterally over the C5-6 zygapophyseal joints, second metacarpal, and tibialis anterior muscle. Active cervical range of motion, neck pain, and self-rated disability using the Neck Disability Index were also assessed. The mean ± SD number of TrPs for the patients with acute WAD was 7.3 ± 2.8 (3.4 ± 2.7 were latent TrPs; 3.9 ± 2.5 were active TrPs). In comparison, healthy controls had 1.7 ± 2.2 latent and no active TrPs (Pactive TrPs were the levator scapulae and upper trapezius muscles. The number of active TrPs increased with higher neck pain intensity (Pactive cervical range of motion than controls (Pactive TrPs and PPT over the C5-C6 joints and cervical range of motion in flexion, extension, and rotation in both directions: the greater the number of active TrPs, the lower the bilateral PPT over the neck and the greater the cervical range of motion limitation. The local and referred pain elicited from active TrPs reproduced neck and shoulder pain patterns in individuals with acute WADs with higher levels of disability. Patients with acute WADs exhibited

  9. Risk factors for volleyball-related shoulder pain and dysfunction.

    Science.gov (United States)

    Reeser, Jonathan C; Joy, Elizabeth A; Porucznik, Christina A; Berg, Richard L; Colliver, Ethan B; Willick, Stuart E

    2010-01-01

    To identify risk factors for volleyball-related shoulder pain and dysfunction. Cross-sectional, observational. National championship sporting event. Competitors at the 2006 National Intramural & Recreational Sports Association Collegiate Club Volleyball Championship competition were invited to volunteer for the study. A total of 422 athletes returned questionnaires, of whom 276 also underwent a structured physical examination. Study participants provided information on any history of volleyball-related shoulder pain or dysfunction. The simple shoulder test (SST) and a visual analog scale permitted subjects to quantify the extent of their perceived functional limitation. Subjects also were invited to undergo a physical examination in which dynamic scapular positioning, glenohumeral range of motion, shoulder girdle strength, and core stability were assessed. Standard statistical methods of comparison and tests of association were used to identify risk factors for shoulder pain among participating volleyball athletes. Approximately 60% of participants reported a history of shoulder problems. Attackers and "jump" servers were more likely to have shoulder problems than setters, defensive specialists, and "float" servers. Nearly half of the athletes who reported shoulder problems perceived some associated functional limitation, with female athletes providing lower SST scores than male athletes (9.0 versus 10.1, P = .001). Athletes reporting shoulder pain and dysfunction were more likely to have SICK scapula scores of 3 or greater (P = .010). Participants who demonstrated core instability also had greater SICK scapula scores (3.9 versus 2.9, P = .038), and were more likely to report a history of shoulder problems (chi2 = 8.83, P = .032). Although the authors observed a significant mean left-right difference of 8.9 degrees in available glenohumeral internal rotation among participating athletes, this deficit was not associated with shoulder problems. However, there was an

  10. ADDITIONAL EFFECT OF TRIGGER POINT THERAPY AND MYO FASCIAL RELEASE ON SECOND STAGE FROZEN SHOULDER AMONG INDUSTRIAL WORKERS

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    Gopal Nambi S

    2017-08-01

    Full Text Available Background and Purpose: Frozen shoulder is a common condition commonly affecting 2-5% of the industrial population typically between 40 and 60 years of age. Most of the studies were analysed the individual interventions and did not investigate the combination of interventions. The purpose of this study is to find two different forms of massage techniques Trigger Point therapy and Myofascial release in second stage of Frozen Shoulder to reduce pain and improve the Range of motion. Subjects: 30 subjects working in industry with unilateral second stage frozen shoulder lasting 3 months or more and 25% decrease in passive joint mobility relative to the non affected side were enrolled in this study. Methods: Subjects who were willing to participate in the study and to fulfil the inclusion and exclusion criteria were included in the study and they were divided into two Groups (A and B randomly. Group A was treated with Trigger Point therapy, Myofascial release, Scapula Stabilization Exercises, and Interferential Therapy (IFT and Group B were treated only with Scapula Stabilization Exercises and IFT. The duration of treatment was 4 weeks and they were assessed at baseline and after 4 weeks. Outcome measures included pain intensity by Visual Analog Scale (VAS and Range of Motion (ROM by goniometer. Results: Subjects in both Groups improved over 4 weeks after intervention. Significant (p ≤ 0.05 difference were found between both Groups after 4 weeks in VAS and ROM. But statistically (p ≤ 0.05 greater change scores were found in the Group A for VAS and ROM than Group B. Discussion and Conclusion: Group A and B was effective in reducing pain and improving the ROM in patients with second stage of Frozen Shoulder. However, subjects in Group A, who received Trigger Point therapy and M yofascial release showed better improvement in reduce pain and improve the ROM than Group B. In conclusion the treatment program consisting of Trigger Point therapy and

  11. Glenohumeral abduction contracture in children with unresolved neonatal brachial plexus palsy.

    Science.gov (United States)

    Eismann, Emily A; Little, Kevin J; Laor, Tal; Cornwall, Roger

    2015-01-21

    Following neonatal brachial plexus palsy, the Putti sign-obligatory tilt of the scapula with brachiothoracic adduction-suggests the presence of glenohumeral abduction contracture. In the present study, we utilized magnetic resonance imaging (MRI) to quantify this glenohumeral abduction contracture and evaluate its relationship to shoulder joint deformity, muscle atrophy, and function. We retrospectively reviewed MRIs of the thorax and shoulders obtained before and after shoulder rebalancing surgery (internal rotation contracture release and external rotation tendon transfer) for twenty-eight children with unresolved neonatal brachial plexus palsy. Two raters measured the coronal positions of the scapula, thoracic spine, and humeral shaft bilaterally on coronal images, correcting trigonometrically for scapular protraction on axial images. Supraspinatus, deltoid, and latissimus dorsi muscle atrophy was assessed, blinded to other measures. Correlations between glenohumeral abduction contracture and glenoid version, humeral head subluxation, passive external rotation, and Mallet shoulder function before and after surgery were performed. MRI measurements were highly reliable between raters. Glenohumeral abduction contractures were present in twenty-five of twenty-eight patients, averaging 33° (range, 10° to 65°). Among those patients, abductor atrophy was present in twenty-three of twenty-five, with adductor atrophy in twelve of twenty-five. Preoperatively, greater abduction contracture severity correlated with greater Mallet global abduction and hand-to-neck function. Abduction contracture severity did not correlate preoperatively with axial measurements of glenohumeral dysplasia, but greater glenoid retroversion was associated with worse abduction contractures postoperatively. Surgery improved passive external rotation, active abduction, and hand-to-neck function, but did not change the abduction contracture. A majority of patients with persistent shoulder weakness

  12. Deficits in Glenohumeral Passive Range of Motion Increase Risk of Shoulder Injury in Professional Baseball Pitchers: A Prospective Study.

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    Wilk, Kevin E; Macrina, Leonard C; Fleisig, Glenn S; Aune, Kyle T; Porterfield, Ron A; Harker, Paul; Evans, Timothy J; Andrews, James R

    2015-10-01

    Shoulder injuries from repetitive baseball pitching continue to be a serious, common problem. To determine whether passive range of motion of the glenohumeral joint was predictive of shoulder injury or shoulder surgery in professional baseball pitchers. Cohort study; Level of evidence, 2. Passive range of motion of the glenohumeral joint was assessed with a bubble goniometer during spring training for all major and minor league pitchers of a single professional baseball organization over a period of 8 successive seasons (2005-2012). Investigators performed a total of 505 examinations on 296 professional pitchers. Glenohumeral external and internal rotation was assessed with the pitcher supine and the arm abducted to 90° in the scapular plane with the scapula stabilized anteriorly at the coracoid process. Total rotation was defined as the sum of internal and external glenohumeral rotation. Passive shoulder flexion was measured with the pitcher supine and the lateral border of the scapula manually stabilized. After examination, shoulder injuries and injury durations were recorded by each pitcher's respective baseball organization and reported to the league as an injury transaction as each player was placed on the disabled list. Highly significant side-to-side differences were noted within subjects for each range of motion measurement. There were 75 shoulder injuries and 20 surgeries recorded among 51 pitchers, resulting in 5570 total days on the disabled list. Glenohumeral internal rotation deficit, total rotation deficit, and flexion deficit were not significantly related to shoulder injury or surgery. Pitchers with insufficient external rotation (<5° greater external rotation in the throwing shoulder) were 2.2 times more likely to be placed on the disabled list for a shoulder injury (P = .014; 95% CI, 1.2-4.1) and were 4.0 times more likely to require shoulder surgery (P = .009; 95% CI, 1.5-12.6). Insufficient shoulder external rotation on the throwing side

  13. SU-F-T-558: ArcCheck for Patient Specific QA in Stereotactic Ablative Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Ramachandran, P [Peter MacCallum Cancer Centre, Melbourne (Australia); RMIT University, Bundoora (Australia); Tajaldeen, A; Esen, N; Geso, M [RMIT University, Bundoora (Australia); Taylor, D; Wanigaratne, D; Roozen, K; Kron, T [Peter MacCallum Cancer Centre, Melbourne (Australia)

    2016-06-15

    Purpose: Stereotactic Ablative Radiotherapy (SABR) is one of the most preferred treatment techniques for early stage lung cancer. This technique has been extended to other treatment sites like Spine, Liver, Scapula, Sternum etc., This has resulted in increased physics QA time on machine. In this study, we’ve tested the feasibility of using ArcCheck as an alternative method to replace film dosimetry. Methods: Twelve patients with varied diagnosis of Lung, Liver, scapula, sternum and Spine undergoing SABR were selected for this study. Pre-treatment QA was performed for all the patients which include ionization chamber and film dosimetry. The required gamma criteria for each SABR plan to pass QA and proceed to treatment is 95% (3%,1mm). In addition to this routine process, the treatment plans were exported on to an ArcCheck phantom. The planned and measured dose from the ArcCheck device were compared using four different gamma criteria: 2%,2 mm, 3%,2 mm, 3%,1 mm and 3%, 3 mm. In addition to this, we’ve also introduced errors to gantry, collimator and couch angle to assess sensitivity of the ArcCheck with potential delivery errors. Results: The ArcCheck mean passing rates for all twelve cases were 76.1%±9.7% for gamma criteria 3%,1 mm, 89.5%±5.3% for 2%,2 mm, 92.6%±4.2% for 3%,2 mm, and 97.6%±2.4% for 3%,3 mm gamma criteria. When SABR spine cases are excluded, we observe ArcCheck passing rates higher than 95% for all the studied cases with 3%, 3mm, and ArcCheck results in acceptable agreement with the film gamma results. Conclusion: Our ArcCheck results at 3%, 3 mm were found to correlate well with our non-SABR spine routine patient specific QA results (3%,1 mm). We observed significant reduction in QA time on using ArcCheck for SABR QA. This study shows that ArcCheck could replace film dosimetry for all sites except SABR spine.

  14. Inter-observer agreement of CT measurement of the glenoid bone surface by the CT Pico method: Comparison with laser in a cadaveric model.

    Science.gov (United States)

    De Filippo, Massimo; Saba, Luca; Negrini, Giulio; Silva, Mario; Pedrazzi, Giuseppe; Pogliacomi, Francesco; Castagna, Alessandro

    2015-10-01

    The aim of this study was to test reproducibility of the CT Pico method in a cadaveric model and to compare CT Pico measurements with a high-precision laser probe for optical scanning. The glenoid surface of ten dried cadaveric scapulae (with intact surface) was measured by and high-precision laser probe for optical scanning, the latter being assumed as a reference standard. Measurements were done according to the Pico technique, using a circle-shaped region of interest (ROI) that was placed on the inferior glenoid rim. Measurements obtained using the CT Pico method (three readers) and with laser were compared to assess differences between radiological assessment and the reference standard. Each observer performed two repeated measurements from each scapulae (20 for each observer). Mean differences between laser measurements and each CT reader were 18.4% (range, -4 to 61%) for reader 1, 12.4% (range, -15 to 64%) for reader 2, and 11% (range, -14 to 58%) for reader 3. Considering all the 60 measurements made by the three readers, 39 measurements out of 60 (65%) were outside the range [-5%; +5%] while 26 measurements (43%) are outside the range [-10%; +10%]. The largest differences (positive and negative) were +64 and -14 %, respectively. Intra-operator reproducibility was high in most cases (intraclass correlation coefficient (ICC) =0.93, ICC = 0.91, ICC = 0.93 and Lin's Concordance correlation coefficient (CCC) = 0.92, CCC = 0.90, CCC = 0.92 for reader 1 to 3, respectively. However, in five cases the CT Pico measurements showed absolute differences between the first and second measurements that exceeded 10%. The inter-observer variability for CT measurement of the glenoid surface using the CT Pico method was high when compared with laser, in the assessment of glenoid surface in cadaveric specimens, thus the CT Pico method is not reliable and could cause errors in the clinical management of the patient. Level of evidence Level II, Development of

  15. Ontogenetic allometry of the Beagle.

    Science.gov (United States)

    Helmsmüller, Daniela; Wefstaedt, Patrick; Nolte, Ingo; Schilling, Nadja

    2013-10-10

    Mammalian juveniles undergo dramatic changes in body conformation during development. As one of the most common companion animals, the time line and trajectory of a dog's development and its body's re-proportioning is of particular scientific interest. Several ontogenetic studies have investigated the skeletal development in dogs, but none has paid heed to the scapula as a critical part of the mammalian forelimb. Its functional integration into the forelimb changed the correspondence between fore- and hindlimb segments and previous ontogenetic studies observed more similar growth patterns for functionally than serially homologous elements. In this study, the ontogenetic development of six Beagle siblings was monitored between 9 and 51 weeks of age to investigate their skeletal allometry and compare this with data from other lines, breeds and species. Body mass increased exponentially with time; log linear increase was observed up to the age of 15 weeks. Compared with body mass, withers and pelvic height as well as the lengths of the trunk, scapula, brachium and antebrachium, femur and crus exhibited positive allometry. Trunk circumference and pes showed negative allometry in all, pelvis and manus in most dogs. Thus, the typical mammalian intralimb re-proportioning with the proximal limb elements exhibiting positive allometry and the very distal ones showing negative allometry was observed. Relative lengths of the antebrachium, femur and crus increased, while those of the distal elements decreased. Beagles are fully-grown regarding body height but not body mass at about one year of age. Particular attention should be paid to feeding and physical exertion during the first 15 weeks when they grow more intensively. Compared with its siblings, a puppy's size at 9 weeks is a good indicator for its final size. Among siblings, growth duration may vary substantially and appears not to be related to the adult size. Within breeds, a longer time to physically mature is

  16. Shoulder and Scapular Kinematics during the Windmill Softball Pitch

    Science.gov (United States)

    Backus, Sherry I.; Kraszewski, Andrew; Kontaxis, Andreas; Gibbons, Mandi; Bido, Jennifer; Graziano, Jessica; Hafer, Jocelyn; Jones, Kristofer J.; Hillstrom, Howard; Fealy, Stephen

    2013-01-01

    Objectives: Pitch count has been studied extensively in the overhand throwing athlete. However, pitch count and fatigue have not been systematically evaluated in the female windmill (underhand) throwing athlete. Direct kinematic measurements of the glenohumeral and scapulo-thoracic joint have not to be correlated and determined. The purpose is to measure scapular kinematics for the high school female windmill softball pitcher and identify kinematic adaptions and changes in pitching performance due to fatigue. Methods: Eight female high school softball pitchers without previous shoulder injury were enrolled. Three-dimensional (3D) motion of the humerus, scapula and trunk were recorded with surface markers at 250 Hz. Marker placement and the anatomical calibration of bony landmarks followed recommendations by the ISB (Wu et al. 2005) and Kontaxis et al (2009). A custom marker cluster was used to dynamically track the scapula (Karduna et al. 2001). The pitching mound was at regulation distance (43’) from the strike zone target. All athletes completed 105 pitches in sets of 15 with a rest of 5 minutes between sets. Ball speed recorded with a radar gun, 3D angular rotations of the glenohumeral joint, scapulo-thoracic joint and thorax with respect to the room were calculated for all throws. The last five pitches of every set were averaged for analysis. Results: Ball speed (Figure 1, n=8 subjects) and peak glenohumeral, scapulo-thoracic and thoracic angular rotations (n=4 subjects) were consistent across all sets. Examples of kinematics at two of these joints are presented across all sets (Figure 2, n=4). Data across all planes demonstrated similar consistency. Conclusion: This study presents a systematic protocol for the study of fatigue during windmill softball pitching. To our knowledge, this is one of the first studies to analyze glenohumeral as well as scapulo-thoracic kinematics during this task. The consistency in the glenohumeral, scapulo-thoracic and torso

  17. Miología pectoral de algunos Centrolenidae (Amphibia: Anura

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    Manzano, Adriana S.

    1999-11-01

    Full Text Available El estudio comparativo de la miología pectoral en dos géneros de Centrolenidae (Centrolene e Hyalinobatrachium que incluyen a cuatro especies (C. geckoideum, C. grandisonae, C. robledal y H. aureoguttatum, brinda una visión más completa de la morfología de la cintura pectoral en los anuros, ampliando la información disponible. Este estudio incorpora caracteres nuevos para el tratado de la familia, antecedente de importancia ya que los caracteres frecuentemente utilizados para definir al grupo son homoplásicos (Lynch, 1973; Duellman & Trueb, 1986; Ford & Cannatella, 1993 y ponen en duda la monofilia del grupo. Los resultados muestran la escasa variabilidad de la musculatura pectoral en los géneros de Centrolenidae. Al mismo tiempo resaltan variaciones con el género Hyalinobatrachium en relación con los músculos depressor mandibulae y pectoralis abdominalis. En general existe una tendencia a la duplicación de algunos músculos como el serratus inferioris, dorsal scapulae y depressor mandibulae (característica observada también en Hylidae; Manzano, 1996. The comparative study of pectoral myology in two genera of Centrolenidae (Centrolene and Hyalinobatrachium, including four species (C. geckoideum, C. grandisonae, C. robledoi y H. aureoguttatum, adds to our understanding of the pectoral girdle morphology of anurans, enlarging the available information. This study examines new characters for the family. Study of new characters is important because the most frequently used characters to define the group are homoplastic (Lynch, 1973; Duellman & Trueb, 1986; Ford & Cannatella, 1993 which produces a dubious monophyly of group. The results of this study show us the little variability of the pectoral musculature in Centrolenid genera. At the same time some variations between Centrolene and Hyalinobatrachium (related to the depressor mandibulae and pectoralis abdominalis muscles, are significant. In addition, a tendency to duplicate some

  18. The reliability of three-dimensional scapular attitudes in healthy people and people with shoulder impingement syndrome

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    Hébert Luc J

    2007-06-01

    Full Text Available Abstract Background Abnormal scapular displacements during arm elevation have been observed in people with shoulder impingement syndrome. These abnormal scapular displacements were evaluated using different methods and instruments allowing a 3-dimensional representation of the scapular kinematics. The validity and the intrasession reliability have been shown for the majority of these methods for healthy people. However, the intersession reliability on healthy people and people with impaired shoulders is not well documented. This measurement property needs to be assessed before using such methods in longitudinal comparative studies. The objective of this study is to evaluate the intra and intersession reliability of 3-dimensional scapular attitudes measured at different arm positions in healthy people and to explore the same measurement properties in people with shoulder impingement syndrome using the Optotrak Probing System. Methods Three-dimensional scapular attitudes were measured twice (test and retest interspaced by one week on fifteen healthy subjects (mean age 37.3 years and eight subjects with subacromial shoulder impingement syndrome (mean age 46.1 years in three arm positions (arm at rest, 70° of humerothoracic flexion and 90° of humerothoracic abduction using the Optotrak Probing System. Two different methods of calculation of 3-dimensional scapular attitudes were used: relative to the position of the scapula at rest and relative to the trunk. Intraclass correlation coefficient (ICC and standard error of measure (SEM were used to estimate intra and intersession reliability. Results For both groups, the reliability of the three-dimensional scapular attitudes for elevation positions was very good during the same session (ICCs from 0.84 to 0.99; SEM from 0.6° to 1.9° and good to very good between sessions (ICCs from 0.62 to 0.97; SEM from 1.2° to 4.2° when using the method of calculation relative to the trunk. Higher levels of

  19. Comparison of 3-Dimensional Shoulder Complex Kinematics in Individuals With and Without Shoulder Pain, Part 2: Glenohumeral Joint

    Science.gov (United States)

    LAWRENCE, REBEKAH L.; BRAMAN, JONATHAN P.; STAKER, JUSTIN L.; LAPRADE, ROBERT F.; LUDEWIG, PAULA M.

    2015-01-01

    STUDY DESIGN Cross-sectional. OBJECTIVES To compare differences in glenohumeral joint angular motion and linear translations between symptomatic and asymptomatic individuals during shoulder motion performed in 3 planes of humerothoracic elevation. BACKGROUND Numerous clinical theories have linked abnormal glenohumeral kinematics, including decreased glenohumeral external rotation and increased superior translation, to individuals with shoulder pain and impingement diagnoses. However, relatively few studies have investigated glenohumeral joint angular motion and linear translations in this population. METHODS Transcortical bone pins were inserted into the scapula and humerus of 12 a symptomatic and 10 symptomatic participants for direct bone-fixed tracking using electromagnetic sensors. Glenohumeral joint angular positions and linear translations were calculated during active shoulder flexion, abduction, and scapular plane abduction. RESULTS Differences between groups in angular positions were limited to glenohumeral elevation, coinciding with a reduction in scapulothoracic upward rotation. Symptomatic participants demonstrated 1.4 mm more anterior glenohumeral translation between 90° and 120° of shoulder flexion and an average of 1 mm more inferior glenohumeral translation throughout shoulder abduction. CONCLUSION Differences in glenohumeral kinematics exist between symptomatic and a symptomatic individuals. The clinical implications of these differences are not yet understood, and more research is needed to understand the relationship between abnormal kinematics, shoulder pain, and pathoanatomy. PMID:25103132

  20. Shoulder Retractor Strengthening Exercise to Minimize Rhomboid Muscle Activity and Subacromial Impingement

    Science.gov (United States)

    Fennell, Jeremy; Mochizuki, George; Ismail, Farooq; Boulias, Chris

    2016-01-01

    Purpose: We investigated the best position for shoulder retractor strengthening exercise to maximize middle trapezius activity and minimize rhomboid major activity. Although both trapezius and rhomboids are scapular retractors, rhomboids also act as downward rotators of the scapula, which can worsen subacromial impingement. Methods: Twelve healthy participants (age 30 [SD 6] y) with no history of shoulder pain were recruited for this study, which used fine-wire electromyography to examine maximal muscle activation of the middle trapezius and rhomboid major muscle fibres in four different positions: with the shoulder in 90° abduction with elbow completely extended and (1) shoulder internal rotation, (2) shoulder neutral rotation, (3) shoulder external rotation, and (4) rowing (shoulder neutral rotation and elbow flexed 90°). The ratio of trapezius to rhomboid muscles was compared with Wilcoxon signed-rank tests. Results: Muscle activation ratio during shoulder retraction exercise was significantly lower by 22% (i.e., rhomboid was more active than middle trapezius) when performed with the shoulder in rowing position (elbow flexed) than with the shoulder in external rotation (elbow extended) position (p=0.031). All four positions produced coactivation of trapezius and rhomboids. Discussion: Rowing position may not be the best position for shoulder retractor strengthening in patients with impingement syndrome. The preferable position for maximizing middle trapezius activity and minimizing rhomboid activity may be shoulder external rotation with elbow extended. PMID:27504044

  1. [Modulation of scoliotic spine growth in experimental animals using intelligent metal bars].

    Science.gov (United States)

    Sánchez-Márquez, J M; Sánchez Pérez-Grueso, F J; Fernández-Baíllo, N; Gil-Garay, E; Antuña-Antuña, S

    2013-01-01

    To create an experimental structural scoliosis model in mice to evaluate the efficacy of shape-memory metals to gradually correct the deformity over time. Experimental scoliosis was generated in 3 week-old mice by means of a suture between the left scapula and pelvis for 8 weeks. They were then randomised into two groups: a control group, in which the suture was cut, and another, in those that also had a Nitinol straight memory-wire implant fixed to the column. Serial X-rays were performed to determine the efficacy of the Nitinol in the correction of the scoliosis. In a second time, the histological changes at apical vertical body level and the adjacent discs were evaluated pre- and post-correction. A mean 81.5° kyphoscoliosis was gradually induced. In the control group, after cutting the suture, an initial reduction in the deformity was observed, but later it remained stable throughout the time (54° at two weeks). In the Nitinol group, a gradual reduction was observed in the scoliosis angle value, to a mean of 8.7° at two weeks. The curvature of the apical vertebral body and adjacent discs were partially corrected after two weeks of correcting the deformity. This scoliosis model has demonstrated the efficacy of a straight Nitinol wire fixed to the spinal column in the gradual correction of kyphoscoliosis and in the changes in its adjacent structures. Copyright © 2013 SECOT. Published by Elsevier Espana. All rights reserved.

  2. A Six-Week Resistance Training Program Does Not Change Shear Modulus of the Triceps Brachii.

    Science.gov (United States)

    Akagi, Ryota; Shikiba, Tomofumi; Tanaka, Jun; Takahashi, Hideyuki

    2016-08-01

    We investigated the effect of a 6-week resistance training program on the shear modulus of the triceps brachii (TB). Twenty-three young men were randomly assigned to either the training (n = 13) or control group (n = 10). Before and after conducting the resistance training program, the shear modulus of the long head of the TB was measured at the point 70% along the length of the upper arm from the acromial process of the scapula to the lateral epicondyle of the humerus using shear wave ultrasound elastography. Muscle thickness of the long head of the TB was also determined at the same site by ultrasonography used during both tests. A resistance exercise was performed 3 days a week for 6 weeks using a dumbbell mass-adjusted to 80% of the 1-repetition maximum (1RM). The training effect on the muscle thickness and 1RM was significant. Nevertheless, the muscle shear modulus was not significantly changed after the training program. From the perspective of muscle mechanical properties, the present results indicate that significant adaptation must occur to make the TB more resistant to subsequent damaging bouts during the 6-week training program to target the TB.

  3. Fiberoptic intubation through laryngeal mask airway for management of difficult airway in a child with Klippel-Feil syndrome

    Directory of Open Access Journals (Sweden)

    Ravi Bhat

    2014-01-01

    Full Text Available The ideal airway management modality in pediatric patients with syndromes like Klippel-Feil syndrome is a great challenge and is technically difficult for an anesthesiologist. Half of the patients present with the classic triad of short neck, low hairline, and fusion of cervical vertebra. Numerous associated anomalies like scoliosis or kyphosis, cleft palate, respiratory problems, deafness, genitourinary abnormalities, Sprengel′s deformity (wherein the scapulae ride high on the back, synkinesia, cervical ribs, and congenital heart diseases may further add to the difficulty. Fiberoptic bronchoscopy alone can be technically difficult and patient cooperation also becomes very important, which is difficult in pediatric patients. Fiberoptic bronchoscopy with the aid of supraglottic airway devices is a viable alternative in the management of difficult airway in children. We report a case of Klippel-Feil syndrome in an 18-month-old girl posted for cleft palate surgery. Imaging of spine revealed complete fusion of the cervical vertebrae with hypoplastic C3 and C6 vertebrae and thoracic kyphosis. We successfully managed airway in this patient by fiberoptic intubation through classic laryngeal mask airway (LMA. After intubation, we used second smaller endotracheal tube (ETT to stabilize and elongate the first ETT while removing the LMA.

  4. Cherubism: report of 3 cases

    Energy Technology Data Exchange (ETDEWEB)

    Nah, Kyung Soo; Jung, Yeun Hwa [Dept. of Oral and Maxillofacial Radiology, College of Dentistry, Pusan National University, Pusan (Korea, Republic of)

    1997-02-15

    The authors reported 3 cases of cherubism which included easily diagnosable cases with typical clinical and radio logic features and a difficult case in which a through study of familial factor contributed to final correct diagnosis. Central mucoepidermoid carcinoma arising in mandible with multiple metastases. The authors diagnosed a 54-year-old male as central mucoepidermoid carcinoma after undergoing clinical, radiological and histopathological examinations. The characteristics were as followed : 1. Clinically, the patient complained of the painless unilateral swelling of the left mandibular molar region and had a pus discharge through the fistula. Painful nodule was palpated on the scalp of the left frontal area and it was regarded as a metastatic lesion. 2. Plain radiographs showed the ill-defined primitive radiolucent lesion. The osteolytic lesions were also detected in the cranial bone, number 9 and 11 ribs, scapula, and vertebral bodies. 3. The mandibular CT and PNS MRI showed the swelling of the left mandible and the enlargement of the several lymph node s of 1.5 cm in size. 4. Histopathologically, many solid epidermoid type cells were mixed with mucus-secreting cells and they were arranged in duct-like structure. Most of them were epidermoid type, which indicates a high grade tumor. Mucins could be found in mucicarmine staining.

  5. Effect of Cortical Bone Thickness on Detection of Intraosseous Lesions by Ultrasonography

    Directory of Open Access Journals (Sweden)

    Sadaf Adibi

    2015-01-01

    Full Text Available Background. Usefulness of ultrasound (US in detection of intrabony lesions has been showed. A cortical bone perforation or a very thin and intact cortical bone is prerequisite for this purpose. Objective. The current in vitro study was aimed at measuring the cut-off thickness of the overlying cortical bone which allows ultrasonic assessment of bony defects. Materials and Methods. 20 bovine scapula blocks were obtained. Samples were numbered from 1 to 20. In each sample, 5 artificial lesions were made. The lesions were made in order to increase the overlying bone thickness, from 0.1 mm in the first sample to 2 mm in the last one (with 0.1 mm interval. After that, the samples underwent ultrasound examinations by two practicing radiologists. Results. All five lesions in samples numbered 1 to 11 were detected as hypoechoic area. Cortical bone thickness more than 1.1 mm resulted in a failure in the detection of central lesions. Conclusion. We can conclude that neither bony perforation nor very thin cortical bones are needed to consider US to be an effective imaging technique in the evaluation of bony lesion.

  6. Central mucoepidermoid carcinoma arising in mandible with multiple metastases

    Energy Technology Data Exchange (ETDEWEB)

    Soh, Byung Chun; Lee, Young Ho; Choi, Soon Chul; Park, Tae Won; You, Dong Soo [Dept. of Oral and Maxillofacial Radiology, College of Dentistry, Seoul National University, Seoul (Korea, Republic of)

    1997-02-15

    The authors diagnosed a 54-year-old male as central mucoepidermoid carcinoma after undergoing clinical, radiological and histopathological examinations. The characteristics were as followed : 1. Clinically, the patient complained of the painless unilateral swelling of the left mandibular molar region and had a pus discharge through the fistula. Painful nodule was palpated on the scalp of the left frontal area and it was regarded as a metastatic lesion. 2. Plain radiographs showed the ill-defined primitive radiolucent lesion. The osteolytic lesions were also detected in the cranial bone, number 9 and 11 ribs, scapula, and vertebral bodies. 3. The mandibular CT and PNS MRI showed the swelling of the left mandible and the enlargement of the several lymph nodes of 1.5 cm in size. 4. Histopathologically, many solid epidermoid type cells were mixed with mucus-secreting cells and they were arranged in duct-like structure. Most of them were epidermoid type, which indicates a high grade tumor. Mucins could be found in mucicarmine staining.

  7. Noninvasive assessment of the activity of the shoulder girdle muscles using ultrasound real-time tissue elastography.

    Science.gov (United States)

    Ishikawa, Hiroaki; Muraki, Takayuki; Sekiguchi, Yusuke; Ishijima, Takahiro; Morise, Shuhei; Yamamoto, Nobuyuki; Itoi, Eiji; Izumi, Shin-Ichi

    2015-10-01

    The purpose of this study was to clarify whether the activity of the shoulder girdle muscles could be estimated by measuring the elasticity of these muscles under several levels of muscle contraction through ultrasound real-time tissue elastography (RTE). Ten healthy men performed submaximal voluntary contractions (MVC) in each manual muscle testing position for the middle deltoid, upper trapezius, supraspinatus, levator scapulae, and rhomboid major. The elasticity of these muscles was measured using ultrasound RTE during the task. The strain ratio of the muscle to an acoustic coupler was calculated as an assessment index of the muscle elasticity. Higher strain ratio values imply lower elasticity. In addition, the electromyographic activity was recorded from surface electrodes attached only to the middle deltoid and upper trapezius. The strain ratios were negatively correlated with the normalized root mean square values for the middle deltoid (r=-0.659, pmuscles decreased with an increase from 10% MVC force to 30% MVC force. Ultrasound RTE may be useful for noninvasively assessing the activity of the shoulder girdle muscles at certain shoulder positions with low levels of muscle contraction. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. 3D skeletal uptake of 18F sodium fluoride in PET/CT images is associated with overall survival in patients with prostate cancer

    DEFF Research Database (Denmark)

    Lindgren Belal, Sarah; Sadik, May; Kaboteh, Reza

    2017-01-01

    Background: Sodium fluoride (NaF) positron emission tomography combined with computer tomography (PET/CT) has shown to be more sensitive than the whole-body bone scan in the detection of skeletal uptake due to metastases in prostate cancer. We aimed to calculate a 3D index for NaF PET/CT and inve......Background: Sodium fluoride (NaF) positron emission tomography combined with computer tomography (PET/CT) has shown to be more sensitive than the whole-body bone scan in the detection of skeletal uptake due to metastases in prostate cancer. We aimed to calculate a 3D index for NaF PET....../CT and investigate its correlation to the bone scan index (BSI) and overall survival (OS) in a group of patients with prostate cancer. Methods: NaF PET/CT and bone scans were studied in 48 patients with prostate cancer. Automated segmentation of the thoracic and lumbar spines, sacrum, pelvis, ribs, scapulae...... segmenting using a threshold of SUV 15 (automated PET15 index), were calculated by dividing the sum of all hotspot volumes with the volume of all segmented bones. BSI values were obtained using a software for automated calculations. Results: BSI, manual PET index, and automated PET15 index were all...

  9. Scanning electron microscope analysis of gunshot defects to bone: an underutilized source of information on ballistic trauma.

    Science.gov (United States)

    Rickman, John M; Smith, Martin J

    2014-11-01

    Recent years have seen increasing involvement by forensic anthropologists in the interpretation of skeletal trauma. With regard to ballistic injuries, there is now a large literature detailing gross features of such trauma; however, less attention has been given to microscopic characteristics. This article presents analysis of experimentally induced gunshot trauma in animal bone (Bos taurus scapulae) using full metal jacket (FMJ), soft point (SP), and captive bolt projectiles. The results were examined using scanning electron microscopy (SEM). Additional analysis was conducted on a purported parietal gunshot lesion in a human cranial specimen. A range of features was observed in these samples suggesting that fibrolamellar bone response to projectile impact is analogous to that observed in synthetic composite laminates. The results indicate that direction of bullet travel can be discerned microscopically even when it is ambiguous on gross examination. It was also possible to distinguish SP from FMJ lesions. SEM analysis is therefore recommended as a previously underexploited tool in the analysis of ballistic trauma. © 2014 American Academy of Forensic Sciences.

