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MedWorm: Bursitis



MedWorm.com provides a medical RSS filtering service. Over 7000 RSS medical sources are combined and output via different filters. This feed contains the latest news and research in the Bursitis category.



Last Build Date: Tue, 22 Mar 2016 08:26:20 +0100

 



Greater Trochanteric Pain Syndrome.

Sat, 19 Mar 2016 10:29:02 +0100

Authors: Redmond JM, Chen AW, Domb BG Abstract Patients who have lateral hip pain historically have been diagnosed with trochanteric bursitis and treated with nonsteroidal anti-inflammatory medications, corticosteroid injections, and physical therapy. Although this strategy is effective for most patients, a substantial number of patients continue to have pain and functional limitations. Over the past decade, our understanding of disorders occurring in the peritrochanteric space has increased dramatically. Greater trochanteric pain syndrome encompasses trochanteric bursitis, external coxa saltans (ie, snapping hip), and abductor tendinopathy. A thorough understanding of the anatomy, examination findings, and imaging characteristics aids the clinician in treating these patients. Open...

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Suture slippage in knotless suture anchors resulting in subacromial-subdeltoid bursitis

Sat, 19 Mar 2016 03:34:45 +0100

We present a prospectively diagnosed case of in vivo suture loosening after rotator cuff repair using a knotless bridge technique resulting in subacromial-subdeltoid bursitis. (Source: Skeletal Radiology)



High resolution ultrasonography and magnetic resonance imaging in the evaluation of tendino-ligamentous injuries around ankle joint

Thu, 17 Mar 2016 00:00:00 +0100

Conclusion US is an excellent tool for imaging soft tissue abnormalities, as it allows rapid, in-expensive detailed examination of the structures of the ankle joint. US and MRI are two complementary tools of investigation with the former being used as primary effective tool of investigation and the latter is done to confirm the diagnosis. (Source: The Egyptian Journal of Radiology and Nuclear Medicine)



Eine außergewöhnliche posttraumatische Haglund-Exostose – Fallbericht und Literaturübersicht

Tue, 15 Mar 2016 00:00:00 +0100

Publication date: Available online 4 February 2016 Source:Sports Orthopaedics and Traumatology Sport-Orthopädie - Sport-Traumatologie Author(s): Sebastian Stoll, Viviane Centmaier-Molnar, Michel Schläppi, Victor Valderrabano, Martin Wiewiorski Eine posttraumatische Exostose des Tuber calcanei ist selten und resultiert in einer Schwellung und Schmerzen über dem Calcaneus und dem Achillessehnenansatz. Ursächlich sind ein prominentes Tuber calcanei mit retrocalcanearer Bursitis und Achillessehneninsertionstendinopathie, was einem Haglund-Syndrom ähnelt. Die Diagnose erfolgt vor allem klinisch und wird ergänzt durch MRT. Bei Versagen konservativer Maßnahmen (Anpassung Aktivitäten, Physiotherapie mit exzentrischen Dehnübungen, Einlagen, NSAR-Behandlung), besteht die Indikation z...



Response to: 'Painful knee but not hand osteoarthritis is an independent predictor of mortality over 23 years follow-up of a population-based cohort of middle-aged women by Gao et al

Thu, 10 Mar 2016 00:00:00 +0100

We thank Gao et al1 for their interest in our paper.2 Gao et al highlighted a number of issues related to discordance between pain and radiographic changes and sensitivity of the pain assessment. Although a single definition of knee osteoarthritis (KOA) remains elusive, the presence of knee pain is the main symptom of KOA3–5 and there is still a strong relationship between pain and radiographic knee osteoarthritis (ROA).6 7 Notwithstanding this, a substantial number of patients with ROA are asymptomatic. Although OA is the most common ‘source’ of knee pain in ROA, it is true, as pointed out by Gao et al that many other diagnoses may be judged to account for a patient's symptoms including bursitis, tendinopathies and overuse injuries. In this cohort of middle aged to elder...



Tendinitis and Bursitis - Staying Active While Healing

Mon, 07 Mar 2016 15:13:02 +0100

Expert advice and tips from Physical Therapy specialist on staying active while healing from Tendinitis or Bursitis and avoiding further injury (Source: Disabled World)

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Bursectomy, Curettage, and Chemotherapy in Tuberculous Trochanteric Bursitis.

Thu, 03 Mar 2016 06:06:02 +0100

We presented three patients with trochanteric tuberculosis and described the clinical and imaging findings of the infection. Histology revealed a necrotizing granulomatous bursitis and microbiology confirmed tuberculosis. All cases were successfully treated with bursectomy and curettage of the trochanteric lesion and antituberculous chemotherapy including isoniazid, pyrazinamide, rifampicin, and ethambutol. PMID: 26929807 [PubMed - in process] (Source: Clinics in Orthopedic Surgery)



Can Quantification of Biceps Peritendinous Effusion Predict Rotator Cuff Pathologies?: A Retrospective Analysis of 1352 Shoulder Ultrasound

Wed, 24 Feb 2016 08:19:33 +0100

Conclusions: Sonographically detected BPE seems to be in association with certain rotator cuff pathologies, and it can be utilized as an adjuvant finding to rule out such rotator cuff abnormalities. To Claim CME Credits: Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME CME Objectives: Upon completion of this article, the reader should be able (1) to realize the association between the biceps peritendinous effusion and other sonographic abnormal findings regarding the shoulder joint, (2) to understand the possible mechanism of biceps peritendinous effusion production, and (3) to use biceps peritendinous effusion as an adjuvant finding to rule out rotator cuff abnormalities. Level: Advanced Accreditation: The Association of Academic Phys...



Phaeohyphomycosis infection in the knee

Tue, 23 Feb 2016 00:00:00 +0100

Publication date: Available online 23 February 2016 Source:Revista Brasileira de Ortopedia (English Edition) Author(s): David Sadigursky, Luisa Nogueira e Ferreira, Liz Moreno de Oliveira Corrêa Phaeohyphomycosis is caused by cutaneous fungi and rarely affects large joints. This is a case report on phaeohyphomycosis in the left knee of an elderly individual without immunosuppression. It was accompanied by pain and swelling the anterior knee. The case was first suspected to be suprapatellar bursitis, and was treated with nonsteroidal anti-inflammatory drugs, without remission of symptoms. Surgical treatment was performed, with resection of the suprapatellar bursa and anterior region of the quadriceps tendon. The material was sent for anatomopathological examination and culturing. The ...



Acute Calcific Bursitis After Ultrasound-guided Percutaneous Barbotage of Rotator Cuff Calcific Tendinopathy: A Case Report

Sat, 20 Feb 2016 00:00:00 +0100

We present the case of a 49-year-old woman with aggravated pain, early after US-guided barbotage of a large calcific deposit in the supraspinatus tendon. Subsequent examination revealed a thick calcification spreading along the subacromial-subdeltoid bursa space, suggesting acute calcific bursitis complicated by barbotage. Additional barbotage alleviated pain completely. (Source: PM and R)



Ultrasound-guided retro-calcaneal bursa corticosteroid injection for refractory Achilles tendinitis in patients with seronegative spondyloarthropathy: efficacy and follow-up study

Fri, 19 Feb 2016 00:00:00 +0100

Abstract Ultrasound (US)-guided corticosteroid injection has been shown to be safe and effective for varied causes of plantar fasciitis; however, its use for Achilles tendinitis is controversial. We studied the efficacy and changes in US findings at Achilles enthesitis after corticosteroid injection in patients with spondyloarthropathy (SpA). Patients with SpA with symptomatic Achilles enthesitis, refractory to 6 weeks of full-dose NSAIDs, were offered US-guided local corticosteroid injection. Injected entheses were examined by US (both B mode and power Doppler) at baseline and 6 weeks after injection. Standard OMERACT definitions were used to define enthesitis. Achilles tendon thickness >5.29 mm, 2 cm proximal to insertion in long axis, was considered thickened. Twenty-sev...



