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)

Tendinites em praticantes de musculação: estudo transversal / Tendinitis in bodybuilders: cross-sectional study

Introdução: Exercícios com cargas vêm se mostrando eficiente na promoção de saúde e ocupando cada vez mais espaço no cenário de prática esportiva atual, porém merecem atenção em relação a ocorrência de lesões, em especial as tendinites. Objetivo: Avaliar a prevalência de tendinites em praticantes de musculação, divididos em três grupos, verificando os fatores de associação. Métodos: Estudo transversal, descritivo e analítico, de caráter quantitativo. A amostra foi composta por 208 alunos com idade a partir de 18 anos. Foi utilizado um questionário próprio composto de dados sociodemográficos e relacionados à presença ou não de tendinites, que foi confirmada através do diagnóstico médico. Os dados foram tabulados e analisados no SPSS 15.0, sendo geradas as frequências relativas e absolutas de interesse para pesquisa. As associações entre a tendinite, o tipo de treinamento e os fatores associados foram analisadas a partir do teste do qui-quadrado ou Exato de Fischer. Resultados: A prevalência de tendinite foi de 17,8% foi associada ao treino de hipertrofia, ser do sexo masculino, usar anabolizantes, suplementos e medicamentos, além de não treinar sem supervisão. Conclusão: A tendinite apresenta-se como uma lesão frequente em praticantes de musculação. Existem alguns fatores que contribuem para ocorrência dessa lesão, servindo de alerta aos profissionais de saúde a fim de minimizar essa lesão. [AU]

Introduction: Exercises with loads have been shown to be efficient in promoting health and occupying more and more space in the current sport practice scenario, but deserve attention in relation to the occurrence of injuries, especially tendinitis. Objective: To evaluate the prevalence of tendonitis in bodybuilders, divided into three groups, verifying the factors that are associated with this affection. Methods: Cross-sectional, descriptive and analytical study of a quantitative nature. The sample consisted of 208 students aged 18 years and over. A self-administered questionnaire composed of sociodemographic data and related to the presence or absence of tendinitis was used, which was confirmed through medical diagnosis. The data were tabulated and analyzed in SPSS 15.0, generating the relative and absolute frequencies of interest for research. The associations between tendonitis, type of training and associated factors were analyzed from the chi-square test or Fischer's exact test. Results: The prevalence of tendonitis was 17.8% and was associated with hypertrophy training, being male, using anabolic steroids, supplements and medications, besides not being accompanied. Conclusion: Tendonitis is a frequent injury in bodybuilders. There are some factors that contribute to the occurrence of this lesion, serving as an alert for health professionals in order to minimize this involvement. [AU]

Nueva visión del tratamiento de la fascitis plantar en deportistas: Utilidad del entrenamiento funcional mediante el esquí / New vision of plantar fasciitis treatment in athletes: Utility of functional training by ski

La fascitis plantar es un síndrome degenerativo que se produce como resultado de traumas repetidos en el origen de ésta, en el calcáneo. Suele presentarse en atletas y corredores, aunque también aparece en la población general, afectando aproximadamente a un 10% en ambos casos. Aunque su etiología no es del todo clara, es probable que la causa no sea única y haya diversos factores que contribuyan a su aparición. Estos son tales como el aumento de peso, el exceso de ejercicio físico o el calzado inadecuado, entre otros. La fascitis plantar se caracteriza por dolor en la región inferior del talón, en la planta del pie, que es especialmente intenso en los primeros momentos de la mañana al andar o después de un período de inactividad física o tras una bipedestación prolongada. A lo largo del día el dolor va disminuyendo, pero volverá si se lleva a cabo la actividad de levantamiento de peso. El tiempo de recuperación o resolución de esta patología es prolongado y existen varios métodos que pueden ayudar en su tratamiento, todos ellos diríamos que convencionales. Esta revisión plantea el tratamiento de la fascitis plantar a través del entrenamiento funcional de esquí, dadas las características biomecánicas que comporta este deporte.

