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Results for “Joint Capsule”

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At least 973 records · Page 54Linked to original sources

PubMed1997

[Ultrasound diagnosis of soft tissue changes in dialysis-associated amyloidosis].

AIM: To develop criteria for the detection of long term dialysis-associated soft tissue changes due to amyloid deposits in various joints. METHOD: Ultrasonographic examination of the shoulder (15 patients), hip (5 patients), knee (6 patients) and elbow (2 patients) using a 7.5 or 5 MHz scanner. A total of 28 joints were examined. RESULTS: Soft tissue changes in long term dialysis were found to be associated with an increased thickness of the supraspinatus tendon and/or biceps tendon as well as joint effusions with echogenic zones. Moreover, increased thickness of the joint capsule and echogenic proliferation of the synovia were observed. CONCLUSION: Ultrasound is an inexpensive and suitable method in the diagnosis and follow-up of soft tissue changes in patients on long term dialysis.

Adult↗

PubMed1983

Double-contrast computed tomography of the glenoid labrum.

Imaging of glenoid labrum pathology is useful to help plan surgical repair of the dislocating shoulder. Eleven patients with suspect labrum damage were imaged with computed tomography (CT) immediately after routine double-contrast shoulder arthrography. Lesions identified included attenuation, tears, and displacement of the labrum as well as stripping and stretching of the anterior shoulder joint capsule. Surgical confirmation of pathology was available in all but one case. CT of the glenoid labrum is easy to perform, low in radiation dose, and accurate.

Adult↗

PubMed1995

Shoulder kinesthesia in healthy unilateral athletes participating in upper extremity sports.

Shoulder kinesthesia has not been extensively studied in upper extremity athletes. The purpose of this study was to determine if there were differences in threshold to detection of passive motion between dominant and nondominant shoulders of healthy overhead athletes in two positions, 0 degrees and 75 degrees of external rotation. In addition, the study attempted to determine if there was a relationship between the range of external rotation (ER) and internal rotation (IR) and the threshold to detection of passive motion values. Shoulder kinesthesia was assessed in the dominant and nondominant shoulders of 20 collegiate athletes participating in unilateral upper extremity sports. A proprioceptive testing device passively moved the shoulder into internal and external rotation. The dominant shoulder had a significantly greater difficulty detecting motion compared with the nondominant arm at both 0 degrees and 75 degrees of external rotation. Both shoulders exhibited enhanced kinesthesia (lower threshold to detection of passive motion scores) at 75 degrees of external rotation compared with 0 degrees, where the glenohumeral joint capsule is relatively taut. The results of this study suggest that healthy upper extremity athletes may have kinesthetic deficits in their throwing shoulder compared with their nondominant shoulder.

Adolescent↗

PubMedDate not supplied

[Role of magnetic resonance in shoulder disease].

Next to the knee, the shoulder is the most common joint to be referred for MRI. Excellent soft tissue contrast and multiplanar acquisition provide optimal assessment of muscle, tendons, hyaline and fibrous cartilage, joint capsule, fat, bursae and bone marrow. In this article the most common indications for shoulder MRI are reviewed and discussed, but we focused primarily on the rotator cuff syndrome and shoulder instability. Correct diagnosis requires the use of appropriate pulse sequences and imaging planes, proper patient positioning, and a satisfactory surface coil. Moreover, technical improvements continuously augment the ability of MRI to study the shoulder; for example Magnetic Resonance arthrography is superior to the other imaging techniques in evaluation of glenohumeral joint. This interdependence between technical development in MRI and clinical advance in shoulder therapy ensures that MRI will continue to play an important role in the routine management of patients with shoulder disease.

Humans↗

PubMedDate not supplied

[Fabry disease, a disease with rheumatic aspects: radiology of soft tissue and bone changes in the hand].

Fabry's disease is a hereditary lipid storage disease with deposition of ceramides in nearly all tissues. The lipid deposition in the skin and the synovial compartments causes an enlargement of the skin, the joint capsules and the tendon sheaths, which are recognizable by low KV radiography. The bones of the hand mainly show multiple enthesopathic ossifications of a peculiar kind at the insertions of fibrous structures and few intra- and extraarticular erosions. The clinical picture often simulates an inflammatory rheumatic disease.

Arthritis, Rheumatoid↗

PubMed2001

Anatomical attachments to the proximal phalangeal base--a case for stability.

Transverse midshaft fractures of the proximal phalanx are often unstable and require open reduction and internal fixation. In contrast, fractures of the base of the proximal phalanx are occasionally amenable to conservative treatment in the form of manipulation and a graded mobilisation programme. This stability may be the result of splinting of the fracture by the surrounding anatomical structures, but to our knowledge this has not been previously elucidated anatomically. In this study we define the extent of attachment of the various anatomical structures to the base of the proximal phalanx. The contribution of the joint capsule, collateral ligaments, accessory collateral ligaments, interosseous muscles, and volar (palmar) plate may confer stability to fractures in the proximal 6-9 mm range at the base of the proximal phalanx, once they are reduced and immobilised in the correct positions.