Surgical Outcomes for Resection of the Dorsal Exostosis of the Metatarsocuneiform Joints

Thu, 11 Feb 2016 00:00:00 +0100

Publication date: Available online 9 February 2016 Source:The Journal of Foot and Ankle Surgery Author(s): Vaishnavi Bawa, Lawrence M. Fallat, John P. Kish A retrospective case series testing the efficacy of surgical resection of the dorsal exostosis deformity of the metatarsocuneiform joints was performed. Surgery was performed in 26 consecutive patients (28 feet), in whom previous conservative therapy had failed. All 26 patients had bursitis at the level of the dorsal exostosis deformity. The patients were separated into 2 groups: group 1, those with bursitis and neuritis before surgery (n = 13; 46.4%), and group 2, those with bursitis without neuritis (n = 15; 53.5%). Both groups were evaluated using an 11-point visual analog scale administered preoperatively and ≤1 year postope...



Pes Anserine Bursitis: An Underdiagnosed Cause of Knee Pain in Overweight Women.

Mon, 01 Feb 2016 00:00:00 +0100

Authors: Pompan DC PMID: 26926606 [PubMed - in process] (Source: American Family Physician)



Needle aspiration of calcific deposits (NACD) for calcific tendinitis is safe and effective: six months follow-up of clinical results and complications in a series of 431 patients

Mon, 25 Jan 2016 00:00:00 +0100

Conclusion Needle aspiration of calcific deposits (NACD) is an effective treatment for calcific tendinitis of the rotator cuff in the majority of patients. Approximately one third of the patients will require multiple treatments, which were equally effective as the primary procedure. Based on this, patients should not be withheld a second or even a third treatment in case of persistent symptoms. Furthermore, NACD has a low complication rate, the risk of infection should, however, always be accounted for. Level of evidence Retrospective study, level IV. (Source: European Journal of Radiology)

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The management of greater trochanteric pain syndrome: A systematic literature review

Mon, 25 Jan 2016 00:00:00 +0100

Publication date: March 2016 Source:Journal of Orthopaedics, Volume 13, Issue 1 Author(s): Diane Reid Greater trochanteric pain syndrome (GTPS) is a common cause of lateral hip pain. Most cases respond to conservative treatments with a few refractory cases requiring surgical intervention. For many years, this condition was believed to be caused by trochanteric bursitis, with treatments targeting the bursitis. More recently gluteal tendinopathy/tears have been proposed as potential causes. Treatments are consequently developing to target these proposed pathologies. At present there is no defined treatment protocol for GTPS. The purpose of this systematic literature review is to evaluate the current evidence for the effectiveness of GTPS interventions, both conservative and surgical. (Sou...



Avascular Necrosis of the Femoral Head Masquerading as Iliopsoas Bursitis: Imaging With Ultrasound and Magnetic Resonance

Mon, 18 Jan 2016 19:15:13 +0100

No abstract available (Source: American Journal of Physical Medicine and Rehabilitation)



Protothecal bursitis after simultaneous kidney/liver transplantation: a case report and review

Mon, 18 Jan 2016 00:00:00 +0100

This article is protected by copyright. All rights reserved. (Source: Transplant Infectious Disease)



Endoscopic Resection of the Bicipitoradial Bursa

Wed, 13 Jan 2016 01:46:00 +0100

The bicipitoradial bursa lies at the insertion of the biceps tendon on the radial tuberosity. It is an unusual site for chronic bursitis. It can be treated conservatively with aspiration and steroid injection. Surgical excision of the bursa is indicated in case of infection cause, failed conservative treatment with recurrence of the enlarged bursa and pain after aspiration, the presence of nerve compression with neurological impairment, mechanical limitation to flexion and extension of the elbow or biceps tendon degeneration, and/or functional impairment. Open resection through the anterior approach requires extensive dissection to expose the radial tuberosity and the radial neck, which increases the risk of neurovascular injury. Endoscopic resection is possible through distal biceps tendo...



Evidence-based indications for hindfoot endoscopy

Thu, 07 Jan 2016 00:00:00 +0100

Conclusion Although a low level of evidence of the included studies, the review showed that adequate literature to support the use of the 2-portal endoscopic techniques for most currently accepted indications exists. Future “higher quality” evidence could strengthen current recommendations and further help surgeons in evidence-based practice. Level of evidence Level V, Review of Level III, IV and V studies. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)

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Fibrin glue for olecranon bursitis: a case report

Thu, 07 Jan 2016 00:00:00 +0100

(Source: Therapeutic Advances in Musculoskeletal Disease)



Noniatrogenic Septic Olecranon Bursitis: Report of Two Cases and Review of the Literature

Fri, 01 Jan 2016 06:00:00 +0100

No abstract available (Source: Current Sports Medicine Reports)



Noniatrogenic Septic Olecranon Bursitis: Report of Two Cases and Review of the Literature.

Fri, 01 Jan 2016 00:00:00 +0100

Authors: Harris-Spinks C, Nabhan D, Khodaee M PMID: 26745168 [PubMed - in process] (Source: Current Sports Medicine Reports)



Achilles Tendinitis.

Sat, 26 Dec 2015 01:40:02 +0100

This article reviews the MRI findings and terminology of Achilles tendinitis often found in radiology reports. PMID: 26688993 [PubMed - in process] (Source: Journal of surgical orthopaedic advances)



Dorsalis pedis psuedoaneurysm: a complication followed extensor tendoscopy of the ankle in a non-tuberculosis patient with tenosynovitis with rice body formation

Thu, 17 Dec 2015 00:00:00 +0100

Rice bodies which mainly consist of fibrin are occasionally observed in the joints, bursae, and tendon sheaths among patients with rheumatoid arthritis or tuberculous arthritis and/or tuberculous tenosynovitis. They are thought to arise from chronic bursitis, whereas some authors suggest that they may arise from micro-infarctions with subsequent synovial shedding and encasement by fibrin [1]. Besides tuberculosis and atypical mycobacterial infections [2], similar loose bodies can be found in rheumatic diseases such as rheumatoid arthritis, systemic lupus erythematosus, and seronegative arthritis, although these are usually smaller in size [1,3–6]. (Source: Foot and Ankle Surgery)

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Coracoid-like osteochondroma and painful giant thoracic bursitis

Wed, 09 Dec 2015 00:00:00 +0100

Publication date: Available online 8 December 2015 Source:Joint Bone Spine Author(s): Mickaël Ropars, Harrold Common, Raphaël Guillin, Anthony Hervé, Pascal Guggenbhul (Source: Joint Bone Spine)



Stemless humeral component in reverse shoulder prosthesis in patient with Parkinson's disease: a case report.

