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At least 19 recordsLinked to original sources
PubMed1993

[Treatment strategies in infections of the shoulder joint].

Shoulder joint infections are severe pathological conditions. Since the success of therapy is decisively dependent on early treatment, if joint infection is suspected, the patient should be hospitalized immediately. Characteristic suspicious features are extremely severe shoulder pain, adoption of a pain-relieving posture, and severe malaise. The diagnosis and differential diagnosis are discussed. In addition to selective parenteral administration of antibiotics, treatment comprises various methods of draining the shoulder joint in combination with temporary immobilization.

Anti-Bacterial Agents↗
PubMed1996

[Arthroscopy and arthroscopic surgery of the shoulder joint].

Shoulder arthroscopy is a valuable procedure in unclear shoulder pain and the differential diagnosis between instability and impingement. With arthroscopic subacromial decompression comparable results to open operations can be achieved whereas in stabilizing procedures of the shoulder joint, open surgery is still superior to arthroscopic operations.

Arthralgia↗
PubMed1988

[Sprains and dislocations of large joints. The shoulder joint].

Injuries of the shoulder joint require exact diagnostic assessment. Soft tissue lesions which lead to instability of the joint must be recognized and treated adequately. Besides clinical and radiological examination, arthroscopy and sonography are becoming increasingly important. Acute sprain of the shoulder joint without instability is treated by a short immobilisation followed by active exercises, sprain (distorsion) with instability (dislocation!) may be treated by short immobilisation (two weeks) and early functional exercises or operatively by repair of a Bankart lesion, rupture of the rotatorcuff etc. A correlation between duration of immobilisation and subsequent recurrent dislocation has not be proven yet.

Adult↗
PubMed2000

Anatomical basics, variations, and degenerative changes of the shoulder joint and shoulder girdle.

This paper summarizes the anatomical basics of the shoulder, their variations, and precise definitions, including differential diagnoses. It also describes the characteristic degenerative changes caused by aging. A typical variation (7-15%) is the os acromiale, which forms the triangular epiphysis of the scapular spine. This abnormality must be differentiated from a fracture of the acromion or a pseudarthrosis. Because ossification of the acromion is complete after age 25, the os acromiale should be diagnosed only after this age. The shape of the acromion is a further important feature. In a recent anatomical study, the following frequencies of the Bigliani-types of the acromial shape were anatomically determined - type 1 (flat), 10.2% and type 2 (curved), 89.8%. Type 3 (hooked) was not observed, which indicates that this type is probably a misinterpretation of the so-called acromial spur. Minor dehiscences and perforations in the infraspinate or supraspinate fossa should not be confused with malignant osteolyses. The scapula has three ligaments of its own, (1) the coracoacromial ligament and its osseous fixations form an osteofibrous arch above the shoulder joint, which plays a part in impingement syndrome; (2) the superior transverse scapular ligament or its ossified correlate arches the scapular incisure and can cause a typical compression syndrome of the suprascapular nerve; (3) the inferior transverse scapular ligament is of no great clinical importance. Two intraarticular structures (glenoid labrum and tendon of the long bicipital head) must be mentioned. The glenoid labrum consists of dense connective tissue and surrounds the margin of the glenoid cavity. Two areas exhibit specialized conditions, cranial at the supraglenoid tubercle an intimate relationship exists to the tendon of the long bicipital head and in about 55% of cases, the labrum is stretched over the glenoid rim at the ventral side. At the area of the biceps-tendon-labrum complex, so-called SLAP-lesions may occur and at the glenoid rim, where the labrum is often not fixed to the bony margin, avulsions of the labrum may occur. This well-established anatomical condition must not be mistaken for a manifest Bankart-lesion. The glenohumeral ligaments, which are located in the ventral articular capsule, have a stabilizing function for the ventral part of the glenoid labrum. The glenohumeral ligaments lift the articular lip where it crosses the glenoid notch. This 'labrum-lift effect' supports the stabilizing features of the articular lip and the glenohumeral ligaments. The rotator cuff is composed of the tendons of the teres minor, infraspinatus, supraspinatus, and subscapularis muscles. This cuff has a poorly vascularized area, due to mechanical conditions, about 1.5 cm from the major tubercle, which causes degenerative changes and eventually may lead to ruptures. Results of the impingement-syndrome and the osteoarthrotic changes of the shoulder and acromioclavicular joint are also presented and discussed. Finally, the coracoclavicular joint, which probably represents no congenital entity but appears due to a changed, lowered position of the shoulder girdle, is discussed. The paper also presents instructive figures of anatomical preparations that can be used to make more precise radiological and differential diagnoses. All preparations were done by the author and are part of a series of more than 300 preparations of the shoulder joint and girdle.

