BACKGROUND Brucella infections in the shoulder joint are uncommon,and few have been reported in the literature.CASE SUMMARY A 26-year-old male was admitted to our hospital with complaint of recurrent pain and limited ...BACKGROUND Brucella infections in the shoulder joint are uncommon,and few have been reported in the literature.CASE SUMMARY A 26-year-old male was admitted to our hospital with complaint of recurrent pain and limited movement of the right shoulder.The patient reported the pain to have first occurred as an isolated event 6 mo previously and to have reoccurred 5 mo later,when it was accompanied by limited movement of the shoulder.Findings from physical examination and magnetic resonance imaging(referred to as MRI)suggested the diagnosis of subacromial bursitis,and diagnostic paracentesis and arthroscopic debridement were performed.Surprisingly,synovial fluid culture detected brucella,and the finding was confirmed by mass spectrometry of a colony sample.The diagnosis was corrected to brucellosis of the shoulder joint,and antibiotic drug treatment(oral rifampicin and doxycycline)was administrated for 6 wk.The 4-mo postoperative follow-up examination(MRI)yielded normal findings.The 2-year follow-up showed no signs of recurrence.CONCLUSION This rare case of brucellosis infection in shoulder highlights the importance of increasing awareness to help avoid misdiagnosis.展开更多
Olecranon bursitis is rarely seen in patients with stroke, but reflex sympathetic dystrophy syndrome is not. Here, we report a stroke case, which represented the clinical symptom of reflex sympathetic dystrophy syndro...Olecranon bursitis is rarely seen in patients with stroke, but reflex sympathetic dystrophy syndrome is not. Here, we report a stroke case, which represented the clinical symptom of reflex sympathetic dystrophy syndrome after development of olecranon bursitis in few days, and describe his clinical association between both conditions. Sonographicpicture of the right elbow in this case is shown.展开更多
Trochanteric bursitis is a common cause of musculoskeletal pain and often requires medical intervention and should be distinguished from sciatica and irradiating pain of pelvic and spinal origin. Previously, the etiol...Trochanteric bursitis is a common cause of musculoskeletal pain and often requires medical intervention and should be distinguished from sciatica and irradiating pain of pelvic and spinal origin. Previously, the etiology of the trochanteric pain syndrome was thought to be caused by inflammation. The current study was performed in order to assess the efficacy of trochanteric injections. Methods: 158 patients were treated for trochanteric bursitis (132 females/26 males, range 22 - 88 years). 59b were treated with corticosteroid injection, 60 with hyaluronate and 39 were injected using a combination of both. Patients were followed by the HOOS score for a minimum of 12 months. Results: Pre-operative HOOS scores were similar in all groups. Following injection, the HOOS score increased from 27 ± 4 to 66 ± 2 after six months and 77 ± 4 after a year. At 12-month follow-up, the average score of patients treated by corticosteroids injection was 44 ± 7 compared with 62 ± 8 for the hyaluronate injected group and 64 ± 6 for the combination injection group. Discussion: It appears that injection therapy is highly efficacious for treating trochanteric bursitis. The effect of hyaluronate or hyaluronate and steroid combination appears to be longer lasting than that of steroid alone.展开更多
BACKGROUND Trochanteric bursitis is a common complication following total hip replacement(THR),and it is associated with high level of disability and poor quality of life.Excision of the trochanteric bursa prophylacti...BACKGROUND Trochanteric bursitis is a common complication following total hip replacement(THR),and it is associated with high level of disability and poor quality of life.Excision of the trochanteric bursa prophylactically during THR could reduce the occurrence of post-operative trochanteric bursitis.AIM To evaluate whether synchronous trochanteric bursectomy at the time of THR affects the incidence of post-operative trochanteric bursitis.METHODS This retrospective cohort study was conducted in the secondary care setting at a large district general hospital.Between January 2010 and December 2020,954 patients underwent elective primary THR by two contemporary arthroplasty surgeons,one excising the bursa and the other not(at the time of THR).All patients received the same post-operative rehabilitation and were followed up for 1 year.We reviewed all cases of trochanteric bursitis over this 11-year period to determine the incidence of post-THR bursitis.Two proportion Z-test was used to compare incidences of trochanteric bursitis between groups.RESULTS 554 patients underwent synchronous trochanteric bursectomy at the time of THR whereas 400 patients did not.A