Wed, 02 Dec 2015 05:00:57 +0100

CONCLUSION: In selected cases of patients with PD, after carefully analysis of bone quality, the use of a stemless component is of benefit in the possible revision cases for periprosthetic fractures and the use of an anterosuperior exposure reduces the percentage of instability. The results obtained about the pain relief are excellent in contrast with functional outcomes that remain poor. PMID: 26136798 [PubMed] (Source: Clinical Cases in Mineral and Bone Metabolism)



Glucocorticoids for Management of Polymyalgia Rheumatica and Giant Cell Arteritis

Wed, 25 Nov 2015 06:02:00 +0100

Diagnosis of polymyalgia rheumatica (PMR) and giant cell arteritis (GCA) is based on typical clinical, histologic, and laboratory features. Ultrasonographic imaging in PMR with assessment especially of subdeltoid bursitis can aid in diagnosis and in following response to treatment. In GCA, diagnosis and disease activity are supported with ultrasonographic, MRI, or [18F]fluorodeoxyglucose PET evaluation of large vessels. Glucocorticoids are the primary therapy for PMR and GCA. Methotrexate may be used in patients at high risk for glucocorticoid adverse effects and patients with frequent relapse or needing protracted therapy. Other therapeutic approaches including interleukin 6 antagonists are under evaluation. (Source: Rheumatic Disease Clinics of North America)



Magnetic resonance imaging evaluation of shoulder joint in patients with early stage of ankylosing spondylitis: A case-control study

Sun, 22 Nov 2015 00:00:00 +0100

Conclusion Shoulder involvement is often overlooked in AS. Knowledge of the early-stage findings of the shoulder involvement due to AS is important to establish an early diagnosis and select treatment options. (Source: Diagnostic and Interventional Imaging)



Snapping scapular syndrome secondary to rib intramedullary fixation device

Sun, 22 Nov 2015 00:00:00 +0100

Conclusion Surgeons should pay attention to any protrusion of intramedullary rib implants, especially in the evaluation of routine x-rays following surgical treatment. We should be aware of the possibility of this rare cause of snapping scapula syndrome to avoid delayed diagnosis and consider removing the implant will resolve the pain. (Source: International Journal of Surgery Case Reports)

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Going barefoot: Strong 'foot core' could prevent plantar fasciitis, shin splints, and other common injuries

Wed, 18 Nov 2015 01:42:01 +0100

Barefoot activities can greatly improve balance and posture and prevent common injuries like shin splints, plantar fasciitis, stress fractures, bursitis, and tendonitis in the Achilles tendon, according to one expert. (Source: ScienceDaily Headlines)



Olecranon bursitis

Wed, 11 Nov 2015 00:00:00 +0100

Bursitis is a common medical condition, and of all the bursae in the body, the olecranon bursa is one of the most frequently affected. Bursitis at this location can be acute or chronic in timing and septic or aseptic. Distinguishing between septic and aseptic bursitis can be difficult, and the current literature is not clear on the optimum length or route of antibiotic treatment for septic cases. The current literature was reviewed to clarify these points. (Source: Journal of Shoulder and Elbow Surgery)



Disorders of the Peritrochanteric and Deep Gluteal Space: New Frontiers for Arthroscopy

Wed, 04 Nov 2015 18:13:36 +0100

Arthroscopic techniques for the hip joint have evolved into endoscopic methods for extra-articular disorders. These endoscopic strategies provide a less invasive alternative to open procedures for traditionally recognized forms of pathology. Endoscopy has defined new disorders amenable to surgical correction and has redefined some of these existing disorders. The peritrochanteric and deep gluteal regions represent 2 of the most currently active areas of exploration. Peritrochanteric problems include trochanteric bursitis, full-thickness and partial-thickness tears of the abductors including the gluteus medius and minimus, and external coxa saltans (snapping iliotibial band). Deep gluteal disorders include piriformis syndrome, and other variations of deep gluteal syndrome, and ischiofemoral...



CORR Insights(®): A Randomized Trial Among Compression Plus Nonsteroidal Antiinflammatory Drugs, Aspiration, and Aspiration With Steroid Injection for Nonseptic Olecranon Bursitis.

Thu, 22 Oct 2015 00:00:00 +0100

Authors: Kennedy SA PMID: 26493988 [PubMed - as supplied by publisher] (Source: Clinical Orthopaedics and Related Research)



Prevalence and pattern of gluteus medius and minimus tendon pathology and muscle atrophy in older individuals using MRI

Sat, 17 Oct 2015 06:01:24 +0100

Conclusions Gluteus medius and minimus tendon pathology and muscle atrophy increase with advancing age with progression of tendinosis to low-grade tendon tears to high-grade tendon tears. There is an associated progression in atrophy of these muscles, which may be important in fall-related hip fractures. (Source: Skeletal Radiology)

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Corticosteroid Injections for Common Musculoskeletal Conditions.

Thu, 15 Oct 2015 00:00:00 +0100

Authors: Foster ZJ, Voss TT, Hatch J, Frimodig A Abstract Family physicians considering corticosteroid injections as part of a comprehensive treatment plan for musculoskeletal diagnoses will find few high-quality studies to assist with evidence-based decision making. Most studies of corticosteroid injections for the treatment of osteoarthritis, tendinopathy, bursitis, or neuropathy include only small numbers of patients and have inconsistent long-term follow-up. Corticosteroid injections for the treatment of adhesive capsulitis result in short-term improvements in pain and range of motion. For subacromial impingement syndrome, corticosteroid injections provide short-term pain relief and improvement in function. In medial and lateral epicondylitis, corticosteroid injections offer on...



Bursitis and Tenosynovitis Due to Mycobacterium avium Complex

Wed, 14 Oct 2015 21:00:59 +0100

New England Journal of Medicine, Volume 373, Issue 16, October 2015. (Source: New England Journal of Medicine)



A Randomized Trial Among Compression Plus Nonsteroidal Antiinflammatory Drugs, Aspiration, and Aspiration With Steroid Injection for Nonseptic Olecranon Bursitis.

Tue, 13 Oct 2015 00:00:00 +0100

CONCLUSIONS: With the numbers available, there were no differences in efficacy when compression bandaging with NSAIDs, aspiration, and aspiration with steroid injection were compared. However, we were powered only to detect a 30% difference, meaning that if there were a smaller difference in efficacy among the groups, we might not have detected it in a study of this size. Our data can be used as pilot data to power future prospective (and likely multicenter) trials. Because olecranon bursitis can recur, and because treatments like aspiration and aspiration with steroid injection can cause complications, unless future trials demonstrate clear efficacy advantages of aspiration and/or injection both at short and longer terms, we suggest that compression bandaging and a short course of NSAIDs ...



Ultrasonographic predictors for clinical and radiological progression in knee osteoarthritis after 2 years of follow-up

Tue, 13 Oct 2015 00:00:00 +0100

Conclusion. We demonstrated a longitudinal association between Baker’s cyst (and to a lesser extent synovial hypertrophy) at baseline and radiological and clinical progression after 2 years. (Source: Rheumatology)



Bone erosion and subacromial bursitis caused by diphtheria-tetanus-poliomyelitis vaccine.

Fri, 09 Oct 2015 00:00:00 +0100

We report a case of bursitis associated with reactive glenohumeral effusion complicated by bone erosion occurring after injection of the dT-IPV vaccine. A 26 year old patient was admitted for painful left shoulder causing functional impairment. Control magnetic resonance imaging showed bone oedema on the upper outer part of the humeral head, with a slight cortical irregularity, indicating that the vaccine was injected in contact with the bone at this location, causing erosion. Outcome was favourable after intra-articular corticosteroids. Reports of articular or periarticular injury after vaccination are extremely rare, in view of the substantial number of vaccines administered every year. The potential complications of vaccination are well known to general practitioners but under-reported ...

