Radial-sided wrist pain differentials: presentation, pathoanatomy, diagnosis, and management / Dolor radial de muñeca: diferencias en la presentación, anatomía patológica, diagnóstico y tratamiento

Abstract Patients with radial-sided wrist pain can be challenging to diagnose and treat. Various physicians, including emergency physicians, primary care physicians, and orthopedic or plastic surgeons can be involved in the initial and subsequent evaluation. We delve into the differential diagnosis of radial-sided wrist pain including osteoarticular, ligament, tendon, nerve, and other pathologies. We review the physical exam findings, diagnostic studies, and treatment options for each pathology based on recent and updated literature.

Resumen Los casos de pacientes que presentan dolor radial de muñeca pueden ser de difícil diagnóstico y tratamiento. Varias especialidades médicas, incluidas emergentólogos, médicos de atención primaria, cirujanos ortopédicos o cirujanos plásticos, pueden estar involucrados desde el inicio de la patología y subsecuente evaluación. Pro fundizamos aquí en el diagnóstico diferencial del dolor radial de muñeca incluyendo las debidas a patologías osteoarticulares, ligamentosas, tendinopatías y neuropatías, entre otras. Esta revisión incluye examen físico, estudios diagnósticos, y opciones terapéuticas para cada condición con base en la literatura reciente y actualizada.

Acute longus colli tendinitis and otolaryngology / Tendinite aguda do músculo longus colli e otorrinolaringologia

Abstract Introduction Acute longus colli tendinitis is caused by calcium hydroxyapatite deposition in the tendon of the longus colli muscle with subsequent inflammation. The calcifications are commonly located at the superior oblique portion at the level of the C1-C2 vertebrae. The typical clinical presentation consists of acute neck pain, odynophagia, and painful limitation of neck range of motion. Objectives We will describe this disease with three that cases presented to our institution and compare the findings on imaging studies. Methods We retrospectively reviewed the clinical data, radiological features, and laboratory reports of three patients diagnosed with acute longus colli tendinitis. Computed tomography and plain radiographs were reviewed and compared by a single radiologist. A contemporary review of the literature was conducted using PubMed (Medline), Embase, and Cochrane library databases. Results Computed tomography showed greater sensitivity for the detection of the pathognomonic calcification than plain radiographs and facilitated the exclusion of other more severe conditions by following a systematic interpretation composed of five key elements. Plain radiographs showed non-specific signs of prevertebral soft tissue swelling and a decreased cervical lordotic curve. However, no calcification was identified on plain radiographs. The literature review revealed 153 articles containing 372 cases. Surgical or invasive procedures were mentioned in 13.7% of publications and were performed in 28 patients. Conclusion Acute longus colli tendinitis can mimic the clinical presentation of more severe conditions that the otolaryngologist may be required to evaluate, such as infectious, traumatic, and neoplastic diseases. Knowledge of this entity, with its pathognomonic imaging findings, can prevent misdirected medical therapy and unnecessary invasive procedures.

Resumo Introdução A tendinite aguda do músculo longus colli é causada pela deposição de hidroxiapatita de cálcio no tendão do músculo longus colli com subsequente inflamação. As calcificações estão comumente localizadas na porção oblíqua superior ao nível das vértebras C1-C2. A apresentação clínica típica consiste em dor cervical aguda, odinofagia e limitação dolorosa da amplitude de movimento do pescoço. Objetivos Descreveremos essa doença por meio de três casos apresentados em nossa instituição e compararemos os achados em exames de imagem. Método Revisamos retrospectivamente os dados clínicos, as características radiológicas e os relatórios laboratoriais de três pacientes com diagnóstico de tendinite aguda do músculo longus colli. A tomografia computadorizada e as radiografias simples foram revisadas e comparadas por um único radiologista. Uma revisão contemporânea da literatura foi feita nos bancos de dados PubMed (Medline), Embase e Cochrane. Resultados A tomografia computadorizada apresentou maior sensibilidade para detecção da calcificação patognomônica do que a radiografia simples e facilitou a exclusão de outras condições mais graves, seguiu uma interpretação sistemática composta por cinco elementos-chave. As radiografias simples mostraram sinais inespecíficos de edema dos tecidos moles pré-vertebrais e diminuição da curva lordótica cervical. Entretanto, nenhuma calcificação foi identificada nas radiografias simples. A revisão da literatura produziu 153 artigos com 372 casos. Procedimentos cirúrgicos ou invasivos foram mencionados em 13,7% das publicações e feitos em 28 pacientes. Conclusão A tendinite aguda do músculo longus colli pode mimetizar a apresentação clínica de condições mais graves que necessitam da avaliação do otorrinolaringologista, como doenças infecciosas, traumáticas e neoplásicas. O conhecimento dessa entidade, com seus achados de imagem patognomônica, pode evitar uma terapia clínica mal direcionada e procedimentos invasivos desnecessários.

