Clinical observation of knee-balancing Tuina manipulation for pes anserina bursitis / 针灸推拿医学（英文版）

Objective:To observe the clinical efficacy and safety of knee-balancing Tuina(Chinese therapeutic massage)manipulation for pes anserina bursitis(PAB). Methods:A total of 64 patients with PAB were enrolled and divided into a Tuina group and a medication group by the random number table method,with 32 cases in each group.The medication group was given votalin for external use,and the Tuina group was given knee-balancing Tuina manipulation based on treatment according to structure differentiation.Both groups were treated for 7 consecutive days.The visual analog scale(VAS)score,Lyshlom score,knee joint range of motion(ROM),and total effective rate were compared between the two groups.Adverse reactions were observed in both groups. Results:During the treatment,there was 1 dropout case in the medication group.The total effective rate was 93.8%in the Tuina group and 83.9%in the medication group.The difference between the two groups was statistically significant(P<0.05).After treatment,the VAS score in both groups decreased significantly(P<0.05),and the Lyshlom score and knee joint ROM increased significantly(P<0.05).The differences in the VAS score,Lyshlom score,and knee joint ROM between the two groups were all statistically significant(P<0.05). Conclusion:The knee-balancing Tuina manipulation based on treatment according to structure differentiation can effectively relieve pain and improve knee function in PAB,and its efficacy is superior to that of external use of votalin.

The Lack of High-quality Educational Resources about Adhesive Capsulitis on YouTube / Ausência de recursos didáticos de alta qualidade sobre a capsulite adesiva no YouTube

Abstract Objective The advent of the Internet has provided new, easily accessible resources for patients seeking additional health information. Many doctors and healthcare organizations post informative videos on this platform, and nearly all patients are looking for videos online for a second opinion. Methods The phrases "frozen shoulder," "frozen shoulder treatment," "adhesive" capsulitis, and "adhesive capsulitis treatment" were entered into YouTube's search bar for a normal inquiry. The informativeness and overall quality of the adhesive capsulitis videos were rated using three separate scales. Results The mean and standard deviation values of the scoring systems were JAMA 1.25 ± 0.51, DISCERN 39.4 ± 13.4, GQS 2.83 ± 0.96 and ACSS 7.43 ± 4.86, respectively. Number of views, rate of views, and likes all had a positive correlation with Global Quality Score (GQS), as did DISCERN and ACSS. There was no statistically significant difference between the median JAMA, GQS score and Discern Criteria values according to the video source/uploader (p > 0.05). Conclusion YouTube videos on adhesive capsulitis, thus, need to be of higher quality, reliability, and instructive quality. There is a need for reliable videos about adhesive capsulitis, with instructional and high-quality cited.

Resumo Objetivo O advento da Internet proporcionou recursos novos e de fácil acesso para pacientes que procuram mais informações sobre saúde. Muitos médicos e organizações de saúde publicam vídeos informativos nesta plataforma e quase todos os pacientes procuram tais vídeos online para uma segunda opinião. Métodos As frases "frozen shoulder (ombro congelado)", "frozen shoulder treatment (tratamento de ombro congelado)", "adhesive capsulitis (capsulite adesiva)" e "adhesive capsulitis treatment (tratamento de capsulite adesiva)" foram inseridas na barra de pesquisa do YouTube para uma consulta normal. A informatividade e a qualidade geral dos vídeos sobre capsulite adesiva foram avaliadas usando três escalas distintas. Resultados Os valores de média e desvio padrão dos sistemas de pontuação do Journal of the American Medical Association (JAMA) foram 1,25 ± 0,51, DISCERN, 39,4 ± 13,4, Global Quality Score (GQS, Índice de Qualidade Global em português) 2,83 ± 0,96 e Adhesive Capsulitis Specific Score (ACSS, Escore Específico de Capsulite Adesiva em português), 7,43 ± 4,86, respectivamente. O número de visualizações, a taxa de visualizações e as curtidas tiveram uma correlação positiva com GQS, DISCERN e ACSS. Não houve diferença estatisticamente significativa entre os valores medianos de JAMA, GQS e DISCERN de acordo com a fonte/carregador do vídeo (p > 0,05). Conclusão Os vídeos do YouTube sobre capsulite adesiva precisam ter maior qualidade, confiabilidade e qualidade instrutiva. Há necessidade de vídeos confiáveis sobre capsulite adesiva, com citações instrutivas e de alta qualidade.

