clinical, and ultrasonographic study of shoulder joint disorders and related disability in the elderly

The present study was carried out on 100 elderly persons [65-80 years old]. They were 36 males and 64females. The objective was to determine the prevalence of shoulder disorders and to identify the associated disability in this age group, using clinical as well as ultra-sonographic methods The results showed that shoulder disorders, affecting one or both shoulders, were present in 39% of this age population The Commonest disorder was frozen shoulder occurring in 14%, while the least identifiable disorder was rotator cuff rupture affecting 3%. Disability related to the shoulder was present in 84% of this age, was correlated to a significantly reduced [P<0.005] range of shoulder movements and was greatly enhanced by shoulder disorders. We concluded that regular assessment of the shoulder joint in persons above 60 years may identify those with subtle signs of shoulder diseases, in the hope of early treatment to improve the quality of their Life

Comparative assessment of inflammation in the knee joint of juvenile rheumatoid arthritis

In this study the thermographic index [TI] of the knee joint was compared with the other parameters of joint inflammation of juvenile rheumatoid arthritis [JRA]. Twenty patients with JRA were included in the study [70% females and 30% males]. The mean age of our patients was 9.9 + 2.5 years. Ten healthy children matching our cases as regard :sex, age and weight served as a control group. All the patients were subjected to clinical assessment [oint score], laboratory investigations [ESR, CRP. HB%], synovial fluid analysis [TLC and glucose] and TI measurement. A significant correlation was observed between the joint score, ESR, HB% and TLC of the synovial fluid. Insignificant correlations were reported between the joint score and CRP, and between the TLC, CRP and HB%. The glucose level in the synovial fluid insignificantly correlated with all the other clinical and laboratory variables. The TI was found to be significantly correlated with the joint score, ESR, HB% and TLC of the synovial fluid while, it was found to be insignificantly correlated with the CRP and the glucose level of the synovial fluid. It is concluded that the TI is a good index for the assessment of joint activity in JRA with an equivalent efficacy to the other clinical and laboratory parameters of joint inflammation

Comparative study between clinical assessment, laboratory markers, synovial fluid analysis and thermography in joint inflammation of juvenile rheumatoid arthritis

In this study the thermographic index [TI] of the knee joint was compared with the other parameters of joint inflammation of juvenile rheumatoid arthritis [JRA]. Twenty patients with JRA were included in the study [70% females and 30% males]. The mean age of our patients was 9.9 +/- 2.5 years. Ten healthy children matching our cases as regard; sex, age and weight served as a control group. All the patients were subjected to clinical assessment [joint score], laboratory investigations [ESR, CRF, HB%], synovial fluid analysis [TLC and glucose] and TI measurement. A significant correlation was observed between the joint score, ESR, HB% and TLC of the synovial fluid Insignificant correlations were reported between the joint score and CRP and between the TLC, CRP and HB%. The glucose level in the synovial fluid insignificantly correlated with all the other clinical and laboratory variables. The TI was found to be significantly correlated with the joint score, ESR, HB% and TLC of the synovial fluid while, it was found to be insignificantly correlated with the CRP and the glucose level of the synovial fluid. It is concluded that the TI is a good index for the assessment of joint activity in JRA with an equivalent efficacy to the other clinical and laboratory parameters of joint inflammation

clinico-pathological study on seronegative arthropathies

Fifty patients with a seronegative arthropathy were evaluated. 40 of them had no apparent associated primary disease [idiopathic], 5 with bilharzial arthropathy, 3 with ankylosing spondylitis and 2 with Reiter's syndrome. They were 40 males [60%] with a mean age of 29.4 years and 20 females [40%] with a mean age 29.5 years. The mean duration of the disease was 2.25 years. All the patients were examined clinically and radiologically with a histopathologic study of some enthesopathic specimens. Peripheral arthritis was present in 60% patients, while 40% had arthralgia. The knee and the sacroilii were the highly affected joints. All the patients had enthesopathic signs, where tenderness at the insertion of the planter aponeurosis and Achillis tendon was highly observed. All the patients shared the same radiological abnormalities of periosteal reaction, marginal irregularity, erosions, calcification, sclerosis and spurs. Radiological calcaneal abnormalities were highly associated with enthesopathic signs. Histopathological enthesopathic changes were comparable in all the patients. The results indicated that striking similarities existed between different entities of the seronegative arthropathy groups

role of surgery in the management of resistant tennis elbow

The aim of this work was to evaluate the role of surgery in the management of prolonged disability in patients with tennis elbow not responding to conservative and physiotherapeutic measures. Thirty patients with pain and tenderness confined to the lateral epicondyle were selected. They were 21 males [70%] and 9 females [30%] whose mean age was 40.2 +/- 5.9 years and mean duration of illness was 5.9 +/- 1.2 months. A course of ultrasonic therapy for 3 weeks was started followed by steroid injection on weekly basis for another 3 weeks. Improvement of pain score was encountered in 80.7% of patients, while degree of tenderness was better in 83.4% and functional disability decreased in 83.4%. Six patients had unfavorable outcome after 8 weeks of conservative therapy. Five cases of these patients were selected for surgical release of the common extensor origin with remarkable improvement encountered in all of them and they were able to resume their previous activities in a period ranging from 4 to 8 weeks