Tendinitis cálcica atraumática de tendón extensor común del dedo medio: un caso infrecuente de dolor metacarpofalángico / Atraumatic calcium tendonitis of common extensor tendon of the middle finger: a rare case of metacarpophalangeal pain

Calcific tendinitis is a pathology characterized by the deposits of periarticular hydroxyapatite. Its pathophysiology is not completely known. It is clinically characterized by important inflammatory changes with incapacitating pain. It most commonly affects the shoulder joint and it rarely affects the hand and wrist. Given the unusual nature of this localization, we present the clinical case of a woman who developed calcific tendinitis of the third metacarpophalangeal muscle. We present the clinical evolution of the case, the treatments carried out, and a review of the literature related to this unusual localization of calcific tendinitis.

Efectividad de la terapia por ondas de choque en lesiones de tendones y ligamentos del sistema osteomioarticular / Effectiveness of Shock Wave Therapy in Tendon and Ligament Injuries of the Osteomioarticular System

Introducción: Por más de 20 años la litotricia extracorpórea se ha aplicado con éxito en el mundo. Objetivo: Evaluar la efectividad de la terapia por ondas de choque en el tratamiento a pacientes que presentan lesiones en los tendones y ligamentos del sistema osteomioarticular. Métodos: Se realizó un estudio descriptivo, de corte transversal, con 107 pacientes diagnosticados con lesiones en los tendones y ligamentos del sistema osteomioarticular, los cuales fueron tratados con el equipo Well Wave (ondas de choque extracorpóreas) en el Complejo Científico Ortopédico Internacional Frank País, en el período comprendido entre marzo de 2019 y abril de 2020. Se realizó el análisis de las variables edad, sexo, dolor y discapacidad. Se obtuvieron frecuencias absolutas y relativas, y con ellas se confeccionaron las tablas que resumen la información estadística de la investigación. Resultados: Predominó el sexo femenino (71,9 por ciento), de 51 - 60 años (28 por ciento). El 40,2 por ciento de los pacientes fueron atendidos por presentar una tendinitis del supraespinoso. Todos los pacientes presentaban dolor antes de la aplicación de la terapia. Luego del tratamiento el 78,5 por ciento de los enfermos dejaron de sentirlo y el 71 por ciento presentó ausencia de discapacidad según escala de DASH. Según los criterios de evaluación de la respuesta al tratamiento los resultados fueron satisfactorios en el 56 por ciento de los pacientes. Conclusiones: La terapia con las ondas de choque posibilitó una rápida recuperación de los pacientes atendidos y su incorporación a las actividades diarias(AU)

ABSTRACT Introduction: Over more than 20 years, extracorporeal lithotripsy has been successfully used worldwide. Objective: To evaluate the effectiveness of shock wave therapy in the treatment of patients with injuries to the tendons and ligaments of the osteomioarticular system. Methods: A descriptive, cross-sectional study was carried out with 107 patients diagnosed with injuries to the tendons and ligaments of the osteomioarticular system. These subjects were treated with the Well Wave equipment (extracorporeal shock waves) at Frank País International Orthopedic Scientific Center, from March 2019 to April 2020. The variables age, sex, pain and disability were analyzed. Absolute and relative frequencies were obtained, and the results of statistical information of the investigation was shown in summarizing tables. Results: The female sex prevailed (71.9percent), 51 - 60 years old (28 percent). 40.2 percent of the patients were treated for supraspinatus tendinitis. All patients had pain before the use of therapy. After treatment, 78.5 percent of the patients stopped feeling pain and 71 percent showed no disability according to DASH scale. According to the treatment response evaluation criteria, the results were satisfactory in 56percent of the patients. Conclusions: This therapy enabled rapid recovery of the patients treated and their integration into daily activities(AU)

