RESUMO
PURPOSE: The suprapatellar bursa is located in the proximal deep layer of the patella and is thought to reduce tissue friction by changing from a single-membrane structure to a double-membrane structure during knee joint motion. However, the dynamics of the suprapatellar bursa have only been inferred from positional relationships, and the actual dynamics have not been confirmed. METHODS: Dynamics of the suprapatellar bursa during knee joint motion were observed in eight knees of four Thiel-fixed cadavers and the angle at which the bursa begins to show a double membrane was revealed. The flexion angles of knee joints were measured when the double-membrane structure of the suprapatellar bursa began to appear during knee joint extension. RESULTS: The suprapatellar bursa changes from a single membrane to a double-membrane structure at 91 ± 4° of flexion, when the knee joint is moved from a flexed position to an extended position. CONCLUSION: The suprapatellar bursa may be involved in limitations to knee joint range of motion and pain at an angle of approximately 90°. Further studies are needed to verify whether the same dynamics are observed in living subjects.
Assuntos
Bolsa Sinovial , Cadáver , Articulação do Joelho , Amplitude de Movimento Articular , Humanos , Amplitude de Movimento Articular/fisiologia , Articulação do Joelho/anatomia & histologia , Articulação do Joelho/fisiologia , Bolsa Sinovial/anatomia & histologia , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Patela/anatomia & histologia , Patela/fisiologia , Fenômenos BiomecânicosRESUMO
Rotator cuff injuries result in more than 500,000 surgeries annually in the United States, many of which fail. These surgeries typically involve repair of the injured tendon and removal of the subacromial bursa, a synovial-like tissue that sits between the rotator cuff and the acromion. The subacromial bursa has been implicated in rotator cuff pathogenesis and healing. Using proteomic profiling of bursa samples from nine patients with rotator cuff injury, we show that the bursa responds to injury in the underlying tendon. In a rat model of supraspinatus tenotomy, we evaluated the bursa's effect on the injured supraspinatus tendon, the uninjured infraspinatus tendon, and the underlying humeral head. The bursa protected the intact infraspinatus tendon adjacent to the injured supraspinatus tendon by maintaining its mechanical properties and protected the underlying humeral head by maintaining bone morphometry. The bursa promoted an inflammatory response in injured rat tendon, initiating expression of genes associated with wound healing, including Cox2 and Il6. These results were confirmed in rat bursa organ cultures. To evaluate the potential of the bursa as a therapeutic target, polymer microspheres loaded with dexamethasone were delivered to the intact bursae of rats after tenotomy. Dexamethasone released from the bursa reduced Il1b expression in injured rat supraspinatus tendon, suggesting that the bursa could be used for drug delivery to reduce inflammation in the healing tendon. Our findings indicate that the subacromial bursa contributes to healing in underlying tissues of the shoulder joint, suggesting that its removal during rotator cuff surgery should be reconsidered.
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Bolsa Sinovial , Ratos Sprague-Dawley , Lesões do Manguito Rotador , Manguito Rotador , Tendões , Cicatrização , Animais , Lesões do Manguito Rotador/patologia , Lesões do Manguito Rotador/metabolismo , Lesões do Manguito Rotador/cirurgia , Humanos , Bolsa Sinovial/patologia , Bolsa Sinovial/metabolismo , Tendões/patologia , Tendões/metabolismo , Masculino , Manguito Rotador/patologia , Ratos , Dexametasona/farmacologia , Dexametasona/uso terapêutico , FemininoRESUMO
The subacromial bursa (SAB) plays an important role in the tendon healing process. Based on previous reports, co-culture of the rotator cuff (RC) and SAB have been shown to increase the tendon-related gene expressions, inflammatory cytokines, and tensile strength. However, the nature of the specific biochemical alterations during the inflammatory and repair phases of tendon healing with or without the SAB remain unknown. Using a full-thickness RC tear rat model, we determined how the presence or absence of the SAB alters the histological characteristics and gene expressions. After 3 and 6 weeks, tissues were collected for histological and real-time quantitative polymerase chain reaction (RT-qPCR) evaluations. Results showed greater cell density at 3 weeks, neovascularization and tendon thickening at 6 weeks with SAB preservation. Immunostaining revealed significant increases in type 3 collagen (COL3) expression at 6 weeks with SAB preservation. The RT-qPCR results showed that SAB preservation induced significant increases in the expression of scleraxis, matrix metalloproteinase-13 (MMP-13), interleukin-1ß (IL-1ß), and inducible nitric oxide synthase (iNOS) at 3 weeks and significant increases in COL3, IL-10, and arginase-1 (Arg-1) at 6 weeks. An RC tear undergoes more appropriate inflammatory and repair phases during the tendon healing process when the SAB is retained.