  10. Safety of subcutaneous microinjections (mesotherapy) in musicians.

    Science.gov (United States)

    Navarte, Danik Arana; Rosset-Llobet, Jaume

    2011-06-01

    Determine the safety and tolerance of mesotherapy as a technique for the treatment of musculoskeletal complaints in musicians. 67 patients (55.2% women) were subjected to a total of 267 mesotherapy sessions. A mesotherapy needle or normal needle was used randomly. The drugs employed were thiocolchicoside and diazepam as muscular relaxants, pentoxifylline or buflomedil as vasodilators, and piroxicam as an anti-inflammatory, as directed. A visual analogue scale was used to quantify the pain produced by the microinjections as well as the degree of immediate and midterm side effects as reported on a standard questionnaire. A mean of 155.5 microinjections were performed per session, of which 45.6% were perceived as painful by the patient with a mean severity of 4.3 out of 10. The pain reduced to 0.5 out of 10 after 24 hours. The most sensitive areas were the levator scapulae and splenius muscles. Systemic symptoms were reported by 5.99% of the musicians after the mesotherapy sessions (muscular weakness 1.5%, rash 1.5%, drowsiness 1.1% and itching 1.1%, being the most frequent). The mean severity of these symptoms was 2.77 out of 10. In all cases the symptoms had completely disappeared after 24 hours. No patient referred to signs of local or systemic infection. The application of drugs by means of subcutaneous injections (mesotherapy) in musicians is a technique that is safe, well tolerated, and without any severe complications.

  11. The reverse shoulder prosthesis: a review of imaging features and complications

    Energy Technology Data Exchange (ETDEWEB)

    McFarland, Edward G.; Sanguanjit, Prakasit; Tasaki, Atsushi [Johns Hopkins University, Department of Orthopedic Surgery, Lutherville, MD (United States); Keyurapan, Ekavit [Mahidol University, Department of Orthopaedic Surgery, Bangkok (Thailand); Fishman, Elliot K.; Fayad, Laura M. [Johns Hopkins Medical Institutions, Johns Hopkins University, Department of Radiology and Radiological Sciences, Baltimore, MD (United States)

    2006-07-15

    The reverse shoulder prosthesis is a prosthesis that has been in clinical use in Europe since 1985 and was approved for use in the United States in 2004. This unique prosthesis has a baseplate attached to the glenoid, which holds a spherical component, while the humeral component includes a polyethylene insert that is flat. This design is the ''reverse'' configuration of that seen with a conventional arthroplasty, in which the spherical component is part of the humeral component. The indications for the reverse prosthesis are: (1) painful arthritis associated with irreparable rotator cuff tears (cuff tear arthropathy), (2) failed hemiarthroplasty with irreparable rotator cuff tears, (3) pseudoparalysis due to massive, irreparable rotator cuff tears, (4) some reconstructions after tumor resection, and (5) some fractures of the shoulder not repairable or reconstructable with other techniques. This prosthesis can produce a significant reduction in pain and some improvement in function for most of the indications mentioned. However, the unique configuration and the challenge of its insertion can result in a high incidence of a wide variety of unusual complications. Some of these complications, such as dislocation of the components, are similar to conventional shoulder replacement. Other complications, such as notching of the scapula and acromial stress fractures, are unique to this prosthesis. (orig.)

  12. Pain management of hemiplegic shoulder pain post stroke in patients from Nanjing, China

    Science.gov (United States)

    Zhu, Yi; Su, Bin; Li, Ning; Jin, Hongzhu

    2013-01-01

    We selected 106 hemiplegic patients with shoulder pain hospitalized after stroke from three hospitals in Nanjing, China between February 2007 and January 2012. All patients had complete clinical data sets and accounted for 45.5% of the inpatients because of stroke. Results showed that the number of patients with hemiplegic shoulder pain post stroke increased yearly, attacking mainly males 50–69 years of age. Of 106 patients, there were 60 cases (56.6%) of adhesive capsulitis, 19 (17.9%) of shoulder subluxation, 14 (13.2%) of complex regional pain syndrome, and 13 (12.6%) of central pain. The main symptoms were shoulder pain (100%), limit of shoulder mobility (98.1%), and adhesion of the scapula (56.6%). MRI of the shoulder showed tendon and ligament lesions (57.1%) and rotator cuff tear (38.1%). 53.8% of central pain was related to the thalamus, in addition to the basal ganglia, brain stem, and cerebellopontine angle. Shoulder pain, upper limb motor function, and function independence were significantly improved after comprehensive rehabilitation. In particular, electroacupuncture based on basic physical therapy exhibited efficacy on shoulder tion and complex regional pain syndrome. Multiple linear regression results showed a negative relationship of efficacy of pain management with the attack period of shoulder pain, involvement of the posterior limb of the internal capsule, and duration between onset and rehabilitation treatment, but a positive correlation with pain-related education, pain regression period, and pain diagnosis. PMID:25206549

  13. Deltoid contracture: A study of nineteen cases

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    Banerji Debabrata

    2008-01-01

    Full Text Available Objective: Deltoid contracture is not uncommon in India. Contractures of deltoid often do not have definite etiology. We have critically analyzed the condition as regards the etiopathogenesis and its surgical results. Materials and Methods: Nineteen patients with deltoid contracture operated between June 1990 and September 2001 were enrolled for a unicentric retrospective study. The surgery was indicated in patients with abduction deformity of more than 30° at the shoulder. The etiology of deltoid contracture was idiopathic ( n = 13 intramuscular injection in deltoid muscle ( n = 5 and blunt trauma ( n = 1. All were operated by distal release (incision near the insertion of the deltoid muscle. The average follow-up was of 9.5 years (range 6-17 years. They were evaluated based on parameters like pain, persistence of deformity, range of shoulder movements and strength of deltoid. Results: All patients recovered painless full range of shoulder motion except one. The correction of deformity was achieved in all patients and there was no loss of strength of deltoid compared to the opposite side. Histology of excised tissue showed features of chronic inflammation. The complications observed were hypertrophic scar ( n = 1, painful terminal restriction of shoulder movements ( n = 1 and prominent vertebral border of scapula ( n = 1. Conclusion: Deltoid contracture has features of chronic inflammation, and the intramuscular deltoid injection is the most incriminating factor in its etiopathogenesis. The condition can be effectively managed surgically by distal release of the deltoid muscle combined with excision of the muscular fibrotic contracture band.

  14. Comparison of 3-dimensional shoulder complex kinematics in individuals with and without shoulder pain, part 1: sternoclavicular, acromioclavicular, and scapulothoracic joints.

    Science.gov (United States)

    Lawrence, Rebekah L; Braman, Jonathan P; Laprade, Robert F; Ludewig, Paula M

    2014-09-01

    Cross-sectional. To compare sternoclavicular, acromioclavicular, and scapulothoracic joint motion between symptomatic and asymptomatic individuals during shoulder motion performed in 3 planes of humerothoracic elevation. Differences in scapulothoracic kinematics are associated with shoulder pain. Several studies have measured these differences using surface sensors, but the results of this technique may be affected by skin-motion artifact. Furthermore, previous studies have not included the simultaneous measurement of sternoclavicular and acromioclavicular joint motion. Transcortical bone pins were inserted into the clavicle, scapula, and humerus of 12 asymptomatic and 10 symptomatic individuals for direct, bone-fixed tracking using electromagnetic sensors. Angular positions for the sternoclavicular, acromioclavicular, and scapulothoracic joints were measured during shoulder flexion, abduction, and scapular plane abduction. Differences between groups were found for sternoclavicular and scapulothoracic joint positions. Symptomatic individuals consistently demonstrated less sternoclavicular posterior rotation, regardless of angle, phase, or plane of shoulder motion. Symptomatic individuals also demonstrated less scapulothoracic upward rotation at 30° and 60° of humerothoracic elevation during shoulder abduction and scapular plane abduction. The results of this study show that differences in shoulder complex kinematics exist between symptomatic and asymptomatic individuals. However, the magnitude of these differences was small, and the resulting clinical implications are not yet fully understood. The biomechanical coupling of the sternoclavicular and acromioclavicular joints requires further research to better understand scapulothoracic movement deviations and to improve manual therapy and exercise-based physical therapy interventions.

  15. The reliability of physical examination tests for the clinical assessment of scapular dyskinesis in subjects with shoulder complaints: A systematic review.

    Science.gov (United States)

    Lange, Toni; Struyf, Filip; Schmitt, Jochen; Lützner, Jörg; Kopkow, Christian

    2017-07-01

    Systematic review. The aim of this systematic review was to summarize and evaluate intra- and interrater reliability research of physical examination tests used for the assessment of scapular dyskinesis. Scapular dyskinesis, defined as alteration of normal scapular kinematics, is described as a non-specific response to different shoulder pathologies. A systematic literature search was conducted in MEDLINE, EMBASE, AMED and PEDro until March 20th, 2015. Methodological quality was assessed with the Quality Appraisal of Reliability Studies (QAREL) by two independent reviewers. The search strategy revealed 3259 articles, of which 15 met the inclusion criteria. These studies evaluated the reliability of 41 test and test variations used for the assessment of scapular dyskinesis. This review identified a lack of high-quality studies evaluating intra- as well as interrater reliability of tests used for the assessment of scapular dyskinesis. In addition, reliability measures differed between included studies hindering proper cross-study comparisons. The effect of manual correction of the scapula on shoulder symptoms was evaluated in only one study, which is striking, since symptom alteration tests are used in routine care to guide further treatment. Thus, there is a strong need for further research in this area. Diagnosis, level 3a. Copyright © 2016. Published by Elsevier Ltd.

  16. Reconstruction of scalp defects with the radial forearm free flap

    Science.gov (United States)

    2012-01-01

    Background Advanced and recurrent cutaneous squamous cell carcinoma of the scalp and forehead require aggressive surgical excision often resulting in complex defects requiring reconstruction. This study evaluates various microvascular free flap reconstructions in this patient population, including the rarely utilized radial forearm free flap. Patients and methods A retrospective review of patients undergoing free flap surgeries (n = 47) of the scalp between 1997 and 2011 were included. Patients were divided primarily into two cohorts: a new primary lesion (n = 21) or recurrence (n = 26). Factors examined include patient demographics, indication for surgery, defect, type of flap used, complications (major and minor), and outcomes. Results The patients were primarily male (n = 34), with a mean age of 67 years (25–91). A total of 58 microvascular free flap reconstructions were performed (radial forearm free flap: n = 28, latissimus dorsi: n = 20, rectus abdominis: n = 9, scapula: n = 1). Following reconstruction with a radial forearm free flap, duration of hospitalization was shorter (P = 0.04) and complications rates were similar (P = 0.46). Donor site selection correlated with defect area (P scalp are aggressive and challenging to treat. The radial forearm free flap is an underutilized free flap in the reconstruction of complex scalp defects. PMID:22583845

  17. Sprengel anomaly in deletion 22q11.2 (DiGeorge/Velo-Cardio-Facial) syndrome.

    Science.gov (United States)

    Radio, Francesca Clementina; Digilio, Maria Cristina; Capolino, Rossella; Dentici, Maria Lisa; Unolt, Marta; Alesi, Viola; Novelli, Antonio; Marino, Bruno; Dallapiccola, Bruno

    2016-03-01

    Sprengel anomaly (SA) is a rare skeletal defect characterized by uni- or bi-lateral elevation of the scapula. This anomaly is often isolated, although it can occur in association with other defects, including cervical spine malformations, cleft palate, and facial anomalies. Neural crest migration anomalies have been involved in the etiology of SA. Since the same embryological pathway accounts for some of the clinical features of deletion 22q11.2 syndrome (del22q11.2; DiGeorge/Velo-Cardio-Facial syndrome), we investigated the occurrence of SA in a consecutive series of 235 del22q11.2 patients aged more than 2 years, undergoing a complete clinical and orthopedic assessment of the dorsal and thoracic skeleton. In the present series, two patients were diagnosed with true SA. Present results and published reports suggest that scapular involvement including SA occurs in 1-2% of del22q11.2 individuals. Accordingly, this anomaly should be investigated as one of the possible skeletal findings of del22q11.2 syndrome, while this diagnosis should be excluded in patients presenting with SA associated with other defects. © 2015 Wiley Periodicals, Inc.

  18. Distribution of cesium-137 in reindeer

    Directory of Open Access Journals (Sweden)

    Kristina Rissanen

    1990-08-01

    Full Text Available The influence of the Chernobyl accident in 1986 on the Finnish reindeer herding area was much smaller than the effects of the nuclear bomb tests in the 1960s. Only in one small area somewhat more Cs-137 was deposited than in the rest of the reindeer herding area. From that area 20 reindeer were chosen for investigation of the distribution of Cs-137. All tissues, organs, the skeleton, digestive tract, hide, head and hooves were sampled quantitatively. Three reindeer were pregnant and also the foetuses were studied. The Cs-137 amounts were determined by gammaspectrometric measurements. The results showed that the differences in the Cs-137 concentrations between muscle tissue from different parts of an individual reindeer were not more than 10 percent. Thus it is not essential from which part of the reindeer meat samples for surveillance purposes are taken. The concentration of Cs-137 in edible tissues other than muscle was lower except in the kidneys and scapula cartilage.

  19. Thoracic limb morphology of the red panda (Ailurus fulgens evidenced by osteology and radiography

    Directory of Open Access Journals (Sweden)

    Modesta Makungu

    2015-02-01

    Full Text Available The red panda (Ailurus fulgens is distributed primarily in the Himalayas and southern China. It is classified as a vulnerable species by the International Union for Conservation of Nature. The aim of this study was to describe the normal osteology and radiographic anatomy of the thoracic limb of the red panda. Radiography of the right thoracic limb was performed in seven captive adult red pandas. Radiographic findings were correlated with bone specimens from three adult animals. The scapula was wide craniocaudally and presented with a large area for the origin of the teres major muscle. The square-shaped major tubercle did not extend proximal to the head of the humerus. The medial epicondyle was prominent. A supracondylar foramen was present. The radial tuberosity and sesamoid bone for the abductor digiti I longus were prominent. The accessory carpal bone was directed palmarolaterally. Metacarpal bones were widely spread. The thoracic limb morphology of the red panda evidenced by osteology and radiography indicated flexibility of the thoracic limb joints and well-developed flexor and supinator muscles, which are important in arboreal quadrupedal locomotion. Knowledge gained during this study may prove useful in identifying skeletal material or remains and diagnosing musculoskeletal diseases and injuries of the thoracic limb.

  20. Skeletal development and adult osteology of Hypsiboas pulchellus (Anura: Hylidae

    Directory of Open Access Journals (Sweden)

    Julio M. Hoyos

    2012-07-01

    Full Text Available Osteological and skeletal characters have long been proven to be particularly informative in taxonomic and systematic research. Furthermore, ossification sequences are assumed to be a potential tool to investigate developmental states and developmental modes of fossil and extant skeletal specimens. Herein, we provide a detailed account on adult osteology and skeletogenesis in the Montevideo treefrog, Hypsiboas pulchellus (Anura: Hylidae based on evaluation of a series of cleared and stained specimens. A consensus sequence of ossification, i.e., the order of appearance of mineralized elements until early metamorphosis could be determined as (parasphenoid, presacral vertebrae I-VII, frontoparietal, exoccipital – transverse processes of presacral vertebrae I-VIII – sacral vertebra – (humerus, radioulna, ilium, femur, tibiofibula, scapula – (cleithrum, clavicle, coracoids, metacarpals, tarsals, metatarsals, phalanges, hypochord – (prootic, angulosplenial, dentary, maxilla, premaxilla, squamosal. Comparing the state of mineralized elements in individual specimens, a number of skeletal elements, including the exoccipital, frontoparietal, parasphenoid and prootic, as well as elements of the shoulder and pelvic girdles, and the phalanges, were found to vary intraspecifically regarding the relative time of their ossification within the ossification sequence.

  1. Comparison between {sup 18}F-FDG PET/CT and EMG Mapping for Identifying Dystonic Superficial Muscles in Primary Cervical Dystonia: Preliminary Results

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Su Jin [Seoul National University School, Seoul (Korea, Republic of); Choi, Joon Young; Sung, Duk Hyun; Park, Kwang Hong; Lee, Ji Young; Cho, Sook Kyung; Yu, Jang; Lee, Kyung Han; Kim, Byung Tae [Sungkyunkawn University School of Medicine, Seoul (Korea, Republic of)

    2010-04-15

    This study was conducted to compare {sup 18}F-FDG PET/CT and electromyography (EMG) mapping in patients with primary cervical dystonia (PCD) to find dystonic superficial cervical muscles. Ten consecutive patients with PCD (M:F=5:5, age 44{+-}13 years) whose dystonic posture was not relieved with conventional muscle relaxant therapy were included. Target cervical muscles for the comparison between {sup 18}F-FDG PET/CT and EMG mapping were four representative superficial bilateral cervical muscles: splenius capitis muscle, sternocleidomstoid muscle, upper trapeziums muscle, and levitator scapulae muscle. The diagnostic efficacy was compared between {sup 18}F-FDG PET/CT and EMG mapping using physical exam and measurement of rotation angle as the gold standard. Among 80 muscles evaluated, there were 21 (26%) dystonic superficial cervical muscles assessed with physical exam and motion analysis. The sensitivity, specificity, and accuracy for localizing dystonic muscles were 76, 92, and 88% for {sup 18}F-FDG PET/CT, and 95, 66, and 74% for EMG mapping, respectively. The sensitivity of EMG mapping was significantly higher than that of {sup 18}F-FDG PET/CT. In contrast, {sup 18}F-FDG PET/CT is more specific and accurate than EMG mapping for finding superficial dystonic cervical muscles. The high sensitivity of EMG mapping suggests that {sup 18}F-FDG PET/CT and EMG mapping are complementary for finding dystonic superficial cervical muscles.

  2. Factors affecting fixation of the glenoid component of a reverse total shoulder prothesis.

    Science.gov (United States)

    Chebli, Caroline; Huber, Philippe; Watling, Jonathan; Bertelsen, Alexander; Bicknell, Ryan T; Matsen, Frederick

    2008-01-01

    The semiconstrained design of the reverse arthroplasty allows loads from the humerus to challenge the fixation of the glenoid component to the scapula. We examined some of the factors affecting the quality of glenoid screw fixation, including the density of the material into which the screws are placed, the purchase of individual screws, and the direction of loading in relation to screw placement. Loads were applied by the humeral component to glenoid components with different conditions of fixation. The load to failure for each set of conditions was measured and compared statistically. Load to failure was less when the glenoid component was fixed to material of lesser density. Each screw contributed to the quality of fixation; the screw nearest the point of load application made the largest contribution. Load to failure was less when the load was colinear with a line through the nonlocking holes in the base plate compared to colinear with a line through the locking holes. In performing a reverse total shoulder, surgeons should emphasize secure intraosseous placement of the fixation screws in the best quality bone available. The placement of the inferior screw appears to be the most critical.

  3. Incomplete joint side tear of the subscapularis tendon with a small fragment in an adolescent tennis player: a case report

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    Kato Soki

    2012-07-01

    Full Text Available Abstract Case In this case report, we presented the case of an adolescent tennis player with avulsion injury of the subscapularis tendon of the right shoulder. Patients A 17-year-old right-hand-dominant male tennis player visited our hospital complaining of pain in the anterior aspect of the right shoulder. We performed X-ray and three-dimensional computed tomography (3D-CT and magnetic resonance imaging (MRI scans for the diagnosis. Results Plain radiographs did not reveal the presence of lesion; however, 3D-CT and MRI scans showed a small bony fragment located between the humeral head and the glenoid of the scapula and a high-intensity area of the subscapularis tendon. He was subsequently diagnosed with incomplete joint side tear of the subscapularis tendon with a small bony fragment. Subsequently, we performed arthroscopic excision of the bony fragment and repair of the subscapularis tendon. Conclusions This case highlighted the presence of an injury with minor trauma associated with repeated tennis strokes in a skeletally immature patient.

  4. Suprascapular Notch Asymmetry: A Study on 311 Patients

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    Michał Polguj

    2014-01-01

    Full Text Available The most important risk factor of suprascapular nerve entrapment is probably the shape of the suprascapular notch (SSN. The aim of the study was to perform a radiological study of the symmetry of SSN. Included in the study were 311 patients (137 women and 174 men who underwent standard computed tomography investigation of the chest. A total of 622 computed tomography scans of scapulae were retrospectively analyzed to classify suprascapular notches into five types. Suprascapular notch was recognized as a symmetrical feature in 53.45% of the patients. Symmetry was more frequently seen in females (54.0% versus 52.9%, but not to any significant degree (P=0.8413. Type III was the most commonly noted symmetrical feature (66.9% and type II was less common (0.6%. Type III was the most symmetrical type of suprascapular notch, occurring significantly more often as a symmetrical feature in comparison with type I (P<0.0001, type II (P=0.00137, or type IV (P=0.001. Our investigation did not show that the suprascapular notch is a symmetrical feature. However, symmetry was recognized more frequently in the case of type III SSN. No significant differences in symmetry were found with regard to sex.

  5. Coptobrycon bilineatus (Ellis, 1911 (Characiformes: Characidae: redescription and comments on its phylogenetic relationships

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    Francisco Langeani

    Full Text Available Coptobrycon bilineatus (Ellis, 1911 is redescribed on the basis of specimens from the District of Paranapiacaba, Municipality of Santo André, upper rio Tietê, and additional ones recently collected in a small coastal river system of Serra do Mar, very near the headwaters of the rio Tietê. The genus was compared to other Characidae lacking a supraorbital, and it seems to be more phylogenetically related to Grundulus based on the possession of various putative apomorphic character states related to: the absence of a rhinosphenoid and fourth, fifth (sometimes and sixth infraorbitals; nasal pores separated; nares with up to six nasal lamellae; cephalic laterosensory system poorly developed on supraorbital and infraorbital series; and a globose scapula. Furthermore, Coptobrycon and Grundulus are characterized by the absence of the adipose fin, of the supraorbital laterosensory series on the parietal, and of the humeral spot, and by the reduction of lateral musculature in front of the first pleural rib and between the first and second pleural ribs. Biogeographic comments are also provided.

  6. EFFECTIVENESS OF RESISTANCE TRAINING ON THE STRENGTH OF SCAPULO-HUMERAL MUSCLES AND ABDOMINALS IN MALE VOLLEY BALL PLAYERS

    Directory of Open Access Journals (Sweden)

    V. Diwakar

    2014-08-01

    Full Text Available Background: Volleyball is a sportive modality that requires strength in the upper and lower extremities along with the trunk musculature. The improvement of muscular strength is very important along with agility and flexibility for a volleyball player. Aim of the study to find the effectiveness of resistance training on the strength of scapulo-humeral muscles and abdominals in male volley ball players. Objectives of this study is find out the effect of resistance training on the strength of the scapulo-humeral muscles by measuring peak torque by using an isokinetic dynamometer and to find out the effect of resistance training on strength of abdominals through 1RM test. Methods: A group of 30 male volleyball players who have fulfilled the inclusion criteria were assigned into two groups control and experimental groups each consisting of 15 subjects. The subjects of the experimental group underwent resistance training under my supervision and the subjects of the control group done the same protocol unsupervised for 6 weeks. Results: There was significant improvement in the strength of scapula-humeral muscles and abdominals in the experimental group when compared to the control group when the pre and post intervention values were measured (p=0.05. Conclusion: Resistance training under supervision of the therapist resulted in significant improvement in strength of the scapulo-humeral muscles and abdominals in the male volleyball players.

  7. Fatal Overdose due to Confusion of an Transdermal Fentanyl Delivery System

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    Ingo Voigt

    2013-01-01

    Full Text Available Background. The use of transdermal fentanyl systems has increased over recent years, especially in patients with chronic pain. Large misuse potential and fatal outcomes have been described. Case Presentation. A 58-year-old patient presenting with clinical signs of opioid poisoning (hypoventilation, bradycardia, hypotension, and miosis was admitted to our ICU. The first body check revealed a 75 mcg per hour fentanyl patch at the patient's right scapula. Some months ago, patient's aunt died after suffering from an oncological disease. During breaking up of her household, the patches were saved by the patient. Not knowing the risk of this drug, he mistook it as a heat plaster. Investigations. Laboratory test showed an impaired renal function and metabolic acidosis. Urine drug test was negative at admittance and 12 h later. CCT scan presented a global hypoxic brain disease. Treatment and Outcome. The patient was discharged 30 days after admittance in a hemodynamic stable condition but a vegetative state and transferred to a rehabilitation center. Learning Points. With the ongoing increase in fentanyl patch prescriptions for therapeutic reasons, it is likely that misuse cases will become more relevant. Conventional urine drug screening tests are not able to exclude the diagnosis fentanyl intoxication. History taking should include family member's drug prescriptions.

  8. Diagnosis of unilateral trapezius muscle palsy: 54 Cases.

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    Seror, Paul; Stojkovic, Tanya; Lefevre-Colau, Marie Martine; Lenglet, Timothée

    2017-08-01

    We assessed medical and surgical causes of unilateral trapezius muscle (TM) palsy and/or wasting. Clinical and electrodiagnostic data were collected in 54 patients with TM impairment over 21 years. In total, 35 cases had a medical origin: neuralgic amyotrophy (NA, n = 22), idiopathic unilateral TM palsy (n = 5), regional neck radiotherapy for different conditions (n = 2), facioscapulohumeral dystrophy (FSH) (n = 4), abnormal loop of the jugular vein (n = 1), or basilar impression (n = 1). Other etiologies were neck surgery (n = 16), cervicofacial lift (n = 2), or trauma (n = 1). There were 5 main diagnostic findings in unilateral TM palsy: (1) dynamic examination of the scapula provides a new clinical sign; (2) NA is the most frequent medical cause; (3) in medical cases, partial preservation of the upper TM can offer good recovery; (4) FSH must be considered, especially in young patients; and (5) minor neck surgery can lead to severe TM palsy. Muscle Nerve 56: 215-223, 2017. © 2016 Wiley Periodicals, Inc.

  9. DISTÚRBIOS OSTEOMUSCULARES RELACIONADOS AO TRABALHO: SITUAÇÃO NA CONSTRUÇÃO CIVIL EM GOIÂNIA

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    Débora Pereira Rosa, Débora Benchimol Ferreira

    2000-06-01

    Full Text Available Skeletal muscle disturbs related to the work: situation in the civil construction in Goiânia - The related muscle skeletal disturbs (WRMD, known as Repetitive Effort Lesion are world wide phenomenon, bringing negative repercussion to the workers, undertaking and the society. There are worker's categories considered at risk. This exploratory research sought to identify de display of WRMD and their repercussion among civil construction's workers in Goiânia, as well to identify the performance of nurses in the area of the civil construction relative the WRMD prevention. After explain consent announce, 105 workers, arising from public undertaking, private and autonomous. From 47 person that described pain in the characteristic regions of WRMD, 38 point pain in the first, 29 in the hand's fingers, 23 in the scapula's region and 16 in the shoulders, that don't motivated the search of the health services, removal or work accidents. We didn't find relate of the use direction about WRMD prevention. It doesn't appear in the individual's account the nurse's of the work figure. We concluded that the WRMD manifestations haven't great repercussion on the workers yet, because it is an area that doesn't have the nurse performance yet.

  10. New information on the Wukongopteridae (Pterosauria revealed by a new specimen from the Jurassic of China

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    Xin Cheng

    2016-07-01

    Full Text Available The Wukongopteridae is an important pterosaur group discovered from Yanliao Biota, because it combines character states seen in non-pterodactyloid and pterodactyloid pterosaurs. So far, the Wukongopteridae contains three genera: Wukongopterus, Darwinopterus and Kunpengopterus; representing five species. Here we report on a new specimen, IVPP V 17959, that can be undoubtedly referred to the Wukongopteridae based on the presence of a confluent nasoantorbital fenestra, elongated cervical vertebrae (convergent with Pterodactyloidea and a long tail enclosed by rod-like bony extensions of the zygapophyses. Traits distinguishing this new specimen from other wukongopterid pterosaurs include a premaxilla with a low ossified anterodorsal crest, a nasal bearing the most elongated process known in the Wukongopteridae, and a lacrimal that has a foramen in its middle portion. The new kind of premaxillary crest preserved in IVPP V 17959 suggests that the presence or absence of a premaxillary crest might be an interspecific feature within the Wukongopteridae. A phylogenetic analysis including all wukongopterid pterosaurs recovers IVPP V 17959 in a polytomy with Wukongopterus and the species of Darwinopterus, having Kunpengopterus in a more basal position. The postcranial skeleton of IVPP V 17959 has ontogenetically mature characteristics including a completely fused scapula and coracoid, fused proximal and distal carpal series, and an ossified extensor tendon process of the first wing phalanx, allowing its classification as ontogenetic stage five. Furthermore, the atlas and axis are separated in IVPP V 17959, which indicates that these two bones probably are not fused in skeletally mature wukongopterid individuals.

  11. Photographic analysis of human posture: a literature review.

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    do Rosário, José Luís Pimentel

    2014-01-01

    The study of posture is not an easy task, mainly because postural assessment is still scientifically inaccurate. Photographs of bipedalism in the frontal and sagittal planes are one of the most widely used methods for this assessment. The aim of this literature review was to determine which anatomical markers authors of scientific papers have taken to minimize the chances of error in measurements. The Medline and Lilacs databases were searched for the period from 2002 to 2012, with the following keywords: "postura"; "posture" and "postural." A number of studies have shown a reasonable correlation between radiographic measurements and the placement of markers. It appears possible to use photography as a form of scientific assessment since the anatomical landmarks are well chosen. The markers that were suggested in this review: malleolus; posterior calcaneal tuberosity; fibular head; tibial tuberosity; greater trochanter of the femur; anterior angle and/or posterior lateral edge of the acromion; spinous processes (particularly C7); inferior angle of the scapula; sternum manubrium; mental protuberance; and the intertragic notch. Iliac spines, both anterior superior and posterior superior, should only be used with lean subjects. Copyright © 2013 Elsevier Ltd. All rights reserved.

  12. Biomechanical Comparison of Three Perceived Effort Set Shots in Team Handball Players.

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    Plummer, Hillary A; Gascon, Sarah S; Oliver, Gretchen D

    2017-01-01

    Plummer, HA, Gascon, SS, and Oliver, GD. Biomechanical comparison of three perceived effort set shots in team handball players. J Strength Cond Res 31(1): 80-87, 2017-Shoulder injuries are prevalent in the sport of team handball; however, no guidelines currently exist in the implementation of an interval throwing protocol for players returning from an upper extremity injury. These guidelines exist for the sport of baseball, but team handball may present additional challenges due to greater ball mass that must be accounted for. The purpose of this study was to examine kinematic differences in the team handball set shot at 50, 75, and 100% effort which are common throwing intensities in throwing protocols. Eleven male team handball players (23.09 ± 3.05 years; 185.12 ± 8.33 cm; 89.65 ± 12.17 kg) volunteered. An electromagnetic tracking system was used to collect kinematic data at the pelvis, trunk, scapula, and shoulder. Kinematic differences at the shoulder, trunk, and pelvis were observed across effort levels throughout the set shot with most occurring at ball release and maximum internal rotation. Significant differences in ball speed were observed between all 3 effort level shots (p handball players are able to gauge the effort at which they shoot; however, it cannot be assumed that these speeds will be at a certain percentage of their maximum. The results of this study provide valuable evidence that can be used to prepare a team handball player to return to throwing activities.

  13. A comparison of the posture between young female handball players and non-training peers.

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    Grabara, Małgorzata

    2014-01-01

    To evaluate and compare the posture in young female handball players and a group of non-training peers. 125 handball players and 135 non-training individuals as a control group. All the subjects were aged 12-15. Measurements of basic somatic parameters (body height and mass, BMI, fat mass and total body water) were taken with an electronic balance 'Tanita'. The posture was evaluated using the moiré method. We analysed the shape of the spine in the sagittal plane and the position of the spine, pelvis and shoulder girdle in terms of symmetry. In 13-year-old handball players there was a smaller inclination of the thoracolumbar segment and a greater forward tilt of the torso. Among the training 15-year-olds, the inclination of the lower back, the sum of angles of anteroposterior curvatures and the angle of lumbar lordosis were smaller than in their non-training peers. Moreover, a correct pelvic alignment in the frontal plane, and pelvis and scapulas asymmetries in the transverse plane were more common in handball players. The formation of anteroposterior curvatures of the spine diversified some of the age groups of training and non-training young females. Handball training can affect the quality of posture.

  14. Traumatic bone and cartilage injuries of the shoulder; Traumatische Knochen- und Knorpelverletzungen der Schulter

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    Scheurecker, G. [CT- und MRT-Institut am Schillerpark, Linz/Donau (Austria)

    2015-03-01

    Traumatic injuries to the shoulder joint occur both as isolated, especially to the humerus and clavicle, as well as accompanying glenohumeral dislocations. To give an overview of the main approach of diagnostic imaging of the more common traumatic injuries to bone and/or cartilage of the shoulder joint. Only the scapula, proximal humerus and lateral clavicle are covered. In this overview radiography (RG), computed tomography (CT) and magnetic resonance imaging (MRI) are considered. Sonography is not included. The radiological report has to correctly identify injuries and describe their extent but the use of classification schemes is strongly dependent on local procedural practices. (orig.) [German] An der Schulter treten Verletzungen von Knochen bzw. Knorpel sowohl eigenstaendig auf - bei Frakturen speziell des Humerus oder der Klavikula - haeufig aber auch begleitend bei v. a. glenohumeralen Luxationen. Darstellung der bildgebenden Diagnostik der typischen traumatischen Verletzungen von Knochen und/oder Knorpel der Schulter. Beruecksichtigt werden der proximale Humerus, die Skapula und das laterale Klavikuladrittel. An bildgebenden diagnostischen Methoden wird auf die konventionelle Radiographie (RG), die Computertomographie (CT) und die Magnetresonanztomographie (MRT) eingegangen. Die Sonographie wird nicht behandelt. Der radiologische Befund soll moeglichst korrekt Verletzungen feststellen und das Ausmass beschreiben, Klassifikationen und ihre Angabe sind aber stark von jeweils lokalen Verfahrensweisen abhaengig. (orig.)