Frequency of pes anserine bursitis in patients with knee osteoarthritis

Background: Knee pain is a very common disease in the elderly, which is often attributed to osteoarthritis but pes anserine bursitis also can cause knee pain, especially in OA patients. The aim of this study was to determine the frequency of pes anserine bursitis in patients with knee osteoarthritis. Methods: This cross-sectional descriptive study included 245 patients with definitive knee osteoarthritis referred to Imam Khomeini Hospital in Ardabil city from September 2020 to December 2021. All patients were sent to ultrasonography to diagnosis Pes Anserine Bursitis. Osteoarthritis was divided into 4 groups based on the radiographic classification of Kellgren-Lawrence. The severity of knee pain was also determined by the Visual Analogue Scale (VAS). The necessary data were collected by a checklist and then analysed by statistical methods in SPSS version 22. Results: Total 175 out of 245 patients (71%) were diagnosed with pes anserin bursitis. There was a significant relationship between age, gender, BMI, OA and staging of OA with the risk of anserin bursitis. Conclusions: Results showed that the high prevalence of anserine bursitis in patients studied indicates the importance of this issue and the need for attention by physician as one of knee pain reasons. Since the clinical examination has a significant diagnostic power in the detection of anserin bursitis, it is recommended that special attention be paid to the clinical examination. Attention to the risk factors in the country such as obesity, the use of toilets and so on, which can be controlled and can be prevented.

Síndrome de contractura del hombro congelado: ¿manipulación bajo anestesia o terapia física?

El síndrome de contractura del hombro congelado es una condición patológica que involucra a la contractura de la cápsula articular de la articulación glenohumeral, generando dolor, restricción del rango de movimiento tanto activo como pasivo y alteración de la función. Diversos tratamientos se han propuesto e investigado para dar solución a esta condición. Por una parte, se encuentran los tratamientos quirúrgicos, y por otra, los no quirúrgicos. En relación a los quirúrgicos, destacan la liberación capsular artroscópica y la manipulación bajo anestesia. Esta última consiste en movilizar el hombro en distintas direcciones para lograr romper las adherencias de la cápsula articular, todo esto bajo anestesia. En relación a los tratamientos no quirúrgicos más utilizados, se encuentra la prescripción de medicamentos, inyecciones de corticoides, la hidrodilatación artrográfica y la terapia física. Las modalidades de terapia física resultan una opción de fácil acceso, de bajo costo y con variadas opciones. A pesar de que se presentan múltiples alternativas, no existe consenso sobre cuál es la mejor opción de tratamiento, y específicamente sigue sin estar claro si la manipulación bajo anestesia es una mejor opción que el tratamiento de fisioterapia.

Frozen shoulder contracture syndrome is a pathological condition that involves contracture of the joint capsule of the glenohumeral joint, generating pain, restriction of both active and passive range of motion, and impaired function. Various treatments have been proposed and investigated to solve this condition. On the one hand, there are surgical treatments, and on the other, non-surgical ones. Regarding surgical procedures, arthroscopic capsular release and manipulation under anesthesia stand out. The latter consists of mobilizing the shoulder in different directions to break the adhesions of the joint capsule, all this under anesthesia. In relation to the most used non-surgical treatments, there is the prescription of medications, corticosteroid injections, arthrographic hydrodilation and physical therapy. The modalities of physical therapy are an option of easy access, low cost and with varied options. Despite multiple alternatives being presented, there is no consensus on which is the best treatment option, and specifically it remains unclear whether manipulation under anesthesia is a better option than physiotherapy treatment.

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.

Shoulder Injury Related to Vaccine Administration: Case Series / Lesão de ombro relacionada à administração de vacina: Série de casos

Abstract Objective Shoulder pain is a common presentation in the primary care setting, and shoulder pain after vaccination has a growing body of literature. The present study sought to understand how a standardized treatment protocol would aid patients experiencing shoulder injury related to vaccine administration (SIRVA). Methods Patients experiencing SIRVA were retrospectively recruited between February 2017 and February 2021. All patients were treated with physical therapy and offered a cortisone injection. Post-treatment range of motion (i.e., forward elevation, external rotation, internal rotation) and patients' reported outcomes were collected with the visual analogue scale (VAS), American Shoulder and Elbow Surgeons (ASES), simple shoulder test (SST), and single assessment numeric evaluation (SANE) scores. Results A total of 9 patients were retrospectively examined. Among them, 6 patients presented within one month of a recent vaccination event, while 3 patients presented 67, 87, and 120 days after vaccination. Furthermore, 8 of the patients completed physical therapy, and 6 of them underwent a cortisone injection. The follow-up time averaged 8 months. At final follow-up, the mean external rotation was 61º (standard deviation, SD±3º) and the mean forward elevation was 179º (SD±45º). Internal rotation ranged between L3 and T10. The VAS pain scores were 3.5/10.0 (SD±2.4), the mean ASES score was 63.5/100.0 (SD±26.3), and the SST scores were 8.5/12.0 (SD±3.9). Finally, the SANE scores were 75.7/100.0 (SD±24.7) and 95.7/100.0 (SD±6.1) in the injured and contralateral shoulders respectively. Conclusion Shoulder pain after a vaccination treated with physical therapy and cortisone injection ultimately resulted in favorable shoulder range of motion and functional score outcomes. Level of Evidence IV

