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Examination of Pediatric Shoulder
Published in Nirmal Raj Gopinathan, Clinical Orthopedic Examination of a Child, 2021
The patient is asked to forward elevate and internally rotate the shoulders in the plane of the scapula with the thumbs pointing toward the floor. This is known as “empty can” position. If the patient has pain or weakness on resistance to abduction, it is a positive test result. This would be indicative of a tear of the supraspinatus tendon or neuropathy of the suprascapular nerve.
Biotensegrity
Published in Sahar Swidan, Matthew Bennett, Advanced Therapeutics in Pain Medicine, 2020
Once information is gained from these post-injection tests, autologous leukocyte poor platelet-rich plasma (LP-PRP) is injected at the same locations. The hypothesis for this patient is that the remote injury to the left flank contributed to altered scapulohumeral rhythm during weight lifting since the accident, leading to abnormal pressure/shear forces at the glenohumeral joint and supraspinatus impingement at the subacromial space. The poor coordination between the abdominal wall and upper extremity under the extreme load of more than 500 pounds allowed the weight to shift left, causing the impaction injury at the humeral head. To address both remote and recent injuries, other locations were treated with the same solutions the same day: Posterior glenohumeral joint capsule and the overlying infraspinatus tendon.Intraarticular glenohumeral joint.Junction of lower and middle trapezius near the medial scapula.Supraspinatus tendon (a small tear was confirmed during injection).Acromioclavicular joint and capsule.
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 is especially useful in the shoulder for the high incidence of rotator cuff disorders. The four rotator cuff muscles are the subscapularis muscle at the anterior aspect of the shoulder, the supraspinatus at its superior aspect and the infraspinatus and teres minor, which are situated at the posterior aspect.
MRI evaluation of shoulder pathologies in wheelchair users with spinal cord injury and the relation to shoulder pain
Published in The Journal of Spinal Cord Medicine, 2022
Ursina Arnet, Wiebe H. de Vries, Inge Eriks-Hoogland, Christian Wisianowsky, Lucas H. V. van der Woude, DirkJan H. E. J. Veeger, Markus Berger
The most common MRI finding was any grading of supraspinatus tear which has been previously reported in this population.27 Our findings that supraspinatus tear is more common than tears of other rotator cuff tendon is similar to findings from the able-bodied population.28 However, the number of partial thickness tear in our study is higher (41%) than reported in the able-bodied population (13% to 32%).28 Similar differences between persons with SCI and controls have been reported previously.29 Fatiguing wheelchair propulsion results in acute changes in the supraspinatus and biceps tendon, which may explain the high injuries presence of these tendons in our studied population.30 Previous research has shown that persons with supraspinatus tear perform functional tasks such as forward reach, pulling or upward reaching with more internal rotation of the humerus than controls.31 This altered motion could be the result of avoiding painful postures, which in turn may exposes the shoulder to impingement, particularly during higher elevation.32 Alternatively, the increased internal rotation could be caused by muscle imbalance. Deltoid and pectoral muscle may compensate the absence of a fully functional rotator cuff, which may affect glenohumeral loading and could result in further joint damage,33 such as arthrosis, which we found in 25% of the participants.
Autologous conditioned serum for degenerative diseases and prospects
Published in Growth Factors, 2021
Seyed Kazem Shakouri, Sanam Dolati, Jessica Santhakumar, Avnesh S. Thakor, Reza Yarani
ACS increased expression of all factors, including BMP-12, bFGF, and TGF-β1, after 8 weeks, except VEGF, and its use in tendon injuries could be a favorable biomolecular treatment (Heisterbach et al. 2012). Tendinopathy of the rotator cuff is the most common cause of shoulder pain in adults. ACS injection for patients with chronic pain caused by supraspinatus tendinopathy has an outstanding safety profile and shows larger improvements in shoulder pain and function than glucocorticoid injections over a 24-week period (Damjanov et al. 2018). ACS indicates an effective and well-tolerated alternative to existing therapies and has the probability to become a more recognized treatment option in rotator cuff injury and other tendinopathies (von Wehren et al. 2016).
Ultrasonographic comparison of the lateral epicondyle in wheelchair-user (and able-bodied) tennis players: A pilot study
Published in The Journal of Spinal Cord Medicine, 2021
Vivian Roy, Leah Lee, Michael Uihlein, Ishan Roy, Kenneth Lee
Manual wheelchair users are a unique population who depend on increased use of their upper extremities for mobility. As a result, they are predisposed to chronic upper extremity joint and muscle pathology. It is well-documented that increased forces are seen through the shoulder joint – using primarily the shoulder flexors for wheelchair propulsion and shoulder extensors for recovery.4 One study used ultrasound to evaluate the shoulders of elite wheelchair tennis players and found a high prevalence of rotator cuff and acromioclavicular pathology.5 A study of MRI findings in manual wheelchair users with shoulder pain revealed that supraspinatus tear was the most likely finding.6 Although extensive research clearly exists on shoulder pathology in this population, there are no prior studies investigating elbow pathology based on literature review.