  15. Poland Syndrome: Use of Vertical Expandable Prosthetic Titanium Rib System before Walking Age—A Case Report

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    Drebov, Rosen S.; Katsarov, Atanas

    2016-01-01

    Aim  To present a new therapy for Poland syndrome (PS) using a novel surgical approach: the vertical expandable prosthetic titanium rib (VEPTR) system. Methods  The VEPTR system rib-to-rib variant was used to enhance the chest wall and vertebral column support in a young patient before walking age. Case Report  We present a 12-month-old infant diagnosed with left-sided PS at the age of 6 months associated with missing ribs, scoliosis, and absence of the left pectoral muscles. Because of four missing ribs, paradoxical breathing was present. In addition, the left scapula was protruding into the chest due to the missing rib support. Scoliosis was caused by a left-sided nonsegmented bar of the thoracic spine. Results  We decided to use the VEPTR system before the patient reached walking age to prevent progression of column deformation and future pulmonary problems. To improve the spinal deformity, to stabilize the thorax, and to improve thoracic function, we performed the operation at 1 year of age. At 10-month follow-up, the patient was reevaluated. The construction was still stable and scoliosis had not deteriorated. Conclusion  The VEPTR system is a choice of treatment in young patients with PS to prevent late complications after a child reaches walking age. PMID:28824998

  16. Poland Syndrome: Use of Vertical Expandable Prosthetic Titanium Rib System before Walking Age-A Case Report.

    Science.gov (United States)

    Drebov, Rosen S; Katsarov, Atanas

    2016-07-01

    Aim  To present a new therapy for Poland syndrome (PS) using a novel surgical approach: the vertical expandable prosthetic titanium rib (VEPTR) system. Methods  The VEPTR system rib-to-rib variant was used to enhance the chest wall and vertebral column support in a young patient before walking age. Case Report  We present a 12-month-old infant diagnosed with left-sided PS at the age of 6 months associated with missing ribs, scoliosis, and absence of the left pectoral muscles. Because of four missing ribs, paradoxical breathing was present. In addition, the left scapula was protruding into the chest due to the missing rib support. Scoliosis was caused by a left-sided nonsegmented bar of the thoracic spine. Results  We decided to use the VEPTR system before the patient reached walking age to prevent progression of column deformation and future pulmonary problems. To improve the spinal deformity, to stabilize the thorax, and to improve thoracic function, we performed the operation at 1 year of age. At 10-month follow-up, the patient was reevaluated. The construction was still stable and scoliosis had not deteriorated. Conclusion  The VEPTR system is a choice of treatment in young patients with PS to prevent late complications after a child reaches walking age.

  17. A case report of acampomelic campomelic dysplasia and operative difficulties in cleft palate reconstruction

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    M Pasupathy

    2016-01-01

    Full Text Available Acampomelic campomelic dysplasia (CD is a type of CD (CD; OMIM #114290, a rare form of congenital short-limbed dwarfism and is due to mutations in SOX9 gene family. Characteristic phenotypes of CD include bowing of the lower limbs, a narrow thoracic cage, 11 pairs of ribs, hypoplastic scapulae, macrocephaly, flattened supraorbital ridges and nasal bridge, cleft palate and micrognathia. The bending of the long bones is not an obligatory feature and is absent in about 10% of cases, referred to as acampomelic CD. A child previously diagnosed with acampomelic CD was brought to our outpatient clinic for cleft palate reconstruction. Our neurosurgeon cautioned us against performing surgery with extension of the neck in view of the possibility of producing quadriparesis, due to narrowing of the spinal canal as part of the osseous anomaly noted in the magnetic resonance imaging study of the spine, thus making the anaesthesia, surgical and post-operative procedures difficult. The cleft palate reconstruction was performed with all precautions and was uneventful.

  18. Multiple, supernumerary retained teeth in the course of cleido-cranial dysplasia. A case report.

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    Lewandowski, Bogumił; Martula-Gala, Katarzyna; Brodowski, Robert; Zych, Barbara

    2015-01-01

    Cleido-cranial dysplasia, often referred to as Scheuthauer-Marie-Sainton syndrome, is an autosomal dominant disorder of the musculo-skeletal system. Patients with cleido-cranial dysplasia are characterized by short stature, frequent varus or valgus hip, kyphoscoliosis, underdevelopment of the scapulas and the sternum, incorrect number of ribs. The most characteristic feature is unilateral or bilateral, partial or total underdevelopment of clavicles. Mental development is not affected in this syndrome. Malocclusion, occlusal irregularities, multiple supernumerary teeth, impacted teeth, and persistent milk teeth are found in the stomatognathic system. Teeth often have abnormal anatomy. Gothic palate, cleft hard and soft palate are diagnosed. The aim of this paper is to present a case of a 12-year-old boy diagnosed with irregularities in the masticatory system involving an additional number of retained teeth. The boy was referred by an orthodontist for surgical and orthodontic team therapy. The case presented confirms the observations of other authors that only the multi-specialty collaboration of a pediatrician, a geneticist, an orthopedist, an orthodontist, a maxillofacial surgeon, an implant prosthetic surgeon and a physiotherapist can provide proper diagnosis and treatment.

  19. [Update on lateral and medial spaces of the dorsal wall of the axillary fossa].

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    Ndoye, J M; Armstrong, O; Rogez, J M; Sow, M L; Le Borgne, J

    2002-01-01

    Lateral and medial axillary spaces (also named quadrilateral and triangular spaces) correspond to orifices of the posterior wall of axillary fossa communicating with deltoid and scapular areas. We attempt to become clear the anatomic boundaries of these spaces and the structures passing through. We studied by dissection 18 fresh and embaulmed human upper limb of both sex. Lateral axillary space was limited by lateral edge of the long head of the triceps muscle medialy, the medial edge of the surgical neck of the humerus lateraly. The tendon of teres major and latissimus dorsi muscles constituted lower limit and the superior boundary was the scapulohumeral capsule rather than the teres minor muscle. Structures passing through the quadrilateral space where the axillary nerve and the posterior humeral circumflex vascular pedicle. Boundaries of the triangular space where, lateraly the medial edge of the long head of the triceps, superiorly the inferior edge of the teres minor and the axillary border of the scapula; the upper edge of the teres major corresponded to the superior limit. Abduction of the upper limb is a movement which increase the risk of entrapment phenomenon of the axillary nerve in relation to rigid anatomic structures like the surgical neck of the humerus, the scapulohumeral capsule and the tendon of latissimus dorsi and teres major muscles. Neverless genetics cause of anatomic predisposition is evocated in the quadrilatere space syndrome.

  20. Coracoclavicular joints. Reflections upon incidence, pathophysiology and etiology of the different forms.

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    Nehme, A; Tricoire, J-L; Giordano, G; Rouge, D; Chiron, P; Puget, J

    2004-02-01

    Since the first description of the coracoclavicular joint in 1861, many papers have been published reporting its occurrence, anatomical description, and geographical distribution. However, there are as yet no published articles with a convincing explanation for the rather variable forms of this variant. In this study, we investigated the occurrence of the coracoclavicular joint in the current and medieval population of Toulouse city and propose, through biometric measures, an explanation for the different forms of this anatomical variant. A total of 2192 chest X-rays taken for various conditions at a receiving hospital and 392 specimens (784 scapulae and an equal number of clavicles) of the L'Isle-Jourdain Series were examined with this aim. When present in the osteologic collection, the sizes of the articular conoid process as well as the height of the corresponding coracoid and acromial processes were noted. A coracoclavicular joint was noted in 0.82% and in 1.78% of the individuals examined in the radiological and osteologic series, respectively. The conoid process varied in size and correlated with the disposition of each correspondent coracoacromial arch. Osteoarthritis was noted in some of these joints when there was discordance between the conoid process size and the architecture of the correspondent coracoacromial arch, suggesting impingement. Our findings support a genetic origin for this variant, and suggest that its occurrence is also probably influenced by environmental factors. Osteoarthritis of this joint may be responsible for shoulder pain.

  1. Calcinosis circumscripta in a common marmoset (Callithrix jacchus jacchus).

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    Wachtman, Lynn M; Pistorio, Ashley L; Eliades, Steven; Mankowski, Joseph L

    2006-05-01

    A 2.5-y-old, male common marmoset (Callithrix jacchus jacchus) developed a 2-cm, interscapular, subcutaneous mass with variably firm and cystic areas. Radiographs demonstrated a radiodense mass in close proximity to a previously implanted microchip. Fine-needle aspiration yielded a chalky liquid that, on cytologic examination, contained amorphous debris. Aerobic and anaerobic cultures were negative. Surgical excision required extensive dissection, with the mass infiltrating deep to the scapula and extending to the mammary gland. The mass weighed 30 g and comprised 10% of the animal's body weight. Microscopic examination demonstrated multifocal, variably sized, amorphous aggregates of granular, basophilic material (mineral) in the subcutis and extending to skeletal muscle. Mineral deposits were surrounded by macrophages, giant cells, and fibrous connective tissue. A focal area of ectopic bone production was present. Crystallographic analysis and x-ray diffractometry determined the material to be comprised of 100% hydroxyapatite. These findings were consistent with a diagnosis of calcinosis circumscripta. Systemic metabolic abnormalities were excluded based on examination of complete blood count, serum chemistry, and ionized calcium. Calcinosis circumscripta in the common marmoset has not previously been reported, although the lesion has been reported to occur in rhesus macaques and is well described in man and dogs. Accumulation of calcium deposits and production of ectopic bone in a marmoset is interesting in light of this species's unique calcium and vitamin D metabolism.

  2. Unusual insidious spinal accessory nerve palsy: a case report

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    Papaioannou Nikolaos

    2010-05-01

    Full Text Available Abstract Introduction Isolated spinal accessory nerve dysfunction has a major detrimental impact on the functional performance of the shoulder girdle, and is a well-documented complication of surgical procedures in the posterior triangle of the neck. To the best of our knowledge, the natural course and the most effective way of handling spontaneous spinal accessory nerve palsy has been described in only a few instances in the literature. Case presentation We report the case of a 36-year-old Caucasian, Greek man with spontaneous unilateral trapezius palsy with an insidious course. To the best of our knowledge, few such cases have been documented in the literature. The unusual clinical presentation and functional performance mismatch with the imaging findings were also observed. Our patient showed a deterioration that was different from the usual course of this pathology, with an early onset of irreversible trapezius muscle dysfunction two months after the first clinical signs started to manifest. A surgical reconstruction was proposed as the most efficient treatment, but our patient declined this. Although he failed to recover fully after conservative treatment for eight months, he regained moderate function and is currently virtually pain-free. Conclusion Clinicians have to be aware that due to anatomical variation and the potential for compensation by the levator scapulae, the clinical consequences of any injury to the spinal accessory nerve may vary.

  3. Characteristics of Morphological Parameters of Donkeys in the Czech Republic

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    Martina Kosťuková

    2015-01-01

    Full Text Available The donkey population in Central Europe and Czech Republic is very variation, which is a consequence of the donkeys originating from various areas of Europe. This has been proved to affect their body conformation. In this work, we are focusing on the population of donkeys in the Czech Republic and its analysis.The main aim of our work was to determine the values morphological parameters in the donkey population in the Czech Republic. Altogether, 23 body dimensions were taken and further processed to calculate 6 hippo metric indexes. The sample group we analyzed consisted by a total of 70 individuals, out of there were 23 stallions and 47 mares. The results were then processed using the methods of general linear model (GLM and multiple comparisons.We managed to prove a statistically significant influence of the sex factor for the following body measurements: shin length of the front limbs, chest width, withers height measured by tape, shin circumference on both front and pelvic limbs and also for weight index. Also, we have found a statistically significant difference in the scapula length when considering the age factor.

  4. Radiologic findings of adult pelvis and appendicular skeletal Langerhans cell histiocytosis in nine patients

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    Song, You Seon; Lee, In Sook; Kim, Do Kyung [Pusan National University Hospital, Medical Research Institute, Department of Radiology, Busan (Korea, Republic of); Pusan National University, School of Medicine, Department of Radiology, Busan (Korea, Republic of); Yi, Jae Hyuck [Kyungpook National University Hospital, Department of Radiology, Daegu (Korea, Republic of); Cho, Kil Ho [Yeungnam University College of Medicine, Department of Radiology, Daegu (Korea, Republic of); Song, Jong Woon [Inje University Haeundae Paik Hospital, Department of Radiology, Busan (Korea, Republic of)

    2011-11-15

    The purpose of this article was to evaluate the radiologic findings of adult pelvis and appendicular skeletal Langerhans cell histiocytosis (LCH), emphasizing the CT and MR findings. The images of nine patients with pathologically proven LCH (five men and four women; mean age, 37.11 years) were retrospectively reviewed. Imaging analysis was confined to the long and flat bones. CT scans were performed in five patients and MR imaging was performed in eight. Images were assessed for the following features on CT and MRI: the location and number of lesions; the presence of cortical destruction, endosteal scalloping, and a periosteal reaction on CT or MRI; the margin of soft tissue masses, the presence of bone marrow edema, and a ''budding'' appearance on MRI; and the presence of sclerotic margins or septations on CT. The involved skeletal sites were the pelvis (seven), femurs (five), humeri (two), tibias (two), fibula (one), clavicle (one), scapula (one), and sternum (one). Endosteal scalloping, a periosteal reaction, and a budding appearance were common on MRI or CT images. Although cortical destruction and the soft tissue lesion formation were rare, soft tissue masses had well-defined margins. Endosteal scalloping and a budding appearance with a periosteal reaction on CT and MRI may be helpful signs for differentiation of LCH from malignant tumors in adults. (orig.)

  5. Upper crossed syndrome and its relationship to cervicogenic headache.

    Science.gov (United States)

    Moore, Michele K

    2004-01-01

    To discuss the management of upper crossed syndrome and cervicogenic headache with chiropractic care, myofascial release, and exercise. A 56-year-old male writer had been having constant 1-sided headaches radiating into the right eye twice weekly for the past 5 years. Tenderness to palpation was elicited from the occiput to T4 bilaterally. Trigger points were palpated in the pectoralis major, levator scapulae, upper trapezius, and supraspinatus muscles bilaterally. Range of motion in the cervical region was decreased in all ranges and was painful. Visual examination demonstrated severe forward translation of the head, rounded shoulders, and right cervical translation. The patient was adjusted using high-velocity, short-lever arm manipulation procedures (diversified technique) and was given interferential myofascial release and cryotherapy 3 times weekly for 2 weeks. He progressed to stretching and isometric exercise, McKenzie retraction exercises, and physioball for proprioception, among other therapies. The patient's initial headache lasted 4 days. He had a second headache for 1.5 days during his exercise training. During the next 7 months while returning to the clinic twice monthly for an elective chiropractic maintenance program, his headaches did not recur. He also had improvement on radiograph. The principles of upper crossed syndrome and the use of exercise, chiropractic care, and myofascial release in the treatment of cervicogenic headache are discussed. A review of the literature indicates that analyzing muscle imbalance as well as vertebral subluxation may increase the effectiveness of chiropractic treatment for cervicogenic headache.

  6. The effects of cervical stabilization exercises on the electromyographic activity of shoulder stabilizers.

    Science.gov (United States)

    Lee, Sangyong; Park, Jungseo; Lee, Daehee

    2013-12-01

    [Purpose] The purpose of the present study was to examine the effects of cervical stabilization exercises on the electromyographic activity of the shoulder stabilizers in normal adults. [Subjects] In the present study, 20 normal adults were divided into an experimental group (EG, n=10) that performed cervical stabilization exercises and shoulder stabilization exercises and a control group (CG, n=10) that performed shoulder stabilization exercises. [Methods] The EG and CG performed their exercises three times per week for four weeks. The cervical stabilization exercises consisted of Craniocervical flexion exercises (CCFEs) that were performed using pressure biofeedback units (PBUs). The shoulder stabilization exercises consisted of scapula-setting exercises, wall stretching, and external rotation exercises. To examine the electromyographic activity of the upper trapezius (UT) muscle, lower trapezius (LT) muscle, and serratus anterior (SA) muscle, the electromyograms for these muscles were compared and analyzed. [Results] In comparisons within the groups, the EG showed statistically significant differences in the UT, the LT and the SA. The CG did not show any significant differences. [Conclusion] Cervical stabilization exercises and shoulder stabilization exercises are considered to be an effective intervention for the electromyographic activity of the shoulder stabilizers, the UT, LT, and SA.

  7. Stretching Exercises for Shoulder Impingement Syndrome: Effects of 6-week Program on Shoulder Tightness, Pain and Disability Status.

    Science.gov (United States)

    Turgut, Elif; Duzgun, Irem; Baltaci, Gul

    2017-01-17

    Increasing soft tissue flexibility and joint mobility is one of the important aims of the shoulder impingement syndrome (SIS). The aim of this study was to investigate the effects of stretching program on posterior capsule tightness, pectoralis minor tightness, pain severity and disability status in SIS. Single-group pre-test post-test design. University outpatient clinic. Eighteen participants diagnosed with subacromial impingement syndrome (34.8 ± 9.4 years old, symptoms duration 5.8 ± 4.9 months) were included. The six-week self-stretching program for pectoralis minor, posterior capsule, levator scapula and, latissimus dorsi was performed. Posterior capsule tightness, pectoralis minor tightness, pain severity (visual analog scale), andself-reported shoulder related pain and disability status (Shoulder Pain and Disability Index) were used to assess the changes flexibility and symptoms. Comparisons showed that there was significantly less posterior capsule and pectoralis minor tightness, less pain severity on activity and at night, and less disability score reported after six-week stretching program (p pain severity at rest after stretching program performed (p > 0.05). The findings of the study showed that flexibility, pain severity and disability gains can be achieved with six-week stretching exercise training for participants with SIS. Therefore, shoulder girdle stretching exercises should be recommended to apply in early shoulder rehabilitation program.

  8. The effects of scapular stabilization based exercise therapy on pain, posture, flexibility and shoulder mobility in patients with shoulder impingement syndrome: a controlled randomized clinical trial.

    Science.gov (United States)

    Moezy, Azar; Sepehrifar, Saeed; Solaymani Dodaran, Masoud

    2014-01-01

    Dysfunction in the kinetic chain caused by poor scapula stabilization can contribute to shoulder injuries and Shoulder Impingement Syndrome (SIS). The purpose of this study was to compare the effectiveness of two treatment approaches scapular stabilization based exercise therapy and physical therapy in patients with SIS. The study is a randomized clinical trial in which 68 patients with SIS were randomly assigned in two groups of exercise therapy (ET) and physical therapy (PT) and received 18 sessions of treatment. Pain, shoulders' range of abduction and external rotation, shoulder protraction, scapular rotation and symmetry as well as postural assessment and Pectoralis minor length were evaluated pre and post intervention. The paired-sample t test and the independent sample t test were applied respectively to determine the differences in each group and between two groups. Our findings indicated significant differences in abduction and external rotation range, improvement of forward shoulder translation and increase in the flexibility of the involved shoulder between the two groups (respectively ; p=0.024, p=0.001, ppain reduction between the groups (p=0.576). Protraction of the shoulder (pshoulder range, decreasing forward head and shoulder postures and Pectoralis minor flexibility.

  9. Acromion Types and Role of Corticosteroid with Shoulder Impingement Syndrome.

    Science.gov (United States)

    Akram, Muhammad; Shah Gillani, Syed Faraz Ul Hassan; Farooqi, Faheem Mubashir; Awais, Syed Muhammad

    2016-12-01

    To determine the association between shoulder impingement and morphological characteristics of acromion and the role of sub-acromial injection of methylprednisolone in the short-term treatment for relieving pain and improve functional disability of these patients. A descriptive study. Department of Orthopedic Surgery and Traumatology Unit-I (DOST-I), Mayo Hospital, Lahore, between November 2013 to June 2014. All patients presented in OPD with shoulder pain were included as subjects and evaluated by clinical test and categorised using X-ray scapula Y-view. Patients with impingement syndrome were correlated with Bigliani types and offered intra-lesional injection into sub-acromial space with 2ml of xylocaine 2% and 40 mg of methylprednisolone using 22 gauge needle. The effectiveness was assessed in terms of relieving pain and good functional outcomes; and rotator cuff tear was clinically assessed among impingement positive patient. The pain was assessed using visual analogue score before and after the administration of the injection. Demographic variables for frequencies and their associations were analysed using SPSS version 20.0. Significance level was p shoulder impingement. Most had moderate pain. Thirty-four patients required intralesional steroid, which relieved the pain in 31 of them. Shoulder impingement syndrome without tear of rotator cuff tendon was found in younger age group between 40 to 45 years, which was relieved by intralesional corticosteroid administration. These patients had type II (curved) acromion, according to Bigliani classification.

  10. The shoulder gradient in patients with unilateral shoulder impingement syndrome.

    Science.gov (United States)

    Kim, Hee-Sang; Lee, Jong Ha; Yun, Dong Hwan; Yun, Jee-Sang; Shin, Yong Won; Chon, Jinmann; Hwang, Dae Gyu

    2011-10-01

    To investigate the relationship between the shoulder gradient and acromiohumeral interval of both shoulders in patients with unilateral shoulder impingement syndrome. Using the angulometer, we measured the shoulder gradient in patients with unilateral shoulder impingement syndrome in a standing position. Using the radiography, we measured the acromiohumeral interval and the angle between a vertical line and a line connecting a superior angle with an inferior angle of the scapula. In patients with unilateral shoulder impingement syndrome, the frequency of shoulder impingement syndrome was 76.2% (16 of 21) on the side of the relatively lower shoulder. The mean acromiohumeral interval on the side of the lower shoulder was 10.03±1.28 mm, compared with 10.46±1.50 mm for the higher shoulder. The angle between a vertical line and a line connecting a superior angle with an inferior angle of the scapular of the side of the lower shoulder was -0.31±3.73 degrees, compared with 3.85±4.42 degrees for the higher shoulder. The frequency of shoulder impingement syndrome was significantly higher on the side of the relatively lower shoulder, and there is no significant difference in the acromiohumeral interval between the side of the lower shoulder and that of the higher shoulder. In patients with unilateral shoulder impingement syndrome, the scapular on the side of lower shoulder was more rotated downward than on the side of the higher shoulder.

  11. A Comparison Study of the Effects of Echinacea purpurea Ethanolic Extract and Mesna on Cyclophosphamide-Induced Macroscopic Fetal Defects in Rats

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    Hossein Najafzadeh Varzi

    2009-03-01

    Full Text Available Objective(s There are some reports that the teratogenic effects of cyclophosphamide (CPA can be prevented by application of antioxidant drugs and stimulation of the maternal immune system. Echinacea purpurea extract is antioxidative and immunomodulator drug. Mesna (Sodium 2-mercaptoethane sulfonate is used for decreasing side effects of CPA, especially hemorrhagic cystitis. In this study, we compared the prophylactic effects of mesna and Echinacea extract on teratogenic effects of CPA. Materials and Methods This study was performed on 32 pregnant rats that were divided into 4 groups. The first group (control group received normal saline and the other groups received CPA (15 mg/kg intraperitoneally on 13th day of gestation. Mesna and E. purpurea extracts were administrated at doses of 100 and 400 mg/kg by IP injection, respectively, along with it and 12 hr later, after CPA injection. Rats were dissected on day 20 of gestation, embryos harvested and after determination of gross malformations they were stained by Alizarin red-Alcian blue method. ResultsCleft palate incidence was 38.46, 30.77 and 14.28% in fetuses of rats that received only CPA, CPA with mesna and CPA with Echinacea extract, respectively. In addition, skeletal anomalies incidence including limbs, vertebra, sternum, and scapula defects were decreased by Echinacea extract.ConclusionE. purpurea has significant effect on preventing CPA-induced malformations and better prophylactic effect than mesna on cases like CPA-induced cleft palate.

  12. Fine Mapping of Chromosome 17 Translocation Breakpoints ⩾900 Kb Upstream of SOX9 in Acampomelic Campomelic Dysplasia and a Mild, Familial Skeletal Dysplasia

    Science.gov (United States)

    Hill-Harfe, Katherine L.; Kaplan, Lee; Stalker, Heather J.; Zori, Roberto T.; Pop, Ramona; Scherer, Gerd; Wallace, Margaret R.

    2005-01-01

    Previously, our group reported a five-generation family in which a balanced t(13;17) translocation is associated with a spectrum of skeletal abnormalities, including Robin sequence, hypoplastic scapulae, and a missing pair of ribs. Using polymerase chain reaction (PCR) with chromosome-specific markers to analyze DNA from somatic cell hybrids containing the derivative translocation chromosomes, we narrowed the breakpoint on each chromosome. Subsequent sequencing of PCR products spanning the breakpoints identified the breaks precisely. The chromosome 17 breakpoint maps ∼932 kb upstream of the sex-determining region Y (SRY)–related high-mobility group box gene (SOX9) within a noncoding transcript represented by two IMAGE cDNA clones. A growing number of reports have implicated chromosome 17 breakpoints at a distance of up to 1 Mb from SOX9 in some cases of campomelic dysplasia (CD). Although this multigeneration family has a disorder that shares some features with CD, their phenotype is significantly milder than any reported cases of (nonmosaic) CD. Therefore, this case may represent an etiologically distinct skeletal dysplasia or may be an extremely mild familial example of CD, caused by the most proximal translocation breakpoint from SOX9 reported to date. In addition, we have refined the breakpoint in an acampomelic CD case described elsewhere and have found that it lies ∼900 kb upstream of SOX9. PMID:15717285

  13. Traumatic aortic injury score (TRAINS): an easy and simple score for early detection of traumatic aortic injuries in major trauma patients with associated blunt chest trauma.

    Science.gov (United States)

    Mosquera, Victor X; Marini, Milagros; Muñiz, Javier; Asorey-Veiga, Vanesa; Adrio-Nazar, Belen; Boix, Ricardo; Lopez-Perez, José M; Pradas-Montilla, Gonzalo; Cuenca, José J

    2012-09-01

    To develop a risk score based on physical examination and chest X-ray findings to rapidly identify major trauma patients at risk of acute traumatic aortic injury (ATAI). A multicenter retrospective study was conducted with 640 major trauma patients with associated blunt chest trauma classified into ATAI (aortic injury) and NATAI (no aortic injury) groups. The score data set included 76 consecutive ATAI and 304 NATAI patients from a single center, whereas the validation data set included 52 consecutive ATAI and 208 NATAI patients from three independent institutions. Bivariate analysis identified variables potentially influencing the presentation of aortic injury. Confirmed variables by logistic regression were assigned a score according to their corresponding beta coefficient which was rounded to the closest integer value (1-4). Predictors of aortic injury included widened mediastinum, hypotension less than 90 mmHg, long bone fracture, pulmonary contusion, left scapula fracture, hemothorax, and pelvic fracture. Area under receiver operating characteristic curve was 0.96. In the score data set, sensitivity was 93.42 %, specificity 85.85 %, Youden's index 0.79, positive likelihood ratio 6.60, and negative likelihood ratio 0.08. In the validation data set, sensitivity was 92.31 % and specificity 85.1 %. Given the relative infrequency of traumatic aortic injury, which often leads to missed or delayed diagnosis, application of our score has the potential to draw necessary clinical attention to the possibility of aortic injury, thus providing the chance of a prompt specific diagnostic and therapeutic management.

  14. The first well-preserved coelophysoid theropod dinosaur from Asia.

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    You, Hai-Lu; Azuma, Yoichi; Wang, Tao; Wang, Ya-Ming; Dong, Zhi-Ming

    2014-10-16

    Coelophysoid dinosaurs represent the earliest major radiation of neotheropods. These small-to-medium-sized agile bipeds lived throughout much of Pangaea during the Late Triassic-arly Jurassic. Previously reported coelophysoid material from Asia (excluding the Gondwanan territory of India) is limited to two specimens that comprise only limb fragments. This paper describes a new genus and species of coelophysoid, Panguraptor lufengensis, from the Lower Jurassic Lufeng Formation of Yunnan Province, China. The new taxon is represented by a well-preserved skeleton, including the skull and lower jaw, the presacral vertebral column and partial ribs, the right scapula, a partial forelimb, part of the pelvic girdle, and an almost complete hind limb. It is distinguished from other coelophysoid theropods by the unique combination of the following three character states: 1) diagonal (rostrodorsal-caudoventral) ridge on lateral surface of maxilla, within antorbital fossa, 2) elliptical, laterally facing fenestra caudodorsal to aforementioned diagonal ridge, and 3) hooked craniomedial corner of distal tarsal IV. Cladistic analysis recovers Panguraptor lufengensis deeply nested within Coelophysoidea as a member of Coelophysidae, and it is more closely related to Coelophysis than to "Syntarsus". Panguraptor represents the first well-preserved coelophysoid theropod dinosaur from Asia, and provides fresh evidence supporting the hypothesis that terrestrial tetrapods tended to be distributed pan-continentally during the Early Jurassic.

  15. Record-Breaking Pain: The Largest Number and Variety of Forelimb Bone Maladies in a Theropod Dinosaur.

    Science.gov (United States)

    Senter, Phil; Juengst, Sara L

    2016-01-01

    Bone abnormalities are common in theropod dinosaur skeletons, but before now no specimen was known with more than four afflicted bones of the pectoral girdle and/or forelimb. Here we describe the pathology of a specimen of the theropod dinosaur Dilophosaurus wetherilli with eight afflicted bones of the pectoral girdle and forelimb. On its left side the animal has a fractured scapula and radius and large fibriscesses in the ulna and the proximal thumb phalanx. On its right side the animal has abnormal torsion of the humeral shaft, bony tumors on the radius, a truncated distal articular surface of metacarpal III, and angular deformities of the first phalanx of the third finger. Healing and remodeling indicates that the animal survived for months and possibly years after its ailments began, but its right third finger was permanently deformed and lacked the capability of flexion. The deformities of the humerus and the right third finger may be due to developmental osteodysplasia, a condition known in extant birds but unreported in non-avian dinosaurs before now.

  16. A distinct pattern of myofascial findings in patients after whiplash injury.

    Science.gov (United States)

    Ettlin, Thierry; Schuster, Corina; Stoffel, Robert; Brüderlin, Andreas; Kischka, Udo

    2008-07-01

    To identify objective clinical examinations for the diagnosis of whiplash syndrome, whereby we focused on trigger points. A cross-sectional study with 1 measurement point. A quiet treatment room in a rehabilitation center. Patients (n=124) and healthy subjects (n=24) participated in this study. Among the patient group were patients with whiplash-associated disorders (n=47), fibromyalgia (n=21), nontraumatic chronic cervical syndrome (n=17), and endogenous depression (n=15). Not applicable. Each patient and control subject had a manual examination for trigger points of the semispinalis capitis, trapezius pars descendens, levator scapulae, scalenus medius, sternocleidomastoideus, and masseter muscles bilaterally. Forty (85.1%) of the patients with whiplash had positive trigger points in the semispinalis capitis muscle. The patients with whiplash had a significantly higher prevalence of positive trigger points in the semispinalis capitis muscle than any of the control groups (Pfibromyalgia or nontraumatic chronic cervical syndrome. It did differ from the patients with endogenous depression and the healthy controls. Patients with whiplash showed a distinct pattern of trigger point distribution that differed significantly from other patient groups and healthy subjects. The semispinalis capitis muscle was more frequently affected by trigger points in patients with whiplash, whereas other neck and shoulder muscles and the masseter muscle did not differentiate between patients with whiplash and patients with nontraumatic chronic cervical syndrome or fibromyalgia.

  17. Plasma Concentrations of Itraconazole, Voriconazole, and Terbinafine When Delivered by an Impregnated, Subcutaneous Implant in Japanese Quail ( Coturnix japonica ).

    Science.gov (United States)

    Souza, Marcy J; Redig, Patrick; Cox, Sherry K

    2017-06-01

    Aspergillosis is a common fungal infection in both wild and pet birds. Although effective antifungal medications are available, treatment of aspergillosis can require months of medication administration, which entails stressful handling one or more times per day. This study examined the delivery of the antifungal drugs itraconazole, voriconazole, and terbinafine to Japanese quail ( Coturnix japonica ) via an impregnated implant. Implants contained 0.5, 3, 8, or 24 mg of itraconazole, voriconazole, or terbinafine. The implants were administered subcutaneously over the dorsum and between the scapulae. Blood was collected from birds before and 2, 7, 21, 42, and 56 days after implant placement. Plasma was analyzed by high-performance liquid chromatography for concentrations of itraconazole, voriconazole, or terbinafine, as appropriate. During the course of the study, targeted terbinafine concentrations were achieved in some birds at various time points, but concentrations were inconsistent. Itraconazole and voriconazole concentrations were also inconsistent and did not reach targeted concentrations. Currently, the implant examined in this study cannot be recommended for treatment of aspergillosis in avian species.

  18. Jeholornis compared to Archaeopteryx, with a new understanding of the earliest avian evolution.

    Science.gov (United States)

    Zhou, Zhonghe; Zhang, Fucheng

    2003-05-01

    The recently reported Jeholornis represents the only known bird with a complete long skeletal tail except for Archaeopteryx. Two newly discovered specimens referable to Jeholornis provide some important new information about its anatomy. The tail of Jeholornis is much longer than that of Archaeopteryx and comprises a maximum of 27 caudal vertebrae compared with only 23 in Archaeopteryx. More interestingly, the tail feathers are shaped more like those of dromaeosaurs than those of Archaeopteryx. We conclude that the common ancestor of birds must have a more primitive tail than that in Archaeopteryx, confirming the side branch position of Archaeopteryx in the early avian evolution. The synsacrum is composed of six sacrals, representing a transitional stage between Archaeopteryx and more advanced birds. The scapula of Jeholornis has a dorso-laterally exposed glenoid facet, and the coracoid has a supracoracoid foramen. The presence of a pair of fenestrae in the sternum of Jeholornis has further implications for the air-sac system in early birds.

  19. Kinematic models of the upper limb joints for multibody kinematics optimisation: An overview.

    Science.gov (United States)

    Duprey, Sonia; Naaim, Alexandre; Moissenet, Florent; Begon, Mickaël; Chèze, Laurence

    2017-09-06

    Soft tissue artefact (STA), i.e. the motion of the skin, fat and muscles gliding on the underlying bone, may lead to a marker position error reaching up to 8.7cm for the particular case of the scapula. Multibody kinematics optimisation (MKO) is one of the most efficient approaches used to reduce STA. It consists in minimising the distance between the positions of experimental markers on a subject skin and the simulated positions of the same markers embedded on a kinematic model. However, the efficiency of MKO directly relies on the chosen kinematic model. This paper proposes an overview of the different upper limb models available in the literature and a discussion about their applicability to MKO. The advantages of each joint model with respect to its biofidelity to functional anatomy are detailed both for the shoulder and the forearm areas. Models capabilities of personalisation and of adaptation to pathological cases are also discussed. Concerning model efficiency in terms of STA reduction in MKO algorithms, a lack of quantitative assessment in the literature is noted. In priority, future studies should concern the evaluation and quantification of STA reduction depending on upper limb joint constraints. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. Thoracic Limb Morphology of the Ring-tailed Lemur (Lemur catta) Evidenced by Gross Osteology and Radiography.

    Science.gov (United States)

    Makungu, M; Groenewald, H B; du Plessis, W M; Barrows, M; Koeppel, K N

    2015-08-01

    There is limited information available on the morphology of the thoracic limb of the ring-tailed lemur (Lemur catta). This study describes the morphology of the thoracic limb of captive ring-tailed lemurs evidenced by gross osteology and radiography as a guide for clinical use. Radiographic findings of 12 captive ring-tailed lemurs are correlated with bone specimens of three adult animals. The clavicle is well developed. The scapula has a large area for the origin of the m. teres major. The coracoid and hamate processes are well developed. The lateral supracondylar crest and medial epicondyle are prominent. The metacarpal bones are widely spread, and the radial tuberosity is prominent. These features indicate the presence of strong flexor muscles and flexibility of thoracic limb joints, which are important in arboreal quadrupedal locomotion. Furthermore, an ovoid ossicle is always seen at the inter-phalangeal joint of the first digit. Areas of increased soft tissue opacity are superimposed over the proximal half of the humerus and distal half of the antebrachium in male animals as a result of the scent gland. Knowledge of the morphology of the thoracic limb of individual species is important for accurate interpretation and diagnosis of musculoskeletal diseases. © 2014 Blackwell Verlag GmbH.