total of 5 patients(incidence 0.5%)developed trochanteric bursitis following THR;4 of whom had undergone bursectomy as part of their surgical approach,1 who had not.There was no statistically significant difference between the two groups(Z value 1.00,95%CI:-0.4%to 1.3%,P=0.32).There were also 8 other patients who had both trochanteric bursitis and hip osteoarthritis prior to their THR;all of whom were treated with THR and synchronous trochanteric bursectomy,and 7 had resolution of their lateral buttock pains but 1 did not.CONCLUSION Synchronous trochanteric bursectomy during THR does not materially affect the incidence of post-operative bursitis.However,it is successful at treating patients with known trochanteric bursitis and osteoarthritis requiring THR.展开更多
We report an unusual manifestation of nontuberculous mycobacterial infection characterized by a giant bursitis on wrist and multiple tenosynovitis with many rice bodies formations. The clinical and radiological examin...We report an unusual manifestation of nontuberculous mycobacterial infection characterized by a giant bursitis on wrist and multiple tenosynovitis with many rice bodies formations. The clinical and radiological examinations are neither rather sensitive nor rather specific. The nuclear imagery of rice bodies formations provides elements of guidance. Cause of absence of the germ isolation, diagnosis was retained on probability items based on a suspicion of arguments beam: clinical, biological, bacteriological and histological. The patient was treated with medical and surgical procedure and provided a satisfactory evolution. At follow-up of 15 months, there were no clinical signs of local recurrence. Through a literature review, the problem of diagnosis of certainty will be discussed.展开更多
Objective: to analyze the clinical efficacy of micro-acupotomy combined with moxibustion in the treatment of anserus bursitis. Methods: a total of 100 patients with anserinus bursitis admitted to our hospital from Jan...Objective: to analyze the clinical efficacy of micro-acupotomy combined with moxibustion in the treatment of anserus bursitis. Methods: a total of 100 patients with anserinus bursitis admitted to our hospital from January 2018 to March 2021 were randomly divided into two groups: control group 50 cases, experimental group 50 cases;the control group was treated with traditional acupotomology, and the experimental group was treated with micro acupotomology and moxibustion. The clinical efficacy was analyzed and compared. Results: the total effective rate of the experimental group was 96%, significantly higher than that of the control group (82%) (P < 0.05). VAS scores of 2 groups after treatment were significantly lower than before treatment (P < 0.05);VAS score of experimental group was significantly lower than that of control group (P < 0.05). Lyshlom scores in both groups were significantly improved after treatment (P < 0.05). Lyshlom score of the experimental group was significantly higher than that of the control group (P < 0.05). Conclusion: the use of micro acupotomy combined with moxibustion in the treatment of anserus bursitis patients can achieve a relatively ideal clinical effect, not only can make the pain effectively reduced, but also can promote the recovery of knee joint function, has clinical promotion value.展开更多
155⁃year⁃old Hilde Dosogne of Belgium recently set a new world record for most consecutive(连续的)marathons after running 366 full marathons(over 15,000 km)in 2024.2 On May 30,2024,Hilde Dosogne had already broken the...155⁃year⁃old Hilde Dosogne of Belgium recently set a new world record for most consecutive(连续的)marathons after running 366 full marathons(over 15,000 km)in 2024.2 On May 30,2024,Hilde Dosogne had already broken the women's world record for most consecutive marathons—150,set by Erchana Murray⁃Bartlett—but she didn't stop running until December 31st,when she recorded her 366th consecutive full marathon of the year.As you can imagine,running 42.195 km per day,every day,for a year is incredibly taxing for the body,but while Hilde had to overcome tiredness and bursitis(滑囊炎),she claimed that the mental stress of having to show up at the starting line every day was her most difficult challenge.展开更多