Plantar fasciitis is a degenerative syndrome that occurs because of repeated traumas in the fascia origin on the calcaneus. It usually occurs in athletes and runners, although it also appears in the general population, affecting approximately 10% in both cases. Although its etiology is not entirely clear, it is likely, not due to a unique cause since there are several factors that contribute to its appearance. These are: weight gain, excessive physical exercise or inadequate footwear, etc. Plantar fasciitis is characterized by pain in the lower region of the heel, in the sole of the foot, which is especially intense in the first moments of the morning when walking, after a period of physical inactivity or after prolonged standing. Throughout the day the pain diminishes, but will return if weight-lifting activity is carried out. The recovery time or resolution of this pathology is prolonged and there are several conservative methods that may help in the treatment of plantar fasciitis. Therefore, in this review we propose the treatment of plantar fasciitis through functional ski training, given the biomechanical characteristics of this sport.

Determinación de factores causantes de Tendinitis de Muñeca

Introducción. La tendinitis es una condición inflamatoria y degenerativa que se caracteriza por dolor en las intersecciones tendinosas de los huesos. La muñeca es uno de los sitios más comunes de tendinitis. La causa principal de tendinitis es la combinación de carga mecánica, uso intenso, movimientos repetitivos, fuerza y posición de la muñeca. Objetivos: Describir los factores asociados a tendinitis de muñeca producida en pacientes con diagnóstico clínico de tendinitis de muñeca. Métodos: Estudio descriptivo observacional, los participantes fueron 33 personas mayores de 18 años de edad con diagnóstico clínico de tendinitis de muñeca en consulta externa de cirugía de la mano. Resultados: Sí existe una relación importante entre los pacientes con diagnóstico clínico y sus condiciones laborales; mayormente la realización de movimientos manuales repetitivos, utilización de máquina de escribir o computadora y el uso de equipo que implique la fuerza entre los dedos pulgar e índice. Conclusión: Las condiciones laborales que impliquen el uso constante y crónico de la muñeca sí están relacionadas con el desarrollo de tendinitis de muñeca. Palabras clave: Tendinitis de muñeca, condiciones laborales, factores asociados.

Background. Tendinitis is an inflammatory and degenerative condition characterized by pain in tendon bone intersections. The wrist is one of the most common sites of tendinitis. The principal cause of tendinitis is the combination of mechanical load, heavy use, repetitive motion, wrist position and force. Objectives: To describe factors associated with wrist tendinitis produced in patients with clinical diagnosis of wrist tendinitis. Methods. Observational descriptive study, the participants were 33 subjects over 18 years old with a clinical diagnosis of wrist tendinitis all from the outpatient clinic of hand surgery. Results: There is a significant relationship between patients with clinical diagnosis and working conditions; mostly performing repetitive hand movements, using typewriter or computer and use of equipment involving force between thumb and forefinger. Conclusion: working conditions involving the use of constant and chronic wrist if it is related to the development of wrist tendinitis. Key words: Wrist tendonitis, working conditions, associated factors

Retrospective study of sonographic findings in bone involvement associated with rotator cuff calcific tendinopathy: preliminary results of a case series / Estudo retrospectivo dos achados da ultrassonografia no envolvimento ósseo associado a tendinopatia calcificada do manguito rotador: resultados preliminares de uma série de casos

Abstract Objective: The present study was aimed at investigating bone involvement secondary to rotator cuff calcific tendonitis at ultrasonography. Materials and Methods: Retrospective study of a case series. The authors reviewed shoulder ultrasonography reports of 141 patients diagnosed with rotator cuff calcific tendonitis, collected from the computer-based data records of their institution over a four-year period. Imaging findings were retrospectively and consensually analyzed by two experienced musculoskeletal radiologists looking for bone involvement associated with calcific tendonitis. Only the cases confirmed by computed tomography were considered for descriptive analysis. Results: Sonographic findings of calcific tendinopathy with bone involvement were observed in 7/141 (~ 5%) patients (mean age, 50.9 years; age range, 42-58 years; 42% female). Cortical bone erosion adjacent to tendon calcification was the most common finding, observed in 7/7 cases. Signs of intraosseous migration were found in 3/7 cases, and subcortical cysts in 2/7 cases. The findings were confirmed by computed tomography. Calcifications associated with bone abnormalities showed no acoustic shadowing at ultrasonography, favoring the hypothesis of resorption phase of the disease. Conclusion: Preliminary results of the present study suggest that ultrasonography can identify bone abnormalities secondary to rotator cuff calcific tendinopathy, particularly the presence of cortical bone erosion.