  1. How spatial abilities and dynamic visualizations interplay when learning functional anatomy with 3D anatomical models.

    Science.gov (United States)

    Berney, Sandra; Bétrancourt, Mireille; Molinari, Gaëlle; Hoyek, Nady

    2015-01-01

    The emergence of dynamic visualizations of three-dimensional (3D) models in anatomy curricula may be an adequate solution for spatial difficulties encountered with traditional static learning, as they provide direct visualization of change throughout the viewpoints. However, little research has explored the interplay between learning material presentation formats, spatial abilities, and anatomical tasks. First, to understand the cognitive challenges a novice learner would be faced with when first exposed to 3D anatomical content, a six-step cognitive task analysis was developed. Following this, an experimental study was conducted to explore how presentation formats (dynamic vs. static visualizations) support learning of functional anatomy, and affect subsequent anatomical tasks derived from the cognitive task analysis. A second aim was to investigate the interplay between spatial abilities (spatial visualization and spatial relation) and presentation formats when the functional anatomy of a 3D scapula and the associated shoulder flexion movement are learned. Findings showed no main effect of the presentation formats on performances, but revealed the predictive influence of spatial visualization and spatial relation abilities on performance. However, an interesting interaction between presentation formats and spatial relation ability for a specific anatomical task was found. This result highlighted the influence of presentation formats when spatial abilities are involved as well as the differentiated influence of spatial abilities on anatomical tasks. © 2015 American Association of Anatomists.

  2. Coracoclavicular joint in a patient with cervicobrachialgy

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    Eraclio Delgado Rifá

    2015-11-01

    Full Text Available The coracoclavicular joint is a rare anomaly of the shoulder; it is described as a diarthrosic synovial joint between the clavicle and the coracoid process. This is a case of a 49-year-old dentist patient who came to the hospital complaining of pain on the right shoulder with an X-ray study that showed an anomalous joint between conoid tubercle of the clavicle and the upper surface of the horizontal part of the coracoid apophysis of the scapula. A comparative shoulder view was done and showed the bilateral presence of the anomaly, making inferences that the pain on the shoulder could be caused by this joint anomaly. Subsequent X-rays of cervical spine were done, due to the persistent pain and they showed marked degenerative changes on C5, C6 and C7 spaces. The final diagnosis was cervical spondylosis. The patient was treated with an intensive conservative treatment and the progressing was satisfactory in midterm period. Coracoclavicular joint is a rare anomalous joint and it was an accidental radiological finding, in this case and in most of the patients. The existence of the coracoclavicular joint is a fortuitous radiographic finding, as it is in this case, and the symptomatic variety of this anomaly is exceptional.

  3. Clinical evaluation of the shape of the suprascapular notch--an ultrasonographic and computed tomography comparative study: Application to shoulder pain syndromes.

    Science.gov (United States)

    Polguj, Michał; Synder, Marek; Kwapisz, Adam; Stefańczyk, Katarzyna; Grzelak, Piotr; Podgórski, Michał; Topol, Mirosław

    2015-09-01

    The most common site of suprascapular nerve compression and injury is the suprascapular notch. The aim of this study was to assess the sensitivity and specificity of sonography in determining the type of suprascapular notch (SSN). Thirty randomized patients (60 upper extremities) underwent USG examination of the shoulder area. The results were further compared with three-dimensional reconstructions of the scapulae obtained through CT examination to place the SSNs within a fivefold classification. For identification of type I, the sensitivity was 73.3% and the specificity 97.8%. For identification of type III, the values was 96.9% and 85.7%, respectively. Type II was not found in USG examination. Discrimination between type IV and V was not possible. The mean distance between the line connecting the edges of the SSN and the skin was 38 mm in right-handed patients and 34 mm in ambidextrous subjects. Ultrasonographic examination of the SSN is characterized by high specificity for type I, and high sensitivity for type III SSN. Discrimination between type IV and V of the SSN is not recommended based on sonographic evaluation. © 2015 Wiley Periodicals, Inc.

  4. Effects of a stretching protocol for the pectoralis minor on muscle length, function, and scapular kinematics in individuals with and without shoulder pain.

    Science.gov (United States)

    Rosa, Dayana P; Borstad, John D; Pogetti, Lívia S; Camargo, Paula R

    Parallel-group intervention with repeated measures. Shortening of the pectoralis minor (PM) may contribute to alterations in scapular kinematics. To evaluate the effects of a stretching protocol on function, muscle length, and scapular kinematics in subjects with and without shoulder pain. A sample of 25 patients with shoulder pain and 25 healthy subjects with PM tightness performed a daily stretching protocol for 6 weeks. Outcome measures included Disabilities of the Arm, Shoulder, and Hand questionnaire, PM length, and scapular kinematics. Disabilities of the Arm, Shoulder, and Hand scores decreased (P .05) were found for PM length in both groups. Scapular anterior tilt increased (P pain and improves function in subjects with shoulder pain. The mechanism responsible for these improvements does not appear directly related to PM muscle length or scapula kinematics, suggesting that other neuromuscular mechanisms are involved. The PM stretching protocol did not change the PM length or scapular kinematics in subjects with or without shoulder pain. However, pain and function of the upper limbs improved in patients with shoulder pain. 2b. Copyright © 2016 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

  5. Three new species of Oreophryne (Anura, Microhylidae from Papua New Guinea

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    Fred Kraus

    2013-09-01

    Full Text Available I describe three new species of the diverse microhylid frog genus Oreophryne from Papua New Guinea. Two of these occur in two isolated mountain ranges along the northern coast of Papua New Guinea; the third is from Rossel Island in the very southeasternmost part of the country. All three are the first Oreophryne known from these areas to have a cartilaginous connection between the procoracoid and scapula, a feature usually seen in species far to the west or from the central cordillera of New Guinea. Each of the new species also differs from the many other Papuan Oreophryne in a variety of other morphological, color-pattern, and call features. Advertisement-call data for Oreophryne species from the north-coast region suggest that they represent only two of the several call types seen in regions further south, consistent with the relatively recent derivation of these northern regions as accreted island-arc systems. The distinctively different, whinnying, call type of the new species from Rossel Island occurs among other Oreophryne from southeastern Papua New Guinea but has been unreported elsewhere, raising the possibility that it may characterize a clade endemic to that region.

  6. Myofascial trigger points in subjects presenting with mechanical neck pain: a blinded, controlled study.

    Science.gov (United States)

    Fernández-de-las-Peñas, C; Alonso-Blanco, C; Miangolarra, J C

    2007-02-01

    The aim of this study was to describe the differences in the presence of myofascial trigger points (TrPs) in the upper trapezius,sternocleidomastoid, levator scapulae and suboccipital muscles between patients presenting with mechanical neck pain and control healthy subjects. Twenty subjects with mechanical neck pain and 20 matched healthy controls participated in this study. TrPs were identified, by an assessor blinded to the subjects' condition, when there was a hypersensible tender spot in a palpable taut band, local twitch response elicited by the snapping palpation of the taut band, and reproduction of the referred pain typical of each TrP. The mean number of TrPs present on each neck pain patient was 4.3 (SD: 0.9), of which 2.5 (SD: 1.3) were latent and 1.8 (SD: 0.8) were active TrPs. Control subjects also exhibited TrPs (mean: 2; SD: 0.8). All were latent TrPs. Differences in the number of TrPs between both study groups were significant for active TrPs (P latent TrPs (P > 0.5). Moreover, differences in the distribution of TrPs within the analysed cervical muscles were also significant (P Active TrPs were more frequent in patients presenting with mechanical neck pain than in healthy subjects. ©2006 Elsevier Ltd.

  7. Neck muscle stiffness quantified by sonoelastography is correlated with body mass index and chronic neck pain symptoms.

    Science.gov (United States)

    Kuo, Wen-Hsiu; Jian, Deng-Wei; Wang, Tyng-Guey; Wang, Yi-Chian

    2013-08-01

    This study aimed to quantify neck muscle stiffness in the normal population with ultrasound elastography. We applied the acoustic radiation force impulse technique and measured shear wave velocities (SWVs) as representative values. The mean ± standard deviation values of SWV in 20 healthy volunteers were 2.09 ± 0.45, 1.21 ± 0.30, 1.12 ± 0.17 and 0.97 ± 0.10 m/s for the trapezius, levator scapulae, scalene anterior and sternocleidomastoid muscles, respectively. The SWV values of the four muscles significantly differed (Kruskal-Wallis test, p < 0.001). The SWV values for the trapezius muscle correlated with body mass indexes (Pearson's correlation, p = 0.034). Subjects with chronic neck pain symptoms had significantly stiffer trapezius muscle (Mann-Whitney U test, p = 0.008). This study demonstrated the technique and feasibility of quantifying neck muscle stiffness using acoustic radiation force impulse elastography and shear wave velocity detection. Further study is necessary to evaluate its diagnostic power in assessing various neck muscle diseases. Copyright © 2013 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  8. Validation of Shoulder Response of Human Body Finite-Element Model (GHBMC) Under Whole Body Lateral Impact Condition.

    Science.gov (United States)

    Park, Gwansik; Kim, Taewung; Panzer, Matthew B; Crandall, Jeff R

    2016-08-01

    In previous shoulder impact studies, the 50th-percentile male GHBMC human body finite-element model was shown to have good biofidelity regarding impact force, but under-predicted shoulder deflection by 80% compared to those observed in the experiment. The goal of this study was to validate the response of the GHBMC M50 model by focusing on three-dimensional shoulder kinematics under a whole-body lateral impact condition. Five modifications, focused on material properties and modeling techniques, were introduced into the model and a supplementary sensitivity analysis was done to determine the influence of each modification to the biomechanical response of the body. The modified model predicted substantially improved shoulder response and peak shoulder deflection within 10% of the observed experimental data, and showed good correlation in the scapula kinematics on sagittal and transverse planes. The improvement in the biofidelity of the shoulder region was mainly due to the modifications of material properties of muscle, the acromioclavicular joint, and the attachment region between the pectoralis major and ribs. Predictions of rib fracture and chest deflection were also improved because of these modifications.

  9. Patient-reported quality of life outcomes following treatment for oral cancer.

    Science.gov (United States)

    Breeze, J; Rennie, A; Dawson, D; Tipper, J; Rehman, K-U; Grew, N; Pigadas, N

    2018-03-01

    Patient-reported quality of life (QoL) outcomes have the potential to assist clinicians in providing individually tailored treatment decisions. QoL assessments were collected prospectively for 168 consecutive patients treated for oral cancer between 1 January 2010 and 31 December 2014 using the University of Washington Quality of Life Questionnaire. Patients were followed up for 18 months post-treatment. Sub-group analyses were performed using paired t-tests and analysis of variance (ANOVA) to compare the effects of adjunctive chemoradiotherapy, type of bone resection, and methods of soft and hard tissue flap reconstruction. The greatest statistically significant reduction in QoL for all oral cavity sub-sites was found following the treatment of floor of mouth tumours (-18.9%, P=0.018). Laser excision for matched patient cohorts resulted in improved resultant QoL compared to other excision techniques (P=0.0002). No significant difference in QoL was found when radial forearm and anterolateral thigh flaps were matched, or when fibula and scapula flaps were matched. These findings support the use of laser excision and the avoidance of postoperative radiotherapy if curative intent and survival outcomes are maintained. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  10. Dicephalic Parapagus Conjoined Twins in a Large Fruit-eating Bat, Genus Artibeus (Chiroptera, Phyllostomidae).

    Science.gov (United States)

    Nogueira, M R; Ventura, A; da Veiga, C C P; Monteiro, L R; Pinheiro, N L; Peracchi, A L

    2017-08-01

    Conjoined twinning is an embryological anomaly rarely reported in wild mammals and with only two previous records in Chiroptera. Here, we report a case of dicephalic parapagus conjoined twins in the Neotropical phyllostomid genus Artibeus. These twins are males and present separated heads and necks, but a conjoined trunk with an expanded upper thoracic region. They developed two complete forelimbs and two complete hindlimbs, all laterally to the trunk. There is a volume in the upper midback and between the heads that resembles a third rudimentary medial forelimb, but X-ray images only suggest the presence of medial skeletal elements of the pectoral girdle (clavicle and scapulae) in this region. The X-ray images also show that vertebral columns run separated from head until the base of lumbar region, where they form a single structure. Using ultrasound images, we detected the presence of two similarly sized and apparently separated hearts. The accumulation of study cases like this will help in the understanding of patterns and process behind this phenomena, and collection material plays a key role in this context. © 2017 Blackwell Verlag GmbH.

  11. Serratus muscle stimulation effectively treats notalgia paresthetica caused by long thoracic nerve dysfunction: a case series

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    Barad Meredith

    2009-09-01

    Full Text Available Abstract Currently, notalgia paresthetica (NP is a poorly-understood condition diagnosed on the basis of pruritus, pain, or both, in the area medial to the scapula and lateral to the thoracic spine. It has been proposed that NP is caused by degenerative changes to the T2-T6 vertebrae, genetic disposition, or nerve entrapment of the posterior rami of spinal nerves arising at T2-T6. Despite considerable research, the etiology of NP remains unclear, and a multitude of different treatment modalities have correspondingly met with varying degrees of success. Here we demonstrate that NP can be caused by long thoracic nerve injury leading to serratus anterior dysfunction, and that electrical muscle stimulation (EMS of the serratus anterior can successfully and conservatively treat NP. In four cases of NP with known injury to the long thoracic nerve we performed transcutaneous EMS to the serratus anterior in an area far lateral to the site of pain and pruritus, resulting in significant and rapid pain relief. These findings are the first to identify long thoracic nerve injury as a cause for notalgia paresthetica and electrical muscle stimulation of the serratus anterior as a possible treatment, and we discuss the implications of these findings on better diagnosing and treating notalgia paresthetica.

  12. The Effects of High-Frequency Transcutaneous Electrical Nerve Stimulation for Dental Professionals with Work-Related Musculoskeletal Disorders: A Single-Blind Randomized Placebo-Controlled Trial

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    Hye Rim Suh

    2015-01-01

    Full Text Available Work-related musculoskeletal symptom disorders (WMSDs have a significant issue for dental professionals. This study investigated the effects of high-frequency transcutaneous electrical nerve stimulation (TENS on work-related pain, fatigue, and the active range of motion in dental professionals. Among recruited 47 dental professionals with WMSDs, 24 subjects received high-frequency TENS (the TENS group, while 23 subjects received placebo stimulation (the placebo group. TENS was applied to the muscle trigger points of the levator scapulae and upper trapezius, while placebo-TENS was administered without electrical stimulation during 60 min. Pain and fatigue at rest and during movement were assessed using the visual analog scale (VAS, pain pressure threshold (PPT, and active range of motion (AROM of horizontal head rotation at six time points: prelabor, postlabor, post-TENS, and at 1 h, 3 h, and 1 day after TENS application. Both groups showed significantly increased pain and fatigue and decreased PPT and AROM after completing a work task. The TENS group showed significantly greater improvements in VAS score, fatigue, PPT, and AROM at post-TENS and at 1 h and 3 h after application (all P < 0.05 as compared to the placebo group. A single session high-frequency TENS may immediately reduce symptoms related to WMSDs in dental professionals.

  13. A NEW RECORD OF MESSAPICETUS FROM THE PIETRA LECCESE (LATE MIOCENE, SOUTHERN ITALY: ANTITROPICAL DISTRIBUTION IN A FOSSIL BEAKED WHALE (CETACEA, ZIPHIIDAE

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    GIOVANNI BIANUCCI

    2016-03-01

    Full Text Available A new partial fossil skeleton of Messapicetus longirostris (Cetacea: Odontoceti: Ziphiidae collected in Cisterna quarry (Lecce from Tortonian (upper Miocene sediments of the "Pietra leccese" is described. It comprises the fragmentary skull (including most of the rostrum, parts of the mandibles, five teeth, the fragmentary right scapula, and one vertebral centrum. This new record, here referred to a juvenile individual, expands our knowledge about the skeletal anatomy of M. longirostris; this species was until now only known by the holotype, an almost complete skull from the same Cisterna quarry. Moreover, the new specimen confirms the distinction between M. longirostris and M. gregarius (late Miocene, Pisco Formation, Peru based on several osteological characters (e.g., the presence of a distinct maxillary tubercle and prominential notch in the latter species. New dating of layers in Cerro Colorado, the type locality of M. gregarius, suggests that M. longirostris and M. gregarius were contemporaneous sister-species with an antitropical distribution (a biogeographical pattern currently shown by two extant ziphiid genera. Unlike extant ziphiids, feeding predominantly on squid and benthopelagic fish in deep waters, the stem ziphiid M. gregarius was recently proposed to have been a raptorial piscivore who may have fed mainly on schools of epipelagic fish. Similarities at the level of the morphology and proportions of the oral apparatus suggest that the two species of Messapicetus may have occupied roughly identical ecological and trophic niches, a hypothesis supported by the characterization of the Pietra leccese environment as neritic.

  14. Restoration of the orbital aesthetic subunit in complex midface defects.

    Science.gov (United States)

    Chepeha, Douglas B; Wang, Steven J; Marentette, Lawrence J; Bradford, Carol R; Boyd, Charles M; Prince, Mark E; Teknos, Theodoros N

    2004-10-01

    Although various options exist for restoration of the orbital defect in complex craniofacial resections, the aesthetic appearance and functional result of the orbit are optimized when the bony orbital architecture, orbital volume, and facial contour are specifically addressed. The study describes an approach using free tissue transfer for restoration of the native orbital aesthetic subunit. Retrospective case series. Nineteen patients (male-to-female ratio, 14:5; mean age, 52 y [age range, 8-79 y]) in the study period between 1997 and 2001 had orbital defects that could be classified into one of the following categories: 1) orbital exenteration cavities only, 2) orbital exenteration cavities with resection of less than 30% of the bony orbital rim, or 3) radical orbital exenteration cavities with resection of overlying skin and bony malar eminence. Group 1 had reconstructions with fasciocutaneous forearm flaps; group 2, with osseocutaneous forearm flaps; and group 3, with osseocutaneous scapula flaps. Eighteen of 19 patients achieved a closed orbital reconstruction with restoration of the orbital aesthetic subunit. Among 16 patients with more than 4 months of follow-up, 10 patients had minimal or no resulting facial contour deformity and 8 patients engaged in social activities outside the home on a frequent basis. Five of the nine patients who were working before their surgery were able to return to work. Patients with complex midface defects involving the orbit can undergo free tissue transfer and have successful restoration of the native orbital aesthetic subunit without an orbital prosthesis.

  15. Fatal Overdose due to Confusion of an Transdermal Fentanyl Delivery System.

    Science.gov (United States)

    Voigt, Ingo

    2013-01-01

    Background. The use of transdermal fentanyl systems has increased over recent years, especially in patients with chronic pain. Large misuse potential and fatal outcomes have been described. Case Presentation. A 58-year-old patient presenting with clinical signs of opioid poisoning (hypoventilation, bradycardia, hypotension, and miosis) was admitted to our ICU. The first body check revealed a 75 mcg per hour fentanyl patch at the patient's right scapula. Some months ago, patient's aunt died after suffering from an oncological disease. During breaking up of her household, the patches were saved by the patient. Not knowing the risk of this drug, he mistook it as a heat plaster. Investigations. Laboratory test showed an impaired renal function and metabolic acidosis. Urine drug test was negative at admittance and 12 h later. CCT scan presented a global hypoxic brain disease. Treatment and Outcome. The patient was discharged 30 days after admittance in a hemodynamic stable condition but a vegetative state and transferred to a rehabilitation center. Learning Points. With the ongoing increase in fentanyl patch prescriptions for therapeutic reasons, it is likely that misuse cases will become more relevant. Conventional urine drug screening tests are not able to exclude the diagnosis fentanyl intoxication. History taking should include family member's drug prescriptions.

  16. [Sotos syndrome diagnosed by comparative genomic hybridisation].

    Science.gov (United States)

    Saldarriaga, Wilmar; Molina-Barrera, Laura Camila; Ramírez-Cheyne, Julián

    2016-01-01

    Sotos Syndrome (SS) is a genetic disease with an autosomal dominant pattern caused by haplo-insufficiency of NSD1 gene secondary to point mutations or microdeletion of the 5q35 locus where the gene is located. It is a rare syndrome, occurring in 7 out of every 100,000 births. The objective of this report is to present the case of a 4 year-old patient with a global developmental delay, as well as specific physical findings suggesting a syndrome of genetic origin. Female patient, 4 years of age, thinning hair, triangular facie, long palpebral fissure, arched palate, prominent jaw, winged scapula and clinodactilia of the fifth finger both hands. The molecular test comparative genomic hybridisation test by microarray was subsequently performed, with the result showing 5q35.2 q35.3 region microdeletion of 2,082 MB, including the NSD1 gene. Finally, this article also proposes the performing of comparative genomic hybridisation as the first diagnostic option in cases where clinical findings are suggestive of SS. Copyright © 2015 Sociedad Chilena de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  17. The Neanderthal in the karst: First dating, morphometric, and paleogenetic data on the fossil skeleton from Altamura (Italy).

    Science.gov (United States)

    Lari, Martina; Di Vincenzo, Fabio; Borsato, Andrea; Ghirotto, Silvia; Micheli, Mario; Balsamo, Carlotta; Collina, Carmine; De Bellis, Gianluca; Frisia, Silvia; Giacobini, Giacomo; Gigli, Elena; Hellstrom, John C; Lannino, Antonella; Modi, Alessandra; Pietrelli, Alessandro; Pilli, Elena; Profico, Antonio; Ramirez, Oscar; Rizzi, Ermanno; Vai, Stefania; Venturo, Donata; Piperno, Marcello; Lalueza-Fox, Carles; Barbujani, Guido; Caramelli, David; Manzi, Giorgio

    2015-05-01

    In 1993, a fossil hominin skeleton was discovered in the karst caves of Lamalunga, near Altamura, in southern Italy. Despite the fact that this specimen represents one of the most extraordinary hominin specimens ever found in Europe, for the last two decades our knowledge of it has been based purely on the documented on-site observations. Recently, the retrieval from the cave of a fragment of bone (part of the right scapula) allowed the first dating of the individual, the quantitative analysis of a diagnostic morphological feature, and a preliminary paleogenetic characterization of this hominin skeleton from Altamura. Overall, the results concur in indicating that it belongs to the hypodigm of Homo neanderthalensis, with some phenetic peculiarities that appear consistent with a chronology ranging from 172 ± 15 ka to 130.1 ± 1.9 ka. Thus, the skeleton from Altamura represents the most ancient Neanderthal from which endogenous DNA has ever been extracted. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. Thoracic limb morphology of the red panda (Ailurus fulgens) evidenced by osteology and radiography.

    Science.gov (United States)

    Makungu, Modesta; Groenewald, Hermanus B; du Plessis, Wencke M; Barrows, Michelle; Koeppel, Katja N

    2015-07-15

    The red panda (Ailurus fulgens) is distributed primarily in the Himalayas and southern China. It is classified as a vulnerable species by the International Union for Conservation of Nature. The aim of this study was to describe the normal osteology and radiographic anatomy of the thoracic limb of the red panda. Radiography of the right thoracic limb was performed in seven captive adult red pandas. Radiographic findings were correlated with bone specimens from three adult animals. The scapula was wide craniocaudally and presented with a large area for the origin of the teres major muscle. The square-shaped major tubercle did not extend proximal to the head of the humerus. The medial epicondyle was prominent. A supracondylar foramen was present. The radial tuberosity and sesamoid bone for the abductor digiti I longus were prominent. The accessory carpal bone was directed palmarolaterally. Metacarpal bones were widely spread. The thoracic limb morphology of the red panda evidenced by osteology and radiography indicated flexibility of the thoracic limb joints and well-developed flexor and supinator muscles, which are important in arboreal quadrupedal locomotion. Knowledge gained during this study may prove useful in identifying skeletal material or remains and diagnosing musculoskeletal diseases and injuries of the thoracic limb.

  19. Evaluation of psoralen ethosomes for topical delivery in rats by using in vivo microdialysis.

    Science.gov (United States)

    Zhang, Yong-Tai; Shen, Li-Na; Zhao, Ji-Hui; Feng, Nian-Ping

    2014-01-01

    This study aimed to improve skin permeation and deposition of psoralen by using ethosomes and to investigate real-time drug release in the deep skin in rats. We used a uniform design method to evaluate the effects of different ethosome formulations on entrapment efficiency and drug skin deposition. Using in vitro and in vivo methods, we investigated skin penetration and release from psoralen-loaded ethosomes in comparison with an ethanol tincture. In in vitro studies, the use of ethosomes was associated with a 6.56-fold greater skin deposition of psoralen than that achieved with the use of the tincture. In vivo skin microdialysis showed that the peak concentration and area under the curve of psoralen from ethosomes were approximately 3.37 and 2.34 times higher, respectively, than those of psoralen from the tincture. Moreover, it revealed that the percutaneous permeability of ethosomes was greater when applied to the abdomen than when applied to the chest or scapulas. Enhanced permeation and skin deposition of psoralen delivered by ethosomes may help reduce toxicity and improve the efficacy of long-term psoralen treatment.

  20. Structures of bats; Komori no kozo

    Energy Technology Data Exchange (ETDEWEB)

    Natori, M. [Institute of the Space and Astronautical Science,Tokyo (Japan); Kishimoto, N. [The University of Tokyo, Tokyo (Japan)

    1999-12-05

    This paper gives an outline of the structures of bats. Unlike birds, bats have a wing membrane structure. The membrane constituted of the skin is spread between five fingers to form the wing. The wing membrane is seen in the forelimbs and the tail. In the chest and the shoulder, the ligament sheet supports the muscles. The wing membrane is about 0.5mm in thickness, with a fiber net woven through reflecting a tension field in flying. The fiber net is composed of compound materials of elastin and collagen. The shoulder joints consists of the clavicle, scapula and humerus, which is close to human beings. The elbow joints rotate only inside the plane of the wings. The leg joints are hook-shaped, with the tendon sheath provided with ruggedness. The carpus is made up of eight bones and is characterized by the ability of spreading and storing the wings. At the time of storing the wing membrane, the finger joints are stored and, during the flight after the wings are spread, it forms the flapping wing plane. Lightweight and formation of the sturdy front edge are characteristics common to other flying creatures. The spreading and the storing are possible through the direct motion of the hands. The shoulder joints and the carpus of the human beings are closer to those of bats than to those of birds. (NEDO)

  1. Shoulder muscle firing patterns during the windmill softball pitch.

    Science.gov (United States)

    Maffet, M W; Jobe, F W; Pink, M M; Brault, J; Mathiyakom, W

    1997-01-01

    The purpose of this study was to describe the activity of eight shoulder muscles during the windmill fast-pitch softball throw. Ten collegiate female pitchers were analyzed with intramuscular electromyography, high-speed cinematography, and motion analysis. The supraspinatus muscle fired maximally during arm elevation from the 6 to 3 o'clock position phase, centralizing the humeral head within the glenoid. The posterior deltoid and teres minor muscles acted maximally from the 3 to 12 o'clock position phase to continue arm elevation and externally rotate the humerus. The pectoralis major muscle accelerated the arm from the 12 o'clock position to ball release phase. The serratus anterior muscle characteristically acted to position the scapula for optimal glenohumeral congruency, and the subscapularis muscle functioned as an internal rotator and to protect the anterior capsule. Although the windmill softball pitch is overtly different from the baseball pitch, several surprising similarities were revealed. The serratus anterior and pectoralis major muscles work in synchrony and seem to have similar functions in both pitches. Although the infraspinatus and teres minor muscles are both posterior cuff muscles, they are characteristically uncoupled during the 6 to 3 o'clock position phase, with the infraspinatus muscle acting more independently below 90 degrees. Subscapularis muscle activity seems important in dynamic anterior glenohumeral stabilization and as an internal rotator in both the baseball and softball throws.

  2. New information on the Wukongopteridae (Pterosauria) revealed by a new specimen from the Jurassic of China.

    Science.gov (United States)

    Cheng, Xin; Jiang, Shunxing; Wang, Xiaolin; Kellner, Alexander W A

    2016-01-01

    The Wukongopteridae is an important pterosaur group discovered from Yanliao Biota, because it combines character states seen in non-pterodactyloid and pterodactyloid pterosaurs. So far, the Wukongopteridae contains three genera: Wukongopterus, Darwinopterus and Kunpengopterus; representing five species. Here we report on a new specimen, IVPP V 17959, that can be undoubtedly referred to the Wukongopteridae based on the presence of a confluent nasoantorbital fenestra, elongated cervical vertebrae (convergent with Pterodactyloidea) and a long tail enclosed by rod-like bony extensions of the zygapophyses. Traits distinguishing this new specimen from other wukongopterid pterosaurs include a premaxilla with a low ossified anterodorsal crest, a nasal bearing the most elongated process known in the Wukongopteridae, and a lacrimal that has a foramen in its middle portion. The new kind of premaxillary crest preserved in IVPP V 17959 suggests that the presence or absence of a premaxillary crest might be an interspecific feature within the Wukongopteridae. A phylogenetic analysis including all wukongopterid pterosaurs recovers IVPP V 17959 in a polytomy with Wukongopterus and the species of Darwinopterus, having Kunpengopterus in a more basal position. The postcranial skeleton of IVPP V 17959 has ontogenetically mature characteristics including a completely fused scapula and coracoid, fused proximal and distal carpal series, and an ossified extensor tendon process of the first wing phalanx, allowing its classification as ontogenetic stage five. Furthermore, the atlas and axis are separated in IVPP V 17959, which indicates that these two bones probably are not fused in skeletally mature wukongopterid individuals.

  3. The largest flying reptile from Gondwana: a new specimen of Tropeognathus cf. T. mesembrinus Wellnhofer, 1987 (Pterodactyloidea, Anhangueridae) and other large pterosaurs from the Romualdo Formation, Lower Cretaceous, Brazil.

    Science.gov (United States)

    Kellner, Alexander W A; Campos, Diogenes A; Sayão, Juliana M; Saraiva, Antônio A F; Rodrigues, Taissa; Oliveira, Gustavo; Cruz, Lilian A; Costa, Fabiana R; Silva, Helder P; Ferreira, Jennyfer S

    2013-03-01

    A very large pterosaur (MN 6594-V) from the Romualdo Formation (Aptian/Albian), Santana Group, Araripe Basin, is described. The specimen is referred to Tropeognathus cf. T. mesembrinus mainly due to the presence of a low and blunt frontoparietal crest, the comparatively low number of teeth and the inclined dorsal part of the occipital region. Two distinct wingspan measurements for pterosaurs are introduced: the maximized wingspan (maxws), which essentially consists of doubling the addition of all wing elements and the length of the scapula or the coracoid (the smaller of the two), and the normal wingspan (nws), which applies a reducing factor (rfc) to the maximized wingspan to account for the natural flexures of the wing. The rfc suggested for pteranodontoids is 5%. In the case of MN 6594-V, the maxws and nws are 8.70 m and 8.26 m, respectively, making it the largest pterosaur recovered from Gondwana so far. The distal end of a larger humerus (MCT 1838-R) and a partial wing (MPSC R 1395) are also described showing that large to giant flying reptiles formed a significant part of the pterosaur fauna from the Romualdo Formation. Lastly, some comments on the nomenclatural stability of the Santana deposits are presented.

  4. The largest flying reptile from Gondwana: a new specimen of Tropeognathus cf. T. mesembrinusWellnhofer, 1987 (Pterodactyloidea, Anhangueridae and other large pterosaurs from the Romualdo Formation, Lower Cretaceous, Brazil

    Directory of Open Access Journals (Sweden)

    ALEXANDER W. A. KELLNER

    2013-03-01

    Full Text Available A very large pterosaur (MN 6594-V from the Romualdo Formation (Aptian/Albian, Santana Group, Araripe Basin, is described. The specimen is referred to Tropeognathus cf. T. mesembrinus mainly due to the presence of a low and blunt frontoparietal crest, the comparatively low number of teeth and the inclined dorsal part of the occipital region. Two distinct wingspan measurements for pterosaurs are introduced: the maximized wingspan (maxws, which essentially consists of doubling the addition of all wing elements and the length of the scapula or the coracoid (the smaller of the two, and the normal wingspan (nws, which applies a reducing factor (rfc to the maximized wingspan to account for the natural flexures of the wing. The rfc suggested for pteranodontoids is 5%. In the case of MN 6594-V, the maxws and nws are 8.70 m and 8.26 m, respectively, making it the largest pterosaur recovered from Gondwana so far. The distal end of a larger humerus (MCT 1838-R and a partial wing (MPSC R 1395 are also described showing that large to giant flying reptiles formed a significant part of the pterosaur fauna from the Romualdo Formation. Lastly, some comments on the nomenclatural stability of the Santana deposits are presented.

  5. Dominant vs. non-dominant shoulder morphology in volleyball players and associations with shoulder pain and spike speed.

    Science.gov (United States)

    Challoumas, Dimitrios; Artemiou, Andreas; Dimitrakakis, Georgios

    2017-01-01

    The aims of our study were to compare the dominant (DOM) and non-dominant (NDOM) shoulders of high-level volleyball athletes and identify possible associations of shoulder adaptations with spike speed (SS) and shoulder pathology. A total of 22 male volleyball players from two teams participating in the first division of the Cypriot championship underwent clinical shoulder tests and simple measurements around their shoulder girdle joints bilaterally. SS was measured with the use of a sports speed radar. Compared with the NDOM side, the DOM scapula was more lateralised, the DOM dorsal capsule demonstrated greater laxity, the DOM dorsal muscles stretching ability was compromised, and the DOM pectoralis muscle was more lengthened. Players with present or past DOM shoulder pain demonstrated greater laxity in their DOM dorsal capsule, tightening of their DOM inferior capsule, and lower SS compared with those without shoulder pain. Dorsal capsule measurements bilaterally were significant predictors of SS. None of the shoulder measurements was associated with team roles or infraspinatus atrophy, while scapular lateralisation was more pronounced with increasing years of experience, and scapular antetilting was greater with increasing age. Adaptations of the DOM shoulder may be linked to pathology and performance. We describe simple shoulder measurements that may have the potential to predict chronic shoulder injury and become part of injury prevention programmes. Detailed biomechanical and large prospective studies are warranted to assess the validity of our findings and reach more definitive conclusions.

