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Biomedical subjects

E V Craig

Publications and source records attributed to E V Craig.

16 recordsLinked to original sources
PubMed1992

Shoulder problems in the weekend athlete.

With more competitive and recreational athletic pursuits now being undertaken by an aging population, the painful shoulder is seen frequently in the weekend athlete. Episodic stresses to soft-tissue restraints and musculotendinous units around the shoulder lead to a variety of overused pathologic entities. The two most common shoulder problems in the weekend athlete are irritation, swelling, and mechanical impingement; and tearing of the rotator cuff with traumatic shoulder instability (typically of an anterior direction).

Arthroscopy↗
PubMed1989

Rheumatoid disease.

This article documents the developments in surgery for the rheumatoid hand that have been made during the last 40 years and reviews the pertinent literature.

Arthritis, Rheumatoid↗
PubMed1988

Ultrasonography of rotator cuff tears: a review of 500 diagnostic studies.

Ultrasonography of the rotator cuff has been shown to be of value in diagnosing rotator cuff tears. This report summarizes our experience with our first 500 diagnostic examinations. All patients were examined in the hyperextended internal rotation view with commercially available high-resolution real-time ultrasound equipment. Patients were diagnosed as having a rotator cuff tear if a focal echogenic lesion or a defect within the rotator cuff was identified. This study confirmed the value of ultrasonography for the diagnosis of rotator cuff tears. Accuracy, sensitivity, and specificity all exceeded 90%, and correlated with surgical findings. This was better than arthrography in the same patient population. Ultrasound is an accurate noninvasive method of examining the rotator cuff for the presence of tears. We suggest that rotator cuff ultrasonography is the procedure of choice for the diagnosis of tears if adequate instrumentation is available.

Arthrography↗
PubMed1988

Total shoulder replacement.

It appears that total shoulder replacement can be performed with a high degree of patient satisfaction, with few complications, and with long-term results which certainly appear to rival the success of other arthroplasties. However, the technique is extremely demanding and requires an experienced shoulder surgeon, who must successfully resolve numerous intraoperative variables and problems, must be able to deal with factors which may affect the stability and strength of the implant, and must individualize the postoperative rehabilitation according to quality of bone and soft tissue, as well as the specific needs and desires of the patient. However, when performed technically satisfactorily with proper patient selection, with meticulous attention to the details of the soft tissue surrounding the implant, and with attention to the postoperative rehabilitation, the results have been impressive. Total shoulder replacement has successfully taken its place in the armamentarium of other total joint replacements which have dramatically altered the quality of life in the arthritic patient.

Arthritis↗
PubMed1987

Management of tumors of the shoulder girdle.

The differential diagnosis of all painful shoulders includes tumors of a wide variety. Evaluation of a shoulder tumor has several areas in common with other musculoskeletal neoplasms, but the function of the rotator cuff is a key consideration in treatment goals. Thorough evaluation of patients with persistent pain requires not only routine radiography, but also radionuclide imaging, computed tomographic (CT) scanning, magnetic resonance imaging, and angiography. As with all tumors, the importance of the biopsy cannot be overemphasized. A poorly executed biopsy can make limb salvage impossible. Surgical treatment of shoulder tumors will depend on age, type of tumor, extent of tumor, and neoplasm aggressiveness. Though in some instances limb sparing is not possible, a variety of reconstructive options exists that will salvage the distal limb and obtain satisfactory surgical margins.

Bone Neoplasms↗
PubMed1986

Sonography of the postoperative rotator cuff.

In experienced hands, high-resolution real-time sonography has been shown to be an accurate noninvasive method for diagnosis of rotator cuff tears. The sonographic appearance of the postoperative rotator cuff has not been previously reported. Forty postoperative patients were studied sonographically 1 week to 6 years after rotator cuff repair. The postoperative rotator cuff is abnormally echogenic and can be very similar in appearance to a small rotator cuff tear in a nonoperated patient. Soft-tissue planes about the tendon are distorted or absent. Criteria for diagnosis of retear must be different from those used in detecting new tears in a nonoperated cuff. Postoperative echogenicity is normal, but the finding of a defect or gap within the rotator cuff tendon is the only accurate sign of a recurrent rotator cuff tear.

Humans↗
PubMed1986

Subacromial impingement syndrome in hereditary multiple exostoses.

