Frozen shoulder : long-term outcome following arthrographic distension.

Arthrographic distension of the glenohumeral joint was adopted as a mainstream treatment for frozen shoulder before any randomised controlled trials were performed. Interpretation of the effectiveness of this procedure rests mostly on data from cohort studies of which there are few of high quality. Papers reporting long-term results have either excluded diabetic patients or failed to report patient orientated outcomes. The authors present a long-term prospective cohort study of 51 patients (12 diabetics and 39 non-diabetics), with 53 frozen shoulders, who had an arthrographic distension performed by a single radiologist as a primary intervention. Oxford shoulder score (OSS), visual analogue pain score (VAS), and range of movement (ROM) were recorded pre-distension, at 2 days and 1 month post-distension. OSS and VAS were recorded again at a mean of 14 months post distension (range : 8-26 months). OSS improved from a pre-distension mean of 22.3 by 16.9 points at final follow-up (p < 0.001, 2 tailed paired samples t-test) whilst VAS improved from a mean pre-distension value of 7.1 by -3.5 (p < 0.001). ROM improved by a mean of 39.3 degrees in flexion, 55.2 degrees in abduction and 19.5 degrees in external rotation at one month (p < 0.001 for all). The outcome in diabetic patients was the same as in non-diabetic patients. Arthrographic distension is a safe and effective treatment for frozen shoulder; it is also effective in diabetic patients. It gives long-term improvement. The authors believe that the low number of patients requiring a secondary procedure makes arthrographic distension preferable to manipulation under anaesthesia.

Femoral nerve palsy secondary to traumatic iliacus haematoma--a young athlete's injury.

Femoral neuropathy secondary to iliacus haematoma in the absence of a bleeding diathesis is rare. Of the few documented cases in the literature, most have occurred in adolescents participating in sport. We report a case of femoral nerve palsy complicating an iliacus haematoma occurring in a young person with minimal trauma that resolved with non-operative management. Although rare, iliacus haematoma should be included in the differential diagnosis of groin pain as the number of children and young adults participating in sport increases.

Multidetector computed tomography imaging of aortoenteric fistula.

Three case reports illustrating multidetector computed tomography (CT) imaging findings of secondary aortoenteric fistula (AEF) are described and presented in axial sections, multiplanar reformats, and 3-dimensional reconstruction. Fistulae occurred in the early and late postgrafting period and involved both end-to-end and end-to-side aortic graft anastomoses. Multidetector CT is quick and accurate in the diagnosis of bleeding AEF.