A comparison of physical examinations with musculoskeletal ultrasound in the diagnosis of biceps long head tendinitis.

Provocative tests are useful in diagnosing biceps tendon tendinitis. This is the first study to establish the reliability of these tests by comparing the resuts with musculoskeletal ultrasound (US) findings. This study examined 125 patients (69 women and 56 men) and 143 shoulders with shoulder pain. Yergason's test, Speed's test and a bicipital groove tenderness test were performed and musculoskeletal US findings were used as standard reference. Biceps tendon tendinitis was diagnosed with US in 39.1% of the patients and, of those, 55.3% had coexisting rotator cuff injury. The sensitivity and specificity of Yergason's test were 32% and 78%, respectively. The sensitivity and specificity of Speed's test were 63% and 58%, respectively. In conclusion, all three tests are limited by poor sensitivity. US can be an image modality choice in diagnosing biceps pathology.

Treatment of frozen shoulder with intra-articular injection of botulinum toxin in shoulder joints.

Frozen shoulder, or adhesive capsulitis, is a disease of chronic inflammation and fibrosis involving the shoulder joints. The disease is challenging in clinical practice due to painful treatment course, with disease evolution usually lasting weeks or even months, causing significant discomfort and functional loss. Botulinum toxin (BTX) has been discovered to possess abilities in pain management at various clinical diseases. The actual mechanism is still under investigation, and involves inhibition of neurotransmitter release. In addition, BTX is also found to retard process of fibrosis, which is also a key issue in pathogenesis of frozen shoulder. Therefore, we hypothesize that intra-articular injection of BTX can be an effective alternative for treatment of frozen shoulder.