An unusual cause of subacromial pain was observed in a 32-year-old woman with multiple exostoses. The pain was the direct result of the mechanical impingement syndrome from these exostoses. Hereditary multiple exostoses should be investigated systematically, because many other, more common pain-producing conditions are possible. Secondary malignant degeneration of one of the cartilaginous coverings of the exostoses is very rare.

Acromion↗
PubMed1986

Biomechanical study of the ligamentous system of the acromioclavicular joint.

The ligamentous structures of the acromioclavicular joint were studied by gross examination and quantitative measurement in twelve human cadaver specimens. Distances between insertions at various extreme positions of the clavicle were studied with the biplane radiographic technique. Ligamentous contributions to joint constraint under displacements were determined by performing load-displacement tests along with sequential sectioning of the ligaments. Twelve modes of joint displacement were examined. The acromioclavicular ligament acted as a primary constraint for posterior displacement of the clavicle and posterior axial rotation. The conoid ligament appeared to be more important than has been previously described. That ligament played a primary role in constraining anterior and superior rotation as well as anterior and superior displacement of the clavicle. The trapezoid ligament contributed less constraint to movement of the clavicle in both the horizontal and the vertical plane except when the clavicle moved in axial compression toward the acromion process. The various contributions of different ligaments to constraint changed not only with the direction of joint displacement but also with the amount of loading and displacement. For many directions of displacement, the acromioclavicular joint contributed a greater amount to constraint at smaller degrees of displacement, while the coracoclavicular ligaments, primarily the conoid ligament, contributed a greater amount of constraint with larger amounts of displacement.

Acromioclavicular Joint↗
PubMed1986

The acromioclavicular joint cyst. An unusual presentation of a rotator cuff tear.

An unusual presentation of a full-thickness tear of the rotator cuff is the acromioclavicular (AC) joint cyst. This is formed when glenohumeral joint fluid leaks through the full-thickness cuff tear and into a diseased AC joint, eventually distending the superior capsule. Often, communication between the cyst and the glenohumeral joint can be demonstrated on shoulder arthrogram. It is essential to recognize that the presenting cyst is usually indicative of an underlying full-thickness rotator cuff tear, which is often massive and which will be difficult to reconstruct. This clinical finding is reported in the following two cases to emphasize the important relation between AC joint disease and rotator cuff abnormalities. Attempted excision of this cyst without recognition of its pathogenesis usually leads to cyst recurrence and unimproved symptoms.

Acromioclavicular Joint↗
PubMedDate not supplied

Clinical significance of sonographic findings in the abnormal but intact rotator cuff: a preliminary report.

Shoulder pain is a common orthopedic problem. Clinical examination is often nonspecific and arthrography is normal in those patients with the most frequent cause of shoulder pain--noncalcific tendonitis secondary to impingement. Ultrasonography has recently shown itself to be of value in the diagnosis of rotator cuff tears. In addition to the diagnosis of tears, however, sonography can demonstrate abnormalities within the intact rotator cuff tendon. These abnormalities consist of changes in echogenicity and thickness of the tendon. The patterns of abnormality demonstrated correlate with pathologic changes seen in tendonitis. This preliminary study suggests that the ability to demonstrate an abnormal rotator cuff tendon has potential for becoming a valuable aid to the orthopedist in allowing confident diagnosis of rotator cuff disease in the presence of nonspecific symptomatology and an intact tendon.

Humans↗
PubMedDate not supplied

Ultrasonography of the rotator cuff. Normal and pathologic anatomy.

Forty-eight patients with shoulder pain and 15 normal volunteers underwent rotator cuff imaging using high resolution real time ultrasound. The potential diagnostic value of sonography in detecting rotator cuff tears was evaluated by correlating ultrasound findings with surgical findings in 19 patients, 12 of whom also underwent preoperative arthrography. The preoperative ultrasound diagnosis was correct in 18 of the 19 patients undergoing surgery for possible rotator cuff tears. In the group of 12 surgical patients undergoing both preoperative arthrography and sonography, ultrasound correctly predicted the presence of a rotator cuff tear in 12 of 12 patients, while arthrography predicted cuff tears in only nine of 12. Good anatomic definition of the rotator cuff was obtained in both symptomatic and asymptomatic groups. The characteristic appearance of the normal and pathologic rotator cuff is described. Rotator cuff sonography promises to be a valuable new diagnostic tool for evaluating patients with suspected rotator cuff tears.

Adult↗