PubMed · 12216968
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Daniel W Carlson, David H Kim. 2002. Os acromiale.. https://pubmed.ncbi.nlm.nih.gov/12216968/
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Adhesive capsulitis (AC) is a disorder that is characterized by shoulder pain and progressive limitation of both active and passive shoulder motion. Although the underlying pathological mechanisms of the disease are not well understood, the inflammatory reactions depending on the stage have been demonstrated histologically. The purpose of the study is to investigate the inflammatory changes that can be demonstrated with Tc-99m HIG in AC, and to determine the presence of correlations between scintigraphic findings and the clinical assessment. Twenty-one patients (12 females and 9 males) with a mean age of 50.57+/-8.49 were included in the study. AC was diagnosed according to recognized criteria. The planar X-ray images of the affected shoulders of all patients were normal. The patients were evaluated with the Constant Scoring System, and the functional and pain assessment parts of the American Shoulder and Elbow Surgeons' Form (ASES). Three phase bone scans and Tc-99m HIG scintigraphy were performed at least two days apart. Bone scan and Tc-99m HIG scintigraphy were evaluated visually and HIG uptake was evaluated in comparison with the contralateral normal shoulder. Bone scan demonstrated hypervascularity in 9 of the 21 patients (43%), whereas increased osteoblastic activity was detected in 19 (90%) in the affected shoulder. Tc-99m HIG uptake was positive in 12 (57%), and negative in 9 (43%) patients. All patients with increased Tc-99m HIG accumulation in the affected shoulder, also had increased osteoblastic activity on Tc-99m bone scintigraphy. A significant correlation was found between HIG uptake and constant, functional and pain scores. The difference between these scores was also statistically significant in patients with HIG positive and negative uptake. This study indicates that there is a good correlation between Tc-99m HIG scan findings and clinical scores. Tc-99m HIG accumulation in the affected shoulder may be related to continuing inflammatory reaction to AC. Tc-99m HIG scan may be a noninvasive, complementary method for demonstrating continuing inflammatory changes and may help in staging the disease.
We compared the results of modified and classic anterior acromioplasty in order to identify the significance of the resected acromion. Fifty patients with shoulder impingement syndrome resistant to conservative therapy underwent surgical treatment. We treated 30 patients with classic Neer acromioplasty (group 1), and 20 patients with modified Neer acromioplasty (group 2). The patients were assessed according to pain and shoulder movement. Excellent or good results were achieved in 28/30 patients in group I and 19/20 patients in group 2. The results indicate that both surgical techniques are effective procedures in the treatment of shoulder impingement syndrome, and the type of bone resection does not influence the clinical outcome.
DESIGN: Deficits in trunk control due to spinal cord injury (SCI) lead to slower target-reaching movements of the hand. We investigated whether the movement path is also affected, and whether providing external support for the trunk can abolish the kinematic differences. OBJECTIVE: To compare movement trajectories between individuals with SCI and neurologically normal individuals, with and without external trunk support. SETTING: Neural Control/Biomechanics Laboratory, University of Illinois, Chicago, USA. METHODS: Five subjects with levels of injury between C7 and T4 were tested 3-8 years post-injury, and compared with five control subjects. Two targets were employed. Trajectories were recorded by a motion-capture system using infrared emitting markers. Peak speed and path curvature were calculated for the fingertip and for the acromion. RESULTS: Compared with control subjects, the subjects with SCI exhibited lower peak speed of the fingertip but not of the acromion, and less straight paths for both. When the trunk was supported externally, the difference in fingertip speed persisted. The support abolished the difference in path curvature for the fingertip but accentuated that for the acromion. CONCLUSION: The slower hand movements of individuals with SCI are not simply time-scaled versions of those of normal subjects, and the provision of trunk support does not erase the kinematic differences between the reaching movements of the two groups.