ABSTRACT
OBJECTIVE: The authors report their experience with extracorporeal lithotripsy in 30 patients with calcific tendinosis of the rotator cuff. MATERIALS AND METHOD: This technique is based upon the utilization of high-energy shockwaves (6000 shocks in 3 sessions Day 1, D8, D30) under continuous ultrasound localization of the lesion (EPOS Ultra1). Calcification were evaluated at plain film, US and CT to characterize their length and features. RESULTS: Complete or partial resorption of calcifying deposits within 2 months and one year was observed in 27.5% and 25% of cases respectively. Clinical improvement results are encouraging at two months (50%), but reduced at one year (28.5%), consistent with the rate of resorption of calcifications. CONCLUSION: This painful, long, and expensive technique seems to be disappointing in the treatment of the calcific tendinosis.
Subject(s)
Calcinosis/therapy , Lithotripsy , Rotator Cuff , Shoulder Joint , Adult , Aged , Female , Follow-Up Studies , Humans , Lithotripsy/methods , Male , Middle Aged , Muscular Diseases/therapy , Time FactorsABSTRACT
PURPOSE: To identify and classify the different types of bony changes of the condyles in patients with disorders of the temporomandibular joint (TMJ). MATERIALS AND METHODS: Since 1993, we have imaged over 600 patients with 0.5T MR unit by using gradient-echo T1-weighted sequences in the sagittal and coronal planes. RESULTS: We will first describe the appearance of the normal TMJ. Then, we will introduce the concept of "Condylo-diskal disunion" using a three grade classification system. We will then describe three patterns of condylar changes: adaptive remodeling, either anterior or more frequently posterior, degenerative lesions with subchondral sclerosis, erosive lesions due to synovial hyperplasia. CONCLUSION: Using a 0.5T MR unit, a GRE T1 sequence is useful to identify lesions of the disk and detect bony changes. In addition, the tissues posterior to the disk can also be assessed on postcontrast images.
Subject(s)
Magnetic Resonance Imaging , Temporomandibular Joint Dysfunction Syndrome/diagnosis , Diagnosis, Differential , Humans , Hyperplasia , Magnetic Resonance Imaging/instrumentation , Magnetic Resonance Imaging/methods , Synovitis/diagnosis , Temporomandibular Joint/anatomy & histology , Temporomandibular Joint/pathology , Temporomandibular Joint Dysfunction Syndrome/pathologySubject(s)
Bone Neoplasms/diagnosis , Bone and Bones/blood supply , Chondrosarcoma/diagnosis , Infarction/diagnosis , Magnetic Resonance Imaging , Bone Neoplasms/diagnostic imaging , Bone and Bones/diagnostic imaging , Chondrosarcoma/diagnostic imaging , Diagnosis, Differential , Humans , Male , Middle Aged , Radiography , ShoulderABSTRACT
Like the anterosuperior subracromial conflict, the coracotrochineal or anteromedial conflict of the shoulder is a groove pathology. In a series of 340 patients who had an arthroscan of the shoulder, including 245 with a conflict syndrome (70%), we observed an anteromedial conflict in 12 cases (8.5%) of the 140 patients with an intact cuff and 52 cases (50%) in 102 patients with an injured cuff. The frequency of the anteromedial conflict appears to be proportional to the degree of cuff injury. We described the signs of the trochin suggesting the anterior musculotendinous structures (subscapsular tendon and/or long biceps tendon) are involved and conclude that the anteromedial conflict is often misdiagnosed. It would appear to be a frequent complication of cuff injury (mechanical theory) which the surgeon should take into consideration when repairing cuff injury.
