Efectividad de la acupuntura en el tratamiento de la bursitis subacromial calcificada

Se presenta el caso de una paciente femenina de 52 años, raza blanca, enfermera de profesión, con antecedentes patológicos personales de hipertensión arterial compensada y tratamiento regular. Manifestó dolor en el hombro derecho y se remitió del Servicio de Ortopedia a la consulta de Medicina Natural y Tradicional del Hospital Clínico Quirúrgico "Lucía Íñiguez Landín". Dos años atrás le habían diagnosticado bursitis subacromial calcificada y había recibido varios tratamientos, pero sin mejoría. Se le corroboró el diagnóstico mediante radiografía digital y ultrasonido. El tratamiento con acupuntura redujo el tamaño de las calcificaciones y alivió los síntomas. La novedad del caso radica en la pertinencia del uso de la acupuntura en el tratamiento de esta patología.

It is presented the case of a female patient of 52 years, white skin, nurse by profession, with a personal pathological history of compensated arterial hypertension and regular treatment. She showed pain in the right shoulder and was referred to the Natural and Traditional Medicine clinic of the "Lucía Íñiguez Landín" Clinical Surgical Hospital. For two years she had been diagnosed with calcific subacromial bursitis and had received several treatments, but without obtaining improvement. The diagnosis was confirmed by digital radiography and ultrasound. Acupuncture treatment reduced the size of calcifications and alleviated symptoms. The novelty of the case lies in the relevance of the use of acupuncture in the treatment of this pathology.

Multiple Rice Body Formation in Subacromial and Subdeltoid Bursal Spaces

We encountered a rare condition of rice body in subacromial and subdeltoid spaces in a patient with unremarkable medical history. Although it is uncommon, there have been continued reports on its formation in certain type of infective and inflammatory arthritis. However, except for a traumatic event, evaluation yielded no known and conceivable cause for his chronic inflammatory bursitis. Relatively typical findings for rice body on magnetic resonance imaging have been described, and in our case the imaging prompted us to schedule early removal, which is generally accepted as the management of choice to prevent further progression of symptoms. The symptoms of the shoulder showed significant improvement, and a close follow-up schedule has been recommended for observation of recurrence and development of any foreseeable underlying cause.

Multiple Rice Body Formation in Subacromial and Subdeltoid Bursal Spaces

We encountered a rare condition of rice body in subacromial and subdeltoid spaces in a patient with unremarkable medical history. Although it is uncommon, there have been continued reports on its formation in certain type of infective and inflammatory arthritis. However, except for a traumatic event, evaluation yielded no known and conceivable cause for his chronic inflammatory bursitis. Relatively typical findings for rice body on magnetic resonance imaging have been described, and in our case the imaging prompted us to schedule early removal, which is generally accepted as the management of choice to prevent further progression of symptoms. The symptoms of the shoulder showed significant improvement, and a close follow-up schedule has been recommended for observation of recurrence and development of any foreseeable underlying cause.

Contribuição da natação para a reabilitação da bursite de ombro pós-fase aguda / Contribution of swimming for the rehabilitation of the shoulder bursitis post-acute phase

A reabilitação da bursite subacromial associada à instabilidade multidirecional dá-se através de um programa de fortalecimento progressivo de todo o complexo do ombro. Sendo o nado crawl um aliado para promoção do fortalecimento do complexo do ombro objetivou-se investigar o potencial efeito que a natação exerce sobre a bursite subacromial. Foi realizada uma pesquisa bibliográfica baseada em cinesiologia aplicada, biomecânica da natação, conceitos de bursite subacromial, estabilidade e instabilidade do ombro e natação. A partir da base teórica de causas, conceitos e fases da bursite foram analisados os possíveis efeitos da natação sobre a patologia, apontando vantagem do meio aquático no processo de reabilitação, bem como pontuais benefícios do nado crawl para a restauração e estabilização da mobilidade articular, juntamente com a reestruturação do engrama proprioceptivo do sujeito patológico.