  6. Shoulder injuries from attacking motion

    Science.gov (United States)

    Yanagi, Shigeru; Nishimura, Tetsu; Itoh, Masaru; Wada, Yuhei; Watanabe, Naoki

    1997-03-01

    Sports injuries have bothered professional players. Although many medical doctors try to treat injured players, to prevent sports injuries is more important. Hence, it is required to clear a kinematic mechanism of the sport injuries. A shoulder of volleyball attacker or baseball pitcher is often inured by playing motion. The injuries are mainly caused at the end of long head tendon, which is located in the upper side of scapula. Generally, a muscle and tendon have enough strength against tensile force, however, it seems that they are sometimes defeated by the lateral force. It is imagined that the effect of the lateral force has a possibility of injuring the tendon. If we find the influence of the lateral force on the injured portion, the mechanism of injuries must be cleared. In our research, volleyball attacking motion is taken by high speed video cameras. We analyze the motion as links system and obtain an acceleration of an arm and a shoulder from video image data. The generated force at a shoulder joint is calculated and resolved into the lateral and longitudinal forces. Our final goal is to discuss a possibility that the lateral force causes the injuries.

  7. Comparative shoulder kinematics during free standing, standing depression lifts and daily functional activities in persons with paraplegia: considerations for shoulder health.

    Science.gov (United States)

    Riek, L M; Ludewig, P M; Nawoczenski, D A

    2008-05-01

    Case series; nonparametric repeated-measures analysis of variance. To compare and contrast three-dimensional shoulder kinematics during frequently utilized upper extremity weight-bearing activities (standing depression lifts used in brace walking, weight-relief raises, transfers) and postures (sitting rest, standing in a frame) in spinal cord injury (SCI). Movement Analysis Laboratory, Department of Physical Therapy, Ithaca College, Rochester, NY, USA. Three female and two male subjects (39.2+/-6.1 years old) at least 12 months post-SCI (14.6+/-6.7 years old), SCI distal to T2 and with an ASIA score of A. The Flock of Birds magnetic tracking device was used to measure three-dimensional positions of the scapula, humerus and thorax during various activities. Standing in a frame resulted in significantly less scapular anterior tilt (AT) and greater glenohumeral external rotation (GHER) than standing depression lifts and weight-relief raises. Standing frame posture offers the most favorable shoulder joint positions (less scapular AT and greater GHER) when compared to sitting rest posture, weight-relief raises, transfers and standing depression lifts. Knowledge of kinematic patterns associated with each activity is an essential first step to understanding the potential impact on shoulder health. Choosing specific activities or modifying techniques within functional activities that promote favorable shoulder positions may preserve long-term shoulder health.

  8. Active herpes zoster infection with cutaneous manifestation and adenopathy on FDG PET/CT

    Directory of Open Access Journals (Sweden)

    Antoine Wadih, MD

    2015-10-01

    Full Text Available We report a patient with history of Hodgkin lymphoma. Six months after treatment, 2-deoxy-2-[18F]fluoro-d-glucose positron emission tomography and/or computed tomography ([18F] FDG PET/CT scan showed abnormal uptake in right axillary lymph nodes concerning for recurrence. In addition, PET/CT showed a new hypermetabolic skin lesion overlying the right scapula. Clinical evaluation was consistent with shingles, and the patient was treated with valacyclovir. Subsequent PET/CT scan was normal with no evidence of lymphoma. Although there have been reported cases of abnormal FDG in nodes or in skin due to herpes zoster, our case is unique in the literature in that the PET/CT demonstrates abnormalities involving both the skin and associated lymph nodes. The possibility of false positive uptake, not because of recurrent malignancy, must always be considered when abnormal FDG uptake is noted in the follow-up of oncology patients. Careful review of the scan and correlation with clinical findings can avoid false positive interpretation and facilitate patient management.

  9. A novel MYH7 Leu1453pro mutation resulting in Laing distal myopathy in an Irish family.

    Science.gov (United States)

    Lefter, Stela; Hardiman, Orla; McLaughlin, Russell L; Murphy, Sinead M; Farrell, Michael; Ryan, Aisling M

    2015-02-01

    Authors describe clinical, pathological, imaging and genetic findings in the first Irish family with Laing distal myopathy in whom a novel mutation in the human slow β-myosin heavy chain (MYH7) gene has been identified. A kindred of 14 over 6 generations included 6 individuals with childhood onset distal lower limb weakness in a scapula-peroneal distribution with subsequent proximal upper and lower limb weakness. Finger extensor weakness especially in the 3rd-5th fingers was present in each and two patients had "hanging big toe" sign. Three patients were non-ambulatory by middle-age. One patient developed cardiomyopathy and two patients had respiratory muscle impairment. Intriguingly, brain white matter lesions and epilepsy were present in three patients. Muscle biopsy revealed fibre-size variation, rimmed vacuoles, mild-extensive central nucleation, redundant and folded sarcolemmal membrane and Z band streaming. Genetic analysis revealed a novel heterozygous mutation in the MYH7 gene in one patient which co-segregated perfectly in the remaining 5 affected members and was absent in six unaffected members. Copyright © 2014 Elsevier B.V. All rights reserved.

  10. CLINICAL OUTCOME AFTER OPERATIVE TREATMENT IN FLOATING SHOULDER- A PROSPECTIVE STUDY

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    Nabarun Saha

    2017-06-01

    Full Text Available BACKGROUND The ‘floating shoulder’ is a rare injury consisting of ipsilateral fractures of the clavicle and glenoid neck. Although it may appear to be bony injury, studies suggest that ligamentous disruption associated with ipsilateral clavicle fracture and scapular neck fracture contributes to such entity. More commonly floating shoulder is defined as double disruption of the superior shoulder suspensory complex. Open reduction and internal fixation of both the fractures is the treatment of choice. We have made this study to assess clinical outcome after operative treatment of floating shoulder by DASH score. MATERIALS AND METHODS This is a study of 10 cases of floating shoulder injury operated in the same sitting by anterior approach for fracture clavicle and Judet’s posterior approach for scapula fracture from Jan 2014 to Oct 2016. All cases were assessed with DASH score at the end of six months. RESULTS Results of our study shows that majority of patients had excellent to good results with improvement in DASH score from 92.8 to 16.8 at final follow up. No major complications. All patients had radiological signs of union at the end of 1 year. CONCLUSION Surgical intervention should be considered for all floating shoulder injuries. open reduction and internal fixation not only increases stability but also to improves functional outcome of the patient. DASH score is an effective method to assess clinicofunctional outcome in post-operative cases of floating shoulder.

  11. Bilateral Distal Radius Fractures in a 12-Year-Old Boy after Household Electrical Shock: Case Report and Literature Summary

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    Norman Stone

    2014-01-01

    Full Text Available Background. Fracture resulting from household electric shock is uncommon. When it occurs, it is usually the result of a fall; however, electricity itself can cause sufficient tetany to produce a fracture. We present the case of bilateral fractures of the distal radii of a 12-year-old boy which were sustained after accidental shock. The literature regarding fractures after domestic electric shock is also reviewed. Methods. An Ovid-Medline search was conducted. The resultant articles and their bibliographies were surveyed for cases describing fractures resulting from a typical household-level voltage (110–220 V, 50–60 Hertz and not a fall after the shock. Twenty-one articles describing 22 patients were identified. Results. Twenty-two cases were identified. Thirteen were unilateral injuries; 9 were bilateral. Proximal humerus fractures were most frequent (8 cases, followed by scapula fractures (7 cases, forearm fractures (4 cases, femoral neck fractures (2 cases, and vertebral body fracture (1 case. Eight of the 22 cases were diagnosed days to weeks after the injury. Conclusions. Fracture after electric shock is uncommon. It should be suspected in patients with persistent pain, particularly in the shoulder or forearm area. Distal radius fractures that occur during electrocution are likely due to tetany.

  12. New Options for Vascularized Bone Reconstruction in the Upper Extremity

    Science.gov (United States)

    Houdek, Matthew T.; Wagner, Eric R.; Wyles, Cody C.; Nanos, George P.; Moran, Steven L.

    2015-01-01

    Originally described in the 1970s, vascularized bone grafting has become a critical component in the treatment of bony defects and non-unions. Although well established in the lower extremity, recent years have seen many novel techniques described to treat a variety of challenging upper extremity pathologies. Here the authors review the use of different techniques of vascularized bone grafts for the upper extremity bone pathologies. The vascularized fibula remains the gold standard for the treatment of large bone defects of the humerus and forearm, while also playing a role in carpal reconstruction; however, two other important options for larger defects include the vascularized scapula graft and the Capanna technique. Smaller upper extremity bone defects and non-unions can be treated with the medial femoral condyle (MFC) free flap or a vascularized rib transfer. In carpal non-unions, both pedicled distal radius flaps and free MFC flaps are viable options. Finally, in skeletally immature patients, vascularized fibular head epiphyseal transfer can provide growth potential in addition to skeletal reconstruction. PMID:25685100

  13. Transformation of the pectoral girdle in the evolutionary origin of frogs: insights from the primitive anuran Discoglossus

    Science.gov (United States)

    Havelková, Pavla; Roček, Zbyněk

    2006-01-01

    Using cleared-and-stained whole mounts and computer-aided three-dimensional reconstructions made from serial histological sections, we studied the development of the pectoral girdle in Discoglossus pictus, an extant member of an ancient frog lineage, represented for example by Eodiscoglossus from the Middle Jurassic to Early Cretaceous periods in Europe. Basic developmental features were compared with those of extinct Temnospondyli, considered to be the most probable anuran ancestors, and with Triadobatrachus, an early Triassic proanuran. In the endochondral girdle, the separate scapula and coracoid of Discoglossus and other anurans (completed by suprascapular and procoracoid cartilages) evolved from the compact scapulocoracoid of temnospondyls by paedomorphosis. In parallel, the dermal ossifications of the girdle were reduced to a small clavicle and cleithrum. The overall reduction in ossification of the anuran pectoral girdle supports the hypothesis of a paedomorphic origin for Anura. The almost simultaneous appearance of dermal and endochondral ossifications may be explained by the accumulation of developmental events during a short, distinct metamorphosis (which did not occur in neotenic temnospondyls living permanently in water). The sternal elements seem to be neomorphs for the most part, which help to cushion the shock of landing in jumping anurans but which also evolved as functional substitutes (insertion area for the pectoralis muscles) of the temnospondyl interclavicle. PMID:16822264

  14. Essential Segmental Myoclonus Responding Well To Fluoxetine A case Report

    Directory of Open Access Journals (Sweden)

    Bhattacharyya K B

    1999-01-01

    Full Text Available We report a case of essential segmental myoclonus a 10 year old girl who presented with continuing movement of both the shoulder girdle muscles for 6 months. The movements were exacerbated with the hands raised above the head or in the outstretched posture and were persisting during sleep. There was no abnormal palatal movement. Additionally there was a rhythmical clicking sound arising from the shoulders that could be felt and ausculated with the stethoscope. CT scan of brain and MRI of cervical spine were non-contributory, EMG showed muscle activates at about 50 per second in the shoulder girdle muscles. Cine-radiography of shoulder joints showed the head of humerus hitting against the spine of the scapula rhythmically. Spinal tap was non-contributory. The diagnosis or essential segmental myoclonus was entertained and the subject with fluoxetine, a selective serotonin reuptake inhibitor with remarkable response. The possible mechanism of action of agents modulating the serotonergic system in the brain for the management of myoclonus has been reviewed and their role suggested.

  15. Geometric morphometrics of the shoulder girdle in extant turtles (Chelonii)

    Science.gov (United States)

    Depecker, Marion; Berge, Christine; Penin, Xavier; Renous, Sabine

    2006-01-01

    The aim of this study was to identify shape patterns of the shoulder girdle in relation to different functional and environmental behaviours in turtles. The Procrustes method was used to compare the shoulder girdles (scapula and coracoid) of 88 adult extant turtles. The results indicate that four shape patterns can be distinguished. The shoulder girdles of (1) terrestrial (Testudinidae), (2) highly aquatic freshwater (Trionychidae, Carettochelyidae) and (3) marine turtles (Cheloniidae, Dermochelyidae) correspond to three specialized morphological patterns, whereas the shoulder girdle of (4) semi-aquatic freshwater turtles (Bataguridae, Chelidae, Chelydridae, Emydidae, Kinosternidae, Pelomedusidae, Platysternidae, Podocnemididae) is more generalized. In terrestrial turtles, the long scapular prong and the short coracoid are associated with a domed shell and a mode of locomotion in which walking is predominant. By contrast, highly aquatic freshwater turtles share traits with marine turtles. In both, the short scapular prong and the long coracoid are associated with a flat shell, and swimming locomotion. The enlarged attachment sites of the biceps, coracobrachialis magnus, and supracoracoideus also give these strong swimmers a mechanical advantage during adduction and retraction of the arm. Increasing size leads to allometrical shape changes that emphasize mechanical efficiency both in terrestrial and in aquatic turtles. PMID:16420377

  16. Posterior subscapular dissection: An improved approach to the brachial plexus for human anatomy students.

    Science.gov (United States)

    Hager, Shaun; Backus, Timothy Charles; Futterman, Bennett; Solounias, Nikos; Mihlbachler, Matthew C

    2014-05-01

    Students of human anatomy are required to understand the brachial plexus, from the proximal roots extending from spinal nerves C5 through T1, to the distal-most branches that innervate the shoulder and upper limb. However, in human cadaver dissection labs, students are often instructed to dissect the brachial plexus using an antero-axillary approach that incompletely exposes the brachial plexus. This approach readily exposes the distal segments of the brachial plexus but exposure of proximal and posterior segments require extensive dissection of neck and shoulder structures. Therefore, the proximal and posterior segments of the brachial plexus, including the roots, trunks, divisions, posterior cord and proximally branching peripheral nerves often remain unobserved during study of the cadaveric shoulder and brachial plexus. Here we introduce a subscapular approach that exposes the entire brachial plexus, with minimal amount of dissection or destruction of surrounding structures. Lateral retraction of the scapula reveals the entire length of the brachial plexus in the subscapular space, exposing the brachial plexus roots and other proximal segments. Combining the subscapular approach with the traditional antero-axillary approach allows students to observe the cadaveric brachial plexus in its entirety. Exposure of the brachial dissection in the subscapular space requires little time and is easily incorporated into a preexisting anatomy lab curriculum without scheduling additional time for dissection. Copyright © 2014 Elsevier GmbH. All rights reserved.

  17. OSTEOSARCOMA IN AFRICAN HEDGEHOGS (ATELERIX ALBIVENTRIS): FIVE CASES.

    Science.gov (United States)

    Reyes-Matute, Alonso; Méndez-Bernal, Adriana; Ramos-Garduño, Liliana-Aurora

    2017-06-01

    Osteosarcomas are unusual neoplasms in African hedgehogs ( Atelerix albiventris ) and have been reported in extraskeletal and skeletal locations, including mandible, ribs, and vertebra. Five hedgehogs with osteosarcoma submitted to the Pathology Department at Facultad de Medicina Veterinaria y Zootecnia, National Autonomous University of Mexico are reported. In two cases, the neoplasm arose from the skull; one case arose from the ribs with associated compression of the thoracic and abdominal cavity, and another case involved the vertebrae. In the last case, the neoplasm arose from the scapula. Histologic lesions were similar in all cases and consisted of well-demarcated nodules in which neoplastic cells were arranged in sheets of polyhedral to spindle-shaped cells with interspersed areas of necrosis. Numerous trabeculae of osteoid were present throughout the tumors. No metastases were detected. The predominant histologic pattern was osteoblastic, but a telangiectatic-like pattern was observed in the vertebral osteosarcoma. Electron microscopy was performed in two cases, and malignant osteoblasts had features consistent with descriptions in other species, including deposits of hydroxyapatite in osteoid. According to these cases and previously published data, axial osteosarcomas are more frequent in contrast to appendicular osteosarcomas in African hedgehogs, and metastases are rare.

  18. [Scapular balance angle reference values in a healthy population].

    Science.gov (United States)

    Contreras, J; Gil, D; de Dios Errázuriz, J; Ruiz, P; Díaz, C; Aguila, P; Rosselot, A; Espinoza, R; Beltrán, M; Liendo, R; Soza, F

    2014-01-01

    To calculate the Scapular Balance Angle (SBA) reference values in a healthy population between 18 and 85 years old, and to define abnormality criteria for this sample. A descriptive study was conducted on a total of 300 individuals (mean age: 44.83, range: 18-83; proportion male/female: 1.59), calculating the SBA through manual measurement with a goniometer. An intraobserver Intraclass Correlation Coefficient (ICC) of 0.87 and a interobserver ICC of 0.84 was observed. The values for the SBA in healthy population were 2.505 ± 2.340°. We define the abnormality criteria for this sample with an angle greater than 7.185°. SBA manual measurement is a simple and reproducible assessment of the position and rotation of the scapula in clinical practice. The main findings of this study are the reference values for the SBA and a statistical cut-off to define abnormality. Copyright © 2013 SECOT. Published by Elsevier Espana. All rights reserved.

  19. Effects of Feldenkrais method on chronic neck/scapular pain in people with visual impairment: a randomized controlled trial with one-year follow-up.

    Science.gov (United States)

    Lundqvist, Lars-Olov; Zetterlund, Christina; Richter, Hans O

    2014-09-01

    To determine whether the Feldenkrais method is an effective intervention for chronic neck/scapular pain in patients with visual impairment. Randomized controlled trial with an untreated control group. Low vision center. Patients (N=61) with visual impairment (mean, 53.3 y) and nonspecific chronic (mean, 23.8 y) neck/scapular pain. Participants were randomly assigned to the Feldenkrais method group (n=30) or untreated control group (n=31). Patients in the treatment group underwent one 2-hour Feldenkrais method session per week for 12 consecutive weeks. Blind assessment of perceived pain (visual analog scale [VAS]) during physical therapist palpation of the left and right occipital, upper trapezius, and levator scapulae muscle areas; self-assessed degree of pain on the Visual, Musculoskeletal, and Balance Complaints questionnaire; and the Medical Outcomes Study 36-Item Short-Form Health Survey bodily pain scale. Patients undergoing Feldenkrais method reported significantly less pain than the controls according to the VAS and Visual, Musculoskeletal, and Balance Complaints questionnaire ratings at posttreatment follow-up and 1-year follow-up. There were no significant differences regarding the Medical Outcomes Study 36-Item Short-Form Health Survey bodily pain scale ratings. Feldenkrais method is an effective intervention for chronic neck/scapular pain in patients with visual impairment. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  20. Evolution of Skin Temperature after the Application of Compressive Forces on Tendon, Muscle and Myofascial Trigger Point.

    Directory of Open Access Journals (Sweden)

    Marina Figueiredo Magalhães

    Full Text Available Some assessment and diagnosis methods require palpation or the application of certain forces on the skin, which affects the structures beneath, we highlight the importance of defining possible influences on skin temperature as a result of this physical contact. Thus, the aim of the present study is to determine the ideal time for performing thermographic examination after palpation based on the assessment of skin temperature evolution. Randomized and crossover study carried out with 15 computer-user volunteers of both genders, between 18 and 45 years of age, who were submitted to compressive forces of 0, 1, 2 and 3 kg/cm2 for 30 seconds with a washout period of 48 hours using a portable digital dynamometer. Compressive forces were applied on the following spots on the dominant upper limb: myofascial trigger point in the levator scapulae, biceps brachii muscle and palmaris longus tendon. Volunteers were examined by means of infrared thermography before and after the application of compressive forces (15, 30, 45 and 60 minutes. In most comparisons made over time, a significant decrease was observed 30, 45 and 60 minutes after the application of compressive forces (p 0.05. In conclusion, infrared thermography can be used after assessment or diagnosis methods focused on the application of forces on tendons and muscles, provided the procedure is performed 15 minutes after contact with the skin. Regarding to the myofascial trigger point, the thermographic examination can be performed within 60 minutes after the contact with the skin.

  1. Evolution of Skin Temperature after the Application of Compressive Forces on Tendon, Muscle and Myofascial Trigger Point

    Science.gov (United States)

    Magalhães, Marina Figueiredo; Dibai-Filho, Almir Vieira; de Oliveira Guirro, Elaine Caldeira; Girasol, Carlos Eduardo; de Oliveira, Alessandra Kelly; Dias, Fabiana Rodrigues Cancio; Guirro, Rinaldo Roberto de Jesus

    2015-01-01

    Some assessment and diagnosis methods require palpation or the application of certain forces on the skin, which affects the structures beneath, we highlight the importance of defining possible influences on skin temperature as a result of this physical contact. Thus, the aim of the present study is to determine the ideal time for performing thermographic examination after palpation based on the assessment of skin temperature evolution. Randomized and crossover study carried out with 15 computer-user volunteers of both genders, between 18 and 45 years of age, who were submitted to compressive forces of 0, 1, 2 and 3 kg/cm2 for 30 seconds with a washout period of 48 hours using a portable digital dynamometer. Compressive forces were applied on the following spots on the dominant upper limb: myofascial trigger point in the levator scapulae, biceps brachii muscle and palmaris longus tendon. Volunteers were examined by means of infrared thermography before and after the application of compressive forces (15, 30, 45 and 60 minutes). In most comparisons made over time, a significant decrease was observed 30, 45 and 60 minutes after the application of compressive forces (p 0.05). In conclusion, infrared thermography can be used after assessment or diagnosis methods focused on the application of forces on tendons and muscles, provided the procedure is performed 15 minutes after contact with the skin. Regarding to the myofascial trigger point, the thermographic examination can be performed within 60 minutes after the contact with the skin. PMID:26070073

  2. Evolution of Skin Temperature after the Application of Compressive Forces on Tendon, Muscle and Myofascial Trigger Point.

    Science.gov (United States)

    Magalhães, Marina Figueiredo; Dibai-Filho, Almir Vieira; de Oliveira Guirro, Elaine Caldeira; Girasol, Carlos Eduardo; de Oliveira, Alessandra Kelly; Dias, Fabiana Rodrigues Cancio; Guirro, Rinaldo Roberto de Jesus

    2015-01-01

    Some assessment and diagnosis methods require palpation or the application of certain forces on the skin, which affects the structures beneath, we highlight the importance of defining possible influences on skin temperature as a result of this physical contact. Thus, the aim of the present study is to determine the ideal time for performing thermographic examination after palpation based on the assessment of skin temperature evolution. Randomized and crossover study carried out with 15 computer-user volunteers of both genders, between 18 and 45 years of age, who were submitted to compressive forces of 0, 1, 2 and 3 kg/cm2 for 30 seconds with a washout period of 48 hours using a portable digital dynamometer. Compressive forces were applied on the following spots on the dominant upper limb: myofascial trigger point in the levator scapulae, biceps brachii muscle and palmaris longus tendon. Volunteers were examined by means of infrared thermography before and after the application of compressive forces (15, 30, 45 and 60 minutes). In most comparisons made over time, a significant decrease was observed 30, 45 and 60 minutes after the application of compressive forces (p 0.05). In conclusion, infrared thermography can be used after assessment or diagnosis methods focused on the application of forces on tendons and muscles, provided the procedure is performed 15 minutes after contact with the skin. Regarding to the myofascial trigger point, the thermographic examination can be performed within 60 minutes after the contact with the skin.

  3. Analysis of Dextromethorphan and Dextrorphan in Skeletal Remains Following Decomposition in Different Microclimate Conditions.

    Science.gov (United States)

    Unger, K A; Watterson, J H

    2016-10-01

    The effects of decomposition microclimate on the distribution of dextromethorphan (DXM) and dextrorphan (DXT) in skeletonized remains of rats acutely exposed to DXM were examined. Animals (n = 10) received DXM (75 mg/kg, i.p.), were euthanized 30 min post-dose and immediately allowed to decompose at either Site A (shaded forest microenvironment on a grass-covered soil substrate) or Site B (rocky substrate exposed to direct sunlight, 600 m from Site A). Ambient temperature and relative humidity were automatically recorded 3 cm above rats at each site. Skeletal elements (vertebral columns, ribs, pelvic girdles, femora, tibiae, humeri and scapulae) were harvested, and analyzed using microwave assisted extraction, microplate solid phase extraction, and GC/MS. Drug levels, expressed as mass-normalized response ratios, and the ratios of DXT and DXM levels were compared across bones and between microclimate sites. No significant differences in DXT levels or metabolite/parent ratios were observed between sites or across bones. Only femoral DXM levels differed significantly between microclimate sites. For pooled data, microclimate was not observed to significantly affect analyte levels, nor the ratio of levels of DXT and DXM. These data suggest that microclimate conditions do not influence DXM and metabolite distribution in skeletal remains. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  4. New approach to evaluate late arm impairment and effects of dragon boat activity in breast cancer survivors.

    Science.gov (United States)

    Melchiorri, Giovanni; Viero, Valerio; Triossi, Tamara; Sorge, Roberto; Tancredi, Virginia; Cafaro, Domenico; Andreis, Caterina; Vulpiani, Maria Chiara; Saraceni, Vincenzo Maria

    2017-11-01

    To verify the applicability of a new approach based on the strength curves (SCs) methodology in late arm impairment in breast cancer (BC) survivors and to evaluate the effects of dragon boat (DB) activity on the late regaining of the muscle strength, upper limb impairment, and quality of life in patients undergoing surgery for BC.Retrospective observational study on 64 subjects (54.5 ± 9.7 years), 47 of them had undergone unilateral mastectomy surgery and were evaluated for late arm impairment. A clinical evaluation of the shoulder and compilation of functional assessment (DASH, Rowe, Constant-Murley) and quality of life (SF-36) scales were carried out. Assessment of muscle strength with SC obtained with isometric assessments and serratus anterior muscle test were performed.Differences between the SC are evident between healthy and operated subjects. Among the 3 groups of operated subjects the difference in strength is maximum at 0°. Statistically significant difference was found between operated and nonoperated only in SF-36 scale. No significant difference was found between groups for shoulder instability and winged scapula.The SC can be used in the study of upper limb impairment after surgery for BC: measurements carried out at 1st degrees of the range of motion are more useful for clinicians. DB activity is useful to reduce the late arm impairment.

  5. Keratoacanthoma occurring within the red dye of a tattoo.

    Science.gov (United States)

    Kluger, Nicolas; Minier-Thoumin, Catherine; Plantier, Françoise

    2008-05-01

    Keratoacanthoma (KA) is a common keratinizing squamous cell neoplasm of unknown origin characterized by rapid growth and spontaneous involution. Trauma-induced forms have been observed with various types of skin injury. To our knowledge, reports of KA arising at tattoo sites are scarce in the literature. A 41-year-old woman with no medical history presented for a rapidly growing nodule confined to the red part of a tattoo located on the scapula. Histology showed a keratin-filled cuplike crater with an epithelial proliferation (hyperkeratosis, parakeratosis, no keratinocyte atypia). An inflammatory infiltrate in the dermis composed of lymphocytes and histiocytes intermixed with red ink-related exogenous pigments was noted. Lack of papillomatosis and viral inclusions ruled out the diagnosis of viral wart, absence of granulomatous reaction ruled out deep fungal or mycobacterial infection and lack of cytological atypia and frank architectural abnormalities did not favour a squamous cell carcinoma. KA should be included in the list of cutaneous complications related to tattooing. Diagnosis can be challenging as differential diagnoses include pseudoepitheliomatous hyperplasia and squamous cell carcinoma. Removal of the entire area, thorough histological examination and careful follow up are mandatory.

  6. Bone histology of the stegosaur Kentrosaurus aethiopicus (Ornithischia: Thyreophora) from the Upper Jurassic of Tanzania.

    Science.gov (United States)

    Redelstorff, Ragna; Hübner, Tom R; Chinsamy, Anusuya; Sander, P Martin

    2013-06-01

    Using bone histology, a slow growth rate, uncommon for most dinosaurs, has been interpreted for the highly derived stegosaur Stegosaurus (Ornithischia: Thyreophora) and the basal thyreophoran Scutellosaurus. In this study, we examine whether this slow growth rate also occurs in the more basal stegosaur Kentrosaurus from the Tendaguru beds of Tanzania. The bone histology of six femora of Kentrosaurus representing an ontogenetic series from subadult to adult was studied, as well as one scapula. The primary bone is mainly highly vascularized fibro-lamellar bone with some reticular organization of the vascular canals. In addition to LAGs and annuli, distinctive shifts in the pattern of vascularization occur, which have been interpreted as potential growth marks. The variation in the development of growth marks may reflect annual climatic fluctuations. The overall bone depositional rate, and hence growth rate in Kentrosaurus appears to be higher than in Stegosaurus and Scutellosaurus. Considering that Stegosaurus is the larger-sized of the two stegosaurs, this would be contrary to an earlier supposition that small-bodied dinosaurs have slower growth rates than larger ones. Our finding of rapid rates of bone deposition in Kentrosaurus suggests that slow growth rates previously reported in Scutellosaurus and Stegosaurus are not a phylogenetic characteristic of the Thyreophora. Thus, slow growth rates are not plesiomorphic for the Thyreophora. We propose that the slow growth rates documented in the highly derived Stegosaurus could have been secondarily derived or alternatively that Kentrosaurus is the exception having increased growth rates. Copyright © 2013 Wiley Periodicals, Inc.

  7. Combination of icotinib, surgery, and internal-radiotherapy of a patient with lung cancer severely metastasized to the vertebrae bones with EGFR mutation: a case report

    Directory of Open Access Journals (Sweden)

    Qu LL

    2015-06-01

    Full Text Available Li-Li Qu, Hai-Feng Qin, Hong-Jun Gao, Xiao-Qing Liu Department of Lung Cancer, Affiliated Hospital of Academy of Military Medical Science, Beijing, People’s Republic of China Abstract: A 48-year-old Chinese female was referred to us regarding EGFR-mutated advanced non-small cell lung cancer, and metastasis to left scapula and vertebrae bones which caused pathological fracture at T8 and T10 thoracic vertebrae. An aggressive combined therapy with icotinib, vertebrae operation, and radioactive particle implantation and immunotherapy was proposed to prevent paraplegia, relieve pain, and control the overall and local tumor lesions. No postoperative symptoms were seen after surgery, and the pain was significantly relieved. Icotinib merited a 31-month partial response with grade 1 diarrhea as its drug-related adverse event. High dose of icotinib was administered after pelvis lesion progression for 3 months with good tolerance. Combination therapy of icotinib, surgery, and internal radiation for metastases of the vertebrae bones from non-small cell lung cancer seems to be a very promising technique both for sufficient pain relief and for local control of the tumor, vertebrae operation can be an encouraging option for patients with EFGR positive mutation and good prognosis indicator. Keywords: lung cancer, spinal metastasis, pathological fracture, spinal canal stenosis, icotinib

  8. Use of vacuum-assisted closure for management of a large skin wound in a cat.

    Science.gov (United States)

    Guille, April E; Tseng, Laura W; Orsher, Robert J

    2007-06-01

    A 9-month-old domestic shorthair cat was evaluated after being struck by a car. The cat had a fractured tibia and avulsion of the tail base. Motor and deep pain sensation were absent from the tail. The fractured tibia was repaired 2 days after the trauma. On the third day, the cat developed tachypnea, dyspnea, high serum urea nitrogen and total bilirubin concentrations, epistaxis, persistent hypotension, and oliguria. The cat recovered with supportive care but developed extensive necrosis of the skin on the dorsum by 9 days after the initial trauma. The skin was debrided from the caudal portion of the scapula to the anus and down each pelvic limb to the level of the distal portion of the femur. The tail was amputated. Wet-to-dry bandages were applied to the wound for 3 days. Approximately 50% of the wound underwent delayed primary closure, and the remainder was managed with vacuum-assisted closure. A healthy granulation bed was quickly established. Vacuum-assisted closure was also applied after graft application. Graft acceptance was 100%, and use of the vacuum-assisted closure bandage was not associated with the complications associated with the traditional bandage. Vacuum-assisted closure is a useful, easily applicable technique for open and grafted wounds, even when wounds are in challenging anatomic locations.

  9. Anterior glenoid perforation with suture anchor causing subscapularis irritation and pain.

    Science.gov (United States)

    Marx, Robert G; Verkuil, Lana; Wilson, Sean; Foo, Li Foong

    2013-07-01

    Suture anchors for labral repair have been associated with complications including suprascapular notch encroachment and osteolysis. We present a case of suture anchor penetration of the anterior glenoid neck leading to pain secondary to subscapularis muscle irritation in a 14-year-old boy. The patient had labral repair and subsequent anterior shoulder pain which resolved after anchor removal. Chondrolysis of the glenohumeral joint has been described following labral repair with knotless anchors. There have also been cases of injury to the suprascapular nerve following labral repair. However, we are not aware of any reports describing suture anchor penetration of the anterior glenoid neck leading to pain secondary to subscapularis muscle irritation. Labral repair has become a common and routine procedure, but complications can occur. We report a new complication related to osseous penetration of the anterior glenoid neck of the scapula by a suture anchor. We identified the complication using magnetic resonance imaging, an important part in reproducible, noninvasive, and objective assessment of the postoperative shoulder. We also present the technique for anchor removal used to resolve the patient's anterior shoulder pain.

  10. An osteomalacia related to phosphate diabetes - bone scintigraphy with SPECT/CT contribution; Une osteomalacie liee a un diabete phosphore - role de la scintigraphie osseuse couplee a la TEMP-TDM

    Energy Technology Data Exchange (ETDEWEB)

    Ruyer, A.; Granier, P.; Mourad, M. [Centre Hospitalier Antoine-Gayraud, Service de Medecine Nucleaire, 11 - Carcassonne (France)

    2009-12-15

    We report the case of a 59-year-old woman, investigated for disabling pain of the left thigh, unrelated to any traumatic event. Interrogation had found diffuse pain of myalgia-type and arthralgia-type for approximately a year without local inflammatory signs and insufficiency fractures of both calcaneus two years before. The Technetium {sup 99m}-labeled hydroxy-methylene diphosphonate ({sup 99m}Tc-H.D.P.) whole-body bone scintigraphy evidenced multiple hot spots on the higher third of left femur, rib cage, sternum, scapula, pelvis, right hip and both calcaneus. Moreover, a more diffuse and heterogeneous prominent uptake appeared on rib cage, spine and pelvis. These images suggested a diffuse metastatic disease of the skeleton. The single photon emission computerized tomography guided by computerized tomography (SPECT/CT), centered on lumbar spine, pelvis and the upper end of femurs showed that the multiple hot spots were in fact bone fractures. These findings pointed diagnosis to a metabolic disease. The clinical context was in favour of an osteomalacia. Further explorations showed an osteomalacia related to phosphate diabetes. A thorough work-up did not reveal any known aetiology. To date, idiopathic phosphate diabetes seems the most likely diagnosis. Nuclear medicine input in osteomalacia is discussed. (authors)

  11. Does Deep Cervical Flexor Muscle Training Affect Pain Pressure Thresholds of Myofascial Trigger Points in Patients with Chronic Neck Pain? A Prospective Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Pavlos Bobos

    2016-01-01

    Full Text Available Background. We need to understand more about how DNF performs in different contexts and whether it affects the pain threshold over myofascial trigger points (MTrPs. Purpose. The objectives were to investigate the effect of neck muscles training on disability and pain and on pain threshold over MTrPs in people with chronic neck pain. Methods. Patients with chronic neck pain were eligible for participation with a Neck Disability Index (NDI score of over 5/50 and having at least one MTrP on either levator scapulae, upper trapezoid, or splenius capitis muscle. Patients were randomly assigned into either DNF training, superficial neck muscle exercise, or advice group. Generalized linear model (GLM was used to detect differences in treatment groups over time. Results. Out of 67 participants, 60 (47 females, mean age: 39.45 ± 12.67 completed the study. Neck disability and neck pain were improved over time between and within groups (p<0.05. However, no differences were found within and between the therapeutic groups (p<0.05 in the tested muscles’ PPTs and in cervicothoracic angle over a 7-week period. Conclusion. All three groups improved over time. This infers that the pain pathways involved in the neck pain relief are not those involved in pain threshold.

