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Exercise and load modification versus corticosteroid injection versus 'wait and see' for persistent gluteus medius/minimus tendinopathy (the LEAP trial): a protocol for a randomised clinical trial.

BACKGROUND: Lateral hip pain is common, particularly in females aged 40-60 years. The pain can affect sleep and daily activities, and is frequently recalcitrant. The condition is often diagnosed as trochanteric bursitis, however radiological and surgical studies have revealed that the most common pathology is gluteus medius/minimus tendinopathy. Patients are usually offered three treatment options: (a) corticosteroid injection (CSI), (b) physiotherapy, or (c) reassurance and observation. Research on Achilles and patellar tendons has shown that load modification and exercise appears to be more …

Vascular endothelial growth factor 121 and 165 in the subacromial bursa are involved in shoulder joint contracture in type II diabetics with rotator cuff disease.

Vascular endothelial growth factor (VEGF) is a glycoprotein that plays an important role in neovascularization and increases vascular permea … g 36 with complete cuff tears, 20 with incomplete tears, and 11 without apparent tears (subacromial bursitis). The patients were into groups according to the presence or absence of diabetes (14 type II diabetics and 53 non-diabetics). Specimens of the synovium of the SAB were obtained from all patients during surgery. Expression of the VEGF gene in the syn …

[Calcific tendinitis of the shoulder].

Degenerative ossification is formed directly at the major tubercle. Like in any other gliding tendon, fibrocartilage cells lie on the articu … xternal rotation to demonstrate the deposits without super-imposition. Ultrasound shows concomitant bursitis and is useful for the differential diagnosis of rupture of the rotator cuff. Radiographic diagnosis is most difficult when there are small opacifications near the rotator attachment. In this case, allocation may become possible only later in the cou …

Running shoes, orthotics, and injuries.

Running is the most visible expression of the continued interest in regular physical activities. Unfortunately injuries are common, primaril … r extremity: iliotibial band friction syndrome; peroneus tendinitis; stress fractures; trochanteric bursitis; and plantar fasciitis. Appropriate footwear advice and the use of energy-absorbing materials to help dissipate shock will benefit these individuals. Running shoes for the pronated runner should control the excessive motion. The shoes should be boar …

The FROSTBLOCK trial: Protocol for a randomized controlled trial of intra-articular corticosteroid injection with or without suprascapular nerve block in frozen shoulder.

BACKGROUND: Frozen shoulder is a challenging musculoskeletal disorder, affecting between 2 and 5% of people, with a higher incidence among those with diabetes and thyroid issues. This condition can persist for years and can be very demanding for both patients and healthcare providers due to the intense pain and restricted shoulder movement. Literature shows that intra-articular corticoid injection (IACI) and suprascapular nerve block (SSNB) can improve pain and range of motion in these patients. The objective of this study is to investigate if there is any significant difference in pain reduct

A team approach to adhesive capsulitis with ultrasound guided hydrodilatation: a retrospective study.

BACKGROUND: Adhesive capsulitis (AC) causes shoulder pain and limited range of motion. While ultrasound-guided suprascapular nerve block, glenohumeral joint hydrodilatation, and physical therapy are effective individually, their combined use is not well-studied. OBJECTIVE: This study evaluates the effect and safety of combining ultrasound-guided suprascapular nerve block, glenohumeral joint hydrodilatation, and physical therapy on range of motion and pain, comparing diabetic and non-diabetic patients. DESIGN: Retrospective Cohort; Level of Evidence 3. METHODS: 150 patients (30-75 years) wit

Arthro-distension with early and intensive mobilization for shoulder adhesive capsulitis: A randomized controlled trial.

BACKGROUND: There are several therapeutic options for the management of shoulder adhesive capsulitis (AC). The superiority of arthro-distension over intra-articular steroid injection (ISI) for AC remains controversial. OBJECTIVES: To evaluate the efficacy of a single arthro-distension procedure combined with early and intensive mobilization (ADM) and physiotherapy, versus ISI and physiotherapy, in people with AC lasting ≥3 months. METHODS: This was a prospective, 2 parallel-group, 2-center, observer-blind randomized controlled trial conducted in tertiary care settings. Adults with AC were ra

Blood flow evaluation by dynamic magnetic resonance imaging of symptomatic rotator cuff tears and frozen shoulders.