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Aripiprazole for Treatment of Apathy

Thu, 08 Oct 2015 21:05:46 +0100

Conclusion: Aripiprazole may be useful for treatment of apathy syndrome. Its role in treatment of apathy requires further investigation in clinical trials. Introduction Apathy is a profound loss of motivation not attributed to decreased level of consciousness, cognitive impairment, or emotional distress.[1] Apathy refers to a set of behavioral, emotional, and cognitive features such reduced interest and participation of activities of daily life. Another prime characteristic is lack of initiative or an absence of responsiveness to stimuli as demonstrated by a lack of self initiated action.[2] Apathy is highly prevalent in neurodegenerative diseases such Alzheimer’s disease (70–90 %) and Parkinson’s disease (63.3 %).[3,4] Although the symptoms of apathy and depression overlap, one hypo...



Mycobacterium bovis hip bursitis in a lung transplant recipient

Thu, 01 Oct 2015 00:00:00 +0100

This article is protected by copyright. All rights reserved. (Source: Transplant Infectious Disease)



Giant cell tumour of tendon sheath with simultaneous two tendon involvement of the foot treated with excision of the tumour and reconstruction of the flexor retinaculum using tibialis posterior tendon in a paediatric patient: A rare case report

Fri, 18 Sep 2015 00:00:00 +0100

Giant cell tumour of the tendon sheath (GCT-TS) is a benign slow growing tumour arising from soft tissues of the limbs. Many terminologies have been used to define this type of tumour adding to the confusion, including extra-articular pigmented villo-nodular synovitis, pigmented villo-nodular bursitis and pigmented nodular synovitis of tendon sheath [1–3]. The clinical presentation of the disease is that of a localised swelling arising from the complex of tendon sheath of small joints of the hands and the feet. (Source: Foot and Ankle Surgery)



Giant Cell Tumour of Tendon Sheath with Simultaneously Two Tendon Involvement of the Foot Treated with Excision of the Tumour and Reconstruction of the Flexor Retinaculum using Tibialis Posterior Tendon in a Paediatric Patient: A Rare Case Report

Fri, 18 Sep 2015 00:00:00 +0100

Giant cell tumour of the tendon sheath (GCT-TS) is a benign slow growing tumour arising from soft tissues of the limbs. Many terminologies have been used to define this type of tumour adding to the confusion, including extra-articular pigmented villo-nodular synovitis, pigmented villo-nodular bursitis and pigmented nodular synovitis of tendon sheath [1–3]. The clinical presentation of the disease is that of a localised swelling arising from the complex of tendon sheath of small joints of the hands and the feet. (Source: Foot and Ankle Surgery)



Radiologic Evaluation of Musculoskeletal Soft Tissue Infections: A Pictorial Review

Wed, 16 Sep 2015 00:00:00 +0100

This article reviews various types of musculoskeletal soft tissue infections that may be encountered and their imaging features utilizing different imaging modalities, including radiography, computed tomography, ultrasound and magnetic resonance imaging. (Source: Current Radiology Reports)

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Caring for Wrestlers

Tue, 01 Sep 2015 05:00:00 +0100

Wrestling is a popular high school and college sport with an injury and illness rate second only to football. It is important that the physician providing medical care for wrestlers be familiar with the unique characteristics of wrestling and the associated common injuries and medical problems. Common orthopedic injuries include shoulder, elbow, and finger dislocation; prepatellar bursitis; knee medial collateral ligament sprains; and cervical strains. Skin infections are the most common cause of missed mat time for wrestlers. Physicians need to be able to identify and treat these infections, and know the rules regarding return to wrestling once an infection has been identified. Other conditions that are common include auricular hematomas, epistaxis, and brow lacerations. Physicians also n...



Caring for Wrestlers.

Tue, 01 Sep 2015 00:00:00 +0100

Authors: Kiningham R, Monseau A Abstract Wrestling is a popular high school and college sport with an injury and illness rate second only to football. It is important that the physician providing medical care for wrestlers be familiar with the unique characteristics of wrestling and the associated common injuries and medical problems. Common orthopedic injuries include shoulder, elbow, and finger dislocation; prepatellar bursitis; knee medial collateral ligament sprains; and cervical strains. Skin infections are the most common cause of missed mat time for wrestlers. Physicians need to be able to identify and treat these infections, and know the rules regarding return to wrestling once an infection has been identified. Other conditions that are common include auricular hematomas, e...



Ultrasound-guided Interventional Procedures around the Shoulder.

Thu, 27 Aug 2015 00:00:00 +0100

Authors: Messina C, Banfi G, Orlandi D, Lacelli F, Serafini G, Mauri G, Secchi F, Silvestri E, Sconfienza LM Abstract Ultrasound is an established modality for shoulder evaluation, being accurate, low-cost and radiation-free. Different pathologic conditions can be diagnosed using ultrasound and treated using ultrasound guidance, such as degenerative, traumatic or inflammatory diseases. Subacromial-subdeltoid bursitis is the most common finding on ultrasound evaluation for painful shoulder. Therapeutic injections of corticosteroids are helpful to reduce inflammation and pain. Calcific tendinopathy of rotator cuff affects up to 20% of painful shoulders. Ultrasound-guided treatment may be performed with both single- and double-needle approach. Calcific enthesopathy, a peculiar form of...



Does subclinical inflammation contribute to impairment of function of knee joints in aged individuals? High prevalence of ultrasound inflammatory findings

Fri, 14 Aug 2015 00:00:00 +0100

Conclusion. The present study showed a high prevalence of US inflammatory abnormalities in the knee joints of a normal aged population. These data suggest a substantial contribution of inflammation in progressive impairment of joint function with age. (Source: Rheumatology)



Stabilisation for the disrupted acromioclavicular joint using a braided polyester prosthetic ligament.

Sat, 01 Aug 2015 00:00:00 +0100

CONCLUSION: The braided polyester prosthetic ligament achieved good outcome for patients undergoing stabilisation for the disrupted ACJ. PMID: 26321556 [PubMed - in process] (Source: Journal of Orthopaedic Surgery)

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The appearance of the pre-Achilles fat pad after endoscopic calcaneoplasty

Fri, 24 Jul 2015 13:07:16 +0100

Conclusion The appearance of the retrocalcaneal recess on a lateral radiograph cannot be used as a reliable diagnostic criterion for retrocalcaneal bursitis in patients who previously underwent endoscopic calcaneoplasty. This study clinical relevance is based upon the conclusion that a lateral radiograph cannot be used after endoscopic calcaneoplasty, whereas previous work reported the diagnostic value of a lateral radiograph for retrocalcaneal bursitis prior to surgery. Level of evidence III. (Source: Knee Surgery, Sports Traumatology, Arthroscopy)



Is entheses ultrasound reliable? A reading Latin American exercise

Tue, 21 Jul 2015 18:07:41 +0100

The objective of this study is to evaluate inter-reader entheses ultrasound (US) reliability and the influence of the type of image or degree of sonographer experience on US reliability in patients with spondyloarthritis (SpA). Eighteen Latin American ultrasonographers with different experience took part in an US reading exercise evaluating 60 entheseal images (50 % static images and 50 % videos) from healthy controls and SpA patients. The following sonographic lesions were assessed: structure, thickness, bone proliferation/tendon calcification, erosions, bursitis, and Doppler signal. Another group of three experts with significant experience in entheses US read all images too. Inter-reader reliability among participants and experts was calculated by the Cohen’s kappa coefficient. Thre...