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Bolsa Sinovial , Modelos Animais de Doenças , Ratos Sprague-Dawley , Lesões do Manguito Rotador , Manguito Rotador , Animais , Lesões do Manguito Rotador/patologia , Lesões do Manguito Rotador/metabolismo , Ratos , Manguito Rotador/metabolismo , Manguito Rotador/patologia , Bolsa Sinovial/metabolismo , Bolsa Sinovial/patologia , Masculino , Tendões/metabolismo , Tendões/patologia , Cicatrização , Regulação da Expressão GênicaRESUMO
BACKGROUND: Olecranon bursitis can be difficult to treat, resulting in persistent or recurrent symptoms. Bursectomy is a frequently applied treatment option for refractory cases but has high complication rates. This is the first in vivo study to investigate the safety and efficacy of hydrothermal ablation, a new treatment modality for recurrent or chronic olecranon bursitis that aims to cause thermal obliteration of the bursal lining by irrigation with heated saline. METHODS: First, a pilot animal trial was set up to determine a safe irrigation temperature window. Second, in a human trial the bursae of patients with chronic, recurrent, or refractory olecranon bursitis were irrigated with a 3-mL/s flow of physiological saline for a duration of 180 seconds at temperatures between 50°C and 52°C. Patients were followed up for 6 months, allowing for assessment of the surgical site to screen for adverse events, volumetric ultrasonographic assessment of the bursae, and collection of the Quick Disabilities of the Arm, Shoulder, and Hand questionnaire (QuickDASH), Patient Global Impression Score, and Clinical Global Impression Score, as well as data on return to activities or work. RESULTS: Twenty-four elbows were prospectively included and underwent a full cycle of hydrothermal ablation. The mean age was 58.4 years (range 40.5-81.5), including 20 male and 4 female patients. None had clinical signs of septic bursitis. Bursal fluid cultures were positive in only 1 case. The average preoperative bursal volume was 11.18 mL (range 4.13-30.75). Eighteen of 24 elbows (75%) were successfully treated, showing a complete remission of symptoms or decided improvement within 6 weeks and without any signs of recurrence during the entire follow-up period of 6 months. The average reduction of ultrasonography-measured bursal volume was 91.9% in the group of patients who responded to treatment. In patients without recurrence, the mean QuickDASH scores before and after treatment were 13.6 (range 0-50) and 3.1 (range 0-27.5), respectively, showing a statistically significant improvement. All patients were able to fully return to work within 6 weeks after the index procedure. No serious adverse events were encountered. Moderate local adverse events were found in 2 patients. Increasing temperatures of irrigation did not result in a higher treatment efficacy. CONCLUSION: Hydrothermal ablation at temperatures between 50°C and 52°C is a safe treatment option for recurrent or chronic olecranon bursitis with fewer complications than open bursectomy and a comparable efficacy.
