MRI and Ultrasound
Harry Griffiths in Musculoskeletal Radiology, 2008
This chapter begins with the sagittal sequences moving from lateral to medial, discusses the coronal sequences going from posterior to anterior, and describes the axial sequences and moving from the top to the bottom. The majority of pelvic and hip magnetic resonance imagings are done to look for either a fracture or avascular necrosis although soft tissue injury such as muscle tears and hematomas are also fairly common indications. Ultrasound is also a useful imaging modality for assessing extremity soft tissue abnormalities in the emergency room patient, including retained foreign bodies and abscesses. The posterior cruciate ligament (PCL) has very low intensity on all sequences because of its tight fibrous tissue construction. Tears of the PCL are rarely complete and are usually only associated with a knee dislocation. The Medial Collateral Ligament originates from the upper surface of the medial femoral condyle. The muscle usually ends in four to six separate tendons before becoming part of the rotator cuff.
Neuroanatomy
E Glucksman in MCQs in Neurology and Neurosurgery for Medical Students, 2022
This chapter provides that the themed presentation encourages quick, focused study and detailed answers aid comprehension and encourages familiarity with each topic with essential diagrams, colour images and sample MRIs. The dorsal scapular nerve supplies the rhomboid muscles and levator scapulae muscle. The suprascapular nerve supplies supraspinatus and infraspinatus (two of the rotator cuff muscles; teres minor is supplied by the axillary nerve and subscapularis by the upper and lower subscapular nerves). The axillary nerve supplies the deltoid muscles; this nerve is commonly injured in shoulder dislocations; always check the sensation over the ‘regimental badge area’ before attempting shoulder reduction to assess if damage has already occurred. The sinus itself receives a venous blood supply from the ophthalmic vein. Thus, the cavernous sinus is unique since an artery passes through a venous structure.
Inflammatory Responses Acquired Following Environmental Exposures Are Involved in Pathogenesis of Musculoskeletal Pain
Kohlstadt Ingrid, Cintron Kenneth in Metabolic Therapies in Orthopedics, Second Edition, 2018
Inflammation from innate immune responses dominates the illnesses created by biotoxins. Innate immunity can heal, but can also become the overwhelming source of illness caused by exuberant host responses. Inflammation from innate immune mediators does not quickly come to mind thinking about "wear and tear" arthritis or overuse syndromes like rotator cuff injuries or tennis elbow. Curiously, the same inflammatory mediators involved in response to adverse environmental exposures also play major roles in musculoskeletal pain. The fundamental elements of chronic inflammatory response syndromes (CIRS) also have importance for musculoskeletal pain and musculoskeletal injury, both as a whole and as individual effectors. The application of genomics to complex human illness is in its early stages. Already, tremendous advances in medicine and science have resulted from transcriptomics.
Electromagnetic transduction therapy and shockwave therapy in 86 patients with rotator cuff tendinopathy: A prospective randomized controlled trial
Published in Electromagnetic Biology and Medicine, 2018
Tim Klüter, André Krath, Martin Stukenberg, Hans Gollwitzer, Norbert Harrasser, Karsten Knobloch, Nicola Maffulli, Jörg Hausdorf, Ludger Gerdesmeyer
Rotator cuff (RC) tendinopathy is the most common cause of shoulder pain. The effectiveness of electromagnetic transduction therapy (EMTT), a high energetic pulsed electromagnetic field therapy in this field has not been tested yet in combination with extracorporeal shock wave therapy (ESWT). A total of 86 patients with RC tendinopathy were randomized to undergo three sessions of ESWT in combination with 8 sessions of EMTT or sham-EMTT. Both intervention groups experienced significant and clinical relevant decrease of pain at all follow-up visits, and the functionality of the shoulder evaluated by the Constant Murley score increased significantly as well. The combination of EMTT + ESWT produced significantly greater pain reduction in the visual analogue scale compared to ESWT with sham-EMTT after 24 weeks, during which the Constant Murley score improved significantly when the combination of ESWT and EMTT was employed. In patients with RC tendinopathy, electromagnetic transduction therapy combined with extracorporeal shock wave therapy significantly improves pain and function compared to ESWT with sham-EMTT.
MRI of symptomatic and asymptomatic full-thickness rotator cuff tears
Published in Acta Orthopaedica, 2010
Stefan Moosmayer, Rana Tariq, Morten G Stiris, Hans-Jørgen Smith
Background and purpose Why some full-thickness rotator cuff tears are symptomatic and others are asymptomatic is not understood. By comparing MRI findings in symptomatic and asymptomatic tears, we wanted to identify any tear characteristics that differed between groups. Patients and methods 50 subjects with asymptomatic and 50 subjects with symptomatic full-thickness tears were examined by MRI. Tear characteristics including tear size, tear location, the condition of the long head of the biceps, atrophy, and fatty degeneration of the muscles were compared between groups. Results Single factor logistic regression analysis showed that there were statistically significant associations between symptoms and tear size exceeding 3 cm in the medial-lateral plane, positive tangent sign, and fatty degeneration exceeding grade 1 of the supraspinatus and infraspinatus muscles. Interpretation We found associations between the symptomatic status of a rotator cuff tear and MRI-derived tear characteristics. The causal relationships are unclear.
Labrum and rotator cuff injuries in the throwing athlete
Published in The Physician and Sportsmedicine, 2015
Travis J. Menge, Ian R. Byram, Robert E. Boykin, Brandon D. Bushnell
The large amount of force imparted across the shoulder during the act of throwing makes the glenohumeral joint highly susceptible to injury in the athlete performing overhead throwing motions. The bony incongruity of the shoulder enables greater range of motion than any other joint in the body, but it also results in significant strain on the surrounding soft tissues during the throwing motion. Throwers can present with acute injuries, but more commonly they suffer from chronic overuse conditions resulting from repetitive overload. Proper management requires early recognition with treatment directed toward the athlete’s safe return to sports. Failure to institute an appropriate management strategy may result in significant complications, including prolonged disability, progression of symptoms, and further injury. We discuss the functional anatomy, pathophysiology, clinical presentation, evaluation, and treatment of common injuries of the glenoid labrum and rotator cuff in the overhead throwing athlete.