Background: Loose bodies (LBs) within the knee joint are commonly encountered during clinical practice and are frequently observed during knee arthroscopy. The primary treatment involves the removal of loose bodies;ho...Background: Loose bodies (LBs) within the knee joint are commonly encountered during clinical practice and are frequently observed during knee arthroscopy. The primary treatment involves the removal of loose bodies;however, their complete eradication is often challenging and may not address underlying diseases, leading to persistent symptoms and the risk of new loose body formation. Aim: This case report aims to present the findings and surgical management of a 52-year-old male with an unusually large osseous loose body in the knee joint and associated pathologies. Case Presentation: The patient, a 52-year-old male, experienced recurrent episodes of severe, sudden, and painful locking of the knee joint, leading to difficulties moving. A plain MRI study was conducted to evaluate the condition of the knee joint, which revealed various degenerative changes and the presence of a loose body. Subsequently, an arthroscopic examination was performed under general anesthesia, uncovering the presence of an abnormally large loose body, as well as other pathologies including chondropathy, meniscal degeneration, and Baker’s cyst. Conclusion: Loose bodies (LBs) in the knee joint pose significant challenges and may lead to debilitating symptoms. Timely diagnosis and appropriate surgical intervention are crucial for symptom relief and the prevention of further joint damage as arthroscopic excision. Comprehensive imaging has a vital role in guiding treatment decisions and optimizing patient outcomes. In this case, the removal of the loose body improved patient outcomes and helped prevent potential joint complications.展开更多
Frozen shoulder is a common disease which causes significant morbidity. Despite over a hundred years of treating this condition the definition, diagnosis, pathology and most efficacious treatments are still largely un...Frozen shoulder is a common disease which causes significant morbidity. Despite over a hundred years of treating this condition the definition, diagnosis, pathology and most efficacious treatments are still largely unclear. This systematic review of current treatments for frozen shoulder reviews the evidence base behind physiotherapy, both oral and intra articular steroid, hydrodilatation, manipulation under anaesthesia and arthroscopic capsular release. Key areas in which future research could be directed are identified, in particular with regard to the increasing role of arthroscopic capsular release as a treatment.展开更多
BACKGROUND The brisement manipulation is an effective treatment for refractory shoulder stiffness.Rotator cuff tears can sometimes exist in combination with adhesive capsulitis.Arthroscopic capsular release combined w...BACKGROUND The brisement manipulation is an effective treatment for refractory shoulder stiffness.Rotator cuff tears can sometimes exist in combination with adhesive capsulitis.Arthroscopic capsular release combined with rotator cuff repair has achieved good outcomes in published reports.CASE SUMMARY We report the case of a patient with right shoulder pain for more than 1 year that was suspected to have adhesive capsulitis and a rotator cuff tear that was treated with brisement manipulation and arthroscopic management.An iatrogenic glenoid fracture with shoulder instability occurred during the manipulation.Arthroscopic treatment for fracture fixation,capsular release,and rotator cuff repair was performed,and the functional results are reported.CONCLUSION Arthroscopic fixation for iatrogenic glenoid fracture and repairing coexisting rotator cuff tear can provide the stability needed for early rehabilitation.展开更多
Bursitis is quite responsive to therapeutic intervention, once the afflicted area is accurately identified. This is especially notable for some hip complaints. Patients' use of the term "hip" can relate ...Bursitis is quite responsive to therapeutic intervention, once the afflicted area is accurately identified. This is especially notable for some hip complaints. Patients' use of the term "hip" can relate to anything from the low back to groin to lateral thigh pain. Trochanteric area surface localization of "hip" pain may afford an opportunity for immediate cure. Effectiveness of therapeutic intervention is predicated upon injection of not one or two, but all four peri-trochanteric bursa with a depot(minimally water-soluble) corticosteroid. The term trochanteric bursitis suggests that the inflammation is more focal than what is clinically observed. While easier to express, perhaps it is time to refer to inflammation in this area, naming all four affected bursae.展开更多
Background: Treatment of insertional achilles tendinopathy is known to be difficult. Eccentric calf muscle exercises and extracorporeal shockwave therapy have been proposed as the primary treatments for this condition...Background: Treatment of insertional achilles tendinopathy is known to be difficult. Eccentric calf muscle exercises and extracorporeal shockwave therapy have been proposed as the primary treatments for this condition, but surgery is indicated after failed conservative management. There is no consensus about the most efficient surgical treatment. Objectives: To evaluate a new ultrasound and color Doppler-guided surgical treatment for insertional achilles tendinopathy. Patients and methods: 24 consecutive patients (13 men and 11 