Assuntos
Bursite , Olécrano , Recidiva , Bursite/cirurgia , Humanos , Feminino , Masculino , Estudos Prospectivos , Pessoa de Meia-Idade , Idoso , Olécrano/cirurgia , Adulto , Idoso de 80 Anos ou mais , Doença Crônica , Animais , Resultado do Tratamento , Irrigação Terapêutica/métodos , Projetos Piloto , Articulação do Cotovelo/cirurgia , Bolsa Sinovial/cirurgia , Técnicas de Ablação/métodosRESUMO
BACKGROUND: Bursitis is the inflammation of a synovial bursa, a small synovial fluid-filled sac that acts as a cushion between muscles, tendons, and bones. Further, calcific bursitis results from calcium deposits on the synovial joint that exacerbates pain and swelling. The Gruberi bursa is located dorsolaterally in the ankle, between the extensor digitorium longus and the talus. Despite limited literature on its pathophysiology, the aim of this case is to discuss the bursa's association with calcific bursitis and its management via a case presented to our clinic. CASE PRESENTATION: A 47-year-old Caucasian female with no past medical or family history presents with acute right ankle pain following a minor injury 3 months prior with no improvement on analgesic or steroid therapy. Imaging demonstrated incidental calcium deposits. The day prior to presentation, the patient stated she used 1-pound ankle weights that resulted in mild swelling and gradual pain to the right dorsoanterior ankle. Physical exam findings displayed a significant reduction in the range of motion limited by pain. Imaging confirmed calcification within the capsule of the talonavicular joint, consistent with Gruberi bursitis. Initial management with prednisone yielded minimal improvement, requiring an interventional approach with ultrasound-guided barbotage that elicited immediate improvement. CONCLUSION: The presented case report highlights a rare and unique instance of acute ankle pain and swelling caused by calcific Gruberi bursitis in a young female. Although the Gruberi bursa is a relatively new discovery, it contains inflammatory components that may predispose it to calcification and should be considered in the differential of ankle swelling. Therefore, utilizing a systematic approach to a clinical presentation and considering all differential diagnoses is essential.
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Bursite , Calcinose , Humanos , Feminino , Pessoa de Meia-Idade , Bolsa Sinovial/diagnóstico por imagem , Cálcio , Bursite/diagnóstico por imagem , Ultrassonografia/métodos , Artralgia/etiologia , Calcinose/diagnóstico por imagem , Calcinose/complicaçõesRESUMO
Hip and knee injections are useful diagnostic and therapeutic tools for family physicians. This article reviews anatomic landmark-guided and ultrasound-guided injections and aspiration techniques for greater trochanteric pain syndrome, the hip joint, the knee joint, the pes anserine bursa, and the iliotibial band. Indications for injections include acute and chronic inflammatory conditions, such as rheumatoid arthritis; osteoarthritis; overuse; and traumas. Joint aspirations may be performed to aid in the diagnosis of unexplained effusions and to relieve pain. Technique, injectant, and follow-up timing depend on the physician's comfort, experience, and preference. Infections of the skin or soft tissue are the primary contraindications to injections. The most common complications are local inflammatory reactions to the injectant. These reactions usually cause soreness for 24 to 48 hours, then spontaneously resolve. Follow-up after injections is usually scheduled within two to six weeks.
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Bursite , Articulação do Joelho , Humanos , Dor/etiologia , Injeções/efeitos adversos , Bursite/terapia , Bolsa Sinovial , Injeções Intra-Articulares/efeitos adversos , Injeções Intra-Articulares/métodosRESUMO
BACKGROUND: Focal hyperintense lesions within the navicular bursa emanating from the dorsal border of the deep digital flexor tendon (DDFT) can be recognised on T1-weighted magnetic resonance images (MRI) and have been attributed to lameness in horses. Removal of these lesions, also referred to as synovial masses, by navicular bursoscopy is currently recommended. OBJECTIVES: To investigate the correlation between MRI and navicular bursoscopic findings. It is hypothesised that the prognosis following surgery is proportional to the size of the DDFT lesion. STUDY DESIGN: Retrospective analysis of clinical records. METHODS: Horses undergoing standing low-field MRI and navicular bursoscopy with >1 year follow-up were included. A grading system was developed to classify the size of synovial mass(es) and lesion(s) of the DDFT on MRI and at surgery. Generalised estimating equations were used to evaluate the association between MRI findings and surgery and between outcome and severity of the tendon injury. RESULTS: Fifty-nine horses presenting over a 15-year period (2006-2021) fulfilled inclusion criteria. Ninety navicular bursae were examined both on MRI and endoscopically. There was strong correlation between the size of synovial masses and tendon lesions on MRI and bursoscopy (p < 0.001, OR: 25.61, 95% CI 8.71-75.29 and p < 0.001, OR: 7.34, 95% CI 2.70-19.92, respectively). Size of tendon lesion and synovial mass had no impact on prognosis (p = 0.3, OR: 1, 95% CI 1-1 and p = 0.1, OR: 1, 95% CI 1-1, respectively), which was guarded (30.5% return to previous level of exercise). MAIN LIMITATIONS: Performance data for conservatively treated horses with MRI-detected synovial masses was not considered, nor was the effect of navicular bursal effusion. Horses were not randomly assigned to treatment protocols. CONCLUSION: There is good correlation between MRI and bursoscopic findings of DDFT lesions and synovial masses within the navicular bursa, with no false positives. Size of the synovial masses and DDFT lesions does not influence prognosis following navicular bursoscopy.