  12. Fascial bundles of the infraspinatus fascia: anatomy, function, and clinical considerations.

    Science.gov (United States)

    Moccia, David; Nackashi, Andrew A; Schilling, Rebecca; Ward, Peter J

    2016-01-01

    The infraspinatus fascia is a tough sheet of connective tissue that covers the infraspinatus fossa of the scapula and the muscle within. Muscle fibers originate from the fossa and fascia and then travel laterally to insert on the greater tubercle of the humerus. Frequently the infraspinatus fascia is quickly removed to appreciate the underlying muscle, but the fascia is an interesting and complex structure in its own right. Despite having a characteristic set of fascial bundles, no contemporary anatomy texts or atlases describe the fascia in detail. The infraspinatus fascia was dissected in detail in 11 shoulders, to characterize the fascial bundles and connections that contribute to it. Thereafter, 70 shoulders were dissected to tabulate the variability of the fascial bundles and connections. Six characteristic features of the infraspinatus fascia were noted: a medial band, an inferior-lateral band, and superior-lateral band of fascia, insertion of the posterior deltoid into the infraspinatus fascia, a transverse connection from the posterior deltoid muscle to the infraspinatus fascia, and a retinacular sheet deep to the deltoid and superficial to the infraspinatus and teres minor muscles. Although other structures of the shoulder are more frequently injured, the infraspinatus fascia is involved in compartment syndromes and the fascial bundles of this structure are certain to impact the biomechanical function of the muscles of the posterior shoulder. © 2015 Anatomical Society.

  13. Effects of scapular stability exercise on shoulder stability and rehabilitative ultrasound images in office workers

    Science.gov (United States)

    Go, Seong-Uk; Lee, Byoung-Hee

    2016-01-01

    [Purpose] To examine the clinical effectiveness of scapular stability exercise on shoulder stability and rehabilitative ultrasound images in office workers. [Subjects and Methods] Thirty-eight subjects were randomly divided into a scapular stability exercise group (n=19) and a manual therapy group (n=19). Subjects in the scapular stability exercise group performed a scapular stability exercise designed to correct the abnormal location of the scapula, at 40 minutes per session, two times per week, for 6 weeks. Forward head horizontal distance, rounded shoulder posture, stability of the upper limb for the shoulder, and rehabilitative ultrasound images were evaluated before and after 6 weeks. [Results] After the intervention, both groups showed significantly decreased forward head horizontal distance and rounded shoulder posture, with significantly improved stability of the upper limb and rehabilitative ultrasound images. Forward head horizontal distance, rounded shoulder posture, stability of the upper limb, and rehabilitative ultrasound images showed greater improvements in the shoulder stability exercise group than in the manual therapy group. [Conclusion] Scapular stability exercise can improve shoulder stability and the thickness of the lower trapezius in rehabilitative ultrasound images of office workers, and could be useful in clinical rehabilitation. PMID:27942108

  14. Effects of scapular stability exercise on shoulder stability and rehabilitative ultrasound images in office workers.

    Science.gov (United States)

    Go, Seong-Uk; Lee, Byoung-Hee

    2016-11-01

    [Purpose] To examine the clinical effectiveness of scapular stability exercise on shoulder stability and rehabilitative ultrasound images in office workers. [Subjects and Methods] Thirty-eight subjects were randomly divided into a scapular stability exercise group (n=19) and a manual therapy group (n=19). Subjects in the scapular stability exercise group performed a scapular stability exercise designed to correct the abnormal location of the scapula, at 40 minutes per session, two times per week, for 6 weeks. Forward head horizontal distance, rounded shoulder posture, stability of the upper limb for the shoulder, and rehabilitative ultrasound images were evaluated before and after 6 weeks. [Results] After the intervention, both groups showed significantly decreased forward head horizontal distance and rounded shoulder posture, with significantly improved stability of the upper limb and rehabilitative ultrasound images. Forward head horizontal distance, rounded shoulder posture, stability of the upper limb, and rehabilitative ultrasound images showed greater improvements in the shoulder stability exercise group than in the manual therapy group. [Conclusion] Scapular stability exercise can improve shoulder stability and the thickness of the lower trapezius in rehabilitative ultrasound images of office workers, and could be useful in clinical rehabilitation.

  15. Enigma of scapular foramen and tunnels: an untold story.

    Science.gov (United States)

    Singh, Nidhi; Chauhan, Puja; Loh, Hitendra Kumar; Kohli, Mangala; Suri, Rajesh Kumar

    2017-10-12

    The study was undertaken to make a qualitative and quantitative assessment of unnamed foramen and tunnels in adult human scapulae with aid of plain and contrast radiographs. A total of 120 dry bones, 60 each of the right and the left side were included in the study. Distribution of these foramina and tunnels was noted for their number, side, location, course and communication. Their morphometry was done using Vernier's caliper. Incidence of scapular foramina was 7.5% (R > L), whereas scapular tunnels were seen in 15.8% cases. Incidence of the sinuous, curved, and straight tunnels was found to be 50, 39, and 10.7% respectively. Left-sided tunnels were longer than the right ones. Plain and contrast radiographs were taken to confirm the findings. Anatomy literature describes only two scapular foramina, namely, nutrient foramen and suprascapular foramen/notch in a great zeal; occurrence of such anonymous foramina is hardly discussed. Through this study, there is an endeavor towards unfolding the mystery of scapular foramina in terms of their morphometry and distribution, the knowledge of which will aid clinicians, forensic experts, and surgeons in better diagnosis and management of clinical cases.

  16. Treatment of axillary web syndrome using instrument assisted soft tissue mobilization and thoracic manipulation for associated thoracic rotation dysfunction: A case report.

    Science.gov (United States)

    Crane, Patricia; Ladden, Jaclyn; Monica, Danielle

    2017-08-30

    There is a paucity of research that investigates physical therapy management for patients with axillary web syndrome (AWS) and thoracic rotation dysfunction. The purpose of this case report is to describe the management of a patient with AWS and thoracic rotation dysfunction using an impairment-based approach that includes instrument assisted soft tissue mobilization (IASTM), thoracic manipulation, and stretching. The patient was a 48-year-old female with a past medical history of bilateral breast cancer with a bilateral latissimus dorsi flap reconstruction. The patient was referred to physical therapy with chief complaints of right shoulder pain with reaching and an inability to resume running due to right shoulder and scapula pain. The patient was seen in outpatient physical therapy for four visits over four weeks. Treatment consisted of IASTM, thoracic manipulation, stretching exercises, and home exercise program instruction. Upon discharge, the patient had improved right shoulder and thoracic range of motion, decreased pain, and improved function on the patient specific functional scale (PSFS). Utilization of an impairment-based physical therapy approach to treat a patient with AWS and thoracic dysfunction yielded positive outcomes. Further research on the efficacy of IASTM and physical therapy management of AWS is warranted.

  17. Quantitative Postural Analysis of Children With Congenital Visual Impairment.

    Science.gov (United States)

    de Pádua, Michelle; Sauer, Juliana F; João, Silvia M A

    2018-01-01

    The aim of this study was to compare the postural alignment of children with visual impairment with that of children without visual impairment. The sample studied was 74 children of both sexes ages 5 to 12 years. Of these, 34 had visual impairment and 40 were control children. Digital photos from the standing position were used to analyze posture. Postural variables, such as tilt of the head, shoulder position, scapula position, lateral deviation of the spine, ankle position in the frontal plane and head posture, angle of thoracic kyphosis, angle of lumbar lordosis, pelvis position, and knee position in the frontal and sagittal planes, were measured with the Postural Assessment Software 0.63, version 36 (SAPO, São Paulo, Brazil), with markers placed in predetermined bony landmarks. The main results of this study showed that children with visual impairment have increased head tilt (P Visual impairment influences postural alignment. Children with visual impairment had increased head tilt, uneven shoulders, greater lateral deviation of the spine, thoracic kyphosis, lower lumbar lordosis, and more severe valgus deformities on knees. Copyright © 2017. Published by Elsevier Inc.

  18. Functional morphology of the Neandertal scapular glenoid fossa.

    Science.gov (United States)

    Macias, Marisa E; Churchill, Steven E

    2015-01-01

    Neandertals and Homo sapiens are known to differ in scapular glenoid fossa morphology. Functional explanations may be appropriate for certain aspects of glenoid fossa morphology; however, other factors--e.g., allometry, evolutionary development--must be addressed before functional morphology is considered. Using three-dimensional geometric morphometrics, shape of the scapular glenoid fossa was compared among Neandertals, early and recent modern humans, chimpanzees, orangutans, Australopithecus afarensis, and Au. sediba. Permutation analysis revealed that side, sex, and lifestyle did not correlate with shape. Of the features we found to differ between groups, anterior glenoid rim morphology and fossa curvature did not correlate with the aforementioned shape variables; thus, a functional explanation is appropriate for these components of glenoid fossa shape. Shared morphology among recent humans and chimpanzees (to the exclusion of Neandertals and orangutans) suggests independent forces contributing to these morphological configurations. Potential explanations include adaptations to habitual behavior and locomotor adaptations in the scapulae of recent humans and chimpanzees; these explanations are supported by clinical and experimental literature. The absence of these morphological features in Neandertals may support the lack of these selective forces on their scapular glenoid fossa morphology. © 2014 Wiley Periodicals, Inc.

  19. Composite synthetic hydroxyapatite 30%, in two physical states, as dermal filler

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    Rodrigo Viana Sepúlveda

    2013-08-01

    Full Text Available The aim of this study was to evaluate the response to the implantation of synthetic hydroxyapatite 30% (HAP-91® in different physical states as dermal filler. Eighteen New Zealand rabbits were used, distributed randomly into two equal groups and then divided into three groups according to the postoperative period at 8, 21 and 49 days. One mL of HAP-91®, fluid and viscous, was implanted in the subcutaneous tissue, 1 cm proximal to the cranial crest of the right scapula. The thickness of the skin was measured before and after implantation and for the following 15 days. Pain sensitivity assessment was conducted, assigning the following scores: 0 - when the animal allowed the touch of the implant area and expressed no signs of pain; 1 - when the animal allowed the touch, but pain reaction occurred, like increase of the respiratory rate or attempt to escape; 2 - when the animal did not allow the touch to the implanted area. At 8, 21 and 49 days, biopsy of the implanted area was performed. No difference was observed between the thickness of the skin (p>0.05 and all animals received a score 0 for soreness. Histological analysis did not reveal any obvious inflammatory process, showing a predominance of mononuclear cells in samples of eight days and tissue organization around the biomaterial with a tendency to encapsulation. The results indicate that HAP-91®, both viscous and fluid, is biocompatible and suitable for dermal filling.

  20. Scapular Dyskinesis: Related Pathology

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    Emilio López-Vidriero,

    2015-02-01

    Full Text Available Shoulder pain is one of the most frequent causes of disability in overhead sports and often forces athletes and workers to stop their activities. Scapular dyskinesis is not an injury or a musculoskeletal diagnosis, but rather an alteration of the normal position or motion of the scapula during coupled scapulohumeral movements. The underlying pathology can be multifactorial in nature, and understanding the various contributing factors is important in order to properly diagnose and treat the patient. An additional goal should be the prevention of further pathology or symptoms. In the present article the concept of scapular dyskinesis is reviewed along with a review of the literature regarding related pathology and our observations. Scapular dyskinesis can exist in asymptomatic individuals. In symptomatic patients with shoulder pain the scapular rhythm should be evaluated and treated. Some of the associated pathologies could be subacromial impingement, internal impingement, chronic acromioclavicular dislocations grade III, chronic neck pain. Physical therapy is usually the preferred treatment of choice and effective to treat these patients.

  1. Safe bicycling – Problems and solutions

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    Grecka M.

    2014-01-01

    Full Text Available Herewith a popularity of bicycling, various safety problems of cyclists are researched. Studies are connected with infrastructure, riding culture, choice of cyclist's suit and riding equipment. Overall, 382 respondents (159 cyclists, 119 drivers, 104 pedestrians were involved in the survey. The road participants' mutual communication problems in the traffic and opportunities of solving them were clarified. Most of cyclists wear comfortable daily or sporty clothing with reflective elements, and in their opinion, clothing with light emissive elements must be like daily clothing. The drivers could better notice cyclists, if they wear brightly colored suit with light emissive and reflective elements, but pedestrians – if cyclists use warning sound signals. The opinions of road participants about the placement of light emissive and reflective elements in cyclist's clothing were clarified. The prototype of cycling belt (Fig. 1e has been drawn up with LED stop signals, which are activated by the accelerometer placed in the central back pocket. The results of approbation have shown that the sensor does not provide the proper functioning of signals, due to a high level of riding movements. Using Motion Capture technology and bicycle exercise equipment, the research of oscillation of anthropometric points on the back has been carried out. The accelerometer should be placed between scapulae to design the cycling jacket.

  2. Novel SOX9 Gene Mutation in Campomelic Dysplasia with Autosomal Sex Reversal

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    Hui-Pin Hsiao

    2006-01-01

    Full Text Available Campomelic dysplasia (CD; OMIM #114290 is an autosomal dominant, frequently lethal dysplasia syndrome whose primary features include angular bowing and shortening of the limbs, and sex reversal in the majority of affected XY individuals. Most CD cases have heterozygous de novo mutations in the coding region of the transcription factor gene SOX9 (SRY-related high-mobility group [HMG] box 9 in chromosome 17q. Here, we report a novel mutation of SOX9 in a female neonate with CD with autosomal sex reversal. Respiratory distress and cyanosis were noted at birth, and endotracheal intubation with mechanical ventilation was performed due to respiratory failure. The presenting phenotypes included dysmorphic face with macrocephaly prominent forehead, low nasal bridge, cleft palate and micrognathia. Skeletal deformities characteristic of CD were observed, including narrow thoracic cage, hypoplastic scapulae, scoliosis and short limbs with anterolateral femoral and tibial bowing. The karyotype was 46,XY despite female external genitalia. SOX9 gene analysis revealed frameshift mutation (at nucleotide position 1095G →AT in the open reading frame, resulting in a frameshift with 211 new amino acids.

  3. Osteonecrosis as a complication in pediatric patients with acute lymphoblastic leukemia

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    Ilaria Riccio

    2016-11-01

    Full Text Available Osteonecrosis is a significant adverse effect of treatment administered to children suffering from acute lymphoblastic leukemia (ALL that may have a negative effect on the quality of life. The purpose of this study is to evaluate the rate of secondary vascular osteonecrosis (ON in a population of pediatric patients with ALL treated with corticosteroids and cytostatic agents. A retrospective analysis of prospectively collected data of the medical records of 328 patients with ALL identified 4 cases with ON, corresponding to 1.2% of all cases observed. Of the 4 patients identified in our study 3 were girls and 1 was a boy, aged from 10 to 16 years old (average age at diagnosis, 12 years. Median time between the diagnosis of ALL and ON was 12.5 months (range, 12 to 36 months. Regarding the lesion size of ON, in all cases the femoral head (monolateral in 1 case and bilateral in 3 cases was involved and was associated with the scapula-humeral joint in one case. ON of the weight-bearing joints has been identified as a severe complication in children with leukemia that may be associated with the development of articular surface collapse, subsequent debilitating arthritis, sometimes needing arthroplasty. For this reason it is very important to implement prevention strategies, especially in adolescent girls treated with steroids and chemotherapy. An early diagnosis of ON and careful orthopedic follow-up are necessary in order to avoid bone deformations related to the late start or the wrong therapy.

  4. Osteonecrosis as a complication in pediatric patients with acute lymphoblastic leukemia.

    Science.gov (United States)

    Riccio, Ilaria; Pota, Elvira; Marcarelli, Marco; Affinita, Maria Carmen; Di Pinto, Daniela; Indolfi, Cristiana; Del Regno, Nicola; Esposito, Marco

    2016-11-28

    Osteonecrosis is a significant adverse effect of treatment administered to children suffering from acute lymphoblastic leukemia (ALL) that may have a negative effect on the quality of life. The purpose of this study is to evaluate the rate of secondary vascular osteonecrosis (ON) in a population of pediatric patients with ALL treated with corticosteroids and cytostatic agents. A retrospective analysis of prospectively collected data of the medical records of 328 patients with ALL identified 4 cases with ON, corresponding to 1.2% of all cases observed. Of the 4 patients identified in our study 3 were girls and 1 was a boy, aged from 10 to 16 years old (average age at diagnosis, 12 years). Median time between the diagnosis of ALL and ON was 12.5 months (range, 12 to 36 months). Regarding the lesion size of ON, in all cases the femoral head (monolateral in 1 case and bilateral in 3 cases) was involved and was associated with the scapula-humeral joint in one case. ON of the weight-bearing joints has been identified as a severe complication in children with leukemia that may be associated with the development of articular surface collapse, subsequent debilitating arthritis, sometimes needing arthroplasty. For this reason it is very important to implement prevention strategies, especially in adolescent girls treated with steroids and chemotherapy. An early diagnosis of ON and careful orthopedic follow-up are necessary in order to avoid bone deformations related to the late start or the wrong therapy.

  5. Analysis of normal and dysplastic glenohumeral morphology at magnetic resonance imaging in children with neonatal brachial plexus palsy

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    Bunt, Fabian van de [VU University Medical Center, Amsterdam (Netherlands); Pearl, Michael L.; Lee, Eric K.; Peng, Lauren; Didomenico, Paul [Kaiser Permanente, Los Angeles, CA (United States)

    2017-09-15

    Glenoid version and percentage of the humeral head anterior to the scapular line are commonly used 2-D measures to assess deformity of the glenohumeral joint of children with neonatal brachial plexus palsy. To assess whether glenoid version and percentage of the humeral head anterior to the scapular line would be altered by standardizing the measurements to the orientation of the scapula. Twenty-one bilateral magnetic resonance imaging (MRI) scans were evaluated by four reviewers. Measurements were performed on the axial image slices and again after applying 3-D reformatting. Three-dimensional reformatting led to intrapatient corrections up to 25 for version and -30% for percentage of the humeral head anterior to the scapular line. The mean difference on the involved side between clinical and anatomical version across all subjects from all reviewers was 2.2 ± 3.9 (range: -4.5 to 11.5 ). The mean difference in the percentage of the humeral head anterior to the scapular line after reformatting was -1.8% (range: -15.9% to 5.2%). Measurements can differ greatly for the same child depending on technical factors of image acquisition and presentation in the clinical setting. With this study, we present a clinically accessible protocol to correct for scapular orientation from MRI data of children with neonatal brachial plexus palsy. (orig.)

  6. Record-Breaking Pain: The Largest Number and Variety of Forelimb Bone Maladies in a Theropod Dinosaur.

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    Phil Senter

    Full Text Available Bone abnormalities are common in theropod dinosaur skeletons, but before now no specimen was known with more than four afflicted bones of the pectoral girdle and/or forelimb. Here we describe the pathology of a specimen of the theropod dinosaur Dilophosaurus wetherilli with eight afflicted bones of the pectoral girdle and forelimb. On its left side the animal has a fractured scapula and radius and large fibriscesses in the ulna and the proximal thumb phalanx. On its right side the animal has abnormal torsion of the humeral shaft, bony tumors on the radius, a truncated distal articular surface of metacarpal III, and angular deformities of the first phalanx of the third finger. Healing and remodeling indicates that the animal survived for months and possibly years after its ailments began, but its right third finger was permanently deformed and lacked the capability of flexion. The deformities of the humerus and the right third finger may be due to developmental osteodysplasia, a condition known in extant birds but unreported in non-avian dinosaurs before now.

  7. Electromyographic analysis of shoulder muscles during press-up variations and progressions.

    Science.gov (United States)

    Herrington, Lee; Waterman, Rosemary; Smith, Laura

    2015-02-01

    Due to the versatility of the press-up it is a popular upper extremity strengthening and rehabilitation exercise. Press-up programmes are often progressed by increasing weight-bearing load and using unstable bases of support. Despite the popularity of the press-up research examining press-up variations is limited. The aim of the study was to examine the influence of common press-up exercises on serratus anterior, infraspinatus, anterior deltoid, pectoralis major and latissimus dorsi muscles overall EMG activity. Twenty-one healthy individuals participated in this study. Surface electrodes were placed on pectoralis major, anterior deltoid, infraspinatus, serratus anterior and latissimus dorsi muscles. Participants were tested under 7 static press-up conditions that theoretically progressively increase weight-bearing load and proprioceptive challenge while surface electromyographic activity was recorded. There was a high correlation between increased weight-bearing load and increased EMG activity for all muscles in stable base conditions. The introduction of the unstable base conditions resulted in an activation decline in all muscles. Within the two-armed press-up the Swiss ball resulted in decreased activation in all muscles except pectoralis major. Serratus anterior demonstrated the greatest activation as a percentage of maximum isometric contraction across all exercises. The findings of this study indicate that by varying the weight-bearing load and base of support whilst in the press-up position results in significantly different demands on shoulder and scapula muscles. Copyright © 2014 Elsevier Ltd. All rights reserved.

  8. Two- and three-dimensional ultrasound imaging to facilitate detection and targeting of taut bands in myofascial pain syndrome.

    Science.gov (United States)

    Shankar, Hariharan; Reddy, Sapna

    2012-07-01

    Ultrasound imaging has gained acceptance in pain management interventions. Features of myofascial pain syndrome have been explored using ultrasound imaging and elastography. There is a paucity of reports showing the benefit clinically. This report provides three-dimensional features of taut bands and highlights the advantages of using two-dimensional ultrasound imaging to improve targeting of taut bands in deeper locations. Fifty-eight-year-old man with pain and decreased range of motion of the right shoulder was referred for further management of pain above the scapula after having failed conservative management for myofascial pain syndrome. Three-dimensional ultrasound images provided evidence of aberrancy in the architecture of the muscle fascicles around the taut bands compared to the adjacent normal muscle tissue during serial sectioning of the accrued image. On two-dimensional ultrasound imaging over the palpated taut band, areas of hyperechogenicity were visualized in the trapezius and supraspinatus muscles. Subsequently, the patient received ultrasound-guided real-time lidocaine injections to the trigger points with successful resolution of symptoms. This is a successful demonstration of utility of ultrasound imaging of taut bands in the management of myofascial pain syndrome. Utility of this imaging modality in myofascial pain syndrome requires further clinical validation. Wiley Periodicals, Inc.

  9. An early Late Triassic long-necked reptile with a bony pectoral shield and gracile appendages

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    Jerzy Dzik

    2016-12-01

    Full Text Available Several partially articulated specimens and numerous isolated bones of Ozimek volans gen. et sp. nov., from the late Carnian lacustrine deposits exposed at Krasiejów in southern Poland, enable a reconstruction of most of the skeleton. The unique character of the animal is its enlarged plate-like coracoids presumably fused with sterna. Other aspects of the skeleton seem to be comparable to those of the only known specimen of Sharovipteryx mirabilis from the latest Middle Triassic of Kyrgyzstan, which supports interpretation of both forms as protorosaurians. One may expect that the pectoral girdle of S. mirabilis, probably covered by the rock matrix in its only specimen, was similar to that of O. volans gen. et sp. nov. The Krasiejów material shows sharp teeth, low crescent scapula, three sacrals in a generalized pelvis (two of the sacrals being in contact with the ilium and curved robust metatarsal of the fifth digit in the pes, which are unknown in Sharovipteryx. Other traits are plesiomorphic and, except for the pelvic girdle and extreme elongation of appendages, do not allow to identify any close connection of the sharovipterygids within the Triassic protorosaurians.

  10. The effect of helmet materials and simulated bone and tissue layers on bullet behaviour in a gelatine model of overmatch penetrating head injury.

    Science.gov (United States)

    Mahoney, Peter F; Carr, Debra J; Miller, David; Teagle, Michael

    2017-11-01

    The aim of this work was to simulate an overmatch ballistic event against a head wearing a helmet. The experiments were designed to understand how layers of bone (or synthetic bone), synthetic skin and currently used helmet materials influence the behaviour of full metal jacket mild steel core (FMJ MSC) 7.62 × 39 mm bullets, impacting on targets with a mean velocity of 650 m/s. Bullet behaviour within 10% (by mass) gelatine blocks was assessed by measurements made of the temporary cavity within the blocks using high-speed video and of the permanent cavity by dissecting blocks post firing. While ANOVA did not find significant difference at the 0.05 level in the mean values of most of the measurements, there was a significant difference in neck length within the gelatine blocks. The addition of material layers did produce greater variability in the temporary cavity measurements under some of the conditions. One of the synthetic bone polymers with a synthetic skin layer produced similar results within the gelatine blocks to the horse scapulae (with residual tissue) and may be suitable for future ballistic experiments.

  11. Activities of daily living with reverse prostheses: importance of scapular compensation for functional mobility of the shoulder.

    Science.gov (United States)

    Terrier, Alexandre; Scheuber, Patricia; Pioletti, Dominique P; Farron, Alain

    2013-07-01

    The nonanatomical design of reverse shoulder prostheses induce medial displacement of the center of rotation, impingements and may reduce the mobility of the shoulder. The aim of this study is to test the hypothesis that during activities of daily living functional mobility of the shoulder can be restored by scapular compensation. A numerical 3-dimensional model was developed to reproduce the movement of the scapula and humerus, during 4 activities of daily living measured experimentally. This hypothesis was tested in 4 configurations of the aequalis reverse prosthesis (standard 36-mm glenosphere, 42-mm glenosphere, lateralized 36-mm glenosphere, lateralized Bony Increased-Offset Reverse Shoulder Arthroplasty [BIO-RSA]), which were implanted in the virtual model. All impingement positions were evaluated, as the required scapular compensation to avoid impingements. With the 36-mm glenosphere, impingements occurred only for rest of hand to back-pocket positions. The 42-mm partly improved the mobility. The 2 lateralized glenospheres were free of impingement. When impingements occurred, the scapular compensation was less than 10°. Most reverse prostheses impingements reported in clinical and biomechanical studies can be avoided, either by scapular compensation or by a glenosphere lateralization. After reverse shoulder arthroplasty, a fraction of the mobility of the gleno-humeral is transferred to the scapulo-thoracic joint. Copyright © 2013 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

  12. Resting position variables at the shoulder: evidence to support a posture-impairment association.

    Science.gov (United States)

    Borstad, John D

    2006-04-01

    A relationship between posture and impairment at the shoulder is theorized, but not supported by evidence. It is proposed that posture and impairment are not directly related, but linked by movement dysfunction. The purpose of this analysis was to explore the relationships among posture, pectoralis minor muscle length, and movement alterations at the shoulder. Subjects who were asymptomatic for shoulder pathology were divided into 2 groups of 25 subjects each based on normalized pectoralis minor muscle resting length. Scapula orientation, thoracic kyphosis, and pectoralis minor muscle lengths were measured, and ratios and indexes of postural variables were calculated. All variables were analyzed for correlations and group differences. Significant group differences were demonstrated for several posture variables, including thoracic spine kyphosis and scapular internal rotation. The distance from the sternal notch to the coracoid process demonstrated the highest correlation with pectoralis minor muscle length. The findings indicate a relationship between posture and pectoralis minor muscle length and support a proposed model linking posture, an anatomical variable, movement dysfunction, and impairment.

  13. Radiography of scoliosis: comparative dosimetry between conventional technique and digital fluorography; Radiographie des scolioses: dosimetrie comparee entre la technique conventionnelle et la fluorographie numerique

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    Gorincour, G.; Paris, M.; Aschero, A.; Bourliere, B.; Devred, P.; Petit, P. [Hopital Timone-Enfants, Service de Radiologie Pediatrique, 13 - Marseille (France); Barrau, K.; Auquier, P. [Faculte de Medecine de Marseille, Service de Sante Publique, 13 - Marseille (France); Waultier, S.; Bourrelly, M.; Mundler, O. [Hopital Timone-Enfants, Service de Medecine Nucleaire, 13 - Marseille (France); Viehweger, E.; Jouve, J.L.; Bollini, G. [Hopital Timone-Enfants, Service de Chirurgie Orthopedique, 13 - Marseille (France)

    2007-03-15

    Objective. Compare the irradiation delivered in conventional radiography and digital radiography by image intensifier during a scoliosis workup. Patients and Methods. Our prospective randomized study included 105 patients, all of whom were identified according to socio-demographic parameters as well as criteria evaluating the quality of the full front spinal x-ray at PA incidence. The entry dose at the scapula and the exit dose in inter-orbital, thyroid, mammary, and hypo-gastric projection was measured by thermoluminescent dosimeters. Results. The results of 71 girls and 28 boys, aged a mean 13.8 years with a mean weight of 47 kg were analyzed. At equal image quality, the entry dose was not significantly different between the two techniques; the mean exit dose reduction was 64% during digital acquisition. This reduction involved the inter-orbital (162%), mammary (43%), and thyroid (309%) regions. However, this system is more irradiating in the hypo-gastric region (34%). Conclusion. The dosimetric evaluation of the different imaging techniques used to explore the entirety of the spine should be part of radiologists' quality standard used to document their work and their choices. (authors)

  14. Ophthalmic manifestations of atypical IgD multiple myeloma

    Science.gov (United States)

    Edmunds, Matthew R; Cikatricis, Peter; Mukherji, Subhanjan; Bowyer, Jeremy D

    2012-01-01

    A previously healthy 32-year-old Caucasian female presented with sudden-onset horizontal diplopia following a paroxysm of coughing. She had recently sustained a pubic ramus fracture during an innocuous fall and had also noted a firm lump developing at the right side of her forehead. On examination, she had a right fronto-temporal mass. Visual acuities were 6/6 bilaterally. There was reduced abduction of the right eye, bilateral white, granular corneal opacities and evidence of bilateral optic disc swelling. Haematological investigations revealed normocytic anaemia, hypercalcaemia and raised erythrocyte sedimentation rate (ESR). CT showed lytic foci throughout the skull, ribs, scapulae, spine, pelvis and upper femora. Serum protein electrophoresis revealed immunoglobulin D (IgD)-kappa paraproteinaemia; urine electrophoresis showed free light chain kappa and bone marrow biopsy demonstrated 87% plasma cells. A diagnosis of IgD multiple myeloma was made, with subsequent chemotherapeutic treatment and eventual autologous stem cell transplant resulting in resolution of neuro-ophthalmic manifestations and prolonged disease remission. PMID:22814986

  15. Daily oscillations of skin temperature in military personnel using thermography.

    Science.gov (United States)

    Costa, Carlos Magno Amaral; Sillero-Quintana, M; Piñonosa Cano, S; Moreira, D G; Brito, C J; Fernandes, A A; Pussieldi, G A; Marins, J C B

    2016-10-01

    The human body makes many physiological adjustments throughout the day, including adjustments to body temperature. The purpose of this study was to determine oscillations in the skin temperature (Tsk-1-Tsk-25) at 25 body regions of interest (ROIs) over 1 day using infrared thermography. Tsk values of 31 male (age 22.9±3.0 years) Brazilian Air Force members were evaluated from five thermograms collected at 7, 11, 15, 19 and 23 h (Tsk7,11,15,19,23) by a Fluke imager. We applied one-way analysis of variance for repeated measures for the different times of the day and Tukey's post hoc test to determine significant Tsk differences between ROIs (α=0.05), and the cosinor analysis was used to determine the midline estimating statistic of rhythm, amplitude and acrophase of Tsk during the 24 h period. The anterior hands showed the greatest Tsk variations throughout the day. In the lower limbs, scapula, abdomen, chest and lower back, Tsk-11, Tsk-15, Tsk-19 and Tsk-23 were significantly different (pthermal stabilisation in some regions in the afternoon and a central upward trend throughout the day in the hands. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  16. Structural variations and their adaptive significances in the bones of some migratory and resident birds

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    Namram Sushindrajit Singh

    2015-05-01

    Full Text Available We investigated variations in the shape and size of some bones and their adaptive significances in both sexes of the migratory yellow breasted bunting (Emberiza aureola Pallas, 1773 and resident house sparrow (Passer domesticus Linnaeus, 1758 and tree sparrow (Passer montanus Linnaeus, 1758. Measurements of the large bones like skull, beak, orbit, sternum, coracoid, scapula, femur, tibiotarsus, humerus and metatarsus were recorded to find out variations in their measurements. The skull, cranial and sternum indices were also calculated. An attempt was also made to correlate the structural differences of these bones between migratory and nonmigratory species and also between sexes with their adaptive significances. Principal component analysis indicated 84.79% of the total variance. Discriminant function analysis shows distinct separation in the bone lengths between the resident and migratory birds while there was little overlap between the sexes. The proportion of original grouped cases correctly classified was found to be 95.0%. Migratory bunting showed significantly longer sternum, tibiotarsus, femur and humerus beside a higher sternum when compared to those of resident sparrows. On the other hand, beak width, sternum width and indices of cranium and sternum, were more in resident sparrows. Thus, our studied birds seem to possess species specific adaptations by modifying their bones to fit their modes of living and conditions for better endurance and performance.

  17. Image-based RSA: Roentgen stereophotogrammetric analysis based on 2D-3D image registration.

    Science.gov (United States)

    de Bruin, P W; Kaptein, B L; Stoel, B C; Reiber, J H C; Rozing, P M; Valstar, E R

    2008-01-01

    Image-based Roentgen stereophotogrammetric analysis (IBRSA) integrates 2D-3D image registration and conventional RSA. Instead of radiopaque RSA bone markers, IBRSA uses 3D CT data, from which digitally reconstructed radiographs (DRRs) are generated. Using 2D-3D image registration, the 3D pose of the CT is iteratively adjusted such that the generated DRRs resemble the 2D RSA images as closely as possible, according to an image matching metric. Effectively, by registering all 2D follow-up moments to the same 3D CT, the CT volume functions as common ground. In two experiments, using RSA and using a micromanipulator as gold standard, IBRSA has been validated on cadaveric and sawbone scapula radiographs, and good matching results have been achieved. The accuracy was: |mu |RSA but higher than in vivo standard RSA. Because IBRSA does not require radiopaque markers, it adds functionality to the RSA method by opening new directions and possibilities for research, such as dynamic analyses using fluoroscopy on subjects without markers and computer navigation applications.

  18. Predictable dental rehabilitation in maxillomandibular reconstruction with free flaps. The role of implant guided surgery.