Finger Injuries↗

PubMedDate not supplied

Kinematic MRI of the normal shoulder using a specially designed positioning device.

OBJECTIVES: The objective of this study was to determine the normal patterns of the normal glenohumeral joint by kinematic MRI with a special positioning device. METHODS: Ten healthy volunteers were examined using an open MRI system. Axial three-dimensional gradient-echo images were obtained through the glenohumeral joint in the transverse axial plane by 30 degrees increments from external rotation to internal rotation. RESULTS: The free margins of the anterior labrum (40%) and the posterior labrum (10%) were seen to be slightly mobile. Although the anterior labrum showed increased signal intensity (20%), no signal intensity changes occurred in the posterior labrum. Most of the anterior labrum was not triangular in internal rotation. The anterior joint capsule showed changes in shape (60%) in neutral and internal rotation. CONCLUSIONS: Kinematic MRI can provide information on the labrocapsular ligamentous complex without the need for intraarticular injection of a contrast agent.

Adult↗

PubMed2005

[Ultrasound evaluation of the acromioclavicular joint. A comparison with magnetic resonance imaging].

INTRODUCTION: Ultrasound is useful in detecting acromioclavicular pathologies in cases of trauma, inflammations and degenerative changes in sports medicine. Many studies compare joint space and capsular dimensions of symptomatic and asymptomatic patients. However, no study has examined the reproducibility and reliability of these measurements. The aim of this study was to evaluate the reliability of ultrasonographic measurements in assessing the acromioclavicular joint. MATERIALS AND METHODS: 27 acromioclavicular joints of 15 healthy subjects were examined by T1 weighted magnetic resonance imaging (MRI) to determine the normal limits of joint space (a) and joint capsule (b). These measurements were compared to standardised ultrasonographic (11 Mhz) measurements, which were repeated three times. RESULTS: The mean difference between MRI and ultrasound measurements was 1.5 +/- 1.3 mm and 1.3 +/- 1.2 mm for distance a and b, respectively. Reproducibility of ultrasonographic measurements was high with a mean standard deviation of 0.3 +/- 0.2 mm and 0.4 +/- 0.3 mm for distance a and b, respectively. CONCLUSION: Due to low costs, safety and wide availability ultrasonography is suited for the evaluation of the acromiocalvicular joint. However, when interpreting the results measurement errors, limitations in resolution of the system used, and the anatomy of the acromioclavicular joint and its anatomic variants have to be taken into consideration.

Acromioclavicular Joint↗

PubMed2004

Analysis of a retrieved delta III total shoulder prosthesis.

A reversed Delta III total shoulder prosthesis was retrieved post-mortem, eight months after implantation. A significant notch was evident at the inferior pole of the scapular neck which extended beyond the inferior fixation screw. This bone loss was associated with a corresponding, erosive defect of the polyethylene cup. Histological examination revealed a chronic foreign-body reaction in the joint capsule. There were, however, no histological signs of loosening of the glenoid base plate and the stability of the prosthetic articulation was only slightly reduced by the eroded rim of the cup.

Aged↗

PubMed1994

[Backward hypertranslation of the head: participation in the whiplash injury mechanism of the cervical spine?].

Based upon a review of the literature, a theory is developed that in whiplash injury the primary mechanism of the trauma is not hyperantiflexion but hypertranslation of the head backwards. Thus a hyperanteflexion (not hyperretroflexion) of the upper cervical spine, probably especially of the atlanto-axial segment, is induced, causing an overstretching of the ligaments concerned (also the alar ligaments) and the joint capsule. The disorder of the propriosensitive information concerning the position of the head relative to the body with chronic disturbances of posture and equilibrium is explained by the thus generated chronic ligamentous instability of the upper cervical spine. In humans our theory is not yet sufficiently supported by experimental results.

Animals↗

PubMed1986

MRI of joint fluid in the normal and ischemic hip.

MR images in 36 hips with documented avascular necrosis and 80 hips without evidence of joint disease were studied to determine the amount and appearance of fluid in the joint. All MRI examinations were done on a 1.5-T machine and included coronal images made with relative T2 weighting (repetition times = 2000-2500 msec, echo delays = 60-100 msec). The amount of joint fluid, which had an intense signal higher than fat, was graded from 0 to 3 and analyzed with respect to the patient's age and radiographic stage of avascular necrosis. Joint fluid was seen in 84% of presumed normal hips. Only four (5%) of 80 had enough fluid to surround the femoral neck (grade 2), and none had sufficient fluid to distend the joint capsule (grade 3). In comparison, 21 (58%) of 36 hips with avascular necrosis had grade-2 or grade-3 effusions (p less than 0.005), and some fluid was seen in all. Grade-3 effusions were seen in seven (50%) of 14 hips with flattening of the femoral head, compared with only one (5%) of 20 in which the femoral contour was normal. It is concluded that small amounts of fluid are present in both normal hips and those with avascular necrosis. In avascular necrosis, increased joint fluid may be present before radiographic abnormalities occur, but it is greatest after there is flattening of the femoral head. MRI is a highly sensitive method for detecting fluid in the hip joint.