Resumo Objetivo: Investigar o envolvimento ósseo secundário a tendinopatia calcificada do manguito rotador por meio da ultrassonografia. Materiais e Métodos: Estudo retrospectivo de uma série de casos. Foi realizada busca dos relatórios de ultrassonografia do ombro no sistema informatizado da instituição, no período de quatro anos. Cento e quarenta e um pacientes foram diagnosticados com tendinopatia calcificada do manguito rotador. Os achados de imagem foram analisados retrospectivamente em consenso por dois radiologistas musculoesqueléticos experientes. Os casos sem confirmação pela tomografia computadorizada foram excluídos da análise descritiva. Resultados: Foram identificados sinais de tendinopatia calcificada com envolvimento ósseo pela ultrassonografia em 7/141 (~ 5%) dos pacientes (idade: 50,9 anos; faixa etária: 42-58 anos; 42% do sexo feminino). Erosão do osso cortical adjacente à calcificação tendínea foi o achado mais comum, observado em 7/7 casos. Foram identificados sinais de migração intraóssea em 3/7 casos e cistos subcorticais adjacentes à calcificação tendínea em 2/7 casos. Os achados foram confirmados pela tomografia computadorizada. Nenhuma calcificação associada com anormalidades ósseas mostrou sombra acústica, favorecendo a fase reabsortiva da doença. Conclusão: Nossos resultados preliminares sugerem que a ultrassonografia é capaz de identificar anormalidades ósseas secundárias a tendinopatia calcificada do manguito rotador, especialmente a presença de erosões da cortical óssea.

Ossified Brodie's Ligament.

The transverse humeral ligament (THL) or Brodie’s ligament is a narrow sheet of connective tissue fibers that runs between the lesser and the greater tubercles of the humerus. Togetherwith the intertubercular groove of the humerus, the ligament creates a canal throughwhich the long head of the biceps tendon and its synovial sheath passes. The ossification of transverse humeral ligament is a rare interesting anatomical variation, which has been identified as one of the predisposing factor for biceps tendonitis and tenosynovitis. In the present study of 100 humerus bones, we found a right side humerus with completely ossified transverse humeral ligament which extended from the lateral margin of lesser tubercle to the medial margin of greater tubercle of the humerus. The Length and breadth of the ossified ligament were 8 mm and 6 mm respectively. Such an ossified ligament may damage the biceps tendon and its synovial sheath during biomechanical movement of the arm leading to anterior shoulder pain. Itmay also complicate the use of bicipital groove as a landmark for orientation of the humeral prosthesis in complex proximal humeral fractures. Hence, the anatomical knowledge of ossified transverse humeral ligament is important for the radiologist and orthopedic surgeon in diagnosis and planning the treatment for patient with anterior shoulder pain.

Tenoscopía tibial posterior: Reporte de un caso / Posterior tibial tenoscopy: Case report

La tendinitis del tibial posterior se presenta comúnmente en pacientes con actividades deportivas. Se puede originar ya sea por exceso de uso o una sobrecarga brusca sobre el tendón. Esta tendinitis también se puede presentar en pacientes con enfermedades inflamatorias sistémicas, y se clasifica como el estadio I en la disfunción del tendón tibial posterior. El tratamiento inicial, con el que se han presentado buenos resultados, se basa en la inmovilización y rehabilitación. En los casos que no presentan mejoría del cuadro clínico o la tendinitis se asocia a una ruptura parcial del tendón, existen técnicas abiertas para realizar tenosinovectomías y revisiones del tendón para mejorar la sintomatología dolorosa. Con el advenimiento de las técnicas miniinvasivas se pueden realizar revisiones amplias del tendón con una mínima agresión o combinarlas con técnicas tradicionales si se asocian con roturas parciales. En este artículo se describe el caso clínico de un paciente femenino de 35 años con patología y dolor crónico a nivel de tibial posterior, la cual fue manejada mediante tenoscopía del tibial posterior y su evolución postquirúrgica a 24 meses. El tratamiento endoscópico y/o tenoscópico es una técnica simple y reproducible. En esta paciente encontramos excelentes resultados funcionales y cosméticos. Es necesario aumentar nuestra casuística sobre este método de tratamiento...