BACKGROUND: This study compared imaging findings of blood flow changes between symptomatic rotator cuff tear (RCT) and frozen shoulder (FS) by using 3-dimensional dynamic magnetic resonance imaging (MRI) to determine the clinical characteristics of symptomatic RCT. METHODS: The 2 study groups comprised 31 symptomatic RCT patients who underwent arthroscopic rotator cuff repair and 30 patients with FS. We denoted abnormal blood flow detected around the glenohumeral joint as the burning sign (BS). We evaluated the characteristics of dynamic MRI and compared them between BS-positive and BS-negati

Three-dimensional analysis of acromial morphologic characteristics in patients with and without rotator cuff tears using a reconstructed computed tomography model.

BACKGROUND: The relationship between rotator cuff tears and acromial shape has yet to be clarified. As a result, the most suitable location for acromioplasty for the treatment of rotator cuff tears is not known. PURPOSE: To determine whether any particular change in acromial shape is significantly associated with the presence of rotator cuff tears. STUDY DESIGN: Cross-sectional study; Level of evidence, 3. METHODS: From 2007 to 2010, we examined 25 consecutive patients with unilateral full-thickness rotator cuff tears who underwent arthroscopic repair and 17 consecutive patients with adhesi

Effect of Bankart repair on the loss of range of motion and the instability of the shoulder joint for recurrent anterior shoulder dislocation.

BACKGROUND: Bankart repair postoperative complications include loss of shoulder motion and shoulder instability. The primary reason that postoperative complications develop may be excessive imbrication of the anterior band of the inferior glenohumeral ligament (AIGHL) or inadequate repair position. The purpose of this study was to quantitatively evaluate the influence of inadequate repair by computer simulation for a normal shoulder joint. METHODS: Magnetic resonance images of 10 normal shoulder joints were acquired for 7 positions every 30° from the maximum internal rotation to the maximum e

The effect of local injections in hemiplegic shoulder pain: a prospective, randomized, controlled study.

OBJECTIVE: The aim of this study was to evaluate the effects of corticosteroid injections on hemiplegic shoulder pain and range of motion. DESIGN: Fifty-two stroke patients with shoulder pain were evaluated. Thirty-eight patients who fulfilled the criteria were assigned randomly into either injection or control groups. Transcutaneous electrical nerve stimulation and therapeutic exercise program were applied to both groups for 15 sessions. The patients in the injection group were administered either intra-articular or subacromial injections of corticosteroid and local anesthetic according to t

Treatment of "frozen shoulder" with distension and glucorticoid compared with glucorticoid alone. A randomised controlled trial.

This study is a comparison of treatments of idiopathic "Frozen Shoulder" (adhesive capsulitis), distension combined with steroid is compared with steroid alone. Evaluation was based on pain scales, analgesic usage, and range of motion outcome scales. Out of one-hundred twenty patients (age, mean 51, range 21-70) that were referred under the diagnosis FS, twenty-six fulfilled the criteria for inclusion in the study, but four patients did not want to participate in the trial, giving a total of 22 patients (age, mean 53, range 40-65) in the study. Patients were randomised by the envelope method.

Arthroscopic treatment of adhesive capsulitis.

Although conservative management with or without manipulation performed with the patient under anesthesia is the generally accepted treatment strategy for adhesive capsulitis, considerable interest is being shown in arthroscopic surgical procedures for this disorder. This study reviews the outcome of patients who underwent an arthroscopic release of the inferior capsule, reproducing in a controlled fashion the traumatic disruption of the inferior capsule commonly caused by manipulation with the patient under anesthesia. The outcome of 24 patients (26 shoulders) was assessed with an average fol

Clinical experience with cefamandole for treatment of serious bone and joint infections.