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Bolsa Sinovial , Doenças dos Cavalos , Imageamento por Ressonância Magnética , Animais , Cavalos , Imageamento por Ressonância Magnética/veterinária , Doenças dos Cavalos/diagnóstico por imagem , Doenças dos Cavalos/patologia , Bolsa Sinovial/diagnóstico por imagem , Bolsa Sinovial/patologia , Estudos Retrospectivos , Prognóstico , Masculino , Feminino , Endoscopia/veterinária , Endoscopia/métodos , Coxeadura Animal/diagnóstico por imagemRESUMO
BACKGROUND: The aim of this study was to investigate the risk factors of neglected osteochondral fractures in primary acute traumatic patellar dislocation in the pediatric population. METHODS: A total of 113 patients with primary acute traumatic patellar dislocation for whom coincident osteochondral fractures could not be confirmed by X-ray examination at initial diagnosis between January 2010 and February 2022 were retrospectively analyzed. Medical history, physical examination, and radiographic images were recorded in detail. The greatest dimension of the suprapatellar pouch (SP) effusion on radiograph was measured. Computed tomography and magnetic resonance imaging were used to confirm the presence of neglected osteochondral fractures and measure the fragment size. Potential risk factors were calculated and correlated with reference to the neglected osteochondral fractures and fragment size using multivariate linear regression analysis. RESULTS: Weight, walking ability, effusion grade, and SP measurement had a significant correlation with neglected osteochondral fractures in primary acute traumatic patellar dislocation (p = 0.046; p < 0.001; p = 0.048; p < 0.001). The cutoff point was 53.5 kg for weight and 18.45 mm for SP measurement. In the neglected fractures group, SP measurement was statistically significant with larger fragment size (beta value = 0.457; p < 0.001), and the cutoff point was 26.2 mm. CONCLUSIONS: SP effusion is not only associated with an increased risk of neglected osteochondral fractures in primary acute traumatic patellar dislocation but also with larger fragment size. Knee radiograph, medical history, and physical examination can predict the need for further imaging examination and even surgery in primary acute traumatic patellar dislocation.