Autologous Peripheral Blood Stem Cell Therapy for Chronic Achilles Tendinopathy: Report of Three Cases

@#The treatment of chronic Achilles tendinopathy (CAT) remains challenging. We report three cases of CAT treated with autologous peripheral blood stem cells (PBSCs), following principles developed for chondrogenesis of the knee joint. Outcome measurement with a minimum of one and a half years follow-up showed significant improvement of Victorian Institute of Sport Assessment-Achilles questionnaire (VISA-A) scores, with reduction of tendon thickness and inflammation on MRI scan.

TREATMENT FOR A REFRACTORY CHRONIC TENDOACHILLES TENDINITIS WITH PLATELET-RICH PLASMA INJECTIONS: A CASE REPORT

To define the pain and functional improvement of the patient with chronic Achilles tendinitis treated with a single PRP (platelet-rich plasma) injection. Chronic Tendoachilles tendinitis is a severe cause for a decrease in physical activity and persistent pain. It arises secondary to an account of repetitive use or exaggerated overload. Platelet-rich plasma therapy is used to provide local regenerative healing of the tendon. This report describes a 50-year-old Active female who presented with continuous pain in bilateral Tendoachilles for Approximately 6 years duration. A single Platelet-rich plasma injection is given to the patient with chronic tendoachilles tendinitis to reduce pain and improve function and improved VAS (visual analogue score) score from 9 to 0 seen at 1-year follow-up. The patient has been pain-free for the past 2 years and is back to daily functional physical activity. A single injection of PRP in each tendoachilles distally has shown significant relief in pain and improvement in day-to-day physical activity and a rapid recovery from chronic TA tendinitis.

Early Clinical and Functional Outcome of Rotator Cuff Tendinopathy of the Shoulder Treated with Platelet Rich Plasma Injection

@#Introduction: Both short and long PFNA are employed to treat intertrochanteric fractures. Controversy exists in the choice between the two nails as each implant has specific characteristics and theoretical advantages. This retrospective study seeks to examine the operative complication rates and clinical outcomes of short versus long (Proximal Femoral Nail Antirotation) PFNA in the treatment of intertrochanteric fractures. Materials and methods: Between July 2011 and February 2015, 155 patients underwent PFNA insertion. The decision on whether to use a short or long PFNA nail, locked or unlocked, was determined by the attending operating surgeon. Visual Analogue Pain Score (VAS) Harris Hip Scores (HHS), Short-form 36 Health Questionnaire (SF-36) and Parker Mobility Scores (PMS) were collected at six weeks, six months and one year post-operatively. Results: A total of 137 (88.4%) patients were successfully followed-up. Forty-two (30.7%) patients received a short PFNA. The patients were similar in baseline characteristics of age, gender, and comorbidities. Operative time was significantly longer in the short PFNA group (62 ±17 mins) versus the long PFNA group (56±17). While the patients in both groups achieved improvement in all outcome measures, there was no significant difference between the groups in terms of HHS (61.0 ±16.0 vs 63.0 ±16.8, p=0.443), PMS (2.3±1.5 vs 2.7±2.1, p=0.545) and VAS (1.7±2.9 vs 1.8 ±2.2 p=0.454). There were 3 (7.1%) and 7 (7.4%) complications in the short versus long PFNA group, respectively. Conclusion: Both short and long PFNA had similar clinical outcomes and complication rates in the treatment of intertrochanteric fractures in an Asian population.