Posterior tibial tendinitis occurs commonly in patients involved in sports activities. It may result from either excessive use or sudden overload of the tendon. This tendinitis may also occur in patients with systemic inflammatory conditions and is classified as posterior tibial tendon dysfunction stage I. Initial treatment, which has produced good results, is based on immobilization and rehabilitation. In cases without clinical improvement or in which tendinitis is associated with partial tendon rupture, open techniques may be used to perform tenosynovectomy and tendon revisions to improve painful symptoms. With the advent of minimally invasive techniques broad tendon revisions may be done that cause minimal damage or they may be combined with traditional techniques in cases of partial rupture. This paper describes the clinical case of a 35 year-old female patient with posterior tibial pathology and chronic pain. She underwent posterior tibial tenoscopy and was followed-up postoperatively for 24 months. Endoscopic and/or tenoscopic treatment is a simple and reproducible technique. We obtained excellent functional and cosmetic results in this patient. We need larger case series of patients subjected to this treatment...

Observations on the Efficacy of Superficial Needling plusJoint Mobilization Training in Treating Supraspinatus Tendonitis / 上海针灸杂志

ObjectiveTo investigate the efficacy of superficial needling plus Joint mobilization training in treatingsupraspinatus tendonitis.MethodForty-one patients with supraspinatus tendonitis were randomly allocated to a treatment group of 21 cases and a control group of 20 cases. The treatment group received one session of superficial needling plus shoulder Joint mobilization training and the control group, one session of pain point injection of 2% lidocaine hydrochloride plus triamcinolone acetonide acetate. The therapeutic effects were compared between the two groups.ResultThe total efficacyrate was significantly higher in the treatment group (100%) and in the control group (65%); there was a statistically significant difference between the two groups (P<0.05). ConclusionSuperficial needling plus Joint mobilization training has a positive therapeutic effect on supraspinatus tendonitis.

Serial superficial digital flexor tendon biopsies for diagnosing and monitoring collagenase-induced tendonitis in horses / Biópsias seriadas do tendão flexor digital superficial para o diagnóstico e monitoração da tendinite induzida por colagenase em equinos

The purpose of this investigation was to demonstrate the feasibility of a biopsy technique by performing serial evaluations of tissue samples of the forelimb superficial digital flexor tendon (SDFT) in healthy horses and in horses subjected to superficial digital flexor tendonitis induction. Eight adult horses were evaluated in two different phases (P), control (P1) and tendonitis-induced (P2). At P1, the horses were subjected to five SDFT biopsies of the left forelimb, with 24 hours (h) of interval. Clinical and ultrasonographic (US) examinations were performed immediately before the tendonitis induction, 24 and 48 h after the procedure. The biopsied tendon tissues were analyzed through histology. P2 evaluations were carried out three months later, when the same horses were subjected to tendonitis induction by injection of bacterial collagenase into the right forelimb SDFT. P2 clinical and US evaluations, and SDFT biopsies were performed before, and after injury induction at the following time intervals: after 24, 48, 72 and 96 h, and after 15, 30, 60, 90, 120 and 150 days. The biopsy technique has proven to be easy and quick to perform and yielded good tendon samples for histological evaluation. At P1 the horses did not show signs of localised inflammation, pain or lameness, neither SDFT US alterations after biopsies, showing that the biopsy procedure per se did not risk tendon integrity. Therefore, this procedure is feasible for routine tendon histological evaluations. The P2 findings demonstrate a relation between the US and histology evaluations concerning induced tendonitis evolution. However, the clinical signs of tendonitis poorly reflected the microscopic tissue condition, indicating that clinical presentation is not a reliable parameter for monitoring injury development. The presented method of biopsying SDFT tissue in horses enables the serial collection of material for histological analysis causing no clinical signs and tendon damage seen by US images. Therefore, this technique allows tendonitis to be monitored and can be considered an excellent tool in protocols for evaluating SDFT injury.