women, mean age 47 years) with a long duration of insertional achilles tendon pain (median 18 months) were included in the study. The surgical procedure consisted of extirpation of the subcutaneous and retrocalcaneal bursa, scraping of the ventral distal achilles tendon and removal of prominent bone at the upper calcaneal tuberosity (Haglund’s deformity). In 13 patients, the plantaris tendon was also cut and excised. VAS for pain during activity, satisfaction with the treatment result and the SF-36 score to measure quality of life were used for evaluation. Results: The mean VAS had decreased from 72 before surgery to 19 after surgery (p 0.001), and 20/24 (83%) patients were satisfied with the result and had returned to full tendon loading activity at the one-year follow-up. The SF-36 score had improved significantly. Conclusion: Ultrasound and color Doppler-guided surgical treatment seems to be a good method for treatment of chronic painful insertional achilles tendinopathy. Longer follow-up studies on larger materials are needed.展开更多
Objective:To unveil the efficacy of Shaolin internal qigong exercise in treating capsulitis of the shoulder(CS)and explore objective outcome measures by observing the changes in the surface electromyography(sEMG)signa...Objective:To unveil the efficacy of Shaolin internal qigong exercise in treating capsulitis of the shoulder(CS)and explore objective outcome measures by observing the changes in the surface electromyography(sEMG)signals of shoulder muscle groups after regular practice of Shaolin internal qigong exercise in CS patients.Methods:Sixty CS patients were randomized into two groups by the random number table method,with 30 cases in each group.Patients in the qigong group practiced Shaolin internal qigong exercise on a regular basis,while patients in the electroacupuncture(EA)group received EA treatment.Before and after treatment,the sEMG signals of six muscles,i.e.biceps brachii,triceps brachii,deltoid,pectoralis major,latissimus dorsi and trapezius muscles,of the affected side were recorded at 45°abduction of the shoulder,60°forward flexion and 90°internal rotation with the elbow flexed during maximal isometric contraction,and the integrated electromyography(iEMG)of each muscle was calculated.Results:The total effective rate was 93.3%in the qigong group,higher than 83.3%in the EA group(P<0.05).Intra-group comparison showed that the iEMG of biceps brachii,triceps brachii,pectoralis major and deltoid muscles in the qigong group increased significantly after intervention at 45°abduction of the shoulder,60°forward flexion and 90°internal rotation with the elbow flexed(all P<0.05),and the iEMG of trapezius and latissimus dorsi muscles decreased(both P<0.05);in the EA group,the iEMG of biceps brachii,pectoralis major and deltoid muscles increased significantly during contraction(all P<0.05),while the iEMG of triceps brachii,trapezius and latissimus dorsi muscles had no significant changes(all P>0.05).After intervention,there were significant differences in the iEMG of most of muscles between the two groups(all P<0.05),except for the iEMG of deltoid muscle at 45°of abduction of the shoulder joint during isometric contraction(P>0.05).Conclusion:Shaolin internal qigong exercise can effectively increase the motion intensity of the biceps brachii,triceps brachii,pectoralis major and deltoid muscles and reduce the compensation of the latissimus dorsi and trapezius muscles in CS patients;compared with EA,it produces a better result in improving the coordination and stability in shoulder joint movements.展开更多
基金Supported by National Natural Science Foundation of China,No.81601901Natural Science Foundation of Liaoning No.2019-MS-079 and No.20170540285.
文摘BACKGROUND Brucella infections in the shoulder joint are uncommon,and few have been reported in the literature.CASE SUMMARY A 26-year-old male was admitted to our hospital with complaint of recurrent pain and limited movement of the right shoulder.The patient reported the pain to have first occurred as an isolated event 6 mo previously and to have reoccurred 5 mo later,when it was accompanied by limited movement of the shoulder.Findings from physical examination and magnetic resonance imaging(referred to as MRI)suggested the diagnosis of subacromial bursitis,and diagnostic paracentesis and arthroscopic debridement were performed.Surprisingly,synovial fluid culture detected brucella,and the finding was confirmed by mass spectrometry of a colony sample.The diagnosis was corrected to brucellosis of the shoulder joint,and antibiotic drug treatment(oral rifampicin and doxycycline)was administrated for 6 wk.The 4-mo postoperative follow-up examination(MRI)yielded normal findings.The 2-year follow-up showed no signs of recurrence.CONCLUSION This rare case of brucellosis infection in shoulder highlights the importance of increasing awareness to help avoid misdiagnosis.