Acromion↗
PubMed1998

Rotational action of the supraspinatus muscle on the shoulder joint.

The shoulder joint allows three-dimensional movement. In order to analyze the function of the muscles which act on the shoulder joint, three-dimensional movements, including rotation, must be considered. Among muscles participating in the shoulder joint movement, the supraspinatus muscle is known to have abduction and stabilization effects on the shoulder joint. However, the rotational function of the supraspinatus muscle has not been identified, because few studies have been reported on it. This study investigates the rotating function of the supraspinatus muscle using electrical stimulation, magnetic resonance imaging (MRI) and anatomical examination. Electrical stimulation was applied selectively to the supraspinatus muscle of healthy subjects using percutaneous wire electrodes. The electrical stimulation was given at different positions of the shoulder joint. It was found that the electrically induced rotational movements changed their direction depending on the position of the shoulder joint. When the humerus was relatively in internal rotation, internal rotation resulted. When it was in external rotation, external rotation occurred. Regarding the abduction angle of the shoulder joint, external rotation was induced with an increase in the abduction angle, whereas internal rotation occurred when the abduction angle was decreased. By the dissection of cadavers and MRI examination, it was indicated that the relation between the running direction of the supraspinatus muscle and the center of rotation of the humeral head was dependent on the position of the shoulder joint. Those findings supported the results of electrical stimulation of the supraspinatus muscle at various shoulder positions. These results indicate that the bi-directional rotating function of the supraspinatus muscle is characterized by an anatomical relationship between the running direction of the supraspinatus muscle and the center of rotation of the humeral head.

Adult↗
PubMed1999

Bone mineral density of the shoulder joint in frozen shoulder.

The purpose of this study was to evaluate the osteopenia in several parts of the shoulder joint in a series of individuals suffering from frozen shoulder and to elucidate the pathogenesis. The bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry (DEXA). In 30 cases of frozen shoulder, 16 men and 14 women, BMD of the head of the humerus, greater tubercle of the humerus, surgical neck of the humerus, and neck of the scapula was evaluated. The average age of the male patients was 58.4 years and of the women, 59.5 years. At the neck of the scapula, there were no significant differences in any of the cases. However, there was a marked decrease in BMD at the proximal end of the humerus on the affected side of women. In contrast, men showed no significant difference between the affected and unaffected shoulders, suggesting that the degree of osteopenia remains low compared with women. Although frozen shoulder is a disease which may occur in both men and women, the loss of bone was conspicuous only in women. This may be due to the involvement of female hormones in alterations of bone in frozen shoulder, as in cases of osteoporosis, in addition to the originally low bone density in women. The degree of osteopenia of the proximal humerus with frozen shoulder was not correlated with the duration of the disease, range of motion of the shoulder joint, or patient's age.

Absorptiometry, Photon↗
PubMed1986

[Analyses of tracking movements of the shoulder joint].

The shoulder joint meets human needs by a free motions in all directions with the maximum ROM of human joints. The author gathered data on whether there exists any difference in directional motion ability of the shoulder joint, that is whether the shoulder joint has any functional plane. The difference between the right and left joints was also investigated. Elevating motions from the hanging position and the 90-degree elevated position, respectively, were tested in two directions of the sagittal and scapular planes: the results showed better motions in the scapular plane. Comparison of the right and left joints indicated that the dexterous side (dextral in all cases) moved more favorably. A few sinistral cases were also studied for the difference between the right and left sides, with the results indicating no appreciable difference.

Adult↗
PubMed2001

[Anatomy of the shoulder joint].

The shoulder joint and its associated joints form one of the most complex joint systems of the human locomotor apparatus. Its large range of motion is made possible by the interplay of 5 joints: sternoclavicular-joint, acromioclavicular-joint, glenohumeral joint, thoracoscapular joint and subacromial joint. The rotator cuff works mostly as an active stabilizer of the shoulder joint. The supraspinatus muscle causes a compression of the humerus in the glenoid mainly, furthermore it effects synergistic the abduction with the delta muscle. On the basis of its lever-arm the supraspinatus works between 0 and 60 degrees abduction the most optimally. With failure of the supraspinatus, the deltoideus can almost completely take its function. The inferior glenohumeral ligament-complex is the main passive stabilizer. The blood supply of the humerus head is ensured mainly by the a. circumflexa anterior and its rami ascendents, by several small branches from the a. circumflexa posterior and over intraosseous anastomoses. The most important vessel of the cap is the intraosseous a. arcuata out of the ramus ascendens lateralis of the a. circumflexa anterior.

Acromioclavicular Joint↗
PubMedDate not supplied

[3-dimensional image analysis of the shoulder joint--a new method for characterizing parameters of shoulder joint function].