    Science.gov (United States)

    Cebrian-Carretero, José-Luis; Guiñales-Díaz de Cevallos, Jorge; Sobrino, José-Andrés; Yu, Tomás; Burgueño-García, Miguel

    2014-11-01

    The reconstruction of maxillomandibular defects secondary to oral cancer surgery, represent a great challenge for Maxillofacial surgeons. During the last decades the reconstructive surgery has experimented a big advance due to the development of the microsurgical techniques. At present, we are able to reconstruct complex defects using free flaps that provide both soft and bone tissue. Fibula, iliac crest and scapula free flaps have been the three classic options for the maxillomandibular reconstruction owing to the amount of bone that this flaps provide, allowing the posterior dental rehabilitation with implants. Today, our objective it is not only the aesthetic reconstruction, but also the functional reconstruction of the patients enhancing their life quality. Guided implant surgery in free flap reconstructed patients has become an essential tool, helping to define the exact position of the dental implant in the flap. In this way it is possible to look for the areas with better bone conditions, avoiding the osteosynthesis material used to fixate the flap with the native bone and deciding the best biomechanical option, in terms of number and situation of the implants, for the future dental prostheses. In summary, using the guided implant surgery, it is possible to design an exact and predictable dental implant rehabilitation in patients with oral cancer who are reconstructed with free microvascular flap, resulting in an optimal aesthetic and functional result.

  19. Congenital insensitivity to pain with anhidrosis (CIPA): the spectrum of radiological findings

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    Schulman, H.; Tsodikow, V.; Hertzanu, Y. [Dept. of Radiology, Soroka University Medical Centre, Beer-Sheva (Israel); Einhorn, M.; Levy, Y.; Shorer, Z. [Dept. of Pediatrics, Soroka University Medical Centre, Beer-Sheva (Israel)

    2001-10-01

    Background: Congenital insensitivity to pain with anhidrosis (CIPA) is an exceedingly rare, hereditary, sensory autonomic neuropathy (HSAN). Aim: To evaluate the various skeletal manifestations and cranial CT features in children affected by CIPA. Materials and methods: In the semidesert area of the Negev, the Bedouin tribes constitute a closed society where consanguineous marriages are the custom. This has resulted in a group of 20 children being affected by this rare autosomal recessive HSAN. The skeletal surveys and CT scans of these 20 Bedouin patients, 12 girls and 8 boys, ages ranging between 1 month and 8 years, were retrospectively analysed. Cranial CT scans were performed in ten children because of neonatal hypotonia and psychomotor retardation. The skeletal findings were classified as follows: fractures, joint deformities, joint dislocations, osteomyelitis, avascular necrosis and acro-osteolysis. Results: All 20 patients had fractures of the extremities and acro-osteolysis of the fingers. Six had joint deformities. Three children had recurrent hip joint dislocations and another three had avascular necrosis. Ten patients presented with osteomyelitis of the limbs, acetabulum and scapula. The cranial CT scans disclosed mild brain volume loss with some ventriculomegaly. Conclusions: CIPA is a severe autosomal recessive condition that leads to self-mutilation early in life and to fractures, osteomyelitis and limb amputation in older children. Mental retardation is common. Death from hyperpyrexia occurs in almost 20 % of patients in the first 3 years of life. (orig.)

  20. Scapular Free Vascularised Bone Flaps for Mandibular Reconstruction: Are Dental Implants Possible?

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    Martin Lanzer

    2015-09-01

    Full Text Available Objectives: Free fibula flap remains the flap of choice for reconstruction of mandibular defects. If free fibula flap is not possible, the subscapular system of flaps is a valid option. In this study, we evaluated the possibility of dental implant placement in patients receiving a scapular free flap for oromandibular reconstruction. Material and Methods: We retrospectively reviewed 10 patients undergoing mandible reconstruction with a subscapular system free-tissue (lateral border of the scapula transfer at the University Hospital Zürich between January 1, 2010 and January 1, 2013. Bone density in cortical and cancellous bone was measured in Hounsfield units (HU. Changes of bone density, height and width were analysed using IBM SPSS Statistics 22. Comparisons of bone dimensions as well as bone density were performed using a chi-square test. Results: Ten patients were included. Implantation was conducted in 50%. However, all patients could have received dental implants considering bone stock. Loss of bone height and width were significant (P < 0.001. There was a statistical significant increase in bone density in cortical (P < 0.001 and cancellous (P = 0.004 bone. Conclusions: Dental implants are possible after scapular free flap reconstruction of oromandibular defects. Bone height and width were reduced, while bone density increased with time.

  1. [Sevoflurane anesthesia for a patient with facioscapulohumeral muscle dystrophy].

    Science.gov (United States)

    Masuda, Y; Hayashi, M; Obara, H

    1994-04-01

    We gave anesthesia to a patient with facioscapulohumeral muscle distrophy (FSHMD). Patient was an 18 year old male, having no peculiar complaint and without family history nor past history relating to FSHMD. The restriction of right arm lifting was pointed out in medical examination. Diagnosis of FSHMD was made by muscle biopsy. The thoraco-scapula fixation was scheduled. Four hours prior to the induction, dantrolene 50 mg was administered per os. Before the induction, to estimate the effect of neuromuscular blockade, we applied Datex Relaxograph to the upper and lower extremities. Anesthesia was induced with thiamylal 200 mg and vecuronium 4 mg, and maintained with sevoflurane and nitrous oxide monitoring ETCO2. The time for the onset of muscular relaxation after the administration of vecuronium was quite different between upper and lower extremities (200 sec. and 407 sec.). Neostigmine and atropine for the reversal of neuromuscular blockade was administered evaluating the extent of neuromuscular relaxation obtained from Datex Relaxograph. We concluded that Relaxograph is essential as a monitor of muscular relaxation, especially in the case of neuromuscular disease.

  2. ANALYSIS OF LONG-TERM RESULTS OF SHOULDER ARTHROPLASTY

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    D. V. Nenashev

    2012-01-01

    Full Text Available The retrospective analysis of 97 shoulder arthroplasties during 1998 to 2009 was performed. The hemiarthroplasty were fulfilled in 92 patients and total shoulder replacement in 5 patients. Total rate good and satisfactory results consists 32,0%, poor results - 68,0% (66 patients, include 5 patients with total shoulder arthroplasty. The lower level of good results was revealed in patients with chronic fractures and fracture-dislocations of shoulder. It related with changes bones of shoulder and muscles of shoulder (rotator cuff. In the studied group of patients there was no proper pre-operative diagnostics of the rotator cuff, articular surface of the scapula, which shows the need for careful preoperative examination to determine the indications for shoulder arthroplasty and select the type of prosthesis. Unsatisfactory results of total arthroplasty related to screw migration (in case of the transacromion approach and to the development of subacromial impingement. The conclusion about the need to narrow the indications for use of the scapular component «Ortho-P». The authors showed preference to cemented implants without a metal base. It is necessary to introduce in practice the anatomic implants of the third generation allowing the fullest play the anatomy and biomechanics of the shoulder joint.

  3. The importance of post-mortem computed tomography (PMCT) in confrontation with conventional forensic autopsy of victims of motorcycle accidents.

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    Moskała, Artur; Woźniak, Krzysztof; Kluza, Piotr; Romaszko, Karol; Lopatin, Oleksij

    2016-01-01

    Since traffic accidents are an important problem in forensic medicine, there is a constant search for new solutions to help with an investigation process in such cases. In recent years there was a rapid development of post-mortem imaging techniques, especially post-mortem computed tomography (PMCT). In our work we concentrated on a potential advantage of PMCT in cases of motorcycle accident fatalities. The results of forensic autopsy were compared with combined results of the autopsy and PMCT to check in which areas use of these two techniques gives statistically important increase in number of findings. The hypothesis was confirmed in case of pneumothorax and fractures of skull, spine, clavicle, scapula, lower leg bones. As for majority of other bone fractures locations and brain injures there were single cases with pathologies visible only in PMCT, but too few to reach expected level of p-value. In case of injuries of solid organs and soft tissues statistical analysis did not confirmed any advantage of unenhanced PMCT use. On the whole it has been shown that PMCT used as an adjunct to forensic autopsy can cause an increase in information about vitally important regions in case of motorcycle accident fatalities. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  4. Crocodyliform feeding traces on juvenile ornithischian dinosaurs from the Upper Cretaceous (Campanian) Kaiparowits Formation, Utah.

    Science.gov (United States)

    Boyd, Clint A; Drumheller, Stephanie K; Gates, Terry A

    2013-01-01

    Crocodyliforms serve as important taphonomic agents, accumulating and modifying vertebrate remains. Previous discussions of Mesozoic crocodyliform feeding in terrestrial and riverine ecosystems have often focused on larger taxa and their interactions with equally large dinosaurian prey. However, recent evidence suggests that the impact of smaller crocodyliforms on their environments should not be discounted. Here we present direct evidence of feeding by a small crocodyliform on juvenile specimens of a 'hypsilophodontid' dinosaur from the Upper Cretaceous (Campanian) Kaiparowits Formation of southern Utah. Diagnostic crocodyliform bite marks present on a left scapula and a right femur, as well as a partial probable crocodyliform tooth crown (ovoid in cross-section) preserved within a puncture on the right femur, comprise the bulk of the feeding evidence. Computed tomography scans of the femoral puncture reveal impact damage to the surrounding bone and that the distal tip of the embedded tooth was missing prior to the biting event. This is only the second reported incidence of a fossil crocodyliform tooth being found embedded directly into prey bone. These bite marks provide insight into the trophic interactions of the ecosystem preserved in the Kaiparowits Formation. The high diversity of crocodyliforms within this formation may have led to accentuated niche partitioning, which seems to have included juvenile dinosaurian prey.

  5. Posterior glenoid wear in total shoulder arthroplasty: eccentric anterior reaming is superior to posterior augment.

    Science.gov (United States)

    Wang, Tim; Abrams, Geoffrey D; Behn, Anthony W; Lindsey, Derek; Giori, Nicholas; Cheung, Emilie V

    2015-12-01

    Uncorrected glenoid retroversion during total shoulder arthroplasty may lead to an increased likelihood of glenoid prosthetic loosening. Augmented glenoid components seek to correct retroversion to address posterior glenoid bone loss, but few biomechanical studies have evaluated their performance. We compared the use of augmented glenoid components with eccentric reaming with standard glenoid components in a posterior glenoid wear model. The primary outcome for biomechanical stability in this model was assessed by (1) implant edge displacement in superior and inferior edge loading at intervals up to 100,000 cycles, with secondary outcomes including (2) implant edge load during superior and inferior translation at intervals up to 100,000 cycles, and (3) incidence of glenoid fracture during implant preparation and after cyclic loading. A 12°-posterior glenoid defect was created in 12 composite scapulae, and the specimens were divided in two equal groups. In the posterior augment group, glenoid version was corrected to 8° and an 8°-augmented polyethylene glenoid component was placed. In the eccentric reaming group, anterior glenoid reaming was performed to neutral version and a standard polyethylene glenoid component was placed. Specimens were cyclically loaded in the superoinferior direction to 100,000 cycles. Superior and inferior glenoid edge displacements were recorded. Surviving specimens in the posterior augment group showed greater displacement than the eccentric reaming group of superior (1.01 ± 0.02 [95% CI, 0.89-1.13] versus 0.83 ± 0.10 [95% CI, 0.72-0.94 mm]; mean difference, 0.18 mm; p = 0.025) and inferior markers (1.36 ± 0.05 [95% CI, 1.24-1.48] versus 1.20 ± 0.09 [95% CI, 1.09-1.32 mm]; mean difference, 0.16 mm; p = 0.038) during superior edge loading and greater displacement of the superior marker during inferior edge loading (1.44 ± 0.06 [95% CI, 1.28-1.59] versus 1.16 ± 0.11 [95% CI, 1.02-1.30 mm]; mean difference, 0.28 mm; p = 0.009) at 100

  6. STUDY OF ACROMIAL MORPHOLOGY IN INDIAN POPULATION. Estudio de la morfología acromial en la población India

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    susmita Saha

    2016-03-01

    Full Text Available Objetivos: El propósito del estudio era evaluar la morfología de acromion adulto en la población India y correlacionar su asociación con varias patologías del hombro. Materiales y métodos: La evaluación morfológica fue realizada en 200 omóplatos secos adultos obtenidos del museo de osteología del Departamento de Anatomía, Maulana Azad Medical College, Nueva Delhi. Se calculó la altura del arco acromial, ángulo anterior y posterior del arco y su índice, usando el método objetivo de Getz et al  (1996 para demarcar forma acromial. La presencia o la ausencia de entesofitos fue observada en la superficie inferior de la cara anterior del acromion. Resultados: 28% de los omóplatos fueron el acromion de tipo I, 67% fueron el tipo II y el 5% fueron el tipoIII. La presencia de entesofitos en la superficie inferior de la cara anterior del acromion también fue estudiada; los enthesofitos fueron observados en 3.5% en el tipo acromial I, 15.67% en el tipo II y el 40% en el proceso acromial de tipoIII. Conclusiones: La asociación entre el síndrome subacromial de compresión y el tipo acromial está bien establecida. Les asistirá a los clínicos para decidir la modalidad del tratamiento: conservador o quirúrgico. Se debe tener en cuenta la asociación de entesofitos subacromiales con la morfología acromial y los desgarros del manguito rotador al interpretar opacidades en las radiografías.  Objectives: The purpose of the study was to asses the morphology of adult acromion  processes in Indian population and correlate its association with various shoulder pathologies. Materials and methods: Morphologic evaluation was conducted on 200 adult dry scapulae obtained from osteology museum of Department of Anatomy, Maulana Azad Medical College, New Delhi. The height of the acromial arch, anterior and posterior angle of arch and their ratio were measured by using objective method of Getz et al (1996 for determining acromial shape. Presence or

  7. Avaliação postural em mulheres com dor pélvica crônica Postural evaluation in women with chronic pelvic pain

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    Renata Miranda

    2009-07-01

    analysis of the ankle, the knee in the saggittal plan, pelvis, lumbar lordosis, thoracic kyphosis, adducted/abducted scapula, shoulders, head and third finger on the floor test were obtained. The qualitative variables studied were the knee (varus, valgus or normal, the presence or not of winged scapula and leveling of shoulders. The Statistical Package for Social Sciences, version 16.0 was used for the statistical analyses. Fisher's exact test and Monte-Carlo method were used to compare the qualitative variables, and for the quantitative data, t or Mann-Whitney test was used. The comparisons among continuous data, corrected for possible confusion variables were realized by the univariate covariance analysis. Significance level was established at 0.05 or 5%. RESULTS: there were significant differences between cases and controls for protruded head (47.5 and 52.0º, respectively; p<0.0001 and for protruded shoulders (1.9 and 1.6 cm, respectively; p=0.03. The other variables did not show significant differences. CONCLUSIONS: based on these results, attention to head and shoulder posture, to antalgic postures and to the emotional factor is recommended. Women with chronic pelvic pain should be treated, taking into consideration individual muscle-skeletal changes, and social and emotional conditions.

  8. Shoulder muscle activity and function in common shoulder rehabilitation exercises.

    Science.gov (United States)

    Escamilla, Rafael F; Yamashiro, Kyle; Paulos, Lonnie; Andrews, James R

    2009-01-01

    The rotator cuff performs multiple functions during shoulder exercises, including glenohumeral abduction, external rotation (ER) and internal rotation (IR). The rotator cuff also stabilizes the glenohumeral joint and controls humeral head translations. The infraspinatus and subscapularis have significant roles in scapular plane abduction (scaption), generating forces that are two to three times greater than supraspinatus force. However, the supraspinatus still remains a more effective shoulder abductor because of its more effective moment arm. Both the deltoids and rotator cuff provide significant abduction torque, with an estimated contribution up to 35-65% by the middle deltoid, 30% by the subscapularis, 25% by the supraspinatus, 10% by the infraspinatus and 2% by the anterior deltoid. During abduction, middle deltoid force has been estimated to be 434 N, followed by 323 N from the anterior deltoid, 283 N from the subscapularis, 205 N from the infraspinatus, and 117 N from the supraspinatus. These forces are generated not only to abduct the shoulder but also to stabilize the joint and neutralize the antagonistic effects of undesirable actions. Relatively high force from the rotator cuff not only helps abduct the shoulder but also neutralizes the superior directed force generated by the deltoids at lower abduction angles. Even though anterior deltoid force is relatively high, its ability to abduct the shoulder is low due to a very small moment arm, especially at low abduction angles. The deltoids are more effective abductors at higher abduction angles while the rotator cuff muscles are more effective abductors at lower abduction angles. During maximum humeral elevation the scapula normally upwardly rotates 45-55 degrees, posterior tilts 20-40 degrees and externally rotates 15-35 degrees. The scapular muscles are important during humeral elevation because they cause these motions, especially the serratus anterior, which contributes to scapular upward rotation

  9. Ocorrência de desvios posturais em escolares do ensino público fundamental de Jaguariúna, São Paulo Occurrence of postural deviations in children of a school of Jaguariúna, São Paulo, Brazil

    Directory of Open Access Journals (Sweden)

    Camila Isabel S. Santos

    2009-03-01

    shoulder (39.7%, abducted scapula (40.5%, knock-knee (29.6%, pelvic unbalance (21.5%, pelvic anteversion (19%, knee hyperextension (19%, medial rotation of hip (12.9%, protracted cervical (11.7%, head tilt (15.4%, thoracic hyperkyphosis (9.7% and lumbar hyperlordosis (26.3%. CONCLUSIONS: A high incidence of postural alterations was detected in school children. Some of the postural alterations, such as abducted scapula, unbalance and protraction of the shoulders, knock-knee and lumbar hiperlordosis, normally occur and they are naturally corrected during growth. However, some postural problems, such as protraction and inclination of the cervical spine, were also prevalent and they require early intervention.

  10. Shoulder muscle recruitment patterns and related biomechanics during upper extremity sports.

    Science.gov (United States)

    Escamilla, Rafael F; Andrews, James R

    2009-01-01

    throwing. Peak rotator cuff activity is also high is the windmill softball pitch (75-93% MVIC), the volleyball serve and spike (54-71% MVIC), the tennis serve and volley (40-113% MVIC), baseball hitting (28-39% MVIC), and the golf swing (28-68% MVIC). Peak scapular muscle activity is also high during the arm cocking and arm deceleration phases of baseball pitching, with peak serratus anterior activity 69-106% MVIC, peak upper, middle and lower trapezius activity 51-78% MVIC, peak rhomboids activity 41-45% MVIC, and peak levator scapulae activity 33-72% MVIC. Moreover, peak serratus anterior activity was approximately 60% MVIC during the windmill softball pitch, approximately 75% MVIC during the tennis serve and forehand and backhand volley, approximately 30-40% MVIC during baseball hitting, and approximately 70% MVIC during the golf swing. In addition, during the golf swing, peak upper, middle and lower trapezius activity was 42-52% MVIC, peak rhomboids activity was approximately 60% MVIC, and peak levator scapulae activity was approximately 60% MVIC.

  11. EFFECT OF LOCATION AND BONE GRAFT REMODELING ON RESULTS OF BRISTOW-LATARJET PROCEDURE

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    D. A. Malanin

    2016-01-01

    Full Text Available Introduction. Operation Bristow-Latarjet proved itself as one of the most effective and predictable surgical treatments. despite its widespread use, there are various complications associated with improper installation of the bone block and the violation of its remodeling.Objective: To obtain new data on the effect of location and remodeling of bone graft block on functional outcome and stability of the shoulder joint in patients with recurrent anterior instability after the operation Bristow-latarjet.Material and methods. The material for the study served as the analysis of results of treatment of 64 patients with posttraumatic recurrent anterior shoulder dislocation who underwent Bristow-latarjet operation. postoperatively, assessed a provision and the degree of bone remodeling unit according to computed tomography in the sagittal, axial slices, and through 3d modeling. To evaluate the functional outcome scale were used western Ontario Shoulder Index (wOSI and Rowe scale.Results. At the level of the articular surface (congruent or flattening in the axial plane were 89% bone blocks, too medially or laterally arranged 9% and 2% grafts, respectively. On sagittal cT images in the middle third of the articular surface of the scapula was located 28% of the bone blocks at the bottom 60%, in the upper third of 12%. Analysis of the dependence of the results of treatment of graft positioning showed that patients with excellent and good summary on the scale WOSI and Rowe, had a correct location of the bone block in the middle and lower third of the articular process of the blade. It can be assumed that excessive lateralized or medialized bone block position in the axial plane of a more profound effect on the outcome than cranial displacement of the latter with the sagittal plane. Bony union of the graft was found by CT in 74% of cases, soft tissue 26%, the degree of resorption of the graft revealed 0-1 84% 2-3 degree in 26% of cases. In the last periods

  12. Qualitative postural analysis among boys and girls of seven to ten years of age Análise postural qualitativa entre meninos e meninas de sete a dez anos de idade

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    PJ Penha

    2008-10-01

    Full Text Available BACKGROUND: Postural abnormalities are often found in children. At this stage of life, posture undergoes many adjustments and adaptations due to body changes. Objective: To qualitatively identify the postural abnormalities which occur most frequently among children aged OBJECTIVE: Reven and ten years, comparing boys and girls, and to evaluate these subjects' lumbar flexibility. METHODS: One hundred and ninety-one children were photographed in the sagittal and frontal planes. The variables analyzed were: ankle (valgus and varus, tibiotarsal angle (opened and closed, knee (hyperextension and semiflexion, valgus and varus, pelvis (anteversion and retroversion; lateral pelvic inclination, trunk (antepulsion and retropulsion, lumbar spine (hyperlordosis and rectification, thoracic spine (hyperkyphosis and rectification, cervical spine (hyperlordosis and rectification, scoliosis, shoulder (imbalance and protraction, scapula (winged, abducted and adducted and head (tilt and protraction. The lumbar flexibility was assessed using Schöber's index. RESULTS: The boys had greater incidence of winged scapula, shoulder imbalance, protraction of shoulders and head and cervical hyperlordosis than the girls did. Conversely, the girls had greater incidence of head tilt and larger Schöber index values. CONCLUSIONS: There were abnormalities in children's postural development that are probably related to muscle, skeletal and flexibility differences between the genders. These differences may influence each child's postural pattern during growth.CONTEXTUALIZAÇÃO: Alterações posturais são freqüentemente encontradas em crianças. Nessa fase, a postura sofre uma série de ajustes e adaptações às mudanças no próprio corpo. OBJETIVO: Identificar, de maneira qualitativa, quais as alterações posturais mais freqüentes em crianças entre sete e dez anos, comparando meninos e meninas, e avaliar a flexibilidade lombar desses sujeitos. MATERIAIS E MÉTODOS: Cento e

  13. Postural assessment of girls between 7 and 10 years of age Avaliação postural em meninas de 7 a 10 anos

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    Patrícia Jundi Penha

    2005-02-01

    Full Text Available Postural alterations are often found in children and teenagers. In this stage of development, the posture undergoes many adjustments and adaptations due to changes of the body and to demanding psychosocial factors. PURPOSE: To identify which postural alterations occur most often in students between 7 and 10 years of age, to identify preventive measures, and to provide information to parents and teachers about the problem of bad posture. METHODS: Thirty three girls in each of 4 age groups between 7 and 10 years of age were assessed, resulting in a sample of 132 subjects. Photos of each girl in the sagittal and frontal planes were examined for postural deviations. RESULTS: The main postural deviations found were knock-knee, medial rotation of the hip, antepulsion, pelvic anteversion, knee hyperextension, lumbar hyperlordosis, valgus ankle, imbalanced shoulders, lateral pelvic inclination, scoliosis, trunk rotation, thoracic hyperkyphosis, winged scapula, shoulder protraction, abducted scapula, medial rotation of shoulders, and head tilt. CONCLUSION: High incidences of postural alterations occur in children of school age. Some of these reflect normal postural development, and get corrected during the child's growth. On the other hand, some alterations are asymmetries that can be caused by daily demands on the body and can result in negative impacts on the quality of life during childhood and adulthood. We emphasize the importance of providing information to parents and teachers about the problem of bad posture.Alterações posturais são freqüentemente encontradas em crianças e adolescentes. Nessa fase, a postura sofre uma série de ajustes e adaptações às mudanças no próprio corpo e à demanda psicossocial que lhe é apresentada, ocorrendo uma grande transformação na busca de um equilíbrio compatível com suas condições. OBJETIVO: Identificar quais as alterações posturais mais freqüentes em escolares, de 7 a 10 anos, com intuito de

  14. Visual scapular dyskinesis: kinematics and muscle activity alterations in patients with subacromial impingement syndrome.

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    Lopes, Andrea Diniz; Timmons, Mark K; Grover, Molly; Ciconelli, Rozana Mesquita; Michener, Lori A

    2015-02-01

    To characterize scapular kinematics and shoulder muscle activity in patients with subacromial impingement syndrome, with and without visually identified scapular dyskinesis. Cross-sectional study. Laboratory. Participants with subacromial impingement syndrome (N=38) were visually classified using a scapular dyskinesis test with obvious scapular dyskinesis (n=19) or normal scapular motion (n=19). Not applicable. An electromagnetic motion capture system measured 3-dimensional kinematics of the thorax, humerus, and scapula. Simultaneously, surface electromyography was used to measure muscle activity of the upper, middle, and lower trapezius; serratus anterior; and infraspinatus during ascending and descending phases of weighted shoulder flexion. Separate mixed-model analyses of variance for the ascending and descending phases of shoulder flexion compared kinematics and muscle activity between the 2 groups. Shoulder disability was assessed with the Pennsylvania Shoulder Score (Penn). The group with obvious dyskinesis reported 6 points lower on Penn shoulder function (0-60 points), exhibited a main group effect of less scapular external rotation of 2.1° during ascent and 2.5° during descent, and had 12.0% higher upper trapezius muscle activity during ascent in the 30° to 60° interval. Patients with obvious dyskinesis and subacromial impingement syndrome have reduced scapular external rotation and increased upper trapezius muscle activity, along with a greater loss of shoulder function compared with those without dyskinesis. These biomechanical alterations can lead to or be caused by scapular dyskinesis. Future studies should determine if correction of these deficits will eliminate scapular dyskinesis and improve patient-rated shoulder use. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  15. Subacromial osteochondroma: A rare cause of impingement syndrome.

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    Çıtlak, Atilla; Akgün, Ulaş; Bulut, Tugrul; Aslan, Cihan; Mete, Berna Dirim; Şener, Muhittin

    2015-01-01

    Subacromial impingement syndrome is one of the most common disorders of shoulder. Scapula is a very rare site for osteochondromas, and osteochondromas arising under the acromion cause impingement syndrome. We presented 34-year old female patient with subacromial impingement syndrome secondary to osteochondroma. She had received conservative treatment several times in other clinics. The osteochondroma causing impingement was not diagnosed. Physical examination of the right shoulder revealed 90° flexion, 70° abduction, 20° external rotation and internal rotation to sacrum. X-ray, CT and MRI of the shoulder was obtained. Osteochondroma of the acromion (35×33×25mm) causing impingement was detected. The osteochondroma of acromion compressed, displaced and ruptured the supraspinatus tendon. Also an osseous prominence of glenoid was detected during shoulder arthroscopy, and it was removed arthroscopically. The giant osteochondroma of acromion could not remove arthroscopically due to the size of the lesion, and it was removed totally through a mini open approach. Histopathological examination confirmed the diagnosis of osteochondroma. Scapular, clavicular and humeral osteochondromas cause impingement syndrome. Osteochondroma should be treated with total excision. Recurrences can be seen due to insufficient removal of osteochondromas. We think that, total excision is important to prevent recurrence. Subacromial osteochondroma is a very rare cause of impingement syndrome, and if it isn't diagnosed early it limits shoulder movements, causes severe shoulder impingement and rotator cuff tear. The diagnosis of subacromial osteochondroma should be considered in any patient with shoulder impingement syndrome and good functional results can be expected following total excision. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  16. [Establishment and Characterization of a Novel Chinese Human Lung Adenocarcinoma Cell Line CPA-Yang2 in Immunodeficient Mice.].

    Science.gov (United States)

    Yang, Shunfang; Su, Jianzhong; Shi, Meiping; Zhao, Lanxiang; Zhang, Peiling; Cao, Jie; Lu, Jianying; Xie, Wenhui

    2009-10-20

    The recurrence, metastasis and multidrug resistance (MDR) in lung cancer are the tough problems worldwide. This study was to establish a novel chinese lung adenocarcinoma cell line with high metastasis potential for exploring the mechanism of reccurrence, development and MDR in lung cancer. The cell came from the abdominal dropsy of a fifty-six years old female patient with lung adenocarcinoma and the tumor markers CA125, CYFRA21-1, CEA, NSE were detected to be higher secretion by radioimmunoassay in the abdominal dropsy. Tumorigenicity of immunodeficient mice was confirmed in 8th passage. The cell growth curve was mapped. Analysis of chromosome karyotype was tested. The gene expression was measured by real-time quantitative PCR. The tumorigenesis rate started at 8th passage in 3/10 immunodeficient mice via subcutaneously and the fully tumorigenicity was at 11th passage as well as later passages. Under the microscope, the cell showed oval-shap and adherence. The chromosome karyotype analysis of the cells was sub-triploid. Approximately 1*10(6) and 1.5*10(6) cancerous cells were injected into left cardiac ventricle and tail vein of immunodeficient mice respectively. The results showed multiorgan metastasis in the mice after three-four weeks, including mandible, scapula, humerus, vertebral column, femur, rib and brain, liver, adrenal gland, pulmonary in the mice after inoculation. The bone metastasis rate was 100% in the tumor bearing mice by bone scintigraphy and pathology. Quantitative real-time PCR was used to examined and compared with SPC-A-1 lung adenocarcinoma, ESM1, VEGF-C, IL-6, IL-8, AR genes were overexpressed. The novel cell was named CPA-Yang2 The characteristics of novel strain CPA-Yang2 is a highly metastasis cell line of Chinese lung adenocarcinoma. It has stable traits, highly metastasis ability and maybe is a MDR lung cancerous cell line. Of course, it's a good experimental model for lung cancer research.

  17. Transient long thoracic nerve injury during posterior spinal fusion for adolescent idiopathic scoliosis: A report of two cases

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    Athanasios I Tsirikos

    2013-01-01

    Full Text Available We present the transient long thoracic nerve (LTN injury during instrumented posterior spinal arthrodesis for idiopathic scoliosis. The suspected mechanism of injury, postoperative course and final outcome is discussed. The LTN is susceptible to injury due to its long and relatively superficial course across the thoracic wall through direct trauma or tension. Radical mastectomies with resection of axillary lymph nodes, first rib resection to treat thoracic outlet syndrome and cardiac surgery can be complicated with LTN injury. LTN injury producing scapular winging has not been reported in association with spinal deformity surgery. We reviewed the medical notes and spinal radiographs of two adolescent patients with idiopathic scoliosis who underwent posterior spinal arthrodesis and developed LTN neuropraxia. Scoliosis surgery was uneventful and intraoperative spinal cord monitoring was stable throughout the procedure. Postoperative neurological examination was otherwise normal, but both patients developed winging of the scapula at 4 and 6 days after spinal arthrodesis, which did not affect shoulder function. Both patients made a good recovery and the scapular winging resolved spontaneously 8 and 11 months following surgery with no residual morbidity. We believe that this LTN was due to positioning of our patients with their head flexed, tilted and rotated toward the contralateral side while the arm was abducted and extended. The use of heavy retractors may have also applied compression or tension to the nerve in one of our patients contributing to the development of neuropraxia. This is an important consideration during spinal deformity surgery to prevent potentially permanent injury to the nerve, which can produce severe shoulder dysfunction and persistent pain.

  18. Like father, like son: assessment of the morphological affinities of A.L. 288-1 (A. afarensis, Sts 7 (A. africanus and Omo 119-73-2718 (Australopithecus sp. through a three-dimensional shape analysis of the shoulder joint.

    Directory of Open Access Journals (Sweden)

    Julia Arias-Martorell

    Full Text Available The postcranial evidence for the Australopithecus genus indicates that australopiths were able bipeds; however, the morphology of the forelimbs and particularly that of the shoulder girdle suggests that they were partially adapted to an arboreal lifestyle. The nature of such arboreal adaptations is still unclear, as are the kind of arboreal behaviors in which australopiths might have engaged. In this study we analyzed the shape of the shoulder joint (proximal humerus and glenoid cavity of the scapula of three australopith specimens: A.L. 288-1 (A. afarensis, Sts 7 (A. africanus and Omo 119-73-2718 (Australopithecus sp. with three-dimensional geometric morphometrics. The morphology of the specimens was compared with that of a wide array of living anthropoid taxa and some additional fossil hominins (the Homo erectus specimen KNM-WT 15000 and the H. neanderthalensis specimen Tabun 1. Our results indicate that A.L. 288-1 shows mosaic traits resembling H. sapiens and Pongo, whereas the Sts 7 shoulder is most similar to the arboreal apes and does not present affinities with H. sapiens. Omo 119-73-2718 exhibits morphological affinities with the more arboreal and partially suspensory New World monkey Lagothrix. The shoulder of the australopith specimens thus shows a combination of primitive and derived traits (humeral globularity, enhancement of internal and external rotation of the joint, related to use of the arm in overhead positions. The genus Homo specimens show overall affinities with H. sapiens at the shoulder, indicating full correspondence of these hominin shoulders with the modern human morphotype.

  19. AN INTERVENTION-BASED CLINICAL REASONING FRAMEWORK TO GUIDE THE MANAGEMENT OF THORACIC PAIN IN A DANCER: A CASE REPORT.

    Science.gov (United States)

    Masaracchio, Michael; Kirker, Kaitlin; Collins, Cristiana Kahl; Hanney, William; Liu, Xinliang

    2016-12-01

    As a result of the anatomical proximity of the thoracic spine to the cervical, lumbar, and shoulder regions, dysfunction in the thoracic spine can influence pain, mobility, and stability across these areas. Currently, a paucity of evidence exists addressing treatment of individuals with primary thoracic pain, especially in young, athletic patients. Furthermore, current research discussing clinical reasoning frameworks focus on the differential diagnostic process. The purpose of this case report was to present a framework that describes the clinical reasoning process for the implementation and sequencing of procedural interventions for the management of a dancer with thoracic pain. A 21-year-old female dancer presented to physical therapy with a medical diagnosis of thoracic pain. The patient reported exacerbation of left thoracic pain with prolonged sitting, twisting/arching her back during dance, and lifting >15 lbs overhead. Examination revealed hypomobility with positive pain provocation during mobility testing of T1-T3 and the sternocostal junction of ribs 2-4, with associated muscle guarding palpated in the left iliocostalis thoracis and levator scapulae. Following 10 visits, the patient had no pain, no functional deficits, and a Global Rating of Change (GROC) of + 6. She returned to full competition, and a 3-month follow-up revealed continued success with dancing and a GROC of +7. This case report described the successful management of a dancer with primary thoracic pain using a clinical reasoning framework for the sequencing of procedural interventions, while incorporating Olson's impairment-based classification system. A combination of manual therapy techniques and neuromuscular control exercises were incorporated to address mobility, stability, mobility on stability, and skill level impairments, which allowed the patient to return to dance activities safely. Future studies should consider the development of further treatment-based clinical reasoning

  20. The years lived with disability due to road traffic accidents based on the nature of injuries in Kermanshah province (2010

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    Neda Izadi

    2015-03-01

    Full Text Available Background: Traffic accidents, with lots of casualties and injuries, cause a lot of economic loss. This study was conducted to determine the Years Lived with Disability (YLD due to road traffic accidents according to the nature of injuries in Kermanshah province. Methods: following a pilot study, a sample of 3258 people was analyzed in order to calculate the YLD. Then, based on various factors, the age, gender and nature of injury of 10070 people were estimated. The YLD was calculated using the Global Burden of Disease (GBD (2010. The data concerning age and gender of the total population of the province was taken from the Statistical Center of Iran. All calculations were performed based on age and gender in Excel software. Results: The mean age of the injured people was 32.7±17.1. Men constituted 67.7 % of patients. The incidence rate of traffic accidents was 283.6 per 100,000. The highest levels of YLD in outpatients, men and women were reported for patella, tibia, fibula and ankle fractures and fractures of clavicle, scapula, humerus and skull, respectively. The highest rate of inpatient YLDs by nature of injury belonged to the fractures of sternum, ribs and face bone. The years lived with disability was calculated to be 2365.96 years (2.46 per 1000 and 1039.01 years (1.1 per 1000 for men and women, respectively. It was 3404.97 years (1.79 per 1000 in both genders. The highest YLD was in the age group of 15–29. Conclusion: Traffic accidents are high rate of YLD is resulted by traffic accidents. The most affected age group are youngsters and fracture are more frequent.