Familial Mediterranean Fever developing in a Japanese kidney transplant recipient

Sun, 19 Jul 2015 20:31:00 +0100

We describe the relationship of FMF and kidney transplantation in terms of prognosis and important points to note for treatment. (Source: CEN Case Reports)



Febrile low back pain: Consider septic interspinous bursitis

Thu, 16 Jul 2015 00:00:00 +0100

Publication date: Available online 14 July 2015 Source:Joint Bone Spine Author(s): Elodie Bauer, Sophie Jacob-Leclerc, Isabelle Chary-Valckenaere, Damien Loeuille (Source: Joint Bone Spine)



Rilonacept in the treatment of subacromial bursitis: A randomized, non-inferiority, unblinded study versus triamcinolone acetonide

Thu, 16 Jul 2015 00:00:00 +0100

Conclusions While improvement in QuickDASH and pain was noted with a single intrabursal injection of rilonacept at 4 weeks, injection with triamcinolone acetonide was more efficacious. This trial was registered with www.clinicaltrials.gov (NCT01830699). (Source: Joint Bone Spine)

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Everything Achilles: Knowledge Update and Current Concepts in Management: AAOS Exhibit Selection

Wed, 15 Jul 2015 00:00:00 +0100

Abstract: Achilles tendon pathology is common and affects athletes and nonathletes alike. The cause is multifactorial and controversial, involving biological, anatomical, and mechanical factors. A variety of conditions characterized by Achilles tendon inflammation and/or degeneration can be clinically and histologically differentiated. These include insertional Achilles tendinopathy, retrocalcaneal bursitis, Achilles paratenonitis, Achilles tendinosis, and Achilles paratenonitis with tendinosis. The mainstay of treatment for all of these diagnoses is nonoperative. There is a large body of evidence addressing treatment of acute and chronic Achilles tendon ruptures; however, controversy remains. (Source: The Journal of Bone and Joint Surgery)



RS3PE Syndrome with Iliopsoas Bursitis Distinguished from an Iliopsoas Abscess Using a CT-guided Puncture.

Sat, 04 Jul 2015 09:32:30 +0100

Authors: Fukui S, Iwamoto N, Tsuji S, Umeda M, Nishino A, Nakashima Y, Suzuki T, Horai Y, Koga T, Kawashiri SY, Ichinose K, Hirai Y, Tamai M, Nakamura H, Origuchi T, Kawakami A Abstract A 55-year-old man was diagnosed with remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome. Contrast-enhanced computed tomography for cancer screening showed a mass with low-density centers with an enhanced rim in the left iliopsoas muscle. We suspected an iliopsoas abscess and performed computed-tomography-guided puncture of the mass. Both Gram staining and the culture of the fluid were negative. We diagnosed the patient with RS3PE syndrome with iliopsoas bursitis and administered low-dose corticosteroids without antibiotics. The symptoms, including left hip pain, quickly...



Targeted knockout of TNF‑α by injection of lentivirus‑mediated siRNA into the subacromial bursa for the treatment of subacromial bursitis in rats.

Fri, 03 Jul 2015 13:05:40 +0100

Authors: Wang Y, Li Q, Wei X, Xu J, Chen Q, Song S, Lu Z, Wang Z Abstract Subacromial bursitis (SAB) is the major source of pain in rotator cuff disease. Although multiple investigations have provided support for the role of inflammatory cytokines in SAB, few have focussed on the use these cytokines in the treatment of SAB. The aim of the present study was to observe the therapeutic efficacy of lentivirus‑mediated RNA interference (RNAi) on carrageenan‑induced SAB by injecting lentivirus‑tumor necrosis factor (TNF)‑α‑RNAi expressing TNF‑α small interfering (si)RNA. Using screened siRNA segments, an siRNA was designed. A lentivirus vector expressing siRNA was established and packed as lentivirus particles. A lentivirus that expressed the negative sequence was used as a...



Fifth Metatarsal Osteotomies

Fri, 26 Jun 2015 17:30:24 +0100

This article discusses 7 corrective measures: medial oblique sliding osteotomy with fixation, medial oblique slide osteotomy–minimal incision procedure without fixation, SERI (simple, effective, rapid, inexpensive) with fixation, chevron with or without fixation, closing, lateral wedge osteotomy at the metatarsal neck or proximal diaphysis, Weil osteotomy, and scarfette. These evidence-based techniques can be used by practitioners for medical management of their patients through evaluation, diagnosis, and prognosis. Complications are also addressed. (Source: Clinics in Podiatric Medicine and Surgery)



Assessment of the Postoperative Appearance of the Rotator Cuff Tendon Using Serial Sonography After Arthroscopic Repair of a Rotator Cuff Tear

Thu, 25 Jun 2015 00:00:00 +0100

Conclusions— Serial sonography after arthroscopic rotator cuff repair was useful for monitoring the postoperative changes in a repaired tendon. The morphologic appearance of the repaired tendon and peritendinous soft tissue changes improved over time and nearly normalized within 6 months of surgery. (Source: Journal of Ultrasound in Medicine)

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Abductor muscle necrosis due to iliopsoas bursal mass after total hip arthroplasty

Sat, 06 Jun 2015 00:00:00 +0100

Conclusions This report highlights the rare findings of abductor muscle necrosis, as well as acute thrombosis, related to iliopsoas bursitis. It also highlights a review of the available literature. (Source: Journal of Clinical Orthopaedics and Trauma)



Comparison of subacromial tenoxicam and steroid injections in the treatment of impingement syndrome.

Fri, 05 Jun 2015 05:23:31 +0100

CONCLUSION: Both subacromial tenoxicam and steroid injections may be successfully used in the treatment of patients with impingement syndrome. Subacromial tenoxicam injection may be preferred as a first-line intervention in these patients thanks to its safe profile. PMID: 25741915 [PubMed - in process] (Source: Eklem Hastaliklari ve Cerrahisi)



Candida glabrata olecranon bursitis treated with bursectomy and intravenous caspofungin.

Fri, 05 Jun 2015 05:21:37 +0100

Authors: Skedros JG, Keenan KE, Trachtenberg JD Abstract Orthopedic surgeons are becoming more involved in the care of patients with septic arthritis and bursitis caused by yeast species. This case report involves a middle-aged immunocompromised female who developed a Candida glabrata septic olecranon bursitis that developed after she received a corticosteroid injection in the olecranon bursa for presumed aseptic bursitis. Candida (Torulopsis) glabrata is the second most frequently isolated Candida species from the bloodstream in the United States. Increased use of fluconazole and other azole antifungal agents as a prophylactic treatment for recurrent Candida albicans infections in immunocompromised individuals is one reason why there appears to be increased resistance of C. glabra...



Clinical and microbiological characteristics of six Staphylococcus pettenkoferi isolates from blood samples.

Wed, 03 Jun 2015 23:08:40 +0100

Authors: Park S, Chung HS, Lee M Abstract Coagulase-negative staphylococci (CoNS) are reported to be the leading cause of nosocomial bloodstream infections. Staphylococcus pettenkoferi is a novel member of CoNS that was first isolated from the human blood and bursitis wound in 2002. We have reported cases of 6 S. pettenkoferi strains isolated from blood specimens, including one pathogen and 5 contaminants and catheter colonizers. Brucker Biotyper (Brucker Daltonics, Bremen, Germany) and molecular typing with 16S rRNA gene sequencing confirmed the 6 isolates as S. pettenkoferi. The conventional phenotypic identification of these isolates is not reliable owing to their inconsistent biochemical characteristics. Five of the 6 isolates were found to be resistant to oxacillin, and all is...



Heel pain: A systematic review.