The safety and efficacy of treatment with cefamandole were evaluated in 30 patients (from 18 institutions) with serious bone and joint infections. Five of the subjects were children. The antibiotic was given intramuscularly or intravenously in doses ranging from 2 to 12 g daily for five to 44 days. Twenty-six of the 30 patients responded satisfactorily. Fourteen of the fifteen infections due to Staphylococcus aureus were among the successful cases. Other pathogens were streptococci, Escherichia coli, Proteus mirabilis, and Bacteroides fragilis. The drug was well tolerated in patients in this s

Morbidity of British coal miners in 1961-62.

Liddell, F. D. K. (1973). Brit. J. industr. Med.,30, 1-14. Morbidity of British coal miners in 1961-62. The British coal mining population in 1961 is described, in terms of the 29 084men covered in a 5% sample census, by age, type of employment, coalfield, size of community, degree of mechanization, and other factors. Over a quarter of the men were in jobs not considered specific to coalmining, although nearly half of such men were working underground. The Ministry of Pensions and National Insurance provided records of over 34 000 spells of incapacity due to sickness for these men. Miners were

Polymyalgia rheumatica: An update (Review).

Polymyalgia rheumatica (PMR) is a chronic inflammatory disease which affects the connective vascular tissue, characterized by pain accompanied by morning stiffness, predominantly of the neck muscles, hip and shoulder girdle. Usually, patients with this disease are >50 years of age and biological inflammatory syndrome is present with an increase in both the erythrocyte sedimentation rate and C-reactive protein levels, aspects similar to giant cell arteritis. The aim of the present review was to depict the current pathogenic hypothesis, diagnostic and treatment approach for patients with PMR, an

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… and tenosynovitis of the long head of the biceps tendon (LHBT), ranging from 6.2 to 100% at the shoulder level, with a higher prevalence of SASD bursitis, and less frequently, trochanteric bursitis and synovitis at the hip level ( 49 , 50 ). … Manzo et al ( 55 ) suggested a 4-point guidance on how to investigate a suspicion of PMR, ultrasound being of real positive value when bilateral SASD bursitis, LHBT tenosynovitis or trochanteric bursitis are present. Differential diagnosis . …

Equine brucellosis in Iran: serological, bacteriological and molecular analysis.

Equine brucellosis significantly impacts the health and functionality of horses, leading to complications such as bursitis infection, septic tenosynovitis, septic arthritis, and non-specific lameness resulting from joint infections. In the present study, we used the Rose Bengal plate agglutination test (RBPT), serum agglutination test (SAT), and the 2-mercaptoethanol (2-ME) assays to find equine brucellosis. From June 2018 to September 2022, 876 blood samples were randomly taken from apparently healthy racing horses in certain parts of Iran, such as Kerman, Isfahan, Tehran, Qom, and Kurdistan.…

A Comparative Analysis of the Efficacy and Safety of Nimesulide/Paracetamol Fixed-Dose Combination With Other NSAIDs in Acute Pain Management: A Randomized, Prospective, Multicenter, Active-Controlled Study (the SAFE-2 Study).

Objective In this study, we aimed to compare the efficacy and safety of the fixed-dose combination (FDC) of nimesulide (100 mg) + paracetamol (325 mg) [NP], ketorolac (10 mg) [Kt] alone, diclofenac (50 mg) + paracetamol (325 mg) [DP], and aceclofenac (100 mg) + paracetamol (325 mg) [AP] in patients with acute painful conditions. Methods This was a randomized, prospective, open-label, multicentre, active-controlled study involving patients aged ≥18 years, with acute painful conditions like low back pain, acute musculoskeletal disorders, and trauma such as tendinitis, tenosynovitis, bursitis, sp…

Clinical Value of FDG-PET/CT for the Evaluation of Rheumatic Diseases: Rheumatoid Arthritis, Polymyalgia Rheumatica, and Relapsing Polychondritis.

FDG is a tracer for visualizing glucose metabolism. PET/CT using FDG is widely used for the diagnosis of cancer, because glycolysis is eleva … ther diseases with similar symptoms. However, FDG-PET/CT reveals a characteristic FDG uptake by the bursitis in ischial tuberosity, greater trochanter, lumbar or cervical spinous process, and scapulohumeral joint. A combination of FDG-PET/CT findings showed a high diagnostic value for PMR in a differential diagnosis from RA. FDG-PET/CT is also very useful …