  1. Severe aberrant glenohumeral motor patterns in a young female rower: A case report

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    McGurk Neal

    2007-11-01

    Full Text Available Abstract Background This case features an 18-year-old female with glenohumeral dysrhythmia and subluxation-relocation patterns. This unusual case highlights the need for careful examination and consideration to the anatomical structures involved. Conventional approaches to shoulder examination include range of motion, orthopaedic tests and manual resistance tests. We also assessed the patient's cognitive ability to coordinate muscle function. With this type of assessment we found that co-contraction of local muscle groups seemed to initially improve the patients abnormal shoulder motion. With this information a rehabilitation method was instituted with a goal to maintain the improvement. Case presentation An 18-year-old female with no history of trauma, presented with painless kinesiopathology of the left shoulder (in abduction consisting of dysrhythmia of the glenohumeral joint and early lateral rotation of the scapula. Examination also showed associated muscle atrophy of the lower trapezius and surrounding general muscle weakness. We used an untested functional assessment method in addition to more conventional methods. Exercise rehabilitation interventions were subsequently prescribed and graduated in accordance with what is known as the General Physical Rehabilitation Pyramid. Conclusion This paper presents an unusual case of aberrant shoulder movement. It highlights the need for careful examination and thought regarding the anatomical structures and normal motor patterns associated with the manoeuvre being tested. It also emphasised the use of co-contraction during examination in an attempt to immediately improve a regional dysrythmia if there is suspicion of a regional aberrant motor pattern. Further research may be warranted to test this approach.

  2. Referred pain from myofascial trigger points in head and neck-shoulder muscles reproduces head pain features in children with chronic tension type headache.

    Science.gov (United States)

    Fernández-de-las-Peñas, César; Fernández-Mayoralas, Daniel M; Ortega-Santiago, Ricardo; Ambite-Quesada, Silvia; Palacios-Ceña, Domingo; Pareja, Juan A

    2011-02-01

    Our aim was to describe the referred pain pattern and areas from trigger points (TrPs) in head, neck, and shoulder muscles in children with chronic tension type headache (CTTH). Fifty children (14 boys, 36 girls, mean age: 8 ± 2) with CTTH and 50 age- and sex- matched children participated. Bilateral temporalis, masseter, superior oblique, upper trapezius, sternocleidomastoid, suboccipital, and levator scapula muscles were examined for TrPs by an assessor blinded to the children's condition. TrPs were identified with palpation and considered active when local and referred pains reproduce headache pain attacks. The referred pain areas were drawn on anatomical maps, digitalized, and also measured. The total number of TrPs was significantly greater in children with CTTH as compared to healthy children (P < 0.001). Active TrPs were only present in children with CTTH (P < 0.001). Within children with CTTH, a significant positive association between the number of active TrPs and headache duration (r (s) = 0.315; P = 0.026) was observed: the greater the number of active TrPs, the longer the duration of headache attack. Significant differences in referred pain areas between groups (P < 0.001) and muscles (P < 0.001) were found: the referred pain areas were larger in CTTH children (P < 0.001), and the referred pain area elicited by suboccipital TrPs was larger than the referred pain from the remaining TrPs (P < 0.001). Significant positive correlations between some headache clinical parameters and the size of the referred pain area were found. Our results showed that the local and referred pains elicited from active TrPs in head, neck and shoulder shared similar pain pattern as spontaneous CTTH in children, supporting a relevant role of active TrPs in CTTH in children.

  3. The influence of a depressed scapular alignment on upper limb neural tissue mechanosensitivity and local pressure pain sensitivity.

    Science.gov (United States)

    Martínez-Merinero, Patricia; Lluch, Enriqe; Gallezo-Izquierdo, Tomas; Pecos-Martín, Daniel; Plaza-Manzano, Gustavo; Nuñez-Nagy, Susana; Falla, Deborah

    2017-06-01

    A depressed scapular alignment could lead to prolonged and repetitive stress or compression of the brachial plexus, resulting in sensitization of neural tissue. However, no study has investigated the influence of alignment of the scapulae on sensitization of upper limb neural tissue in otherwise asymptomatic people. In this case-control study, we investigate the influence of a depressed scapular alignment on mechanosensitivity of the upper limb peripheral nervous system as well as pressure pain thresholds (PPT). Asymptomatic individuals with neutral vertical scapular alignment (n = 25) or depressed scapular alignment (n = 25) participated. We measured the upper limb neurodynamic test (ULNT1), including assessment of symptom response and elbow range of motion (ROM), and PPT measured over upper limb peripheral nerve trunks, the upper trapezius muscle and overlying cervical zygapophyseal joints. Subjects with a depressed scapular reported significantly greater pain intensity (t = 5.7, p < 0.0001) and reduced elbow extension ROM (t = -2.7, p < 0.01) during the ULNT1 compared to those with a normal scapular orientation. Regardless of the location tested, the group presenting with a depressed scapular had significantly lower PPT compared to those with a normal scapular orientation (PPT averaged across all sites: normal orientation: 3.3 ± 0.6 kg/cm(2), depressed scapular: 2.1 ± 0.5 kg/cm(2), p < 0.00001). Despite being asymptomatic, people with a depressed scapular have greater neck and upper limb neural tissue mechanosensitivity when compared to people with a normal scapular orientation. This study offers insight into the potential development of neck-arm pain due to a depressed scapular position. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. LEVEL OF SOMATIC DEVELOPMENT OF CHILDREN AGED SIX YEARS FROM AN URBAN AGGLOMERATION IN POLAND WITH RESPECT TO SELECTED ENVIRONMENTAL CONDITIONS.

    Science.gov (United States)

    Trzcińska, Dorota; Tabor, Piotr; Olszewska, Elżbieta

    2015-11-01

    The aim of this study was to assess the somatic development of children from an urban agglomeration in Poland at the end of preschool education and the beginning of primary education with respect to selected socioeconomic and educational conditions. Data were collected for 742 children from selected Warsaw kindergartens in spring 2011 and 2012. Their mean age was 5.84±0.31 years. The sex categories were equal: 371 boys and 371 girls. Kindergartens chosen for the study constituted a representative sample. The diagnostic survey method (questionnaire technique) was used to assess the selected environmental conditions of development in the participating children. Body height and the sum of six skin folds (over the biceps, over the triceps, under the scapula, on the abdomen, over the wing of ilium and on the calf) were chosen from the assessed anthropometric parameters for the purpose of determining somatic development of study participants. The obtained data were analysed using selected descriptive statistics methods (including cluster analysis), data standardization (normalization by mean values and SD) and the chi-squared test. The results showed certain relationships between the selected parameters of somatic development and family living conditions. These relationships involved differences between individual clusters depending on given living conditions and were most prominent for mother's education, for which variable differences between clusters were found for both sexes. The somatic build of boys (including body height and body adiposity) also differed depending on the number of offspring in the family, while the somatic build of girls differed depending on father's employment and father's education. Furthermore, the obtained results lead to the conclusion that the total number of differences between the analysed clusters was relatively low. This indicates that the biological effects of social stratification tend to diminish in the environment of an urban

  5. Like Father, Like Son: Assessment of the Morphological Affinities of A.L. 288–1 (A. afarensis), Sts 7 (A. africanus) and Omo 119–73–2718 (Australopithecus sp.) through a Three-Dimensional Shape Analysis of the Shoulder Joint

    Science.gov (United States)

    Arias-Martorell, Julia; Potau, Josep Maria; Bello-Hellegouarch, Gaëlle; Pérez-Pérez, Alejandro

    2015-01-01

    The postcranial evidence for the Australopithecus genus indicates that australopiths were able bipeds; however, the morphology of the forelimbs and particularly that of the shoulder girdle suggests that they were partially adapted to an arboreal lifestyle. The nature of such arboreal adaptations is still unclear, as are the kind of arboreal behaviors in which australopiths might have engaged. In this study we analyzed the shape of the shoulder joint (proximal humerus and glenoid cavity of the scapula) of three australopith specimens: A.L. 288–1 (A. afarensis), Sts 7 (A. africanus) and Omo 119–73–2718 (Australopithecus sp.) with three-dimensional geometric morphometrics. The morphology of the specimens was compared with that of a wide array of living anthropoid taxa and some additional fossil hominins (the Homo erectus specimen KNM-WT 15000 and the H. neanderthalensis specimen Tabun 1). Our results indicate that A.L. 288–1 shows mosaic traits resembling H. sapiens and Pongo, whereas the Sts 7 shoulder is most similar to the arboreal apes and does not present affinities with H. sapiens. Omo 119–73–2718 exhibits morphological affinities with the more arboreal and partially suspensory New World monkey Lagothrix. The shoulder of the australopith specimens thus shows a combination of primitive and derived traits (humeral globularity, enhancement of internal and external rotation of the joint), related to use of the arm in overhead positions. The genus Homo specimens show overall affinities with H. sapiens at the shoulder, indicating full correspondence of these hominin shoulders with the modern human morphotype. PMID:25651542

  6. Like father, like son: assessment of the morphological affinities of A.L. 288-1 (A. afarensis), Sts 7 (A. africanus) and Omo 119-73-2718 (Australopithecus sp.) through a three-dimensional shape analysis of the shoulder joint.

    Science.gov (United States)

    Arias-Martorell, Julia; Potau, Josep Maria; Bello-Hellegouarch, Gaëlle; Pérez-Pérez, Alejandro

    2015-01-01

    The postcranial evidence for the Australopithecus genus indicates that australopiths were able bipeds; however, the morphology of the forelimbs and particularly that of the shoulder girdle suggests that they were partially adapted to an arboreal lifestyle. The nature of such arboreal adaptations is still unclear, as are the kind of arboreal behaviors in which australopiths might have engaged. In this study we analyzed the shape of the shoulder joint (proximal humerus and glenoid cavity of the scapula) of three australopith specimens: A.L. 288-1 (A. afarensis), Sts 7 (A. africanus) and Omo 119-73-2718 (Australopithecus sp.) with three-dimensional geometric morphometrics. The morphology of the specimens was compared with that of a wide array of living anthropoid taxa and some additional fossil hominins (the Homo erectus specimen KNM-WT 15000 and the H. neanderthalensis specimen Tabun 1). Our results indicate that A.L. 288-1 shows mosaic traits resembling H. sapiens and Pongo, whereas the Sts 7 shoulder is most similar to the arboreal apes and does not present affinities with H. sapiens. Omo 119-73-2718 exhibits morphological affinities with the more arboreal and partially suspensory New World monkey Lagothrix. The shoulder of the australopith specimens thus shows a combination of primitive and derived traits (humeral globularity, enhancement of internal and external rotation of the joint), related to use of the arm in overhead positions. The genus Homo specimens show overall affinities with H. sapiens at the shoulder, indicating full correspondence of these hominin shoulders with the modern human morphotype.

  7. Surgical management of superior sulcus tumors.

    Science.gov (United States)

    Dartevelle, P; Macchiarini, P

    1999-01-01

    Superior sulcus tumor refers to any primary lung cancer presenting with constant pain in the nerve distribution of the eighth cervical, first and second thoracic nerve roots and Horner's syndrome caused by invasion of the stellate ganglion. The pain is steady, severe, and unrelenting, involving the shoulder, the vertebral margin of the scapula and ulnar distribution of the arm to the elbow and finally to the ulnar surface of the forearm, and the small and ring fingers of the hand (Pancoast-Tobias syndrome). Weakness and atrophy of the hand muscles can also occur as the lesions spreads to involve the first and second ribs and vertebrae. Radiologically, there is a small shadow at the extreme apex of the lung with rib and possible vertebral body invasion. Pulmonary symptoms are less frequent because of the peripheral location of the lesions. Since Shaw and Paulson approached superior sulcus tumors in 1961 by using preoperative radiation-therapy (30 to 45 Gy in four weeks including the primary tumor, mediastinum and supraclavicular region) followed by surgical resection, this radiosurgical approach shortly became the standard treatment yielding better disease control and survival than that offered by other treatment modalities. It has now become evident that en bloc resection of the chest wall, involved adjacent structures as well as lobectomy must be considered the standard surgical approach for superior sulcus tumors combined with external radiation (preoperative, postoperative, or both). The goal of the operation is the complete and en bloc resection of the upper lobe in continuity with the invaded ribs, transverse processes, subclavian vessels, T1 nerve root, upper dorsal sympathetic chain and prevertebral muscles.

  8. Idiopathic Syringomyelia in a Military Helicopter Pilot.

    Science.gov (United States)

    Schiemer, Anthony

    2017-10-01

    A syrinx is a fluid-filled cavity within the spinal cord. They can lead to a variety of symptoms, including limb weakness and back pain. Incidental finding of syringomyelia provides a challenge for clinicians due to the wide variety of possible symptoms. In military aviation, neurological findings in pilots can result in extensive investigation that can lead to potentially invasive management. Conversely, the potential for chronic progression of a spinal syrinx and subsequent neurological deterioration makes early identification critical. Ultimately, the discovery of a lesion may have implications for flying status and operational capability. A 25-yr-old man working as a navy Seahawk helicopter pilot presented with episodes of right arm paraesthesia and pain between the scapulae. On at least one occasion, these symptoms woke him at night. Upon magnetic resonance imaging, dilatation of the central canal in a syrinx-like pattern in the lower cervical region was noted. Neurology review suggested the finding was persistent and unlikely to be responsible for his symptoms. No surgical input was recommended. His symptoms were attributed to mild cervical spondylosis, which resolved with ongoing physiotherapy, and he was returned to flying status. This case highlights several issues involved with the incidental finding of a syringomyelia. Surgical intervention has been known to worsen symptoms. Conversely, studies have identified minimal radiological progression in cases of idiopathic syringomyelia, with fewer individuals displaying neurological deterioration. For aircrew, potentially unnecessary neurosurgical intervention poses risks to a flying career and overall operational capability.Schiemer A. Idiopathic syringomyelia in a military helicopter pilot. Aerosp Med Hum Perform. 2017; 88(10):962-965.

  9. Unusual Location of Primary Hydatid Cyst: Soft Tissue Mass in the Supraclavicular Region of the Neck

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    Slim Jarboui

    2012-01-01

    Full Text Available Cystic hydatid disease is a zoonosis caused by Echinococcus granulosus. It may affect any organ and tissue in the body, in particular the liver and Lung. Musculoskeletal or soft tissue hydatidosis accounts for about 0,5%–5% of all echinococcal infections in endemic areas and is almost secondary to the hepatic or pulmonary disease (Karaman et al., 2011; Dirican et al., 2008; Kouskos et al., 2007. Case Presentation. We report an unusual case of primary subcutaneous hydatidosis in the left supraclavicular region of the neck. A 53-year-old female patient was admitted with three-month history of pain and gradually growing mass located in the left supraclavicular region. Physical examination revealed a moderately hard, painful, and erythematous mass. The blood cell count was normal. Computed tomography demonstrated, a multilocular cystic lesion with thin borders and thin wall. The mass is binocular and extends to the scapula. CT showed no involvement of the lung. From these signs, the patient was diagnosed as having abscess (bacterial infection or tuberculosis. The diagnosis of Echinococcus granulosus infection was made per operatively after visualization of the cyst wall and the daughter cysts. Following irrigation of cystic cavity with hypertonic saline solution, the cyst wall was excised along with a portion of surrounding tissue. Histopathological examination of the specimen confirmed the hydatid origin. Hemagglutination tests for Echinococcus and ELISA were negative. Ultrasound of the abdomen was normal. The patient received albendazole (400 mg/day for 8 weeks postoperatively. No sign of recurrence could be detected by physical examination and imaging (CT at 4-month followup. Conclusion. The case illustrates that echinococcal disease should be considered in the differential diagnosis of every cystic mass in every anatomic location, especially when it occurs in endemic areas.

  10. SU-E-J-162: Quality Assurance Procedures for MR Guided Focused Ultrasound Treatment of Bone Metastasis

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    Chen, L; Chen, X; Wang, B; Gupta, R; Ma, C [Fox Chase Cancer Center, Philadelphia, PA (United States)

    2014-06-01

    Purpose: The purpose of this work is to develop and verify our quality assurance (QA) procedures to ensure the safety and efficacy of MR-guided focused ultrasound (MRgFUS) treatment of bone metastases. Methods: A practical QA program was developed. Monthly and daily QA (DQA) procedures were performed. The major QA items included the checks of the machine hardware, software and patient safety features. Briefly, these checks/tests include: 1) the cooling system reservoir and treatment table; 2) power to the treatment table; 3) the MR coil; 4) the transducer position with MRI; 5) image display on the treatment work station; 6) the effective focal spot in 3 directions using MR thermometry; and 7) all the safety devices including a sonication lamp, and the emergency stop-sonication switches. In order to avoid patient skin burn, it is important to remove gas bubbles in the interfaces between the treatment table and the gel pad, and the gel pad and patients skin during the patient setup. Our QA procedures have been verified and evaluated through patient treatments. Seven patients with scapula, humeral head, sacrum, ilium, pubic ramus and acetabular bone metastases were treated using MRgFUS. Results: Our study showed that all seven patients tolerated the MRgFUS treatment well. No skin toxicity or other complications were observed. The pain score (0–10) using the visual analog scale (VAS) was significantly reduced from 8.0 ± 1.1 before treatment to 4.7 ± 3.0, 3.0 ± 1.5, 3.2 ± 2.8 and 3.4 ± 1.5 at one day, one month, two months and three months after the MRgFUS treatment, respectively. Conclusion: We demonstrated that with the appropriate QA procedures, MRgFUS is a safe, effective and noninvasive treatment modality for palliation of bone metastases.

  11. Nd:YAG Laser Treatment for Keloids and Hypertrophic Scar/span>s: An Analysis of 102 Cases

    Science.gov (United States)

    Koike, Sachiko; Akaishi, Satoshi; Nagashima, Yuki; Dohi, Teruyuki; Hyakusoku, Hiko

    2014-01-01

    Background: The present retrospective cohort study was performed to determine the efficacy of contact-mode 1064 nm neodymium-yttrium-aluminum-garnet (Nd:YAG) laser laser for keloids and hypertrophic scar/span>s. The indication and limitations of this modality are discussed. Methods: The cohort consisted of 102 consecutive Japanese patients (23 males and 79 females) with keloids and hypertrophic scar/span>s for more than 1 year. They were treated every 3–4 weeks for 1 year with a long-pulsed 1064 nm Nd:YAG laser (Cutera, Brisbane, Calif.) in contact mode. Thirty-eight patients had hypertrophic scar/span>s and 64 had keloids. The scars were evaluated before the treatment commenced and 1 month after the last session by using the Japan Scar Workshop Scar Scale 2011. Recurrence was assessed at 6 months after the termination of treatment. Results: The average total Japan Scar Workshop score of the keloid and hypertrophic scar region groups dropped significantly after 1 year of treatment compared with before treatment (all P hypertrophic scar/span>s or keloids deteriorated. However, 3 of the 34 anterior chest keloids (8.8%) did not respond. The following recurrence rates were observed 6 months after stopping laser treatment: 1 of the abdomen hypertrophic scar/span>s (4%), 18 of the anterior chest keloids (52.9%), 5 of the upper arm keloids (35.7%), and 4 of the scapula keloids (25%). Conclusions: Hypertrophic scar/span>s responded significantly better to 1064 nm Nd:YAG laser treatment than keloids. However, keloid recurrence occurred when there was remaining redness and induration, even if only a small part of the scar was affected. PMID:25587506

  12. Percutaneous radiofrequency ablation in painful bone metastases

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    German Garabano

    2015-09-01

    Full Text Available Backgraund There are different treatment for painful bone metastases (mtts, with different results. CT-guided Percutaneous Radiofrequency Ablation (CT-PRA is one of them. The pupose of this retrospective study was to assess the initial results using this methods, focusing on pain relief, showing details of the surgical technique. Methods 18 patients with an average age of 59.2 years and 15 months follow-up were treated. Nine mtts were located in the femur, 4 dorsal / lumbar spine, 3 in scapula and 2 in Iliac. The Mtts origin were Breast Ca 7 cases, lung in 4, Kidney in 4 and 3 in Thyroid. The rachis mtts were found at more than 10mm of the medullary cavity and mtts of long bones showed low risk of fracture. Lesions >3cm were treated whit CT-PRA  using Valleylab Rita needle and these <3cm with CoolTip needle. Pain was assessed by Visual Analog Scale (VAS preoperatively, at 2, 7 and 30 days, and then at 3 and 6 months. Results Preoperative pain score was 8.33 on average. At 7 days of ablatión de VAS score was 5 on average and at 30 days was 2 points. After at 3 and 6 months de VAS average was 1. This method had excellent patients tolerance and no complications. There were two recurrences which underwent endoprosthesis unconventional proximal femur and knee respectively, evolving favorably. Conclusion CT-guided APRF impresses a promising, simple and effective tool in the treatment of painfull bone mtts, achieving excellent pain control with good tolerance by the patient.

  13. Mechanisms of traumatic shoulder injury in elite rugby players

    Science.gov (United States)

    Crichton, James; Jones, Doug R; Funk, Lennard

    2012-01-01

    Background Shoulder injuries in rugby players are common, but the mechanisms of injury are less well understood. This study aims to elucidate common mechanisms of injury and identify the patterns of injury they produce. Materials and methods Twenty-four elite rugby players, referred to the senior author for diagnosis and management of shoulder injuries, were selected. Videos of the injuries were independently reviewed by rugby-medical experts to describe the mechanisms of injury. The mechanisms reported were collated and analysed to determine the level of agreement between reviewers and conclude an overall description of injury mechanisms. Results The authors identified three mechanisms of shoulder injury from the video analysis. These are the ‘Try-Scorer’, characterised by hyperflexion of the outstretched arm such as when scoring a try; the ‘Tackler’, extension of the abducted arm behind the player while tackling; and the ‘Direct Impact’, a direct blow to the arm or shoulder when held by the side in neutral or slight adduction. The Try Scorer and Tackler mechanisms both involve a levering force on the glenohumeral joint (GHJ). These mechanisms predominantly cause GHJ dislocation, with Bankart, reverse Bankart and superior labrum anterior–posterior tears. The Try-Scorer Mechanism also caused the majority (83%) of rotator cuff tears. The Direct Hit mechanism resulted in GHJ dislocation and labral injury in 37.5% of players and was most likely to cause acromioclavicular joint dislocation and scapula fractures, injuries that were not seen with the other mechanisms. Conclusion Greater understanding of the mechanisms involved in rugby shoulder injury is useful in understanding the pathological injuries, guiding treatment and rehabilitation and aiding the development of injury-prevention methods. PMID:22510645

  14. Variability of measurements of sweat sodium using the regional absorbent-patch method.

    Science.gov (United States)

    Dziedzic, Christine E; Ross, Megan L; Slater, Gary J; Burke, Louise M

    2014-09-01

    There is interest in including recommendations for the replacement of the sodium lost in sweat in individualized hydration plans for athletes. Although the regional absorbent-patch method provides a practical approach to measuring sweat sodium losses in field conditions, there is a need to understand the variability of estimates associated with this technique. Sweat samples were collected from the forearms, chest, scapula, and thigh of 12 cyclists during 2 standardized cycling time trials in the heat and 2 in temperate conditions. Single measure analysis of sodium concentration was conducted immediately by ion-selective electrodes (ISE). A subset of 30 samples was frozen for reanalysis of sodium concentration using ISE, flame photometry (FP), and conductivity (SC). Sweat samples collected in hot conditions produced higher sweat sodium concentrations than those from the temperate environment (P = .0032). A significant difference (P = .0048) in estimates of sweat sodium concentration was evident when calculated from the forearm average (mean ± 95% CL; 64 ± 12 mmol/L) compared with using a 4-site equation (70 ± 12 mmol/L). There was a high correlation between the values produced using different analytical techniques (r2 = .95), but mean values were different between treatments (frozen FP, frozen SC > immediate ISE > frozen ISE; P sweat sodium concentration estimates differed depending on the number of sites included in the calculation. Environmental testing conditions should be considered in the interpretation of results. The impact of sample freezing and subsequent analytical technique was small but statistically significant. Nevertheless, when undertaken using a standardized protocol, the regional absorbent-patch method appears to be a relatively robust field test.

  15. Effect of induced metabolic alkalosis on sweat composition in men.

    Science.gov (United States)

    Patterson, M J; Galloway, Stuart D R; Nimmo, M A

    2002-01-01

    To determine whether induced metabolic alkalosis affects sweat composition, 10 males cycled for 90 min at 62.5 +/- 1.3% peak oxygen uptake, on two separate occasions. Subjects ingested either empty capsules (placebo) or capsules containing NaHCO3- (0.3 g kg-1 body mass; six equal doses) over a 2-h period, which commenced 3 h prior to exercise. Arterialized-venous blood samples were drawn prior to and after 15, 30, 60 and 90 min of exercise. Sweat was aspirated at the end of exercise from a patch located on the right scapula region. NaHCO3- ingestion elevated blood pH, [HCO3-] and serum [Na+], whereas serum [Cl-] and [K+] were reduced, both at rest and during exercise (P Sweat pH was greater in the NaHCO3- trial (6.24 +/- 0.18 vs. 6.38 +/- 0.18; P sweat [Na+] (49.5 +/- 4.8 vs. 50.2 +/- 4.3 mEq L-1), [Cl-] (37.5 +/- 5.1 vs. 39.3 +/- 4.2 mEq L-1) and [K+] (4.66 +/- 0.19 vs. 4.64 +/- 0.34 mEq L-1) did not differ between trials (P > 0.05). Sweat [HCO3-] (2.49 +/- 0.58 vs. 3.73 +/- 1.10 mEq L-1) and [lactate] (8.92 +/- 0.79 vs. 10.51 +/- 0.32 mmol L-1) tended to be greater after NaHCO3- ingestion, although significance was not reached (P=0.07 and P=0.08, respectively). These data indicate that induced metabolic alkalosis can modify sweat composition, although it is unclear whether the secretory coil, reabsorptive duct, or both are responsible for this alteration.

  16. The reproducibility of closed-pouch sweat collection and thermoregulatory responses to exercise-heat stress.

    Science.gov (United States)

    Hayden, Gavin; Milne, Helen C; Patterson, Mark J; Nimmo, Myra A

    2004-05-01

    Seven active male subjects cycled for 60 min at 29.5 (0.8)% peak work rate on three separate occasions in a hot environmental condition [36.0 (0.1) degrees C, 60 (1)% relative humidity] in order to determine the reproducibility of a closed-pouch sweat collection technique for sweat composition at the scapula, forearm and thigh. To confirm that sweat composition was not influenced by between-trial variations in sudomotor drive, local sweat rate, whole-body sweat rate, heart rate (HR), rectal temperature (T(re)) and mean skin temperature (T(sk)) responses were also measured, consequently reproducibility was also established for these variables. Sweat composition did not differ among trials, with the mean coefficients of variation (CVs) for sweat [Na(+)], [K(+)] and pH being 10.4 (7.4)%, 8.1 (6.5)% and 1.3 (1.1)%, respectively. Local sweat rates did not differ among the three trials (P>0.05) although whole-body sweat rate was reduced in the third trial (Psweat rates, respectively. Between-trial differences were not evident for T(re), T(sk) or HR with mean CVs of 0.3 (0.2)%, 0.7 (0.6)% and 3.9 (1.7)%, respectively, although HR tended to be greater in the first trial ( P=0.08). It is proposed that moderate variations in sweat composition were influenced by variations in the local sweat rate, which were induced by application of the pouch.

  17. Glenoid version by CT scan: an analysis of clinical measurement error and introduction of a protocol to reduce variability

    Energy Technology Data Exchange (ETDEWEB)

    Bunt, Fabian van de [VU University Medical Center, Amsterdam (Netherlands); Pearl, Michael L.; Lee, Eric K.; Peng, Lauren; Didomenico, Paul [Kaiser Permanente, Los Angeles, CA (United States)

    2015-11-15

    Recent studies have challenged the accuracy of conventional measurements of glenoid version. Variability in the orientation of the scapula from individual anatomical differences and patient positioning, combined with differences in observer measurement practices, have been identified as sources of variability. The purpose of this study was to explore the utility and reliability of clinically available software that allows manipulation of three-dimensional images in order to bridge the variance between clinical and anatomic version in a clinical setting. Twenty CT scans of normal glenoids of patients who had proximal humerus fractures were measured for version. Four reviewers first measured version in a conventional manner (clinical version), measurements were made again (anatomic version) after employing a protocol for reformatting the CT data to align the coronal and sagittal planes with the superior-inferior axis of the glenoid, and the scapular body, respectively. The average value of clinical retroversion for all reviewers and all subjects was -1.4 (range, -16 to 21 ), as compared to -3.2 (range, -21 to 6 ) when measured from reformatted images. The mean difference between anatomical and clinical version was 1.9 ± 5.6 but ranged on individual measurements from -13 to 26 . In no instance did all four observers choose the same image slice from the sequence of images. This study confirmed the variation in glenoid version dependent on scapular orientation previously identified in other studies using scapular models, and presents a clinically accessible protocol to correct for scapular orientation from the patient's CT data. (orig.)

  18. Glenohumeral joint motion after subscapularis tendon repair: an analysis of cadaver shoulder models.

    Science.gov (United States)

    Sano, Teiichi; Aoki, Mitsuhiro; Tanaka, Yoshitaka; Izumi, Tomoki; Fujimiya, Mineko; Yamashita, Toshihiko

    2014-05-23

    As for the surgical treatment of the rotator cuff tears, the subscapularis tendon tears have recently received much attention for the mini-open or arthroscopic repair. The results of surgical repair for the subscapularis tendon tear are satisfactory, but the range of external rotation is reported to be restricted after the repair. The purpose of this study was to evaluate the range of glenohumeral joint motion after repairs of various sizes of subscapularis tendon tears. Using eight fresh frozen human cadaveric shoulders (mean age at death, 81.5 years), three sizes of subscapularis tendon tear (small, medium, and large) were made and then repaired. With the scapula fixed to the wooden jig, the end-range of glenohumeral motion was measured with passive movement applied through 1.0-Nm torque in the directions of scapular elevation, flexion, abduction, extension, horizontal abduction, and horizontal adduction. The passive end-ranges of external and internal rotation in various positions with rotational torque of 1.0 Nm were also measured. Differences in the ranges among the three type tears were analyzed. As tear size increased, range of glenohumeral motion in horizontal abduction after repair decreased gradually and was significantly decreased with the large size tear (P size in every glenohumeral position. The prominent decrease in external rotation (around 40° reduction from intact shoulders) was observed in shoulders after repair of large size tear at 30° to 60° of scapular elevation and abduction. As the size of the subscapularis tendon tear increased, the passive ranges of horizontal abduction and external rotation of the glenohumeral joint after repair decreased significantly. In shoulders with a subscapularis tendon tear, it is necessary to consider the reduction of external rotation depending on tear size.

  19. Cervical Spine Injuries: A Whole-Body Musculoskeletal Model for the Analysis of Spinal Loading

    Science.gov (United States)

    Holsgrove, Timothy P.; Preatoni, Ezio; Gill, Harinderjit S.; Trewartha, Grant

    2017-01-01

    Cervical spine trauma from sport or traffic collisions can have devastating consequences for individuals and a high societal cost. The precise mechanisms of such injuries are still unknown as investigation is hampered by the difficulty in experimentally replicating the conditions under which these injuries occur. We harness the benefits of computer simulation to report on the creation and validation of i) a generic musculoskeletal model (MASI) for the analyses of cervical spine loading in healthy subjects, and ii) a population-specific version of the model (Rugby Model), for investigating cervical spine injury mechanisms during rugby activities. The musculoskeletal models were created in OpenSim, and validated against in vivo data of a healthy subject and a rugby player performing neck and upper limb movements. The novel aspects of the Rugby Model comprise i) population-specific inertial properties and muscle parameters representing rugby forward players, and ii) a custom scapula-clavicular joint that allows the application of multiple external loads. We confirm the utility of the developed generic and population-specific models via verification steps and validation of kinematics, joint moments and neuromuscular activations during rugby scrummaging and neck functional movements, which achieve results comparable with in vivo and in vitro data. The Rugby Model was validated and used for the first time to provide insight into anatomical loading and cervical spine injury mechanisms related to rugby, whilst the MASI introduces a new computational tool to allow investigation of spinal injuries arising from other sporting activities, transport, and ergonomic applications. The models used in this study are freely available at simtk.org and allow to integrate in silico analyses with experimental approaches in injury prevention. PMID:28052130

  20. Fracture occurrence from radionuclides in the skeleton

    Energy Technology Data Exchange (ETDEWEB)

    Lloyd, R.D.; Taylor, G.N.; Miller, S.C.

    2000-06-01

    Because skeletal fractures were an important finding among persons contaminated with {sup 226}Ra, experience with fractures among dogs in the colony was summarized to determine the projected significance for persons contaminated with bone-seeking radionuclides. Comparison by Fisher's Exact Test of lifetime fracture occurrence in the skeletons of beagles injected as young adults suggested that for animals given {sup 226}Ra, {sup 228}Ra, {sup 228}Th, or {sup 239}Pu citrate, there was probably an excess over controls in fractures of the ribs, leg bones, spinous processes, and pelvis (os coxae) plus the mandible for dogs given {sup 226}Ra and the scapulae for dogs given {sup 228}Ra or 228 Th. Regression analysis indicated that significantly elevated fracture occurrence was especially notable at the higher radiation doses, at about 50 Gy average skeletal dose for {sup 239}Pu, 140 Gy for {sup 226}Ra, about 40 Gy for {sup 228}Ra, and more than 15 Gy for {sup 228}Th. The average number of fractures per dog was significantly elevated over that noted in controls for the highest radiation doses of {sup 239}Pu and {sup 226}Ra and for the higher doses of {sup 228}Ra and {sup 228}Th. For those dogs given {sup 90}Sr citrate, there was virtually no important difference from control beagles not given radionuclides, even at group mean cumulative skeletal radiation doses up to 101 Gy. Because of a large proportion of dogs with fractures that died with bone malignancy (even at dosage levels lower than those exhibiting an excess average number of fractures per dog), they conclude that fracture would not be an important endpoint at lower levels of plutonium contamination in humans such as would be expected to occur from occupational or environmental exposure.