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J Lubowitz

Publications and source records attributed to J Lubowitz.

5 recordsLinked to original sources
PubMed1996

How much does inferior capsular shift reduce shoulder volume?

The purpose of this study was to quantitate the effect of inferior capsular shift on shoulder volume. Four fresh frozen cadaveric shoulders were analyzed. Volume before and after shift was determined using 3 techniques: (1) Magnetic resonance imaging sequences were digitized to computer and analyzed for volume via a 35-mm camera using Cue 2 software. The capsule was delineated by contrast between light and dark regions. Volume was calculated by summing the total area of respective slices. (2) Ultrasound images, obtained after surgical exposure of the capsule, were digitized. Volume was calculated using the formula for a prolate ellipsoid. (3) An 18-gauge needle was used to inject and evacuate saline via an anterior approach. Quantity of aspirated fluid provided a direct measure of volume. Inferior capsular shift was performed. After the operation, measurements were repeated. Inferior capsular shift reduced volume in all shoulders with each technique. On average, inferior capsular shift reduced joint volume by 57 %). A measurable reduction in shoulder joint volume is an effect of capsular shift. This measurement may have clinical application if volume is an indicator of instability or laxity.

Cadaver↗
PubMed1995

Adhesive capsulitis of the shoulder: MR diagnosis.

OBJECTIVE: Adhesive capsulitis is a clinical syndrome of pain and severely decreased joint motion ("frozen shoulder") caused by thickening and contraction of the joint capsule and synovium. Although arthrographic criteria for the diagnosis have been described, to our knowledge, the MR characteristics have not been reported. Accordingly, we studied the MR findings in 10 patients with this syndrome. MATERIALS AND METHODS: MR images of 25 subjects were included in the study. Nine had adhesive capsulitis documented by arthrography, and one had adhesive capsulitis proved at surgery. The MR findings in these patients were compared with those of 15 asymptomatic volunteers. Images were assessed for thickness of the joint capsule and synovium, for thickness of the coracohumeral ligament, and for volume of articular fluid. Capsule and synovium thickness was measured adjacent to the axillary recess. The volume of intraarticular fluid was calculated from direct measurements of the axillary recess and biceps tendon sheath. The rotator cuff interval was qualitatively evaluated for the presence of abnormal tissue. RESULTS: Thickening of capsule and synovium on MR images was characteristic of adhesive capsulitis, with a significant difference between mean thickness in patients with adhesive capsulitis (5.2 mm) and in asymptomatic volunteers (2.9 mm) (p < .01). Capsule and synovium thickness greater than 4 mm was a specific (95%) and sensitive (70%) criterion for the diagnosis of adhesive capsulitis. There was no significant difference in volume of articular fluid or thickness of the coracohumeral ligament between patients with adhesive capsulitis and asymptomatic volunteers (p > .5). The rotator cuff interval was not useful for assessing changes of adhesive capsulitis. CONCLUSION: Joint capsule and synovium thickness greater than 4 mm is a useful MR criterion for the diagnosis of adhesive capsulitis. The volume of articular fluid seen on MR images is not significantly diminished in patients with adhesive capsulitis.

Adult↗
PubMed1993

Case report 815: Tear of the rotator interval.

Rotator interval tears are an uncommon, but clinically important subtype of rotator cuff tear. As MRI assumes an ever increasing role in the imaging evaluation of the painful shoulder, radiologists must be aware of this entity and appreciate the difficulty in diagnosing these tears with MRI. Differentiation of a true rotator interval tear from normal synovium and capsule in this space is most likely not possible with MRI, and symptoms may be referred and misleading. It is therefore important to correlate the MR findings with the clinical history and physical examination.

Aged↗
PubMed1993

Midtarsal fracture-subluxation. Case report and review of the literature.

Avulsion of the navicular tuberosity in association with fracture at the calcanecuboid joint is a characteristic pattern of injury resulting from an acute valgus and dorsiflexion stress. Only 22 cases of this unusual injury pattern have been reported, and confusion exists regarding treatment. Recommendations for management focus primarily on the calcaneocuboid disruption. Only two of these reports specifically addressed the posterior tibial tendon avulsion. Each component of this injury pattern should be considered separately. Calcaneocuboid fractures should be treated conservatively or operatively, depending on the extent of articular involvement. Conversely, the navicular tuberosity avulsion should be considered as the acute phase of a syndrome potentially leading to a chronic, posterior tibial tendon-deficient foot. Depending on the degree of displacement of the navicular avulsion fracture, prompt surgical intervention may be justified. A 73-year-old woman illustrates the rationale and treatment of a typical case.

Aged↗