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Fraturas Intra-Articulares , Luxação Patelar , Criança , Humanos , Luxação Patelar/complicações , Luxação Patelar/diagnóstico por imagem , Estudos Retrospectivos , Extremidade Inferior , Patela , Bolsa SinovialRESUMO
OBJECTIVE: To describe the etiologies, clinicopathologic findings, diagnostic modalities employed, treatments, and outcome associated with cases of septic bicipital bursitis. ANIMALS: 9 horses. CLINICAL PRESENTATION AND PROCEDURES: Medical records of horses diagnosed with septic bicipital bursitis between 2000 and 2021 were reviewed. Horses were included if synoviocentesis of the bicipital bursa revealed a total nucleated cell count of ≥ 20,000 cells/µL with a neutrophil proportion of ≥ 80%, a total protein concentration of ≥ 4.0 g/dL, and/or the presence of bacteria on cytology, or positive culture of the synovial fluid. Information retrieved from medical records included signalment, history, clinicopathologic variables, diagnostic imaging findings, treatment, and outcome. RESULTS: Trauma was the most common inciting cause (n = 6). Synoviocentesis using ultrasonographic guidance was performed in all cases and showed alterations consistent with septic synovitis. Radiography identified pathology in 5 horses, whereas ultrasonography identified pathology in all horses. Treatment consisted of bursoscopy (n = 6) of the bicipital bursa of which 1 was performed under standing sedation, through-and-through needle lavage (3), bursotomy (2), or medical management alone (2). Five (55.6%) horses survived to discharge. Long-term follow-up was available for 3 horses and all were serviceably sound, with 2 in training as pleasure horses and 1 case continuing retirement. CLINICAL RELEVANCE: Ultrasonography was the most informative imaging modality and paramount in obtaining synovial fluid samples for definitive diagnosis of septic bicipital bursitis. Bursoscopy performed under standing sedation is a feasible treatment option. Horses treated for bicipital septic bursitis have a fair prognosis for survival and may return to some level of athletic performance.
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Infecções Bacterianas , Bursite , Doenças dos Cavalos , Sinovite , Cavalos , Animais , Bolsa Sinovial/lesões , Bolsa Sinovial/patologia , Bolsa Sinovial/cirurgia , Bursite/diagnóstico , Bursite/veterinária , Bursite/cirurgia , Inflamação/veterinária , Sinovite/diagnóstico por imagem , Sinovite/veterinária , Radiografia , Infecções Bacterianas/veterinária , Doenças dos Cavalos/diagnóstico por imagem , Doenças dos Cavalos/cirurgia , Estudos RetrospectivosRESUMO
The cause of knee osteoarthritis (OA) and knee pain associated with OA is not well understood. Periarticular cystic lesions and bursae around the knee are among the most common morphologic features identified on MRI in the setting of OA. Despite widespread association of these lesions with knee OA and their inclusion in semiquantitative MRI scoring assessment systems for knee OA, the role that these lesions play in the development of knee pain and OA remains uncertain. In this discussion, we review the cystic lesions and bursae most commonly associated with OA of the knee, examine their relation and role in whole organ imaging assessments of OA, and present the literature investigating the associations of periarticular cysts and cyst-like lesions with knee pain and OA.
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Osteoartrite do Joelho , Humanos , Osteoartrite do Joelho/diagnóstico por imagem , Osteoartrite do Joelho/patologia , Articulação do Joelho/diagnóstico por imagem , Articulação do Joelho/patologia , Joelho/patologia , Bolsa Sinovial/patologia , Imageamento por Ressonância Magnética/métodos , DorRESUMO
OBJECTIVE: The objective of this study was to determine the anatomical relationship of the congenital calcaneal bursae in the bovine, and describe the computed tomography (CT), endoscopic and gross anatomy of these bursae. STUDY DESIGN: Ex vivo experimental. SAMPLE POPULATION: Eighteen clinically normal cadaver bovine hindlimbs. METHODS: Intrasynovial injection of iodinated contrast and methylene blue into the intertendinous calcaneal bursa (ICB) (n = 16) or gastrocnemius calcaneal bursa (GCB) (n = 2). Limbs were imaged post-contrast injection using multidetector CT. Endoscopic examination of the ICB was performed on two randomly selected limbs. All limbs underwent gross anatomical dissection. RESULTS: The anatomy of the congenital calcaneal bursae was consistent between CT imaging, endoscopic examination and gross dissection. The ICB and GCB were two separate synovial structures with no communication in all limbs. The distal and proximal extent of the ICB, defined as the distance from the point of tuber calcanei to the distal/proximal aspect of the ICB, was (median [IQR]) 7.4 (7.4 to 7.8) cm distally and 5.4 (4.7 to 6.0) cm proximally. CONCLUSION: Positive contrast CT and gross anatomical dissection revealed no communication between the congenital calcaneal bursae in any limb. Routine bursoscopy allowed complete endoscopic examination of the ICB. The proximal extent of the ICB is shorter than the distal extent. The use of a collective term for these bursae should be avoided in the bovine, as the ICB and the GCB are two separate synovial structures with no communication. CLINICAL SIGNIFICANCE: Knowledge of distinct anatomy and relationship between the congenital calcaneal bursae in the bovine may facilitate diagnosis and treatment of disorders affecting the region of tuber calcanei, including septic bursitis and osteomyelitis.