Objetivou-se demonstrar a viabilidade de uma técnica de biópsia na realização de avaliações sequenciais de amostras de tecido do tendão flexor digital superficial (TFDS) do membro torácico, em equinos hígidos e em equinos submetidos à indução de tendinite do TFDS. Oito equinos adultos foram avaliados em duas fases (F) diferentes, controle (F1) e apresentando tendinite induzida (F2). Na F1, os equinos foram submetidos a cinco biópsias do TFDS do membro torácico esquerdo, com 24 horas (h) de intervalo entre as mesmas. Avaliações clínicas e ultrassonográficas (US) foram realizadas imediatamente antes e, 24 e 48 h após cada procedimento. O tecido tendíneo coletado por biópsia foi analisado histologicamente. A F2 ocorreu três meses depois, quando os mesmos equinos foram submetidos à indução de tendinite do TFDS do membro torácico direito por injeção intratendínea de colagenase. Na P2, Avaliações clínicas e US foram realizadas antes da indução da tendinite e após a mesma nos seguintes momentos: 24, 48, 72 e 96 h depois e, 15, 30, 60, 90, 120 e 150 dias depois. A técnica de biópsia se demonstrou ser de fácil e rápida realização, fornecendo fragmentos de tecido tendíneo adequados para a realização de histologia. Na F1, os equinos não demonstraram sinais de inflamação local, dor ou claudicação, bem como não apresentaram alterações na avaliação US do TFDS após as biópsias, demonstrando que o dano físico ao tendão provocado pela biópsia não compromete sua integridade. Assim, o procedimento pode ser utilizado rotineiramente para avaliações histológicas do tecido tendíneo. Na F2, observou-se uma relação entre os achados US e histológicos no que se refere à evolução da tendinite induzida. Entretanto, observou-se que os sinais clínicos da tendinite não acompanham a condição microscópica do tecido, o que indica que a apresentação clínica não pode ser utilizada como parâmetro para a monitoração da evolução da enfermidade. A técnica de biópsia apresentada para colheita de tecido do TFDS em equinos, permite a obtenção de tecido para avaliação histológica seriada sem provocar sinais clínicos e alterações ultrassonográficas que indiquem dano tecidual. Assim, a técnica permite a monitoração da tendinite e pode ser considerada uma excelente ferramenta na avaliação de injúrias do TFDS.

Equívocos diagnósticos envolvendo as tendinites: impacto médico, social, jurídico e econômico: [revisão] / Diagnostic mistakes involving tendonitis: medical, social, legal, and economic impact: [review]

Evidências sobre o impacto clínico, social e econômico provenientes de equívocos diagnósticos são analisadas à luz das tendinites e outras moléstias dolorosas crônicas. O objetivo desta revisão é alertar sobre uma possível hipervalorização diagnóstica das tendinites, em especial aquelas supostamente múltiplas ou refratárias, com base em evidências. É apresentada uma revisão da literatura sobre as condições dolorosas crônicas, tais como a síndrome da fibromialgia, no contexto dos diagnósticos equivocados de tendinites, bem como revisão sobre falsa-positividade e parâmetros diagnósticos da ultrassonografia (US) neste cenário. Foram encontradas evidências de equívocos terapêuticos em 41 por cento e equívocos diagnósticos entre 70 e 85 por cento, com despreparo comprovado em até 93,7 por cento dos médicos, tudo envolvendo tais doenças. As vastas repercussões dessa epidemia de equívocos são comentadas.

Evidence of the clinical, social, and economic impact of mistaken diagnoses of tendonitis and other chronic painful disorders are analyzed. The objective of this review is to call attention to the possible diagnostic hyper valuation of tendonitis, especially those supposedly multiple or refractory, based on evidence. A review of the literature on chronic painful disorders, such as fibromyalgia, in the context of mistaken diagnosis of tendonitis, as well a review of false positive and ultrasonographic (US) scan diagnostic parameters, is presented. Evidence of therapeutic mistakes were found in 41 percent and diagnostic mistakes in 70 to 85 percent of the cases, with proven unpreparedness regarding those disorders in up to 93.7 percent of the physicians. The diverse repercussions of this epidemic of mistakes are discussed.

Comparação de diferentes doses de colagenase em modelo de indução de tendinite para eqüinos: estudo clínico e ultra-sonográfico / Comparison of different doses of collagenase-induced equine tendonitis: clinical and ultrasonographic study

Neste estudo, lesões tendíneas foram induzidas experimentalmente em eqüinos por meio da administração de diferentes doses de colagenase. Foram usados 12 eqüinos adultos, clinicamente sadios e distribuídos aleatoriamente em dois grupos que receberam diferentes doses de colagenase. O grupo 1 (G1) recebeu 1,25mg e o grupo 2 (G2) recebeu 2,5mg de colagenase. Com a agulha posicionada no centro dos tendões flexores digitais superficiais dos membros torácicos, as diferentes doses de colagenase foram aplicadas conforme o grupo experimental. O acompanhamento das lesões tendíneas baseou-se em exames físicos e ultra-sonográficos, realizados a cada sete dias até o período de 28 dias pós-indução. Nas imagens ultra-sonográficas, foram avaliados os parâmetros ecogenicidade, percentual de área lesada, grau de redução e severidade das lesões do tendão flexor digital superficial. O parâmetro mais fiel em resposta às diferentes doses de colagenase administradas foi o percentual de área lesada no interior do tendão. O G2 apresentou uma melhor resposta ultra-sonográfica da tendinite do flexor digital superficial para a realização de estudos experimentais.