Arthroscopic treatment for the calcific tendinitis at soft tissues around hip / 中国骨伤

OBJECTIVE@#To explore the feasibility and clinical effects of arthroscopic treatment for the calcific tendinitis at soft tissues around hip.@*METHODS@#A total of 16 patients diagnosed as the calcific tendinitis at soft tissues around hip from May 2013 to July 2018 were retrospectively analyzed. All the 16 patients received arthroscopic procedures. There were 10 males and 6 females with an average age of 35 to 63 (44.50±6.67) years old and 9 left hips, 6 right hips were involved. The course of disease were 1 to 8(3.18±1.97) days. Clinical effects were evaluated with visual analogue scale(VAS), modified Harris hip scores (HHS), nonarthritic hip score (NAHS) and imaging examinations before operation, 1 day after operation and the final follow-up.@*RESULTS@#All 16 patients successfully finished the arthroscopic procedures in 0.5 to 1.2 (0.75±0.21) hours. Primary healing of incision were obtained without any complications of infection, wound hematocele and neurovascular injury. All 16 patients received an average postoperative follow-up of 6 to 12 (9.6±2.3) months. Before operation, the VAS were 7.88±0.72, modified HHS were 29.25±3.23, NAHS were 27.42±3.08. The 1st day postoperative VAS were 2.19±0.66, modified HHS were 82.56± 5.64, NAHS were 82.11±2.94, all the difference were statistically significant between before and 1 day after operation (@*CONCLUSION@#Arthroscopic treatment for the calcific tendinitis at soft tissues around hip is effective.It has advantages of minimal invasive, rapid pain relief, rapid hip joint function recovery and definite clinical effects.

Tendinitis calcificante del musculo largo del cuello: presentación de un caso clínico / Calcific tendinitis of the longus colli muscle: a case report / Tendinite calcificante do músculo longo do pescoço: apresentação de um caso clínico

La tendinitis calcificante del músculo largo del cuello es una patología subdiagnsoticada, de baja frecuencia, autolimitada. Se presenta clínicamente como una de las causas de odinofagia en la consulta médica. Se produce debido al depósito de cristales de hidroxiapatita en espacio retrofaríngeo, desencadenándose una respuesta inflamatoria local. En la TMLC el principal diagnóstico diferencial es el absceso retrofaríngeo, ya que puede presentarse clínicamente con odinofagia, disfagia , disminución de la movilidad del cuello y cervicalgia. En nuestro trabajo se analiza un caso clínico sobre dicha patología, en un hombre de 45 años; realizando un análisis de la sintomatología, diagnóstico y tratamiento de esta entidad.

Calcific tendinitis of the long neck muscle is an underdiagnosed, low frequency, self-limited pathology. It is clinically presented as one of the causes of odynophagia in the medical consultation. It occurs due to the deposit of hydroxyapatite crystals in the retropharyngeal space, triggering a local inflammatory response. On This patholgy, the main differential diagnosis is retropharyngeal abscess, since it can present clinically with odynophagia, dysphagia, decreased mobility of the neck, and neck pain. In our work, a clinical case of this pathology is analyzed, in a 45-year-old man; performing an analysis of the symptoms, diagnosis and treatment of this entity.

A tendinite calcificante do músculo longo do pescoço é uma patologia subdiagnsoticada, de baixa frequência, autolimitada. Apresenta-se clinicamente como uma das causas de odinofagia na consulta médica. Ocorre devido ao depósito de cristais de hidroxiapatita em espaço retrofaríngeo, desencadeando-se uma resposta inflamatória local. Na TMLC o principal diagnóstico diferencial é o abscesso retrofaríngeo, já que pode apresentar-se clinicamente com odinofagia, disfagia , diminuição da mobilidade do pescoço e cervicalgia. Em nosso trabalho analisa-se um caso clínico sobre essa patologia, em um homem de 45 anos; realizando uma análise da sintomatologia, diagnóstico e tratamento desta entidade.

Impact of Physiotherapy Rehabilitation Program on Post-Operative Stiffness of Supraspinatus Tendinitis.