Resumo Objetivo A dor no ombro é um quadro comum na atenção primária e há cada vez mais relatos acerca de sua ocorrência após a vacinação. Este estudo buscou entender como um protocolo de tratamento padronizado ajudaria pacientes com lesão no ombro relacionada à administração de vacina (SIRVA). Métodos Os pacientes com SIRVA foram recrutados de forma retrospectiva entre fevereiro de 2017 e fevereiro de 2021. Todos os pacientes foram submetidos à fisioterapia e receberam uma prescrição de cortisona injetável. A amplitude de movimento pós-tratamento (ou seja, elevação anterior, rotação externa, rotação interna) e os desfechos relatados pelo paciente foram analisados a partir das pontuações da escala visual análoga (EVA), da American Shoulder and Elbow Surgeons (ASES), do teste simples do ombro (SST) e da avaliação numérica única (SANE). Resultados No total, 9 pacientes foram examinados de maneira retrospectiva. Entre eles, 6 pacientes foram atendidos no primeiro mês após a vacinação e os outros três, depois de 67, 87 e 120 dias. Ademais, 8 dos pacientes fizeram todo o tratamento fisioterápico e 6 receberam uma injeção de cortisona. O período médio de acompanhamento foi de 8 meses. À última consulta, a rotação externa média foi de 61° (desvio padrão, DP±3°)ea elevação anterior média foi de 179° (DP ± 45°). A rotação interna variou entre L3 e T10. As pontuações de dor à EVA foram de 3,5/10,0 (DP ± 2,4) e o escore médio ASES foi de 63,5/100,0 (DP ± 26,3); as pontuações de SST foram 8,5/12,0 (DP ± 3,9). Por fim, os escores de SANE foram de 75,7/100,0 (DP ± 24,7) e 95,7/100,0 (DP ± 6,1) nos ombros lesionados e contralaterais, respectivamente. Conclusão A dor no ombro após a vacinação tratada com fisioterapia e injeção de cortisona melhorou a amplitude de movimento e os escores funcionais. Nível de Evidência IV

Synovial chondromatosis of the hip was misdiagnosed as rice body bursitis: a case report / 中华骨科杂志

This study shows a case of a patient with synovial chondromatosis of the hip misdiagnosed as rice body bursitis. The patient complained of pain and limited activity in his left hip. He was diagnosed with synovial chondromatosis of the hip by medical history, physical examination, imaging examination and postoperative pathology. Based on literature review, the characteristics and differential diagnosis of the disease in epidemiology, imaging and pathology were discussed in detail, so as to improve the understanding of the disease and avoid misdiagnosis. He was treated with hip arthroscopy and obtained satisfactory therapeutic effect. The patient was followed up for 1 year without recurrence.

Incidence and epidemiology of adhesive capsulitis during the covid-19 pandemic / Incidência e epidemiologia de capsulite adesiva durante a pandemia de covid-19

ABSTRACT Objective: To evaluate a possible increase of adhesive capsulitis incidence during the COVID-19 pandemic. Methods: A total of 1,983 patients with shoulder disorders were retrospectively analyzed regarding gender, age, development of adhesive capsulitis and comorbidities (systemic arterial hypertension, diabetes mellitus, dyslipidemia, hypothyroidism, hyperthyroidism, depression, and anxiety) in two different periods: from March 2019 to February 2020 and from March 2020 to February 2021. Descriptive and quantitative variables were statistically analyzed. The program used for the calculations was SPSS 17.0 for Windows. Results: During the pandemic, there was a 2.41-fold increase (p < 0.001) in cases of adhesive capsulitis (compared to the previous year). Patients with depression and anxiety had a significantly increased risk by 8.8 (p < 0.001) and 14 (p < 0.001) times, respectively, of developing frozen shoulder (regarding the two periods studied). Conclusion: A significant increase in the incidence of frozen shoulder was observed after the onset of the COVID-19 pandemic in addition to a simultaneous increase of psychosomatic disorders. Prospective studies would help to ratify the idea contained in this research. Level of Evidence III, Observational Cross-Sectional Study.

