Anatomía del manguito rotador / Rotator cuff anatomy

Introducción: en la región del hombro encontramos cuatro grupos musculares. Dentro del segundo grupoesta el manguito de rotadores. Objetivo: resaltar la importancia del manguito rotador, su constitución, inserciones, ubicación y dirección. Material y métodos: se utilizaron cincuenta hombros formolizados de la Cátedra de Anatomía Normal de la Facultad de Ciencias Médicas de la Universidad Nacional de Córdoba. Con disección clásica. Resultados: la ubicación del manguito de rotadores en su totalidad fue por debajo del arco córaco-acromial. Encontramos las tres variantes anatómicas del acromion. Su constitución se puede describir como una estructurade cinco capas. La orientación de las fibras y capas tienen relación con las lesiones del manguito rotador. Conclusión: es importante el estudio anatómico detallado, en particular su constitución y la irrigación de lazona, en la patogénesis de estas lesiones y para la aplicación clínica e implementar la técnica quirúrgica más adecuada.

Introduction: in the region of the shoulder we find four muscular groups. Inside the second group the rotator cuff is located. Objective: the objective of this work is to stand out of the same one, its constitution, inserts, location anddirection. Material and methods: fifty formalized shoulders of the class of Normal Anatomy of the Facultad de Ciencias Médicas of the Universidad Nacional de Córdoba were used. With classic dissection. Results: the location of the rotators cuff is entirety under the coraco-acromial arch. We find the three anatomical variants of the acromion according to Neer. The constitution can describe like an structure of 5 layers. The orientations of the fibers and layers have relationship with the lesions of the cuff rotator. Conclusion: is important the detailed anatomical study, the irrigation and constitution in pathogenesis and forthe clinical application and to implement the appropriate surgical technique.

Clinical evaluation versus ultrasonographic findings in the diagnosis of painful shoulder

The differentiation of causes of shoulder pain is a clinical challenge. Among a wide variety of conditions that may produce similar shoulder pain and dysfunction, periarticular disorders play the main role. Accurate diagnosis is therapeutically important and early management may prevent capsulitis and rotator cuff lesions from becoming adhesive, so true frozen shoulder may be avoided. With the advent of high-resolution ultrasonography, interest in musculoskeletal sonography has increased and it can be used to evaluate the accuracy of clinical diagnosis of painful shoulder. Our aim was to compare the clinical diagnosis established by a physical examination with high frequency ultrasonographic findings in patients with painful shoulder. Twenty-seven consecutive patients were prospectively included in the study. All had a physical examination performed. Utrasonographic examination was carried out within one week of the physical examination. Ultrasonography was considered the optimal diagnostic technique. Our results showed that the clinical assessment had low accuracy in the diagnosis of periarticular shoulder lesions. Ultrasonography should be used whenever possible to improve diagnosis and treatment of painful shoulder