The rehabilitation of subacromial bursitis associated with multidirectional instability takes place through a program of gradual strengthening of the entire complex of shoulder. As the crawl swimming an ally to promote the strengthening of shoulder complex the objective was to investigate the potential effect that swimming has on subacromial bursitis. A literature search based on applied kinesiology, biomechanics of swimming, concepts of subacromial bursitis, stability and instability of the shoulder and swimming. From the theoretical basis of causes, concepts and stages of bursitis analyzed the possible effects of swimming on the pathology, pointing advantage of the aquatic environment in the rehabilitation process, and crawl off benefits for the restoration and stabilization of joint mobility along with the restructuring of the engram proprioceptive subject's pathological.

Gene Expression Profile Analysis by cDNA Array in the Subacromial Bursa of Patients with Rotator Cuff Disease / 대한정형외과학회잡지

PURPOSE: To examine the expression pattern of inflammatory cytokines/receptors in the subacromial bursa of patients with rotator cuff disease using a cDNA(Complement DNA) Array technique. MATERIALS AND METHODS: Twenty two human subacromial bursal specimens were obtained intraoperatively from patients during shoulder surgery (18 bursitis, 4 normal bursa). The RNA was isolated from the bursal tissues and the presence of gene expression was analyzed using a cDNA Array technique. The statistical differences between bursitis and the normal bursa specimens were determined using a Mann Whitney U test and Student's t-test. RESULTS: cDNA Array analysis revealed a significant increase in the expression of several cytokine genes and their receptors in patients with subacromial bursitis compared with the controls (p<0.05). These cytokines included the interleukins (IL-1, 6, 12, 13, 15, 16, 17) and their receptors, lymphotoxin, small inducible cytokines, chemokine receptor (CCR 4, 6, 7) and stromal cell derived factor-1 (SDF-1). CONCLUSION: This study demonstrated a significant increase in many inflammatory cytokines in the subacromial bursa of patients with rotator cuff disease. This suggests that there is an active inflammatory reaction at the subacromial bursa in rotator cuff disease.

Multiple Rice Bodies in Subacromial Space: A Case Report

Multiple rice bodies are a rare disorder that is most commonly observed in chronic rheumatoid arthritis patients and as a complication of chronic inflammation in the bursa. However, it can occur in the absence of an underlying systemic disorder. Although it resembles synovial chondromatosis clinically and on imaging, the condition can be discriminated by an analysis of the radiographic and MR appearances. We encountered a case of multiple rice body formation with subacromial bursitis on the shoulder of a 37-year old man suffering from pain and motion limitation. The patient was treated by arthroscopic removal of the multiple rice bodies and a subacromial bursectomy. We present this case with a review of the relevant literature.

Massive Subacromial Bursitis with Rice Bodies in Rheumatoid Arthritis / 대한류마티스학회지

Rice bodies are numerous small fibrinous, cartilaginous-like materials which were first described in tuberculous joints. Rice bodies are common findings in joints afflicted with rheumatoid arthritis or other seronegative arthropathy. But less commonly, those can be seen in periarticular bursae or at the sites of tendon or ligament insertion. Rice bodies, thought to be a nonspecific response to synovial inflammation, probably evolve from ischemia in a proliferative synovium. Some of these bodies contain a core of collagen with a mantle of fibrin, others contain only fibrin. Subacromial bursa are sometimes involved in the patients with rheumatoid arthritis and can reach impressive dimensions before becoming clinically detectable because significant constrain is lacking. Subacromial arthrography or magnetic resonance imaging accurately delineated the existence of cartilaginous loose bodies before surgical exision. We experienced a man with rheumatoid arthritis who had massive subacromial bursitis with rice bodies. His shoulder had been swollen since 5 years ago. He felt no pain and had only mild limitation of motion. Subacromial arthrography or magnetic resonance imaging of right shoulder showed multiple rice bodies in enlarged subacromial bursa. Operation finding showed a large encapsulated mass in the subacromial bursa, and hundreds of fibrinous rice bodies were revealed, which were resected. We report this patient with a review of literatures.