RESUMO Objetivo: Avaliar se houve aumento da incidência de capsulite adesiva durante a pandemia de COVID-19. Métodos: Foram analisados, retrospectivamente, 1.983 pacientes com desordens do ombro quanto a sexo, idade, desenvolvimento de capsulite adesiva e comorbidades (hipertensão arterial sistêmica, diabetes mellitus, dislipidemia, hipo/hipertireoidismo, depressão e ansiedade) em dois períodos distintos: de março de 2019 a fevereiro de 2020 e de março de 2020 a fevereiro de 2021. Procedeu-se à análise estatística das variáveis descritivas e quantitativas, utilizando o software SPSS 17.0 for Windows para os cálculos. Resultados: Durante a pandemia, houve aumento de 2,41 vezes (p < 0,001) de casos de capsulite adesiva em relação ao ano anterior. Considerando os períodos estudados, pacientes com depressão e ansiedade apresentaram um risco significativamente aumentado em 8,8 (p < 0,001) e 14 (p < 0,001) vezes, respectivamente, de desenvolver a patologia em questão. Conclusão: Observou-se um aumento significativo da incidência de ombro congelado após o início da pandemia de COVID-19, além de sua relação com distúrbios psicossomáticos. São necessários estudos prospectivos futuros para ratificar a ideia contida nesta pesquisa. Nível de Evidência III, Estudo Transversal Observacional.

Evaluación y detección bioinformática de terpenoides con potencial inhibitorio de la proteína viral 1 (VP1) del virus de la bursitis infecciosa / Evaluation and bioinformatic detection of terpenoids with inhibitory potential of viral protein 1 (VP1) of infectious bursitis virus

El virus de la bursitis infecciosa (IBDV) es el agente causal de la enfermedad de la bursa, la cual afecta principalmente a poblaciones avícolas jóvenes y genera un impacto económico negativo en la producción. La proteína viral (VP1) es una enzima con funciones clave para la replicación del genoma viral, por lo que puede ser considerada blanco para la búsqueda de compuestos con posibles actividades inhibitorias. El objetivo de esta investigación fue evaluar terpenoides con potencial inhibitorio de la proteína VP1 del IBDV mediante herramientas de aproximaciones bioinformáticas. Se seleccionó un total de 52 terpenoides, cuyas propiedades farmacológicas, farmacocinéticas y tóxicas (ADME-Tox) se evaluaron. Las moléculas sin actividades tóxicas y con aptitudes farmacocinéticas fueron sometidas a pruebas exhaustivas de acoplamiento molecular con el sitio catalítico de la VP1 mediante el uso del algoritmo genético y de Broyden-Fletcher-Goldfarb-Shanno junto con el método de optimización local de gradientes. Los datos obtenidos revelaron que la Giberelina A1 presenta valores de energía libre de unión significativamente (p< 0,05) favorables (ΔG=-7,28±0,06 kcal/mol; Kdcalc= 8,62±0,99 µM) en comparación con los sustratos rCTP y rGTP. El complejo Giberelina A1-VP1 presenta puentes de hidrógeno con los residuos Arg335 y Asp402, los cuales cumplen roles importantes en la actividad catalítica en la replicación viral. Estos hallazgos sugieren que el terpenoide Giberelina A1 puede ser considerado como compuesto candidato para estudios in vitro de inhibición de funciones de la VP1 e in vivode actividades antivirales contra el virus de la bursitis infecciosa.

Infectious bursitis virus (IBDV) is the infectious agent of bursal disease, which mainly affects young poultry populations, generating a negative economic impact on productions. The viral protein 1 (VP1) is an enzyme with important functions for the replication of the viral genome, so it could be considered as a target for searching compounds with possible inhibitory activities. The aim of this research was to evaluate terpenoids with inhibitory potential of the VP1 protein of IBDV using computational approximations tools. A total of 52 terpenoids were selected and evaluated for their pharmacological, pharmacokinetic and toxic properties (ADME-Tox). Molecules without toxic activities and with pharmacokinetic competences were subjected to extensive molecular docking tests with the catalytic site of VP1 using the genetic and Broyden-Fletcher-Goldfarb-Shanno algorithms with a local gradient optimization method. Data obtained revealed that Gibberellin A1 exhibits significantly (P < 0.05) favorable binding free energy values (ΔG=-7.28±0.06 kcal/mol; Kdcalc= 8.62±0.99 µM) compared to rCTP and rGTP subs-trates. The Gibberellin A1-VP1 complex exhibits hydrogen bonds with residues Arg335 and Asp402, which play important roles in catalytic activity in viral replication. These findings suggest that the terpenoid Gibberellin A1 could be considered as a candidate compound for in vitro studies of inhibition of VP1 functions and in vivo antiviral activities against infectious bursitis virus.