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Bursite , Calcâneo , Doenças dos Bovinos , Animais , Bovinos , Bolsa Sinovial/anatomia & histologia , Bursite/diagnóstico por imagem , Bursite/veterinária , Membro Posterior , Meios de Contraste , Calcâneo/diagnóstico por imagem , Cadáver , Doenças dos Bovinos/diagnóstico por imagemAssuntos
Lesões do Manguito Rotador , Manguito Rotador , Humanos , Ombro , Bolsa Sinovial , CicatrizaçãoRESUMO
OBJECTIVE: To describe a technique of targeted CT-guided scapulothoracic bursal injections in an illustrated and step-wise manner. MATERIALS AND METHODS: This technical report describes the authors' experience in using CT guidance for targeted scapulothoracic bursal injections in 8 patients with suspected scapulothoracic bursitis over an 18-month period. RESULTS: The outcome of the image-guided injection was retrospectively assessed in 8 patients. None of the patients had any complications related to the procedure. Symptomatic improvement was achieved in 62.5% of the patients while 25% of patients did not report any benefit from the injection. CONCLUSION: In providing a record of needle tip position and contrast distribution, CT-guided scapulothoracic bursal injections provide an objective record of the procedure, which may assist in further treatment planning.
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Bolsa Sinovial , Bursite , Humanos , Estudos Retrospectivos , Bolsa Sinovial/diagnóstico por imagem , Bursite/terapia , Injeções , Tomografia Computadorizada por Raios XRESUMO
The native bursa is a structure lined by synovium located adjacent to a joint which may serve to decrease friction between the tendons and overlying bone or skin. This extra-articular structure can become inflamed resulting in bursitis. Steroid injections have proven to be an effective method of treating bursal pathology in various anatomic locations. Performing these procedures requires a thorough understanding of relevant anatomy, proper technique, and expected outcomes. Ultrasound is a useful tool for pre procedure diagnostic evaluation and optimizing needle position during these procedures while avoiding adjacent structures. The purpose of this article is to review core principles of ultrasound-guided musculoskeletal procedures involving bursae throughout the upper and lower extremities.
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Bolsa Sinovial , Bursite , Humanos , Bolsa Sinovial/patologia , Bursite/terapia , Ultrassonografia/métodos , Injeções , Ultrassonografia de Intervenção/métodos , Injeções Intra-Articulares/métodosRESUMO
INTRODUCTION: The subacromial/subdeltoid bursa can develop inflammation and effusion related to autoimmune, infectious, and musculoskeletal disorders. Rice bodies, or loose bodies within bursa, have been described as an uncommon complication of bursitis and have been the subject of case studies over a number of years. However, they have not been described in anatomical or physical therapy-related literature. METHODS: A donor body dissected for a physical therapy anatomy course was found to have an enlarged subacromial/subdeltoid bursa. This bursa, along with the biceps brachii tendon sheath, and the subscapularis muscle bursa, were filled with numerous rice-like bodies. The bursal wall was well developed and thickened. Tissue specimens were obtained of the suspected rice bodies, the subacromial/subdeltoid bursal wall, and the biceps brachii tendon sheath. The tissue was embedded, sectioned, and processed with hematoxylin and eosin or Masson's Trichrome staining for blinded histologic assessment. RESULTS: The tissue samples from within the bursa were identified as tissue similar to that in prior descriptions of rice bodies. Tissue samples from the bursal wall and tendon sheath were identified as similar to synovial membranes. CONCLUSIONS: Rice bodies found within the cadaveric body were similar histologically to those described in rheumatology, radiology, and orthopedic literature. Anatomists teaching future health-care providers and practicing physical therapists should be familiar with rice bodies as a potential finding in cadavers, and patients.