In the general population, shoulder pain is a common musculoskeletal problem. Older people are frequently affected, and the most common causes of shoulder pain are the problems with rotator cuffs which are seen in primary care practice. The incidence of rotator cuff tear increases with advanced age and it has been estimated that the prevalence of shoulder pain in older patients ranges from 21% to 27%.(1)Tendons are thick, fibrous tissues that transmits muscle-generated force to the bones and thus generates joint movement. Repeated activities and complex muscle-tendon overuse can damage tendons that lead to pain and decrease function.(2)The supraspinatus muscle is a part of the rotator cuff of shoulder.(3) The inflammation of a muscle tendon causes tendinitis and it has varying levels of pain. Supraspinatus tendonitis is an inflammation of supraspinatus tendon often associated with shoulder impingement syndrome.(4) The Supraspinatus tear that causes the supraspinatus tendon to affect the acromion leading to pain is the cause of Supraspinatus Tendinitis. The main cause of the Supraspinatus tear is constant pressure, increased workload and wear and tear associated with age.(5)Total loss of active abduction at the glenohumeral joint is due to a complete tear of supraspinatus.(6) Supraspinatus tendonitis complications include leading to a rotator cuff tear. Initially, rotator cuff tears were almost identified as secondary to tendon haemorrhage and tendonitis products of untreated impingement.(7)The primary purpose of rehabilitation to achieve short-term and long-term goal, patient education and consistent plan of care. The patient's awareness on the need to take non-operative steps, improvement, and the availability of choices will assist them in being active participants in their treatment.(7)

Tendinopatía cálcica: etiopatogenia y evaluación por imágenes / Calcific tendinitis: aetiopathogenesis and imaging evaluation

Resumen: La tendinopatía cálcica es causada por el depósito patológico de cristales de hidroxiapatita de calcio en los tendones y es una causa común de dolor en las articulaciones. Afecta más frecuentemente al hombro y la cadera, con hallazgos característicos en imágenes; sin embargo, cualquier tendón puede estar involucrado. Ocasionalmente, la tendinopatía cálcica puede simular patología agresiva, como infección o neoplasia, especialmente en RM. Fisiotpatológicamente, las calcificaciones provendrían de una diferenciación anormal de las células madre del tendón, que comienzan a producir calcio, aunque todavía no es del todo claro. Los radiólogos deben estar familiarizados con los hallazgos de las imágenes para distinguir la tendinopatía cálcica de procesos más agresivos. La aspiración y lavado guiado bajo ecografía es una técnica útil realizada por el radiólogo para el tratamiento de casos sintomáticos. La familiaridad con estos procedimientos y su apariencia en imágenes es un aspecto importante en el manejo de esta enfermedad. El propósito de esta revisión es analizar la etiopatogenia de la tendinopatía cálcica, la evaluación con imágenes en los sitios de presentación más comunes y también en los menos frecuentes, así como el papel que desempeña la ecografía en el tratamiento de la patología.

Abstract: Calcific tendinitis is caused by abnormal deposition of calcium hydroxyapatite crystals in tendons and is a common cause of joint pain. The disease typically affects the shoulder and hip, with characteristic imaging findings; however, any tendon can be involved. Occasionally, calcific tendinitis can mimic aggressive disorders, such as infection and neoplasm, especially on MRI. Apparently, the calcifications come from an abnormal differentiation of the tendon stem cells, which begin to produce calcium. Radiologists should be familiar with the imaging findings to distinguish calcific tendinitis from more aggressive processes. Image-guided percutaneous needle aspiration is a useful technique performed by the radiologist for the treatment of symptomatic cases. Being familiar with these processes and their imaging appearance is an important aspect in the management of this common disease. The purpose of this review is to analyze the pathogenesis of calcium tendinopathy, the evaluation of images in both the most common and less frequent presentation sites, as well as the role played by ultrasound in the treatment of pathology.