Scapulothoracic Bursitis or the Snapping Scapula Syndrome May Mimic with Shoulder Pain

Background: The scapulothorasic joint plays an important role in overall shoulder function by providing a stable base for glenohumeral rotation. Snapping scapula syndrome, a likely under diagnosed condition, can produce significant shoulder dysfunction in many patients. Because the precise origin is difficult to understand, sometimes mimic with shoulder pain. Dysfunctioning of any of muscles, ligament, bursa may cause abnormal scapular motion and predispose to scapulothoracic joint disorders. Accurate recognition of the syndrome may lead to prompt and long-term relief of symptoms by conservative or noninvesiveintervension treatment.Results:The causes of scapulothoracic bursitis and crepitus include direct or indirect trauma, overuse syndromes, glenohumeral joint dysfunction, boney abnormalities, muscle microtrauma or atrophy or fibrosis, and idiopathic causes. Scapulothoracic bursitis and crepitus remain primarily clinical diagnoses. However, imaging studies or local injections may also be helpful. The initial treatment of scapulothoracic bursitis and scapulothoracic crepitus should be conservative. Intevension procedure is best for treating modalitis for scapulothoracic dysfunction, most reports have demonstrated well to excellent outcomes in a significantly high percentage of patients.Conclusions:Clearly, the best initial approach to these conditions is a conservative treatment like nonsteroidal antiinflammatory drugs plan that combines scapular strengthening, postural reeducation, and core strength endurance. If an appropriate trial of nonoperative management proves unsuccessful, local non invesiveintervension can produce good results.

Incidence of adhesive capsulitis of the shoulder during the beginning of the COVID-19 pandemic

ABSTRACT Objective Adhesive capsulitis is an inflammatory disease of the joint capsule, clinically manifested as pain, stiffness, and dysfunction of the shoulder. We subjectively observed an increased incidence of adhesive capsulitis, and raised the hypothesis that adhesive capsulitis was more frequent in magnetic resonance imaging examinations performed during the COVID-19 pandemic as compared with examinations prior to this period. Methods Data from medical records and magnetic resonance imaging of the shoulder presenting typical imaging findings of adhesive capsulitis, performed in our organization from March to June 2020, were evaluated and compared with data and imaging from the same period of the previous year. To this end, an organizational business intelligence tool called "search reports" was used, searching for the term "adhesive capsulitis" in the radiological report, results were tabulated, and corresponding magnetic resonance imaging exams were analyzed. Results Our search found a total of 240 and 1,373 cases of adhesive capsulitis in the 2020 and 2019 periods, respectively. The mean age of patients was 53.9 years in the 2020 group and 49.9 years in 2019 (p<0.001). Magnetic resonance imaging findings were positive for adhesive capsulitis in 40 out of 240 shoulders (16.7%) in the 2020 group versus 127 out of 1,373 shoulders (9.2%) in the 2019 group. This difference was statistically significant (p=0.001). Conclusion Our study findings suggest a relative increase in the proportion of magnetic resonance imaging findings suggestive of adhesive capsulitis cases during COVID-19 pandemics based on data from our organization.

Shoulder Injury after Vaccination: A Systematic Review / Lesão de ombro após a vacinação: Uma revisão sistemática

Abstract Adverse reactions to vaccine injections are usually mild and incredibly rare in nature, but multiple cases of shoulder events including bursitis, generalized pain or decreased range of motion have been reported following routine vaccine administrations. These events are known as Shoulder Injury Related to Vaccine Administration or SIRVA. A systematic review of literature was performed to identify all published accounts of SIRVA. Twenty-seven papers reporting one or more accounts of SIRVA were identified. The most common vaccination involved was the Influenza vaccine. The most common symptoms were pain that began in 48 hours or less and loss of shoulder range of motion. The most common treatment modalities were physical therapy, corticosteroid injections and anti-inflammatory medication; but in some patients, surgery was required. Regardless of intervention, the vast majority of outcomes demonstrated improved pain and functional except in the occasions of nerve injury. The etiology of SIRVA injuries has multiple possibilities including needle length, mechanical injury from needle overpenetration and the possibility of an immune inflammatory response from the vaccine components, but a unique definitive test or quantifiably result does not yet exist.