文摘Olecranon bursitis is rarely seen in patients with stroke, but reflex sympathetic dystrophy syndrome is not. Here, we report a stroke case, which represented the clinical symptom of reflex sympathetic dystrophy syndrome after development of olecranon bursitis in few days, and describe his clinical association between both conditions. Sonographicpicture of the right elbow in this case is shown.
文摘Trochanteric bursitis is a common cause of musculoskeletal pain and often requires medical intervention and should be distinguished from sciatica and irradiating pain of pelvic and spinal origin. Previously, the etiology of the trochanteric pain syndrome was thought to be caused by inflammation. The current study was performed in order to assess the efficacy of trochanteric injections. Methods: 158 patients were treated for trochanteric bursitis (132 females/26 males, range 22 - 88 years). 59b were treated with corticosteroid injection, 60 with hyaluronate and 39 were injected using a combination of both. Patients were followed by the HOOS score for a minimum of 12 months. Results: Pre-operative HOOS scores were similar in all groups. Following injection, the HOOS score increased from 27 ± 4 to 66 ± 2 after six months and 77 ± 4 after a year. At 12-month follow-up, the average score of patients treated by corticosteroids injection was 44 ± 7 compared with 62 ± 8 for the hyaluronate injected group and 64 ± 6 for the combination injection group. Discussion: It appears that injection therapy is highly efficacious for treating trochanteric bursitis. The effect of hyaluronate or hyaluronate and steroid combination appears to be longer lasting than that of steroid alone.
文摘BACKGROUND Trochanteric bursitis is a common complication following total hip replacement(THR),and it is associated with high level of disability and poor quality of life.Excision of the trochanteric bursa prophylactically during THR could reduce the occurrence of post-operative trochanteric bursitis.AIM To evaluate whether synchronous trochanteric bursectomy at the time of THR affects the incidence of post-operative trochanteric bursitis.METHODS This retrospective cohort study was conducted in the secondary care setting at a large district general hospital.Between January 2010 and December 2020,954 patients underwent elective primary THR by two contemporary arthroplasty surgeons,one excising the bursa and the other not(at the time of THR).All patients received the same post-operative rehabilitation and were followed up for 1 year.We reviewed all cases of trochanteric bursitis over this 11-year period to determine the incidence of post-THR bursitis.Two proportion Z-test was used to compare incidences of trochanteric bursitis between groups.RESULTS 554 patients underwent synchronous trochanteric bursectomy at the time of THR whereas 400 patients did not.A total of 5 patients(incidence 0.5%)developed trochanteric bursitis following THR;4 of whom had undergone bursectomy as part of their surgical approach,1 who had not.There was no statistically significant difference between the two groups(Z value 1.00,95%CI:-0.4%to 1.3%,P=0.32).There were also 8 other patients who had both trochanteric bursitis and hip osteoarthritis prior to their THR;all of whom were treated with THR and synchronous trochanteric bursectomy,and 7 had resolution of their lateral buttock pains but 1 did not.CONCLUSION Synchronous trochanteric bursectomy during THR does not materially affect the incidence of post-operative bursitis.However,it is successful at treating patients with known trochanteric bursitis and osteoarthritis requiring THR.
文摘We report an unusual manifestation of nontuberculous mycobacterial infection characterized by a giant bursitis on wrist and multiple tenosynovitis with many rice bodies formations. The clinical and radiological examinations are neither rather sensitive nor rather specific. The nuclear imagery of rice bodies formations provides elements of guidance. Cause of absence of the germ isolation, diagnosis was retained on probability items based on a suspicion of arguments beam: clinical, biological, bacteriological and histological. The patient was treated with medical and surgical procedure and provided a satisfactory evolution. At follow-up of 15 months, there were no clinical signs of local recurrence. Through a literature review, the problem of diagnosis of certainty will be discussed.