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Bursite , Corpos Livres Articulares , Articulação do Ombro , Humanos , Ombro/patologia , Bolsa Sinovial/patologia , Bursite/terapia , Articulação do Ombro/patologia , Corpos Livres Articulares/complicações , Corpos Livres Articulares/patologia , CadáverRESUMO
BACKGROUND: Joint pain and swelling are common symptoms of osteoarthritis. The fluid collects mainly in the suprapatellar bursa. Persisting excess synovial fluid accelerates the degeneration of joint tissues and contributes to limited mobility. MATERIAL AND METHODS: The study involved 150 patients with knee osteoarthritis whose ultrasound examination of the suprapatellar bursa showed > 4 mm of fluid in the transverse and longitudinal dimensions. A VAS analog scale was used to assess pain intensity in four settings: at rest, climbing stairs, walking on flat ground, and at night. RESULTS: There was no correlation in the study group between an excessive amount of synovial fluid in the suprapatellar bursa and pain severity during movement and at rest. CONCLUSIONS: Excess synovial fluid in the suprapatellar bursa is not associated with knee joint pain at night, at rest, and when climbing stairs and walking on flat ground.
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Osteoartrite do Joelho , Líquido Sinovial , Humanos , Articulação do Joelho , Bolsa Sinovial , Artralgia/etiologia , EdemaRESUMO
CME-Sonography 106: Subacromial Bursa - A Myth Abstract. In everyday clinical practice, we frequently encounter bursitis. It can occur in practically any joint region, for example in local mechanical overload situations, after a trauma or in the context of an inflammatory systemic disease. In this review we focus on the location of bursitis in the shoulder region and would like to contribute to get away from the "myth" called subacromial bursitis.
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Bursite , Síndrome de Colisão do Ombro , Articulação do Ombro , Humanos , Ombro , Bolsa Sinovial/diagnóstico por imagem , Bursite/diagnóstico por imagem , Articulação do Ombro/diagnóstico por imagemRESUMO
Objective: To explore the application value of musculoskeletal ultrasound in the diagnosis and conservative treatment of knee osteoarthritis. Methods: Patients with knee osteoarthritis who were treated in our hospital from January 1, 2020 to August 31, 2021 were selected as the research subjects. The subjects underwent musculoskeletal ultrasonography to record the thickness of the lateral femoral malleolus cartilage, the thickness of the medial femoral malleolus cartilage, the depth of the suprapatellar bursa effusion, and the thickness of the suprapatellar bursa synovium. All patients in the study group received acupuncture treatment after musculoskeletal ultrasonography, and musculoskeletal ultrasonography was performed again after 2 weeks of treatment. The differences in musculoskeletal ultrasound-related parameters were compared between the two groups. Results: The thickness of the lateral femoral malleolus cartilage and medial femoral malleolus cartilage in the study group was significantly smaller than those in the control group. The depth of the effusion in the suprapatellar bursa and the thickness of the synovial membrane in the suprapatellar bursa were significantly greater than those in the control group. Ultrasonography showed no significant difference in abnormal status compared with arthroscopy, and musculoskeletal ultrasonography revealed knee osteoarthritis, such as cruciate ligament injury, joint effusion, synovial hyperplasia, meniscus injury, and patellar ligament injury. The cartilage thickness of the lateral femoral malleolus and medial malleolus of femur after treatment were significantly greater than those before treatment. The depth of the deep suprapatellar bursa effusion and the thickness of the suprapatellar bursa synovium were significantly smaller than those before treatment. Conclusion: Musculoskeletal ultrasound has high diagnostic value in knee osteoarthritis. It can detect the lesion as soon as possible and can be used to evaluate the effect of conservative treatment, so as to provide reference basis for clinical formulation or adjustment of further intervention plan.