Resumo As reações adversas às injeções de vacina tendem a ser brandas e são incrivelmente raras. No entanto, vários casos de eventos em ombros, como bursite, dor generalizada ou diminuição da amplitude de movimento, foram relatados após vacinações de rotina. Esses eventos são conhecidos como lesões em ombro relacionadas à administração de vacina (SIRVA, do inglês shoulder injury related to vaccine administration). Uma revisão sistemática da literatura foi realizada para identificar todos os relatos publicados de SIRVA. Vinte e sete artigos que relataram um ou mais casos de SIRVA foram encontrados. A vacina mais comumente citada foi a vacina contra influenza. Os sintomas mais comuns foram dor com início em até 48 horas e perda da amplitude de movimento do ombro. As modalidades de tratamento mais comuns foram fisioterapia, injeções de corticosteroides e administração de medicamentos anti-inflamatórios; alguns pacientes, porém, precisaram de cirurgia. Independentemente da intervenção, a grande maioria dos casos apresentou melhora da dor e da função, à exceção dos pacientes com lesão nervosa. A SIRVA tem múltiplas possíveis etiologias, inclusive comprimento da agulha, lesão mecânica por penetração excessiva da agulha e resposta inflamatória aos componentes da vacina; no entanto, ainda não há um exame definitivo ou resultado quantificável.

Tumor de células gigantes de la bursa de la pata de ganso (bursitis villonodular pigmentada extraarticular): a propósito de un caso / Giant cell tumor of the pes anserine bursa (extraarticular pigmented villonodular bursitis): a case report

Resumen: La sinovitis villonodular pigmentada extraarticular, también llamada tumor de células gigantes de la vaina tendinosa, es frecuente en la mano, siendo extremadamente rara su localización en la rodilla. Se presenta el caso de un paciente con una bursitis villonodular pigmentada de la bursa de la pata de ganso sin afectación intraarticular. Extra-articular pigmented villonodular synovitis, also called giant cell tumor of the tendon sheath, is common in the hand, being extremely rare in the knee. We present the case of a patient with a pigmented villonodular bursitis of the pes anserine bursa without intraarticular involvement.

Abstract: Extra-articular pigmented villonodular synovitis, also called giant cell tumor of the tendon seath, is common in the hand, being extremely rare in the knee. We present the case of a patient with a pigmented villonodular bursitis of the pes anserine bursa without intraarticular involvement.

A significant relationship between personality traits and adhesive capsulitis

SUMMARY OBJECTIVE We investigated the associations between adhesive capsulitis (AC) and a specific psychological profile. METHODS We assessed 72 patients with phase-II AC. In our study, 36 patients were affected by primary disease and 36 by secondary disease. The inclusion criteria were as follows: unilateral AC and pain in the shoulder for at least two months. The exclusion criteria were: psychiatric and neurological manifestations with a previous diagnosis and inability to comprehend the instruments. Outcomes were determined at 52 weeks. Shoulder pain severity was assessed with the Visual Analog Scale. We also measured the range of motion with a universal goniometer and the strength with the Medical Research Council. We assessed the personality traits of our patients with the Cloninger's Temperament and Character Inventory and the Multidimensional Perfectionism Scale. RESULTS Patients with primary AC needed more time to improve the symptomatology compared to the group with the secondary disease (p<0.01). Patients with primary AC complained of severe and lasting pain more frequently than patients with the secondary disease (p< 0.01). In patients with primary disease, the prevalence of perfectionism, low levels of novelty seeking, and high levels of harm avoidance were 88.2 and 86.2%, and 80.4, respectively, and below 20 percent in patients with secondary AC disease. CONCLUSION We found a significant correlation between primary AC and particular personality traits, indicating an interaction between psychological and somatic factors.

RESUMO OBJETIVO Investigar as associações entre a capsulite adesiva (CA) e um perfil psicológico específico. METODOLOGIA Foram avaliados 72 pacientes com CA fase II. Em nosso estudo, 36 pacientes foram afetados pela doença primária e 36 pela secundária. Os critérios de inclusão foram os seguintes: CA unilateral e dor no ombro durante por pelo menos dois meses. Os critérios de exclusão foram: manifestações neurológicas e psiquiátricas com um diagnóstico prévio e incapacidade de compreender os instrumentos de medição utilizados. Os resultados foram determinados após 52 semanas. A intensidade da dor no ombro foi avaliada usando a Escala Visual Analógica. Também medimos a amplitude de movimento com um goniômetro universal e a força com a escala do Conselho de Pesquisa Médica. Avaliamos os traços da personalidade dos nossos pacientes através do Inventário de Temperamento e Caráter de Cloninger e da Escala Multidimensional de Perfeccionismo. RESULTADOS Pacientes com CA primária precisaram de mais tempo para melhorar a sintomatologia quando comparados ao grupo secundário (p<0,01). Pacientes com CA primária apresentaram mais queixas de dor intensa e duradoura do que pacientes secundários (p< 0,01). Em pacientes com a doença primária, a prevalência de perfeccionismo, baixos níveis de procura por novidade, e altos níveis de prevenção de danos foram 88,2, 86,2% e 80,4, respectivamente, e abaixo de 20% em pacientes secundários. CONCLUSÃO Encontramos uma correlação significativa entre CA primária e traços de personalidade específicos, indicando uma interação entre fatores psicológicos e somáticos.