Mon, 01 Jun 2015 00:00:00 +0100

Authors: Agyekum EK, Ma K Abstract Heel pain is a very common foot disease. Varieties of names such as plantar fasciitis, jogger's heel, tennis heal, policeman's heel are used to describe it. Mechanical factors are the most common etiology of heel pain. Common causes of hell pain includes: Plantar Fasciitis, Heel Spur, Sever's Disease, Heel bump, Achilles Tendinopathy, Heel neuritis, Heel bursitis. The diagnosis is mostly based on clinical examination. Normally, the location of the pain and the absence of associated symptoms indicating a systemic disease strongly suggest the diagnosis. Several therapies exist including rest, physical therapy, stretching, and change in footwear, arch supports, orthotics, night splints, anti-inflammatory agents, and surgery. Almost all patients respo...

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Cutaneous vasculitis associated with severe bacterial infections. A study of 27 patients from a series of 766 cutaneous vasculitis.

Sat, 30 May 2015 21:36:03 +0100

CONCLUSIONS: CV may be the presenting manifestation of a severe underlying bacterial infection. Physicians should keep in mind this fact to make an early diagnosis of infection and, consequently, prevent life-threatening complications. PMID: 26016750 [PubMed - in process] (Source: Clinical and Experimental Rheumatology)



Use of the S-hook for Pelvic Fixation in Rib-Based Treatment of Early-Onset Scoliosis: A Multicenter Study

Sat, 30 May 2015 15:44:01 +0100

Conclusion. The use of the S-hook as a pelvic attachment of the rib-based system is indicated in nonambulatory patients with progressive, early-onset scoliosis curve with a lack of adequate anchor at the lumbar spine. Several technical factors should be considered to reduce the complication rate. Level of Evidence: 3 (Source: Spine)



Ultrasound-guided versus blind subacromial-subdeltoid bursa injection in adults with shoulder pain: a systematic review and meta-analysis

Wed, 20 May 2015 00:00:00 +0100

Inflammation of the subacromial-subdeltoid (SASD) bursitis is a common cause of shoulder pain and functional disability[1]. SASD bursitis is regarded as the nonstenotic impingement of the shoulder. It is often secondary to lesions in the tendinous cuff[2]. The patient suffering from SASD bursitis frequently complains of pain with any movement of the shoulder, but especially with abduction. Although there has been a debate about the effectiveness of local corticosteroid injections for patients with shoulder pain[3][4], SASD bursa injection of corticosteroids is an effective therapy for SASD bursitis or symptomatic subacromial impingement[5]. (Source: Seminars in Arthritis and Rheumatism)



Primary septic greater trochanteric bursitis

Tue, 19 May 2015 00:00:00 +0100

Ellen S Novatnack, Nicole M Protzman, Carl B WeissJournal of Global Infectious Diseases 2015 7(2):93-94 (Source: Journal of Global Infectious Diseases)



Triceps tendon rupture: the knowledge acquired from the anatomy to the surgical repair

Sat, 09 May 2015 18:20:24 +0100

Abstract Triceps injuries are relatively uncommon in most traumatic events, and the distal triceps tendon ruptures are rare. Recently, the knowledge of this tendon lesion has increased, and it seems to be related to more precise diagnostic and clinical assessments. The most common mechanism of injury remains a forceful eccentric contraction of the muscle, while several other risk factors have been studied as chronic renal failure, endocrine disorders, metabolic bone diseases as well as steroid use. Olecranon bursitis and local corticosteroid injections may also play a role. The commonest site of rupture is at the tendon’s insertion into the olecranon and rarely at the myotendinous junction or intramuscularly. The surgical intervention is recommended in acute complete ruptures, a...

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Prototheca wickerhamii olecranon bursitis successfully treated with adjunctive systemic itraconazole

Fri, 08 May 2015 20:30:21 +0100

No abstract available (Source: Pathology)



Histopathology of Disseminated Mycobacterium bovis Infection Complicating Intravesical BCG Immunotherapy for Urothelial Carcinoma

Wed, 29 Apr 2015 00:00:00 +0100

We report 3 additional cases of BCG-osis complicating BCG therapy, all confirmed by cultures and molecular assays, including the first cases of wedge biopsy-confirmed BCG pneumonia and BCG olecranon bursitis. When suggested by a relevant clinical history, recognition of randomly distributed granulomas in any organ should prompt consideration of BCG-osis and liberal performance of AFB stains, aided by targeted molecular assays. Physicians should maintain a high index of suspicion when miliary infiltrates arise after intravesical BCG instillation, and close multidisciplinary communication is essential. Pathologist awareness of this rare cause of granulomatous inflammation aids recognition of BCG-osis and facilitates prompt initiation of antimycobacterial therapy. (Source: International Journ...



Response to ‘Interspinous bursitis is common in polymyalgia rheumatica, but is not associated with spinal pain’

Tue, 28 Apr 2015 00:00:00 +0100

No description available (Source: Arthritis Research and Therapy)



Response to ‘Interspinous bursitis is common in polymyalgia rheumatica, but is not associated with spinal pain’

Mon, 27 Apr 2015 21:41:39 +0100

No description available (Source: Epidemiologic Perspectives and Innovations)



Mycobacterium avium complex olecranon bursitis resolves without antimicrobials or surgical intervention: a case report and review of the literature

Wed, 22 Apr 2015 00:00:00 +0100

Conclusion This case raises an important clinical question of whether close observation off antimicrobials is appropriate in select cases of immunocompetent patients with localized atypical mycobacterial disease of soft tissue and skeletal structures. (Source: IDCases)

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Can We Measure the Heel Bump? Radiographic Evaluation of Haglund's Deformity

Tue, 21 Apr 2015 00:00:00 +0100

Publication date: May–June 2015 Source:The Journal of Foot and Ankle Surgery, Volume 54, Issue 3 Author(s): Gythe H. Bulstra , Thijs A. van Rheenen , Vanessa A.B. Scholtes Haglund's deformity is a symptomatic posterosuperior deformity of the heel. The lateral radiograph of the ankle will show a prominent, large, posterosuperior part of the calcaneus, which can be measured using the Fowler and Philips angle (FPA, the angle between the posterior and plantar surface of the calcaneus) and the calcaneal pitch angle (CPA, the angle between the sole of the foot and the plantar part of the calcaneus). Although these angles are commonly used, these radiographic angle measurements have never shown a relationship with Haglund's deformity. In 78 patients (51% male) with symptomatic Haglund's defor...



Performance of ultrasound to monitor Achilles enthesitis in patients with ankylosing spondylitis during TNF-a antagonist therapy

Tue, 21 Apr 2015 00:00:00 +0100

Abstract Enthesitis is considered as the primary anatomical lesion in ankylosing spondylitis (AS). We aimed to investigate the potential of ultrasound to detect early changes after TNF-a antagonist therapy of Achilles enthesitis of AS patients. One hundred AS patients with active disease, requiring TNF-a antagonist therapy, were included (etanercept n = 25, infliximab n = 25, adalimumab n = 25, non-biologic disease-modifying antirheumatic drugs (DMARDs) n = 25). Physical examination was performed to evaluate disease activity and detect Achilles enthesitis and/or retrocalcaneal bursitis. Ultrasound of the Achilles enthesitis was performed bilaterally. Follow-up examinations were performed 3 months after the initiation of therapy. Gray scale (GS) scores, Power Doppl...



Small diameter acetabulum and femoral head in total hip arthroplasty for developmental dysplasia of the hip, with no femoral osteotomy.