文摘Objective: to analyze the clinical efficacy of micro-acupotomy combined with moxibustion in the treatment of anserus bursitis. Methods: a total of 100 patients with anserinus bursitis admitted to our hospital from January 2018 to March 2021 were randomly divided into two groups: control group 50 cases, experimental group 50 cases;the control group was treated with traditional acupotomology, and the experimental group was treated with micro acupotomology and moxibustion. The clinical efficacy was analyzed and compared. Results: the total effective rate of the experimental group was 96%, significantly higher than that of the control group (82%) (P < 0.05). VAS scores of 2 groups after treatment were significantly lower than before treatment (P < 0.05);VAS score of experimental group was significantly lower than that of control group (P < 0.05). Lyshlom scores in both groups were significantly improved after treatment (P < 0.05). Lyshlom score of the experimental group was significantly higher than that of the control group (P < 0.05). Conclusion: the use of micro acupotomy combined with moxibustion in the treatment of anserus bursitis patients can achieve a relatively ideal clinical effect, not only can make the pain effectively reduced, but also can promote the recovery of knee joint function, has clinical promotion value.
文摘155⁃year⁃old Hilde Dosogne of Belgium recently set a new world record for most consecutive(连续的)marathons after running 366 full marathons(over 15,000 km)in 2024.2 On May 30,2024,Hilde Dosogne had already broken the women's world record for most consecutive marathons—150,set by Erchana Murray⁃Bartlett—but she didn't stop running until December 31st,when she recorded her 366th consecutive full marathon of the year.As you can imagine,running 42.195 km per day,every day,for a year is incredibly taxing for the body,but while Hilde had to overcome tiredness and bursitis(滑囊炎),she claimed that the mental stress of having to show up at the starting line every day was her most difficult challenge.
文摘Background: Loose bodies (LBs) within the knee joint are commonly encountered during clinical practice and are frequently observed during knee arthroscopy. The primary treatment involves the removal of loose bodies;however, their complete eradication is often challenging and may not address underlying diseases, leading to persistent symptoms and the risk of new loose body formation. Aim: This case report aims to present the findings and surgical management of a 52-year-old male with an unusually large osseous loose body in the knee joint and associated pathologies. Case Presentation: The patient, a 52-year-old male, experienced recurrent episodes of severe, sudden, and painful locking of the knee joint, leading to difficulties moving. A plain MRI study was conducted to evaluate the condition of the knee joint, which revealed various degenerative changes and the presence of a loose body. Subsequently, an arthroscopic examination was performed under general anesthesia, uncovering the presence of an abnormally large loose body, as well as other pathologies including chondropathy, meniscal degeneration, and Baker’s cyst. Conclusion: Loose bodies (LBs) in the knee joint pose significant challenges and may lead to debilitating symptoms. Timely diagnosis and appropriate surgical intervention are crucial for symptom relief and the prevention of further joint damage as arthroscopic excision. Comprehensive imaging has a vital role in guiding treatment decisions and optimizing patient outcomes. In this case, the removal of the loose body improved patient outcomes and helped prevent potential joint complications.
文摘Frozen shoulder is a common disease which causes significant morbidity. Despite over a hundred years of treating this condition the definition, diagnosis, pathology and most efficacious treatments are still largely unclear. This systematic review of current treatments for frozen shoulder reviews the evidence base behind physiotherapy, both oral and intra articular steroid, hydrodilatation, manipulation under anaesthesia and arthroscopic capsular release. Key areas in which future research could be directed are identified, in particular with regard to the increasing role of arthroscopic capsular release as a treatment.
文摘BACKGROUND The brisement manipulation is an effective treatment for refractory shoulder stiffness.Rotator cuff tears can sometimes exist in combination with adhesive capsulitis.Arthroscopic capsular release combined with rotator cuff repair has achieved good outcomes in published reports.CASE SUMMARY We report the case of a patient with right shoulder pain for more than 1 year that was suspected to have adhesive capsulitis and a rotator cuff tear that was treated with brisement manipulation and arthroscopic management.An iatrogenic glenoid fracture with shoulder instability occurred during the manipulation.Arthroscopic treatment for fracture fixation,capsular release,and rotator cuff repair was performed,and the functional results are reported.CONCLUSION Arthroscopic fixation for iatrogenic glenoid fracture and repairing coexisting rotator cuff tear can provide the stability needed for early rehabilitation.