Effect of Shaolin internal qigong exercise on the surface electromyography signals of shoulder muscle groups in patients with capsulitis of the shoulder / 针灸推拿医学（英文版）

Objective: To unveil the efficacy of Shaolin internal qigong exercise in treating capsulitis of the shoulder (CS) and explore objective outcome measures by observing the changes in the surface electromyography (sEMG) signals of shoulder muscle groups after regular practice of Shaolin internal qigong exercise in CS patients. Methods: Sixty CS patients were randomized into two groups by the random number table method, with 30 cases in each group. Patients in the qigong group practiced Shaolin internal qigong exercise on a regular basis, while patients in the electroacupuncture (EA) group received EA treatment. Before and after treatment, the sEMG signals of six muscles, i.e. biceps brachii, triceps brachii, deltoid, pectoralis major, latissimus dorsi and trapezius muscles, of the affected side were recorded at 45° abduction of the shoulder, 60° forward flexion and 90° internal rotation with the elbow flexed during maximal isometric contraction, and the integrated electromyography (iEMG) of each muscle was calculated. Results: The total effective rate was 93.3％ in the qigong group, higher than 83.3％ in the EA group (P<0.05). Intra-group comparison showed that the iEMG of biceps brachii, triceps brachii, pectoralis major and deltoid muscles in the qigong group increased significantly after intervention at 45° abduction of the shoulder, 60° forward flexion and 90° internal rotation with the elbow flexed (all P<0.05), and the iEMG of trapezius and latissimus dorsi muscles decreased (both P<0.05); in the EA group, the iEMG of biceps brachii, pectoralis major and deltoid muscles increased significantly during contraction (all P<0.05), while the iEMG of triceps brachii, trapezius and latissimus dorsi muscles had no significant changes (all P>0.05). After intervention, there were significant differences in the iEMG of most of muscles between the two groups (all P<0.05), except for the iEMG of deltoid muscle at 45° of abduction of the shoulder joint during isometric contraction (P>0.05). Conclusion: Shaolin internal qigong exercise can effectively increase the motion intensity of the biceps brachii, triceps brachii, pectoralis major and deltoid muscles and reduce the compensation of the latissimus dorsi and trapezius muscles in CS patients; compared with EA, it produces a better result in improving the coordination and stability in shoulder joint movements.

Iliopectineal Bursitis Associated With Calcium Pyrophosphate Crystal Deposition Disease: A Case Report / 日本農村医学会雑誌

A 93-year-old man with a history of calcium pyrophosphate deposition disease (CPPD) in the right shoulder and wrist had severe pain in his right lower limb in the absence of trauma. He was transported by ambulance to our hospital. He was febrile (38℃) and swelling of the inguinal region was noted on physical examination. Laboratory examination showed elevated C-reactive protein (19.1 mg/dL, normal range ＜ 0.3 mg/dL) and white blood cell count (9600/μl, normal range ＜ 9000/μL). X-ray showed calcifications near the hip bilaterally, computed tomography showed distension of the iliopectineal bursa, and magnetic resonance imaging showed a cystic lesion of the iliopectineal bursa. Aspiration was performed under ultrasound guidance. Fluid analysis under an optical microscope revealed calcium pyrophosphate crystals. Bacterial examination was negative. Iliopectineal bursitis associated with CPPD was diagnosed, and he was treated conservatively with NSAIDs. To our knowledge, only 5 cases of iliopectineal bursitis associated with CPPD have been reported in Japan, and here we present the details of this rare case.

