ABSTRACT
[Introduction] We evaluated the efficacy of treatment and clinical characteristics of a patient with incomplete rotator cuff tear with a clinical presentation similar to that of frozen shoulder. It seems difficult to differentiate incomplete rotator cuff tear from frozen shoulder on physical findings alone since the former lacks the specific characteristics of rotator cuff tear. However, many patients with incomplete rotator cuff tears show a poor response to treatment due to mechanical disorders; thus, differentiation of incomplete rotator cuff tear from frozen shoulder may be demonstrated during the patient's clinical course.<BR>[Patient] In this patient, the joint range of motion improved in all directions, and the pain score also improved from 10 to 5, showing reduction of pain. However, the symptoms did not resolve smoothly; frequent remis-sions and exacerbations of symptoms were observed.<BR>[Discussion] We frequently encounter disorders diagnosed as periarthritis scapulohumeralis in daily clinical practice, and patients with such disorders usually respond well to treatment. However, we should realize that a variety of clinical conditions are involved in the disorders, and the clinical courses of patients should be followed closely during treatment.
ABSTRACT
One of the complications in patients on long-term hemodialysis is spondyloarthropathy resulting from amyloidosis due to abnormal accumulation of β2-microglobulin. With deposition of β2-microglobulin in soft tissues, such as ligaments and joints, destruction of bones and cartilages begins at the site of ligament attachment and proceeds with the accompanying inflammatory reaction, fibrosis and ligament thickening. The soft tissue proliferative lesion and destruction of bones and cartilages produce spinal canal stenosis and, ultimately, compression of the spinal cord and cauda equina, to give rise to various clinical symptoms.<br>We tried acupuncture treatment on two patients with lumbar spinal canal stenosis due to hemodialysis-related spondyloarthropathy who presented with neurogenic intermittent claudication, and evaluated its effects. Acupuncture treatment involved placement of acupuncture needles chiefly in the stenotic region, once weekly, for about three months. Marked improvement was obtained regarding claudication distance and JOA score in patient number one, who had radicular type intermittent claudication. Slight improvement of claudication distance and improvement of JOA score (particularly relief of pain) were obtained in patient number two, who had mixed type intermittent claudication. These results suggest that acupuncture treatment might be effective for dialysis patients with lumbar spinal canal stenosis associated with hemodialysis-induced spondyloarthropathy.