China
Africa
Explore chapters and articles related to this topic
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
Intra-articular and peri-articular pain can be caused by myriad of conditions. Some are generic and can affect any joint, such as inflammatory arthritis. Some are specific to the processes within a particular joint or region, for example: Shoulder; pain commonly caused by the process of impingement – injection to the subacromial bursa.Elbow; pain commonly caused by ‘tennis’ or ‘golfer’s’ elbow – injection into the common extensor or flexor origins respectively.Wrist; pain commonly caused by de Quervain’s tenosynovitis – injection into the tendon sheath of the first extensor tendon.Hip; pain commonly caused by trochanteric bursitis – injection into the region of the trochanteric bursa.
The disease: chronic myofascial pain
Published in Kirsti Malterud, Steinar Hunskaar, Chronic Myofascial Pain, 2018
Kirsti Malterud, Steinar Hunskaar
Patients with myofascial pain often complain about pain in both shoulders which could be due to local tenosynovitis or bursitis. Patients with CMP are predisposed to such conditions, and long-standing tenosynovitis predisposes to more widespread and chronic pain. Inflammation of the subacromial bursa or rotator cuff tendons may cause a ‘painful arc’ during abduction of the shoulder. The initial movement is painless, but from 90° the movement causes pain. When the arm reaches full abduction the pain ceases. Inflammation of the infraspinatus tendon is tested by resisted external rotation giving rise to pain. Inflammation of the subscapularis tendon is performed by resisted internal rotation of the shoulder, giving rise to more pain in the subacromial region. Inflammation of the supraspinatus tendon is performed by resisted abduction thereby increasing the pain felt in the subacromial region.
History taking and clinical examination in musculoskeletal disease
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
This is impairment of rotator cuff function within the subacromial bursa. It may lead to inflammation (tendinitis) or a partial or full-thickness tear. Impingement is characterised by pain and weakness on abduction and internal rotation.
Bilateral ultrasound findings in patients with unilateral subacromial pain syndrome
Published in Physiotherapy Theory and Practice, 2022
Anna Eliason, Marita Harringe, Björn Engström, Kerstin Sunding, Suzanne Werner
During the US examinations the patients were seated on a swivel chair with a low backboard, and the examiner was standing behind the patient. The tendons of supraspinatus, subscapularis, infraspinatus and the long head of biceps were visualized in both a longitudinal and transversal plane. Both the tendons of subscapularis and infraspinatus were evaluated dynamically during internal and external rotation with the forearm in supination and the elbow in 90° of flexion. The acromioclavicular joint was evaluated in terms of possible sprains and osteoarthritis. The supraspinatus tendon and the subdeltoid/subacromial bursae were evaluated dynamically during abduction with the arm slightly internally rotated. The supraspinatus tendon was examined with the patient’s palm placed on the posterior region of the iliac wing with the elbow flexed and directed posteriorly. The US examiner was blinded to arm dominance, the patient´s symptom as well as to the purpose of the study.
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
A distinct cluster of MRI findings (tears of the supraspinatus, biceps and subscapularis and AC arthrosis) was found in 49% of the participants. This cluster has not been described previously for the studied population. However, besides supraspinatus tears, also subscapularis tears with concomitant lesions of the long head of the biceps have previously been reported in the able bodied population.37 The four pathologies of the cluster are related. Fatiguing wheelchair propulsion results in acute changes in the supraspinatus and biceps tendon, which might be related to tendinopathy.30 In combination with an existing AC arthrosis and subacromial osteophytes that might impinge the tendons, irritation of the subacromial bursa and ultimately rotator cuff tears can follow.
Image guidance used for large joint and bursa injections; a survey study
Published in The Physician and Sportsmedicine, 2020
Daniel M. Cushman, Jacob Christiansen, Melissa Kirk, Nathan D. Clements, Shellie Cunningham, Masaru Teramoto, Zachary L. McCormick
Needle placement accuracy has routinely been demonstrated to be higher for image-guided injections [14,15], and clinical efficacy also appears to be beneficial in some studies. Subacromial bursa injections show mixed clinical improvement between the two techniques but generally favor ultrasound [16–22]. Knee injections [23] have also improved clinical outcomes, while glenohumeral injections have shown improved clinical outcomes [24] and accuracy [14,24,25]. Greater trochanteric injections, conversely, have not shown superiority with image guidance [26]. Although accuracy is much higher for the hip [27] and pes anserine bursa [28], to the authors knowledge, no studies have examined clinical outcomes based on image guidance for these joints/bursae. While both accuracy and clinical effectiveness may be influenced by the use of image guidance during various injections, additional time and equipment are required, which may influence usage patterns. Furthermore, patient populations may dictate choice of image guidance – if a practitioner mostly sees athletic, thin patients, he or she may be more likely to use palpation guidance compared to the practitioner who sees larger patients, who often have more challenging injections. This survey unfortunately did not assess this point, though it is hard to quantify a practitioner’s patient population in a question or two.