Finite element analysis on the biomechanical changes of patellar tendinitis / 中国组织工程研究

BACKGROUND: It is difficult to obtain the biomechanics of patellar tendinitis by using experimental conditions. Finite element method can solve this problem by using its powerful modeling and computer simulation functions. OBJECTIVE: To summarize the application of finite element analysis in several aspects, such as the mechanism of patellar tendinitis, treatment method and design of knee wearable device, so as to provide theoretical guidance for the prevention and rehabilitation of patellar tendinitis, and provide new ideas for the application of finite element analysis in the study of patellar tendinitis. METHODS: The first author used the search terms “finite element analysis, patellar tendon (patellar tendinitis), knee, biomechanics” in Chinese and English, respectively. Relevant literature published from 1981 to 2019 in CNKI, SportDiscus, PubMed and Elsevier databases were searched. RESULTS AND CONCLUSION: At present, a variety of simulation and analysis algorithms for simulating the mechanism of human biomechanics are continuously developed, so as to establish and analyze the knee tissue with complex structure and the wearable device model. The nonlinear and dynamic analysis of the continuous motion of the knee will be realized, and the simulation analysis will be more real. Further exploration of the treatment of patellar tendinitis by using finite element method, research and development of rehabilitation equipment, and design of overall materials and structures of wearable devices will be the development direction of future research.

Tendinitis calcificante del longísimo del cuello / Acute calcific tendinitis of the longus colli muscles

RESUMEN La tendinitis calcificante prevertebral es una patología benigna y poco frecuente, con una incidencia anual de 0,5 casos por cada 100.000 habitantes. Se presenta un caso de una paciente de 52 años que consultó por cervicalgia, odinofagia y disfonía de 5 días de evolución. Tras una exploración otorrinolaringológica completa se sospechó ocupación del espacio retrofaríngeo, confirmada con pruebas de imagen. Ante estos hallazgos y con la sospecha de absceso retrofaríngeo, se decidió ingreso hospitalario para tratamiento intravenoso. Por discordancia entre la clínica, la TC y los hallazgos analíticos, se solicitó RM cervical, cuya imagen hizo sospechar una tendinitis aguda calcificante del longísimo del cuello. En este trabajo se ha realizado una revisión de la sintomatología, el diagnóstico y el tratamiento de esta entidad. Consideramos importante sospecharla dentro del diagnóstico diferencial de la ocupación del espacio retrofaríngeo para evitar realizar procedimientos innecesarios.

ABSTRACT Prevertebral calcific tendinitis is a benign and infrequent pathology, with an annual incidence of 0.5 cases per 100,000 habitants. We report the case of a 52-year-old woman that presented with a 5-day history of cervicalgia, odynophagia and dysphonia. Otolaryngological examination and radiological images showed occupation of the retropharyngeal space. The patient was admitted to the hospital for intravenous treatment. A cervical MRI was requested, suggesting an acute calcific tendinitis of the longus colli muscles. The authors provide a discussion of the clinical findings, diagnosis and treatment of this condition. We consider it to be an important differential diagnosis of a retropharyngeal space occupation, in order to avoid unnecessary procedures.

Biomecánica de las lesiones en hombro: Revisión bibliográfica crítica desde la perspectiva médico legal laboral / Biomechanics of shoulder injuries: Critical bibliographic review from the medical-legal-occupational perspective

Resumen La base fundamental de la valoración médico legal de un individuo es establecer la relación de causalidad entre la historia narrada por el mismo y los hallazgos documentados. La biomecánica del trauma es una herramienta que permite dilucidar dicha concordancia, ya que su estudio involucra los mecanismos de trauma implicados en la génesis de las distintas lesiones. Este artículo consiste en una revisión bibliográfica y crítica de la literatura actual en materia de etiopatogenia de las lesiones en hombro por su alta incidencia laboral y capacidad de generar secuelas.

Abstract The basis of the forensic evaluation of an individual is to establish the relationship of causality between the story that has been told by the patient and the documented findings. The study of injury biomechanics is a tool that helps to clarify said concordance, since it involves the trauma mechanisms that are implied in the genesis of the different lesions. This article consists of a bibliographical revision and critique of the current literature about the etiopathogenesis of the shoulder lesions, since they are frequent in the work place and can generate sequels.