Tue, 21 Apr 2015 00:00:00 +0100

We present the results of 66 total hip arthroplasties in 62 patients of mean age 46 years (24-74 years), with developmental dysplasia of the hip. In all cases the centre of rotation of the new hip was positioned at the site of the true acetabulum. In all patients cementless press fit acetabular components of small diameter (42-44 mm) were used, articulating exclusively with a 22.25 mm modular metal femoral head, without the use of bone grafts or shortening osteotomies of the femur. Despite the use of small diameter femoral heads the rate of dislocation was 3%. After an average follow-up period of 9 years (4-18 years), no revisions were required for infection, loosening or wear or implant migration. Osteolytic lesions were seen in the periacetabular region in 3 patients who were symptom fre...



Knee bursitis: a sonographic evaluation

Sat, 18 Apr 2015 00:00:00 +0100

Conclusion Ultrasound can be used as a valuable tool for the evaluation of bursitis of the superficial bursae in patients who cannot undergo MRI. (Source: Journal of Ultrasound)



Migration of calcium deposits into subacromial–subdeltoid bursa and into humeral head as a rare complication of calcifying tendinitis: sonography and imaging

Fri, 17 Apr 2015 00:00:00 +0100

We present sonographic and other imaging features of subacromial–subdeltoid bursitis and humeral osteitis related to the migration of calcium. (Source: Journal of Ultrasound)

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Ultrasonography of Subcoracoid Bursal Impingement Syndrome

Wed, 08 Apr 2015 00:00:00 +0100

Publication date: March 2015 Source:PM&R, Volume 7, Issue 3 Author(s): Shane Drakes , Sunil Thomas , Sooyeon Kim , Luis Guerrero , Se Won Lee Subcoracoid impingement syndrome with bursitis is an underrecognized cause of anterior shoulder pain. It usually presents with pain around the coracoid process and a positive impingement test with shoulder adduction, forward flexion, and internal rotation. The pain is mediated by impingement of soft tissues such as the subcoracoid bursa or subscapularis tendon between the coracoid process and humerus. Ultrasonography (US) can be useful in the evaluation of subcoracoid bursal impingement syndrome because of its high resolution capacity and the use of dynamic maneuvers. In this case series, we present 3 patients with subcoracoid impingement s...



What factors predict the need for further intervention following corticosteroid injection of Morton's neuroma?

Thu, 02 Apr 2015 00:00:00 +0100

Morton's neuroma (MN) is a common condition affecting the common digital nerve and its branches most frequently in the third plantar webspace [1]. Theories for its pathogenesis include chronic repetitive trauma, ischemia, entrapment, and intermetatarsal bursitis. It has a predilection for middle aged women [2]. Ultrasound studies describe it as an ovoid, hypo-echoic mass oriented parallel to the long axis of the metatarsals [3]. Patients complain of pain in the affected webspace, mainly on weight-bearing, as well as burning and paraesthesia [4]. (Source: Foot and Ankle Surgery)



Prevalence of subacromial-subdeltoid bursitis in shoulder pain: an ultrasonographic study

Wed, 01 Apr 2015 17:50:35 +0100

Conclusions Our study shows that the effusion in the SASD bursa is frequently associated with shoulder pain often independently from the underlying pathology; further studies are needed to confirm the statistical significance of this relationship by clarifying possible confounding factors. (Source: Journal of Ultrasound)



Scapulothoracic Bursitis in a Patient With Quadriparesis: A Case Report

Wed, 01 Apr 2015 05:00:00 +0100

Abstract: Scapulothoracic bursitis is a rare disease and presents as pain or swelling around the bursa of the scapulothoracic articulation. It has been reported to be related to chronic repetitive mechanical stress of the periscapular tissue, trauma, overuse, and focal muscle weakness. The authors experienced an atypical case of scapulothoracic bursitis with shoulder and periscapular pain after quadriparesis. This case implies that muscular atrophy around the scapula and chest wall from quadriparesis may contribute to the development of scapulothoracic bursitis with shoulder and periscapular pain. In addition, clinician should be alert to it as a possible cause when a patient with quadriparesis complains of shoulder and periscapular pain and consider proper diagnostic options such as ultra...



Is Ultrasound Guidance Needed for Shoulder Injections?

Wed, 01 Apr 2015 00:00:00 +0100

MJ is a 44-year-old teacher who has had right lateral shoulder pain for 5 weeks. The pain developed acutely after he played a pickup game of basketball. He initially presented to his primary care physician, who suspected an acute rotator cuff injury and prescribed naproxen, 500 mg twice daily, along with physical therapy. MJ has completed 4 weeks of appropriate therapy focusing on scapular retraction exercise, pectoralis stretching, and rotator cuff strengthening. He experienced no relief from the therapy or medication, so his primary care physician obtained a shoulder magnetic resonance (MR) arthrogram, which demonstrated thickening of the subacromial-subdeltoid bursa, suggestive of bursitis, and a type I superior labral anterior to posterior (SLAP) lesion. (Source: PM and R)

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Arthroscopic treatment of bilateral snapping scapula syndrome: a case report and review of the literature.

Thu, 26 Mar 2015 03:54:03 +0100

We report a 24-year-old female patient with persisting shoulder pain and disturbing crepitus during movement of the left shoulder. Radiographic examination revealed increased angulation of the superomedial scapula on both sides and MRI, bursitis of the left shoulder. The patient was successfully treated with minimally invasive arthroscopic trimming of the prominent osseous formation at the left scapula combined with bursectomy. Additionally, specific pain-adapted physiotherapeutic exercises of both shoulders were performed. The patient had a pain-free shoulder movement without crepitus on both sides at the 6th month follow-up. PMID: 25803260 [PubMed - in process] (Source: Acta Orthopaedica et Traumatologica Turcica)



Bursitis

Tue, 24 Mar 2015 07:00:00 +0100

(Source: eMedicineHealth.com)



Diagnosis and Management of Extra-articular Causes of Pain After Total Knee Arthroplasty.

Wed, 11 Mar 2015 03:07:04 +0100

Authors: Manning BT, Lewis N, Tzeng TH, Saleh JK, Potty AG, Dennis DA, Mihalko WM, Goodman SB, Saleh KJ Abstract Postoperative pain, which has been attributed to poor outcomes after total knee arthroplasty (TKA), remains problematic for many patients. Although the source of TKA pain can often be delineated, establishing a precise diagnosis can be challenging. It is often classified as intra-articular or extra-articular pain, depending on etiology. After intra-articular causes, such as instability, aseptic loosening, infection, or osteolysis, have been ruled out, extra-articular sources of pain should be considered. Physical examination of the other joints may reveal sources of localized knee pain, including diseases of the spine, hip, foot, and ankle. Additional extra-articular pat...



Intracranial plasmacytoma with hypoglossal nerve palsy in multiple myeloma

Wed, 04 Mar 2015 00:00:00 +0100

Introduction Isolated hypoglossal nerve palsy (HNP) presents with ipsilateral tongue deviation due to atrophy of the tongue musculature.1 Isolated HNP is rare due to its close proximity to other cranial nerves and long anatomical course. Unilateral lesions usually suggest space-occupying lesions while bilateral involvement is usually due to nerve degeneration or demyelination.2 Plasma cell neoplasms may affect the skull base producing a range of cranial nerve palsies including HNP, with up to 30% of those affected subsequently developing multiple myeloma (MM).3 Prompt recognition of this important differential diagnosis of HNP is important for effective patient management. Case history A 56-year-old man presented with a 4-day history of right-sided tongue deviation with numbness. This was ...



