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The shoulder
Published in David Silver, Silver's Joint and Soft Tissue Injection, 2018
In any form of tendinosis: Only diagnose if there is pain on resisted movement.Pain in the absence of movement may imply other pathology.
Tendinopathy
Published in Kohlstadt Ingrid, Cintron Kenneth, Metabolic Therapies in Orthopedics, Second Edition, 2018
Joint laxity or hypermobility may be an underlying cause of tendinosis. The reason for this is that muscles that are involved in stabilizing a joint that is hypermobile can be overworked, leading to trigger points or overuse of a tendon. For example, if there is glenohumeral laxity in a shoulder joint, rotator cuff and biceps tendinopathy are more likely to develop over time.
Foot and ankle
Published in Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie, Bailey & Love's Short Practice of Surgery, 2018
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie
Non-insertional and insertional tendinosis are frequent, often related to overuse and are usually managed non-operatively. Shockwave therapy is a recent addition to the armoury. Steroid injections may rupture the Achilles and are discouraged, but high volume saline, dry-needling and sclerosant injections have all been described. Surgery for non-insertional tendinosis has moderate success. Minimally invasive excision of the prominent posterolateral corner of the calcaneum or reshaping osteotomy forms the mainstay of modern surgical techniques for insertional problems but both conditions have a high failure rate with surgery.
Prevalence of asymptomatic radiological findings in the groin region: a systematic review
Published in The Physician and Sportsmedicine, 2020
Jonas Massa, Frederik Vanstraelen, Stijn Bogaerts, Koenraad Peers
To correctly diagnose these groin injuries, in addition to a thorough history taking and clinical examination, imaging (in particular ultrasound or MRI) is a frequently used tool to further specify the diagnosis. However, like Docking et al. concluded in their narrative review about imaging of tendinopathies, imaging does not tell the entire story [5]. Imaging needs to be placed in the context of the overall clinical picture. For example, tendon structure changes (e.g. fiber disorganization and neovascularisation) are radiologically diagnosed as ‘tendinosis’ [5], but tendinosis does not always have a clinical significance (‘tendinopathy’). Girish et al. showed that supraspinatus tendinosis on ultrasound of the shoulder was seen in 39% of asymptomatic men and subscapularis tendinosis in 25% [6]. Therefore, it is important that clinicians are aware of the occurrence of asymptomatic findings. Heerey et al. recently conducted a systematic review about the asymptomatic prevalence of hip-related pathologies [7]. They included 29 studies reporting on the prevalence of hip-related pathologies in their review, which identified moderate evidence of a labral tear prevalence of 54% (95% CI 41% to 66%) and a cartilage defect prevalence of 12% (95% CI 7% to 21%) in asymptomatic individuals.
Long-standing groin pain in an elite athlete: usefulness of ultrasound in differential diagnosis and patient education – a case report
Published in European Journal of Physiotherapy, 2018
Kingsley S. R. Dhinakar, Anjanette Cantoria Lacaste
The radiation of pain on the inner thigh along the distribution of obturator nerve may also suggest injury of neurogenic in origin. This can be supported by the reduced muscle activity of left hip adductors on surface EMG findings and physical assessments. The nature of sport participated by the patient and the repetitive stresses placed on the above structures may have contributed to tendinitis. The anterior branch of the obturator nerve can be potentially entrapped by fascia as it traverses the adductor brevis muscle. This may have started as pain of an inflammatory nature and gradually developed to consistent exercise-related pain. Hip adductor-related groin pain may have developed that can potentially lead to fibrosis and adhesion resulting to nerve entrapment.
Appropriate care for orthopedic patients: effect of implementation of the Clinical Practice Guideline for Diagnosis and Treatment of Subacromial Pain Syndrome in the Netherlands
Published in Acta Orthopaedica, 2019
Egbert J D Veen, Martin Stevens, Cornelis T Koorevaar, Ron L Diercks
A clinical practice guideline for diagnosis and treatment of subacromial pain syndrome based on the available scientific evidence was created by the Dutch Orthopedic Society in 2012. The major recommendations were: SAPS should preferably be treated nonoperatively; patients who do not respond to exhaustive nonoperative treatment can be offered surgery; asymptomatic rotator cuff tears should not be treated surgically; when surgical repair of symptomatic rotator cuff tears is considered, the size of the tear, the condition of the muscles, and age and activity level of the patient are important factors to consider in the context of patient expectations; surgical treatment of tendinosis calcarea is not recommended.