In this study, tendinous injuries were induced experimentally in horses, through the administration of different doses of collagenase. Twelve horses, clinically healthy, were distributed into two groups that received different doses of collagenase. Group 1 (G1) received 1.25mg and Group 2 (G2) received 2.5mg of collagenase. With the needle positioned at the center of the superficial digital flexor tendon in the equine forelimbs, different doses of collagenase were applied in agreement the experimental group. The monitoring of colagenase-induced tendonitis was based on physical and ultrasonographic exams, carried out every seven days until the period of 28 days post-induction. In the images of ultrasound were evaluated the echogenicity, the percentage of injured area, degree of reduction and severity of injuries of colagenase-induced tendonitis. The most accurate parameter in response to different doses of collagenase administered was the percentage of area injured in the interior of the tendon. The G2 presented one better ultrasonographic reply of the tendonitis of the superficial digital flexor for the accomplishment of experimental studies.

Extra-articular arthroscopic treatment of rotator cuff calcifying tendonitis / 中国矫形外科杂志

[Objective]To evaluate the surgical technique and effectiveness of extra-articular arthroscopic debridement in patients with rotator cuff calcifying tendinitis unresponsive to conservative treatment.[Methods]Arthroscopic debridement was performed in 18 patients(5 males,13 females;mean age 56.4,range 34 to 78) in whom pain and functional disability persisted for more than 3 months despite conservative therapy for rotator cuff calcifying tendinitis.Arthroscopy was inserted into subacromial interspace and bursectomy was done.Calcified plaques in supraspinatus tendon were explored and eliminated outside shoulder joint under arthroscopy.VAS pain score,Constant-Murley score and plain radiograph was adopted for evaluation before and after surgery.[Results]The mean follow-up period was 9 months(6 to 15 months)[KG-58x].Pain and functional disturbance of the shoulder disappeared or obviously improved.The average VAS pain score was(7.8?0.6) preoperatively and(1.7?0.4) postoperatively.The average Constant-Murley score was(61?7)preoperatively and(91?4)at the last follow-up.Radiograph showed little residual deposits in 2 cases but without preoperative symptoms.No case need rotator cuff repair.[Conclusion]Extra-articular arthroscopic removal of calcium deposits together with bursectomy is effective and reliable in patients with chronic calcifying tendinitis unresponsive to conservative treatment.

Ultrasonography study of tendinitis of rotator cuff / 中华超声影像学杂志

Objective To evaluate the diagnostic values of location and qualitation of tendinitis of rotator cuff. Methods One hundred and sixty-two shoulders with shoulders pain or functional incapacity were performed ultrasonography and the sonograms were classified. Results Ultrasonic findings of these tendinitis were tendinitis of caput longum musculi bicipitis brachii in 39 cases, tendinitis of caput longum musculi bicipitis brachii in 33 cases, supraspinatus tendinitis in 51 cases, calcific supraspinatus tendinitis in 19 cases and bursitis of shoulder in 20 cases,especially. Conclusions Ultrasonography is a useful tool for diagnosis of tendinitis of rotator cuff in location and qualitation.

Tendonitis of the Flexor Hallucis Longus with Triggering of the Great Toe: A Case Report / 대한정형외과학회잡지

We present an unusual case of 31 year old lady with a longitudinal tear of flexor hallucis longus(FHL) caused by trauma. Tendonitis of the FHL, well known as dancers tendonitis, can be characterized by triggering of the great toe. As the foot is brought into plantar flexion with a forcible active contraction of the FHL, a snap is noted in the region of the posteromedial aspect of the ankle. Magnetic resonance imaging may be helpful in establishing diagnosis. The patient has obtained longterm satisfactory relief of her symptoms with surgical treatment. The literature on tendonitis of the FHL is reviewed with a reported case.