Prevalence of pes anserine bursitis in symptomatic osteoarthritis patients: an ultrasonographic prospective study

Sun, 01 Mar 2015 00:00:00 +0100

Abstract The aim of this prospective study was to determine the prevalence of pes anserine bursitis (PAB) in patients with osteoarthritis. A total of 85 patients with primary knee osteoarthritis diagnosed according to the American College of Rheumatology (ACR) criteria were included in the study. The patients were divided into four groups using the Kellgren-Lawrence staging system. The knee X-rays evaluated according to this system indicated that 15.6 % of patients were grade 1, 34.1 % grade 2, 37.1 % grade 3, and 13.5 % grade 4. Ultrasonography (USG) was performed on both knees by a radiologist experienced in musculoskeletal system ultrasonography and unaware of the patients’ physical examination or direct X-ray findings. The presence of PAB, longest diameter of bursitis, ...

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Ultrasound Evaluation of the Greater Trochanter Pain Syndrome: Bursitis or Tendinopathy?

Thu, 26 Feb 2015 20:35:12 +0100

No abstract available (Source: JCR: Journal of Clinical Rheumatology)



How Do You Diagnose Hypermobility?

Mon, 23 Feb 2015 00:18:35 +0100

Discussion Hypermobility can be seen in several different clinical entities. These include generalized joint hypermobility, joint hypermobility syndrome, Marfan syndrome, Ehlers-Danlos syndrome and Osteogenesis Imperfecta. For adults, a Beighton score of at least 4 or 5 is used as a definition of hypermobility. For children a score of 5 or 6 is used as a definition. (see scoring system below). Generalized joint hypermobility is hypermobility with few or no symptoms. If they occur, knee symptoms are the most common. Joint hypermobility syndrome has hypermobility along with other symptoms such as pain, reduced muscle strength, and decreased proprioception and balance. Joint hypermobility syndrome is diagnosed by: 2 major criteria 1 major criteria and 2 minor criteria 4 minor criteria 2 m...



A multi-center, double-blind, randomized, placebo-controlled trial protocol to assess Traumeel injection vs dexamethasone injection in rotator cuff syndrome: the TRAumeel in ROtator cuff syndrome (TRARO) study protocol

Wed, 04 Feb 2015 00:00:00 +0100

DiscussionIt is hoped that the results of this trial will expand the treatment options and evidence base available for the management of rotator cuff disease.Trial registrationClinicalTrials.gov: NCT01702233. EudraCT number: 2012-003393-12. (Source: BMC Musculoskeletal Disorders)



Health Care Cost Consciousness: Testing Triceps Strength Instead of Routinely Ordering Imaging Procedures

Sun, 01 Feb 2015 00:00:00 +0100

In an era of cost consciousness, diagnostic tests might best be ordered only when there is a clear indication. Instead of “always” ordering ultrasound or MRI of the triceps tendon in patients with olecranon bursitis as Heikenfeld et al.1 suggest in their recent article, these tests could be limited to those patients with pain and/or weakness on resisted extension of the elbow. As olecranon bursitis is common and accompanying triceps tears are rare, brief physical examination with triceps strength testing simplifies the care and decreases the cost of care for most patients with olecranon bursitis. (Source: Arthroscopy - Journal of Arthroscopic and Related Surgery)



Authors' Reply

Sun, 01 Feb 2015 00:00:00 +0100

We highly appreciate the comment of Dr. Fleiss on our article “Endoscopic Repair of Tears of the Superficial Layer of the Distal Triceps Tendon.” Dr. Fleiss is absolutely right in pointing out that olecranon bursitis is a common disorder that does not necessarily need MRI. In our clinical practice we do not routinely perform MRI for olecranon bursitis. (Source: Arthroscopy - Journal of Arthroscopic and Related Surgery)

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Physical Therapy Helps Patient with Hip Pain Avoid Surgery

Sun, 01 Feb 2015 00:00:00 +0100

Radiographs reveal greater trochanteric calcific bursitis; guide targeted treatment (Source: The Rheumatologist)



Ultrasonography as a prognostic and objective parameter in Achilles tendinopathy: A prospective observational study

Fri, 30 Jan 2015 00:00:00 +0100

Conclusion Heterogeneity is a prognostic marker in AT. Tendon thickness, hypoechogenicity and increased Doppler activity can be used as objective outcome parameters for the treatment effect of AT. (Source: European Journal of Radiology)



Point‐of‐care musculoskeletal ultrasound is critical for the diagnosis of hemarthroses, inflammation and soft tissue abnormalities in adult patients with painful haemophilic arthropathy

Tue, 27 Jan 2015 13:32:37 +0100

Summary We previously demonstrated in adult patients with haemophilia (PWH) that hemarthrosis is present in only ~1/3rd of acutely painful joints by using point‐of‐care‐musculoskeletal ultrasound (MSKUS). Therefore, other unrecognized tissue abnormalities must contribute to pain. Using high resolution MSKUS, employing grey scale and power Doppler, we sought to retrospectively (i) investigate soft tissue abnormalities in painful haemophilic joints and (ii) to determine to what extent MSKUS findings, functional or radiographic joint scores correlate with biomarkers of inflammation in PWH. Findings were correlated with Hemophilia Joint Health Scores (HJHS), Pettersson scores, high sensitivity C‐reactive protein and von Willebrand factor activity and antigen levels. A total of 65 MSKUS...



Safety of Achilles Detachment and Reattachment Using a Standard Midline Approach to Insertional Enthesophytes

Sat, 24 Jan 2015 00:00:00 +0100

Publication date: Available online 22 January 2015 Source:The Journal of Foot and Ankle Surgery Author(s): Jeffrey E. McAlister , Christopher F. Hyer Detachment with reattachment of the Achilles tendon is a common surgery for debridement of retrocalcaneal exostosis, bursitis, and other insertional pathologic entities. The technique involves a midline skin incision on the posterior Achilles to the tendon. The distal Achilles attachment is removed in a U-shaped manner, leaving the medial and lateral flares, but exposing the posterior spur. This midline approach provides excellent exposure and allows for rapid and efficient surgical debridement. The tendon is reapproximated and repaired with a suture anchor to facilitate fixation to the posterior calcaneus. Some surgeons have expressed conc...



Shockwave treatment for musculoskeletal diseases and bone consolidation: qualitative analysis of the literature

Sat, 24 Jan 2015 00:00:00 +0100

Publication date: Available online 22 January 2015 Source:Revista Brasileira de Ortopedia (English Edition) Author(s): Paulo Kertzman , Mario Lenza , André Pedrinelli , Benno Ejnisman Shockwave treatment is an option within orthopedics. The exact mechanism through which shockwaves function for treating musculoskeletal diseases is unknown. The aim of this study was to make a qualitative analysis on the effectiveness of shockwave treatment among patients with musculoskeletal pathological conditions and pseudarthrosis. Searches were conducted in the Cochrane Library, Medline and Lilacs databases. Thirty-nine studies that reported using shockwave treatment for musculoskeletal diseases were found. Their results varied greatly, as did the types of protocol used. The studies that evaluated the...

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Safety of Achilles Detachment and Reattachment Using a Standard Midline Approach to Insertional Enthesophytes

Thu, 22 Jan 2015 00:00:00 +0100

Detachment with reattachment of the Achilles tendon is a common surgery for debridement of retrocalcaneal exostosis, bursitis, and other insertional pathologic entities. The technique involves a midline skin incision on the posterior Achilles to the tendon. The distal Achilles attachment is removed in a U-shaped manner, leaving the medial and lateral flares, but exposing the posterior spur. This midline approach provides excellent exposure and allows for rapid and efficient surgical debridement. (Source: Journal of Foot and Ankle Surgery)