Scapulothoracic Bursitis or the Snapping Scapula Syndrome May Mimic with Shoulder Pain

Background: The scapulothorasic joint plays an important role in overall shoulder function by providing a stable base for glenohumeral rotation. Snapping scapula syndrome, a likely under diagnosed condition, can produce significant shoulder dysfunction in many patients. Because the precise origin is difficult to understand, sometimes mimic with shoulder pain. Dysfunctioning of any of muscles, ligament, bursa may cause abnormal scapular motion and predispose to scapulothoracic joint disorders. Accurate recognition of the syndrome may lead to prompt and long-term relief of symptoms by conservative or noninvesiveintervension treatment.Results:The causes of scapulothoracic bursitis and crepitus include direct or indirect trauma, overuse syndromes, glenohumeral joint dysfunction, boney abnormalities, muscle microtrauma or atrophy or fibrosis, and idiopathic causes. Scapulothoracic bursitis and crepitus remain primarily clinical diagnoses. However, imaging studies or local injections may also be helpful. The initial treatment of scapulothoracic bursitis and scapulothoracic crepitus should be conservative. Intevension procedure is best for treating modalitis for scapulothoracic dysfunction, most reports have demonstrated well to excellent outcomes in a significantly high percentage of patients.Conclusions:Clearly, the best initial approach to these conditions is a conservative treatment like nonsteroidal antiinflammatory drugs plan that combines scapular strengthening, postural reeducation, and core strength endurance. If an appropriate trial of nonoperative management proves unsuccessful, local non invesiveintervension can produce good results.

Cuando sospechar de edema fugaz pulmonar / When suspect pulmonary oedema flash

Edema pulmonar relámpago o edema pulmonar fugaz es una condición clínica caracterizada por episodios recurrentes y súdbitos de disnea en reposo, resultado en congestión pulmonar venosa aguda pero en la presencia de función sistólica del ventrículo izquierdo normal o preservada. Está usualmente asociada a estenosis bilateral o unilateral de la arteria renal en riñón único. Relatamos un caso de una paciente femenina de 60 años de edad, con enfermedad arterial coronaria, que desarrolló estenosis de arteria renal unilateral derecha y presentó un episodio de edema fugaz pulmonar. El tratamiento consistió en intervención percutánea en la arteria renal derecha con la colocación de prótesis metálica o stent.

Flash pulmonary edema is a condition characterizaed by sudden and recurrent episodes of dyspnea at rest resulting from acute pulmonary venous congestion in the presence of normal or well-preserved LV systolic function. This is usually associated with bilateral renal artery stenosis of a single surviving kidney. We report a case of a 60-year-old woman, with coronary artery disease who later developed unilateral renal artery atenosis and presented with one episode of flash pulmonary edema. She was successfully treated with stenting of the compromised renal artery.