文摘Bursitis is quite responsive to therapeutic intervention, once the afflicted area is accurately identified. This is especially notable for some hip complaints. Patients' use of the term "hip" can relate to anything from the low back to groin to lateral thigh pain. Trochanteric area surface localization of "hip" pain may afford an opportunity for immediate cure. Effectiveness of therapeutic intervention is predicated upon injection of not one or two, but all four peri-trochanteric bursa with a depot(minimally water-soluble) corticosteroid. The term trochanteric bursitis suggests that the inflammation is more focal than what is clinically observed. While easier to express, perhaps it is time to refer to inflammation in this area, naming all four affected bursae.
文摘Background: Treatment of insertional achilles tendinopathy is known to be difficult. Eccentric calf muscle exercises and extracorporeal shockwave therapy have been proposed as the primary treatments for this condition, but surgery is indicated after failed conservative management. There is no consensus about the most efficient surgical treatment. Objectives: To evaluate a new ultrasound and color Doppler-guided surgical treatment for insertional achilles tendinopathy. Patients and methods: 24 consecutive patients (13 men and 11 women, mean age 47 years) with a long duration of insertional achilles tendon pain (median 18 months) were included in the study. The surgical procedure consisted of extirpation of the subcutaneous and retrocalcaneal bursa, scraping of the ventral distal achilles tendon and removal of prominent bone at the upper calcaneal tuberosity (Haglund’s deformity). In 13 patients, the plantaris tendon was also cut and excised. VAS for pain during activity, satisfaction with the treatment result and the SF-36 score to measure quality of life were used for evaluation. Results: The mean VAS had decreased from 72 before surgery to 19 after surgery (p 0.001), and 20/24 (83%) patients were satisfied with the result and had returned to full tendon loading activity at the one-year follow-up. The SF-36 score had improved significantly. Conclusion: Ultrasound and color Doppler-guided surgical treatment seems to be a good method for treatment of chronic painful insertional achilles tendinopathy. Longer follow-up studies on larger materials are needed.
文摘Objective:To unveil the efficacy of Shaolin internal qigong exercise in treating capsulitis of the shoulder(CS)and explore objective outcome measures by observing the changes in the surface electromyography(sEMG)signals of shoulder muscle groups after regular practice of Shaolin internal qigong exercise in CS patients.Methods:Sixty CS patients were randomized into two groups by the random number table method,with 30 cases in each group.Patients in the qigong group practiced Shaolin internal qigong exercise on a regular basis,while patients in the electroacupuncture(EA)group received EA treatment.Before and after treatment,the sEMG signals of six muscles,i.e.biceps brachii,triceps brachii,deltoid,pectoralis major,latissimus dorsi and trapezius muscles,of the affected side were recorded at 45°abduction of the shoulder,60°forward flexion and 90°internal rotation with the elbow flexed during maximal isometric contraction,and the integrated electromyography(iEMG)of each muscle was calculated.Results:The total effective rate was 93.3%in the qigong group,higher than 83.3%in the EA group(P<0.05).Intra-group comparison showed that the iEMG of biceps brachii,triceps brachii,pectoralis major and deltoid muscles in the qigong group increased significantly after intervention at 45°abduction of the shoulder,60°forward flexion and 90°internal rotation with the elbow flexed(all P<0.05),and the iEMG of trapezius and latissimus dorsi muscles decreased(both P<0.05);in the EA group,the iEMG of biceps brachii,pectoralis major and deltoid muscles increased significantly during contraction(all P<0.05),while the iEMG of triceps brachii,trapezius and latissimus dorsi muscles had no significant changes(all P>0.05).After intervention,there were significant differences in the iEMG of most of muscles between the two groups(all P<0.05),except for the iEMG of deltoid muscle at 45°of abduction of the shoulder joint during isometric contraction(P>0.05).Conclusion:Shaolin internal qigong exercise can effectively increase the motion intensity of the biceps brachii,triceps brachii,pectoralis major and deltoid muscles and reduce the compensation of the latissimus dorsi and trapezius muscles in CS patients;compared with EA,it produces a better result in improving the coordination and stability in shoulder joint movements.