OBJECTIVE: An exact assessment of shoulder movement is of special importance both in the diagnosis of and in the therapy for different shoulder diseases. Therefore, we developed a feasible method for the analysis of shoulder movement. METHODS: On the basis of an ELITE system and 6 skin markers (marker positions. acromion, humerus, olecranon, proc. styloideus ulnae, cervical and thoracic spine), movement analysis was performed during continuous abduction of the arm over 15 s. With the help of a purpose made software we determined the exact angle of abduction and, in addition, the acceleration (+aAC) and the deceleration (-aAC) of the acromion. We evaluated 12 normal subjects (10 male, 2 female, average age 29 yrs) without shoulder conditions and 8 patients (6 male, 2 female, average age 46 yrs.) with unilateral impingement syndrome stage II according to Neer. RESULTS: In addition to a significantly diminished abduction ability in patients with impingement syndrome, our results also revealed significantly decreased acceleration values for the acromion in impingement patients. In contrast, deceleration values for the acromion were not altered in patients with impingement syndrome. CONCLUSION: The presented method allows exact measurements of shoulder movement. In addition, measurements of acromion acceleration and deceleration seem to offer two parameters for the assessment of shoulder function in pathological conditions. Further investigations are required to prove the advantages and limitations of this method.

Adult↗
PubMed1984

[Double contrast arthrography of the shoulder joint].

The shoulder joint consists of the soft as well as the hard components. Therefore, the shoulder arthrography is a very important diagnostic tool. Although both positive and negative contrast arthrography have been critically studied, there has been little literature on the double contrast arthrography. The purpose of this paper is to determine the standard technique of the double contrast arthrography, to describe arthrographic findings and to assess its clinical effectiveness of this method. Firstly, the author macroscopically examined the anatomical specimens and molded the interior of the joints with Mercox in the various arm positions. From this experiment, the author correlated the anatomical structures with the shadows on the double contrast arthrogram. Secondly, the arthrography was performed in the normal young adults to determine the ideal volume of the contrast media and the standard positioning of roentgenography. The standard findings were obtained from the arthrograms of normal adults. Thirdly, the author performed the double contrast arthrography to the various shoulder disorders based on the previous experiments to determine the effectiveness of this method. It was concluded as follows pertaining to the double contrast arthrography of the shoulder: The ideal volume of the contrast media is the combination of 1.0-1.5 ml of 76% Urografin and 10-12 ml of room-air. The minimal standard projections needed are antero-posterior views in internal and external rotation, scapular Y view in standing position and axillary view in supine position. This method provides many informations about the interior of the joint and enables us to build up three-dimensional image. This is best indicated to examine the anatomical changes in the disturbance of the anterior capsular mechanism.

Adolescent↗
PubMed1991

Biomechanical model of the human shoulder joint--II. The shoulder rhythm.

A method to investigate the rhythm of the human shoulder, i.e. the interplay between the motion of constituent parts of the shoulder, has been devised and tested. The method is based upon numerical evaluation of low dose roentgenstereophotogrammetric motion pictures of subjects equipped with radiation dense implantations in the bones. Evaluation of the method shows that it may be used in determining motion patterns and that the employed interpolation techniques can be used to simulate motions not actually performed in the laboratory. The shoulder rhythm has been previously poorly investigated and quantified results published pertain to one plane only. Our results on motion patterns correlate with previous investigations. With this method, we show that the absolute position of the bones varies significantly between individuals while the relative displacement of the bones during motion exhibit similarities. In particular the results show that, under normal conditions, the individual rhythm is very stable and insensitive to small hand-loads.

Acromion↗
PubMed1995

Origin of the calcitonin gene-related peptide-immunoreactive nerve fibers in the rat shoulder joint.

The rat shoulder joint capsule is innervated by thin sympathetic and sensory nerve fibers, most of which contain calcitonin gene-related peptide (CGRP). In order to establish the origin and distribution of CGRP-immunoreactive (IR) fibers, wheat germ agglutinin-conjugated horseradish peroxidase (WGA-HRP) was injected into the shoulder joints of rats via a dorsal surgical approach. After WGA-HRP injection, the cervico-thoracic dorsal root ganglia (DRG) were removed and processed using both HRP histochemistry and CGRP immunohistochemistry. In the C4 to C7 DRG, small to medium-sized neurons (20-40 microns) were labeled by this combined method. The number and size of the labeled neurons were measured in the cervical 4th-7th DRG. The number of double-labeled neurons was one quarter of the total number of HRP-labeled neurons and 1/20 of the CGRP-IR neurons. Most of the double-labeled cells were located in the C6 ganglion, and the mean number of double-labeled neurons was 13 at this level. This distribution and function of the CGRP-IR fibers in the rat shoulder joint capsule are discussed.

Animals↗