Adolescent↗

PubMed1997

Structural, material, and anatomic characteristics of the collateral ligaments of the canine cubital joint.

OBJECTIVE: To document gross and microscopic anatomic features of the collateral ligaments of the canine cubital joint and to determine their structural and material properties. ANIMALS: 37 canine cadavers. PROCEDURE: After measurement of ligament dimensions, the bone-collateral ligament-bone specimens were loaded in tension until failure, using a materials testing machine. Data from the load-displacement curves were used to determine the structural and material properties of the ligaments. Gross anatomic features were studied during dissection of the specimens from the medial collateral ligament (MCL) and lateral collateral ligament (LCL), which then were saved for microscopic examination. RESULTS: Failure load and stiffness values for the LCL were significantly (P < 0.05) greater than those for the MCL. The LCL had obvious cranial and caudal components that attached to the radius and ulna, respectively. The MCL also had cranial and caudal components; however, the cranial component was indistinct, appearing only as a slight thickening of the joint capsule. The caudal component was more prominent; as it extended distad, it had minor attachments to the interosseous and annular ligaments and attached principally on the caudolateral surface of the proximal portion of the radius. The caudal component did not have substantial attachment to the ulna in any of the specimens studied. Both ligaments were composed of closely packed, parallel fascicles of dense collagen, with scant amounts of fibrocartilage and no detectable elastin. CONCLUSIONS: Gross anatomic features of the collateral ligaments of the canine cubital joint indicate that they provide principal structural support to the joint; microscopic anatomic features are typical of other ligaments. The LCL is stronger and stiffer than the MCL; however, their material properties are similar. CLINICAL RELEVANCE: Knowledge of the sites of attachment of collateral ligament components is essential for surgeons undertaking repair or reconstruction of these structures.

Animals↗

PubMed2003

Structure and vascularization of the acetabular labrum with regard to the pathogenesis and healing of labral lesions.

INTRODUCTION: The aim of this study is to examine the structure and vascularization of the acetabular labrum with regard to the pathogenesis and healing of labral tears. MATERIALS AND METHODS: The labral tissue was characterized immunohistochemically and under light microscopy; the collagen fibril texture was demonstrated by scanning electron microscopy after temporary staggered maceration of the tissue; and the vascularization of the acetabular labrum was studied immunohistochemically using antibodies against laminin. RESULTS: The peripheral aspect of the acetabular labrum consists of dense connective tissue. The internal layer consists of type II collagen-positive fibrocartilage. Scanning electron microscopy revealed three distinct layers in the acetabular labrum: (1) the articular surface was covered by a meshwork of thin fibrils; (2) beneath the superficial network, there is a layer of lamella-like collagen fibrils; (3) the majority of the collagen fibrils are oriented in a circular manner. Blood vessels enter the labrum from the adjacent joint capsule. The distribution of vessels within the labrum is not homogenous. Blood vessels can be detected only in the peripheral one-third of the labrum. The internal part is avascular. CONCLUSION: The result of this study demonstrates that the structure of the acetabular labrum is highly significant for the direction of traumatic and dysplastic labral lesions. The biomechanical analysis of the structure suggests that the labrum is stressed by compressive load. Therefore, excision or removal of the labrum may alter physiological functions such as enhancing joint stability and load distribution. The vascular pattern identified should encourage surgeons to develop repair strategies of peripheral labral tears to maintain its functions in the hip.

Acetabulum↗

PubMed1995

Human lumbar apophyseal joint damage and intervertebral disc degeneration.