Successive Acute Calcific Tendinitis at Different Sites

Acute calcific tendinitis (ACT) is a benign painful inflammatory disorder characterized by resorptive process of calcific deposits following the formation of calcium hydroxyapatite crystals in the tendons. It can occur at various sites, especially in the shoulder or hip joint. ACT involving the lateral epicondyle of the humerus and the cervical spine is very rare. Few reports have demonstrated successive ACT at different sites. We report three cases of successive ACT in women, occurring at the subscapularis followed by the lateral epicondyle, flexor carpi ulnaris followed by the supraspinatus, and longus colli followed by the iliopsoas, respectively.

Coexistence of musculoskeletal disorders in the upper body of labor origin / Coexistencia de trastornos musculoesqueléticos en miembro superior de origen laboral

The coexistence of musculoskeletal disorders is common in work activities around the world, however, information on the subject is insufficient both in Latin America and in Colombia despite its impact at the economic and social level. The objective of this research was to determine the coexistence of musculoskeletal disorders of work origin in the upper body in the working population that attends a Service Provider Institution (IPS). An observational, descriptive, quantitative, and cross-sectional design study was conducted between the first of March in 2017 and the first of March in 2018. Four semiological tests were applied for physiotherapists to seek the coexistence of carpal tunnel syndrome, lateral epicondylitis, rotator cuff syndrome, and cervical myofascial syndrome. Among the results, it was found that 92.6% (n=138) of the patients had two or more pathologies, 59.73% (n=89) had the rotator cuff and the myofascial syndrome, 52.35% (n=78) had epicondylitis and myofascial syndrome, and 37.58% (n=56) had carpal tunnel syndrome and lateral epicondylitis. This study highlights the high coexistence of musculoskeletal disorders in the upper body, especially in the female gender.

La coexistencia de trastornos musculoesqueléticos es común en actividades laborales de todo el mundo, sin embargo la información sobre el tema es insuficiente tanto en América Latina como en Colombia a pesar de su impacto a nivel económico y social; la investigación tuvo como objetivo determinar la coexistencia de trastornos musculoesqueléticos en miembro superior de origen laboral en la población trabajadora que asiste a una Institución Prestadora de Servicios (IPS); Se realizó un estudio de diseño Observacional, descriptivo, cuantitativo y de corte transversal, durante el periodo comprendido entre el primero de marzo de 2017 y el primero de marzo del 2018, se aplicaron cuatro pruebas semiológicas por fisioterapeutas para buscar la coexistencia de Síndrome de túnel del carpo, epicondilitis lateral, síndrome de manguito rotador y síndrome miofascial cervical; entre los resultados se encontró que el 92,6% (n=138) de los pacientes presentaban dos o más patologías, el 59,73% (n=89) síndrome de manguito rotador y síndrome miofascial, el 52,35% (n=78) Epicondilitis y síndrome miofascial y el 37,58% síndrome de túnel del carpo y epicondilitis lateral (n=56). El estudio pone en evidencia la elevada coexistencia de trastornos musculoesqueléticos en miembro superior especialmente en el género femenino.

Clinical and Imaging Features of Longus Colli Calcific Tendinitis: An Analysis of Ten Cases

BACKGROUND: Longus colli calcific tendinitis (LCCT) exhibits characteristic clinical features; thus, misidentification can be avoided once it is learned. There is a lack of reports on this disease. In this study, we analyzed the imaging and clinical features of LCCT in 10 patients. METHODS: We retrospectively reviewed the radiolographic findings, laboratory data and clinical features of 10 patients diagnosed with LCCT between January 2015 and June 2017. All patients were treated with medical treatment consisting of intravenous methylprednisolone 125 mg twice and oral nonsteroidal anti-inflammatory drug administration. RESULTS: On clinical findings, all 10 patients complained of severe posterior neck pain and cervical motion limitation. Odynophagia was present in nine patients. The mean time from symptom onset to hospital visit was 2.9 days. The mean time to symptom relief was 4.6 days. Of the 10 patients, three patients were admitted through the emergency room. There were five patients in the medical records who were transferred from another hospital. On the laboratory data, the mean value of C-reactive protein and erythrocyte sedimentation rate were 2.08 mg/dL (reference range, < 0.30 mg/dL) and 36.9 mm/hr (reference range, < 20 mm/hr), respectively. Leukocytosis was found in only two patients and fever was not present all patients. On radiographic findings, calcification was present on computed tomography images of all patients. The calcification was located at the lower part of the C1 arch, except for one case where calcification occurred in the anterolateral aspect of the C4–5 disc space. The mean value of the retropharyngeal space was 7.2 mm. CONCLUSIONS: LCCT, a rare disease, has characteristic radiographic findings and clinical features. Understanding such characteristics of this disease can prevent unnecessary testing and misdiagnosis.

