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Musculoskeletal system
Published in A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha, Clark’s Procedures in Diagnostic Imaging: A System-Based Approach, 2020
A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha
Ultrasound has been established as an effective imaging method in the MSK system. Besides the non-ionising nature of ultrasound, the main advantages include the ability to perform dynamic examinations, to conduct side-by-side comparisons on the spot, and to guide interventions such as fluid aspirations or cavity injections. The shoulder joint is a synovial ball-and-socket joint made up of the scapula’s glenoid cavity and the articular surface of the humeral head. It has a wide range of movements and relies on the rotator cuff muscles support for stability.
Upper Limb
Published in Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno, Understanding Human Anatomy and Pathology, 2018
Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno
The proximal portion of the humerus includes several gross features: head of the humerus, anatomical neck of the humerus, surgical neck of the humerus; processes for muscle attachment such as the greater tubercle of the humerus, lesser tubercle of the humerus, and deltoid tuberosity; and grooves for passage of tendons and vessels such as the humeral intertubercular sulcus (bicipital groove), and radial groove (Plate 4.7). As their names indicate, the anatomical neck is the one that can be more easily seen in gross observation of dry bones, surrounding the articular surface, while the surgical neck is the one most at risk of fracture. The articulation between the head of the humerus and the glenoid cavity of the scapula is called the glenohumeral joint or shoulder joint. The glenohumeral ligaments connecting the humerus and scapula strengthen the anterior wall of the capsule of the shoulder joint. The shoulder joint allows the humerus to be highly mobile: It can be flexed, extended, adducted, abducted, medially (internally) rotated, and externally (laterally) rotated (see Box 4.3).
Arthroscopic HAGL and RHAGL repair
Published in Andreas B. Imhoff, Jonathan B. Ticker, Augustus D. Mazzocca, Andreas Voss, Atlas of Advanced Shoulder Arthroscopy, 2017
Stephen Thon, Felix H. Savoie, Michael J. O'Brien
The glenohumeral ligaments provide the attachment of the glenoid to the humerus via the glenoid labrum. The combination of the labrum and capsular ligaments acts to deepen the socket of the glenoid cavity and provide increased stability to the shoulder girdle. The IGHL complex is made of three discrete sections: the anterior band, the posterior band, and the axillary pouch.14–16 It acts as the primary restraint to anterior, posterior, and inferior glenohumeral translation when the shoulder is in 45°–90° of abduction.14,15 The combination of the three creates a suspensory complex to the inferior portion of the glenohumeral joint, providing increased shoulder stability to anterior and inferior translation. The primary action of the IGHL varies with arm position. In 90° of abduction and external rotation, the anterior band provides the primary restraint to shoulder subluxation, whereas the posterior band provides primary restraint with the arm positioned in flexion and internal rotation.11,15
Comparison of low level and high power laser combined with kinesiology taping on shoulder function and musculoskeletal sonography parameters in subacromial impingement syndrome: a Randomized placebo-controlled trial
Published in Physiotherapy Theory and Practice, 2022
Zohreh Zaki, Roya Ravanbod, Marc Schmitz, Kambiz Abbasi
Lifetime prevalence of the shoulder pain ranges from 6.7 to 66.7% and overall prevalence of the rotator cuff abnormalities ranges from 9.7 to 62% and increased in an age-dependent manner (Ghosh, 2012; Teunis, Lubberts, Reilly, and Ring, 2014). Structures in the subacromial space impinge against the coracoacromial arch in the subacromial impingement syndrome (SAIS) (Mackenzie, Herrington, Horlsey, and Cools, 2015; Neer, 1972). Various factors may influence on the existing structures in the subacromial space. Impaired muscle function of the shoulder girdle including supraspinatus and deltoid could be a leading cause of SAIS (Graichen et al., 1999b; Kase, Wallis, and Kase, 2013). Biomechanically, during shoulder abduction deltoid roles up the humeral head while rotator cuff muscles glide the head down to keep it centered in the glenoid cavity. Narrowing of the subacromial space inevitably occurs when deltoid momentum excels and increases upward translation of the humeral head, simultaneously with rotator cuff impairment (Graichen et al., 1999a).
Longitudinal assessments of strength and dynamic balance from pre-injury baseline to 3 and 4 months after labrum repairs in collegiate athletes
Published in Physiotherapy Theory and Practice, 2022
Ling Li, Brenna K. McGuinness, Jacob S. Layer, Yu Song, Megan A. Jensen, Boyi Dai
The glenoid labrum is a fibrous rim that surrounds the glenoid cavity to stabilize the glenohumeral joint. Certain labrum injuries may require surgical repairs for specific populations (Dodson and Altchek, 2009). In the general population, the superior labrum from anterior to posterior (SLAP) repairs represent approximately 9.4% of total shoulder surgeries (Weber, Martin, Seiler, and Harrast, 2012). In National Collegiate Athletics Association (NCAA) athletes, SLAP tears and other non-SLAP labrum tears are the two upper extremity injuries mostly requiring surgical treatment (Gil, Goodman, DeFroda, and Owens, 2018). SLAP tears comprise over 17% of shoulder surgeries, while non-SLAP labrum tears are a portion of surgical treatment to shoulder instability that makes up more than 60% of shoulder surgeries (Gil, Goodman, DeFroda, and Owens, 2018).
A comparison of isokinetic rotator cuff performance in wheelchair basketball athletes vs. non-athletes with spinal cord injury
Published in The Journal of Spinal Cord Medicine, 2021
Poliane Silva Freitas, Tiago Silva Santana, Lucas Sartori Manoel, Felipe de Souza Serenza, Marcelo Riberto
Internal rotators and ER relationship of shoulder rotators in both groups registered muscular balance, indicating the similarity between athletes and non-athletes and no influence of WB on ER/IR strength ratio. The muscular balance indicates that the internal rotators were stronger than external rotators, which may be explained by the absence of shoulder pain before the spinal cord injury.1,9,19 Surface electromyography and kinematic analysis showed high demands of muscular activities in the shoulder griddle due to the weight discharge of the individual in the wheelchair.15 To prevent displacement of the humeral head and to keep it centralized in the glenoid cavity, a muscle balance of the internal and external rotators is mandatory. Once shoulder joint is subject to a high load during the movement of the wheelchair,26,27 muscle overload can lead to imbalance.15,28,29 Future studies should assess individuals with a wider range of neurological function to clarify the role of injury level on shoulder strength.