OBJECTIVES: To record the extent and location of lumbar apophyseal cartilage damage, and to ascertain if the extent of damage is correlated with the grade of disc degeneration, age, or both. METHODS: The extent and location of fibrillated areas of the apophyseal cartilage of the joint surfaces of 29 lumbar motion segments were examined using computer aided image processing of Indian ink stained areas, and degeneration of the associated intervertebral discs graded using the method of Nachemson. RESULTS: It was found that these joints showed a greater extent and prevalence of cartilage fibrillation than the knee, hip or ankle, with significant damage in specimens younger than 30 years. Damage was predominantly located peripherally, superiorly, and posteriorly in the concave superior apophyseal surfaces, and was predominantly peripheral and posterior in the inferior surfaces, with a tendency to be located inferiorly. There was a weak correlation between apophyseal joint damage and the intervertebral disc degenerative grade, but this was inconclusive, as both increased with age. CONCLUSIONS: The pattern of damage exhibited by superior joint surfaces is most probably caused by tension on collagenous joint capsule fibres which insert into the surfaces posteriorly, so producing an area of fibrocartilage unsuited to loadbearing. Tension on such fibres would be greatest during spinal flexion. The pattern of damage of the inferior surfaces lends some support to the hypothesis that their apices impact the laminae of the lumbar vertebra inferior to them, consequent upon the degeneration and narrowing of the associated intervertebral disc. The predominantly peripheral location of fibrillation of both superior and inferior surfaces may be associated with inadequate mechanical conditioning of marginal joint areas. Disc degeneration cannot be the initial cause of apophyseal fibrillation in most specimens. The study indicates a need for regular spinal exercise, starting at a young age.

Adolescent↗

PubMed1992

Bilateral subluxation of the pastern joint in the forelimbs of a foal.

A three-month-old foal was presented with subluxation of the proximal interphalangeal joint in both forelimbs. The condition, which was considered to represent an unusual manifestation of breakdown of the suspensory apparatus, appeared to have developed as a consequence of extreme overexertion, 10 days previously. This had resulted in rupture of the palmar supporting structures of the joint; namely, the superficial distal sesamoidean ligament, the insertion of the superficial digital flexor tendon and the palmar joint capsule. Severe laxity of the flexor tendons had been present in the neonatal period, and it is postulated that this might have contributed to the development of the condition by weakening the suspensory apparatus, and placing increased strain on the suspensory ligament and its associated structures.

Animals↗

PubMed2001

Cervical spine: postmortem assessment of accident injuries--comparison of radiographic, MR imaging, anatomic, and pathologic findings.

PURPOSE: To assess the ability of postmortem radiography and magnetic resonance (MR) imaging to depict occult cervical spine injuries as compared with anatomic and pathologic findings. MATERIALS AND METHODS: The cervical spines of 10 adult accident victims underwent radiography and MR imaging, with T1-weighted, fast spin-echo T2-weighted, and four gradient-echo pulse sequences. The frozen specimens were cut into 3-mm-thick slices (sagittal plane) and photographed, and microfocus radiographs were obtained. Imaging findings were compared with the anatomic and pathologic findings. RESULTS: Eight of the 10 specimens had 28 posttraumatic lesions: three fractures (two missed at the initial MR imaging reading), 10 facet joint capsule lesions with bleeding, five soft-tissue and ligament lesions, eight disk lesions, and two spinal cord lesions. Radiography depicted one lesion (4%). Two partial ruptures of the anterior annulus fibrosus were depicted at only MR imaging. Initially, 11 of 28 lesions were detected on MR images; retrospectively, 17 of 28 lesions were correlated with anatomic findings. CONCLUSION: Soft-tissue and intervertebral disk and ligament injuries account for 89% (25 of 28) of posttraumatic cervical spine lesions detected on postmortem images. Occult lesions, including apophyseal joint injuries, were found in clinically noninjured cervical spines. MR imaging was limited in the depiction of discrete lesions when T1-weighted non-fat-saturated, fast spin-echo T2-weighted, and gradient-echo pulse sequences were used.

Adult↗

PubMed1995

[The trans-ulnar approach to the elbow joint].

A lateral approach to the elbow joint by ulnar diaphyseal osteotomy, first reported by Lenehan and Nunamaker (1982), is described. The ulna is transsected distally to the elbow joint. After the joint capsule, the caudal crus of the lateral collateral ligament and the annular ligament of the radius are dissected, the olecranon can be displaced medially. An optimal survey of the humeral condyle is guaranteed. The efficiency of this approach is demonstrated by a case report.

Animals↗

PubMed1997

Staged extensor tendon reconstruction in the finger.

Staged extensor tendon reconstruction using a silicone implant followed by tendon grafting was done to restore proximal interphalangeal (PIP) joint extension in 6 fingers with severe injuries to the dorsal skin and extensor mechanism. Abrasions to the joint capsule and cortical surfaces were also present. To avoid finger stiffness, the reconstruction was delayed and range of motion exercises were initiated early. The skin injury was managed by split-thickness skin grafting or allowed to heal by secondary intention to avoid prolonged immobilization. During surgery, the peritendinous fascia of the extensor tendon is used to guide insertion of the implant, and it serves as a premade tunnel that appears to aid the gliding and stability of the implant and subsequent tendon graft. Active extension of the PIP joint was restored in all fingers; there was an average extension lag of 15 degrees. PIP joint flexion averaged 95 degrees. On the basis of this experience, the author believes the technique to be a reliable treatment alternative for severely injured fingers with extensor mechanism loss.

Adult↗