Clinical analysis on arthroscopic incomplete removal of calcifications of supraspinatus tendinitis / 局解手术学杂志

Objective To evaluate the treatment effect of the arthroscopic incomplete removal of calcifications of the supraspinatus tendinitis without acromioplasty.Methods The clinical data of 20 patients of calcified supraspinatus tendinitis with Ellman Ⅰ or Ⅱ in general hospital of Shenyang military area command from January 2014 to February 2016 were retrospectively analyzed.Of the 20 patients,4 males and 16 females,the age ranged from 45 to 62 years old,with average age (50.2 ± 6.3) years old.All the patients received removal incomplete of calcification without acromioplasty.Pre-and postoperative 3,6,9 months general situation were evaluated by the VAS score,Constant-Murley score,University of California Los Angeles (UCLA) score,X-Radiographs and CT.Results The shoulder function was evidently improved in all 20 patients.The average VAS pain score was (8.2 ± 1.4) preoperatively and (0.8 ± 0.6) at the 6 months follow-up.The average Constant-Murley score was (44.6 ± 7.4) preoperatively and (95.4± 3.4) at the 6 months follow-up.The average UCLA score was (12.2 ± 3.6) preoperatively and (33.1 ± 1.4) at the 6 months follow-up.Conclusion The arthroscopic incomplete removal of calcifications of the supraspinatus tendon without acromioplasty can lead to good results with less iatrogenic injury.

Functional Recovery of the Shoulder after Arthroscopic Treatment for Chronic Calcific Tendinitis

BACKGROUND: We investigated the resolution of pain and functional recovery of shoulder after arthroscopic removal of calcific deposits in patients with chronic calcific tendinitis. METHODS: We enrolled 39 patients who were treated arthroscopically for chronic calcific tendinitis that had been non-responsive to at least 6 months of conservative treatment. We evaluated clinical outcome in terms of the American Shoulder Elbow Surgeons (ASES), the Constant score, the visual analogue score (VAS) for pain. We used plain radiography to measure the size of the calcific deposits. We also analyzed the clinical outcomes in terms of whether or not a cuff repair was performed or the degree of removal of calcific deposits. RESULTS: We found that complete resolution of pain took on average 5.7 months after the arthroscopic treatment. The ASES and the Constant score significantly improved from the 3-month follow-up, however it took 6 months until the scores reached on average 80 points or above. We found that these clinical outcomes at the final follow-up did not significantly differ by whether or not cuff repair was performed. Similarly, we found that the clinical outcomes did not significantly differ by the degree of calcium removal. CONCLUSIONS: We found that arthroscopic removal of calcification leads to improved clinical outcomes in patients with chronic calcific tendinitis. However, our findings show it takes at least 6 months for the clinical improvement to become statistically significant. We also found that concomitant cuff repairs or the degree of removal of calcification does not affect the clinical outcome of the arthroscopic treatment.

Tendinitis del iliopsoas / Iliopsoas tendinitis

Dentro de las lesiones deportivas, las lesiones de pelvis y cadera representan el 2-5%. La tendinitis del ileopsoas es una de las menos comunes, generalmente asociada a una bursitis del ileopsoas debido a su proximidad anatómica. Siendo idéntica su presentación clínica y manejo. Se define como una inflamación del tendón o del área que lo rodea, provocada en general por la repetitiva flexión de la cadera.

Pelvic and hip lesions account for 2-5% of sports lesions. Iliopsoas tendinitis is one of the least common and is generally associated with iliopsoas bursitis because of its anatomical proximity. Their clinical presentation and management are the same. It is defined to be an inflammation of the tendon or surrounding tissue, caused by repetitive hip flexion.