Effects of Inflammatory Disease on Clinical Progression and Treatment of Ischiogluteal Bursitis: A Retrospective Observational Study

@#Introduction: The symptoms of Ischiogluteal Bursitis (IGB) are often nonspecific and atypical, and its diagnosis is more challenging. Moreover, it is difficult to predict cases of chronic progression or poor treatment response. Therefore, the aim of this study was to investigate the clinical course of IGB patients and identify factors that are predictive of failure of conservative treatment. Materials and Methods: Our study consisted of IGB patients diagnosed between 2010 March and 2016 December who had been followed-up for at least one year. Structured questionnaires and medical records were reviewed to analyse demographic characteristics, lifestyle patterns, blood tests, and imaging studies. We categorized the cases into two groups based on the response to conservative treatment and the need for surgical intervention. Results: The most common initial chief symptoms were buttock pains in 24 patients (37.5%). Physical examinations showed the tenderness of ischial tuberosity area in 59 (92.2%) patients, but no specific findings were confirmed in 5 patients (7.8%). 51 patients (79.7%) responded well to the conservative management, 11 patients (17.2%) needed injection, and 2 patients (3.1%) had surgical treatment performed due to continuous recurrence. There was no difference in demographic and blood lab data between the two groups. However, the incidence of inflammatory diseases (response group: 10.3% vs non-response group: 66.7%, p=0.004) was significantly different between the two groups. Conclusion: The diagnosis of IGB can be missed due to variations in clinical symptoms, and cautions should be exercised in patients with inflammatory diseases as conservative treatment is less effective in them, leading to chronic progression of IGB.

Biomecánica de las lesiones en hombro: Revisión bibliográfica crítica desde la perspectiva médico legal laboral / Biomechanics of shoulder injuries: Critical bibliographic review from the medical-legal-occupational perspective

Resumen La base fundamental de la valoración médico legal de un individuo es establecer la relación de causalidad entre la historia narrada por el mismo y los hallazgos documentados. La biomecánica del trauma es una herramienta que permite dilucidar dicha concordancia, ya que su estudio involucra los mecanismos de trauma implicados en la génesis de las distintas lesiones. Este artículo consiste en una revisión bibliográfica y crítica de la literatura actual en materia de etiopatogenia de las lesiones en hombro por su alta incidencia laboral y capacidad de generar secuelas.

Abstract The basis of the forensic evaluation of an individual is to establish the relationship of causality between the story that has been told by the patient and the documented findings. The study of injury biomechanics is a tool that helps to clarify said concordance, since it involves the trauma mechanisms that are implied in the genesis of the different lesions. This article consists of a bibliographical revision and critique of the current literature about the etiopathogenesis of the shoulder lesions, since they are frequent in the work place and can generate sequels.

Os Acromiale-unusual Manifestation as Superior Spur and Bursitis-A Case Report

An Os acromiale is a condition that results from the failure of fusion of the anterior acromial apophysis. It can be asymptomatic. It can also result in subacromial impingement and rotator cuff tear. In this case report of a 39year-old lady we would like to present the management of the painful bursitis and spur formation on the superior surface of a meso-type of os acromiale. Conservative management in the form of rest, anti-inflammatory drugs and physiotherapy did not provide symptomatic relief. Patient then underwent surgical excision of the superior spur. Open reduction and internal fixation was not carried out. Patient had resolution of pain and no recurrence of symptoms or features of impingement at 6 months follow up. To the best of our knowledge there are limited reportsin English literature about this rare subset of patients with symptomatic os acromiale with superior spur formation and with no features of impingement or cuff pathology.

Ondas de choque extracorpórea en el tratamiento de la bursitis trocantérica / Extracorporeal shock waves in the treatment of trochanteric bursitis

RESUMEN Introducción: La terapia con ondas de choque son ondas acústicas presentes en situaciones diarias. Es un método que se emplea en la actualidad para tratar la bursitis trocantérica. Objetivo: Evaluar la efectividad de la terapia con ondas de choque en el tratamiento de la bursitis trocantérica. Métodos: Se realizó un estudio descriptivo, de corte transversal, con 46 pacientes diagnosticados con bursitis trocantérica, los cuales fueron tratados con el equipo Piezolith-3000 (ondas de choque extracorpóreas) en el Complejo Científico Ortopédico Internacional "Frank País", en el periodo comprendido entre marzo de 2014 y abril de 2018. Se realizó el análisis de las variables (edad, sexo, dolor y escala de Harris). Se obtuvieron las frecuencias absolutas y relativas, y con ellas se confeccionaron las tablas y gráficos que resumen la información estadística de la investigación. Resultados: Hubo predominio del sexo femenino (86,9 por ciento) y del grupo etario de 46 - 55 años (50 por ciento). Todos los pacientes presentaban dolor antes de la aplicación de las ondas de choque. Luego del tratamiento esta situación se revirtió y 69,5 por ciento de los enfermos dejaron de sentirlo. Según la escala de Harris, 50 por ciento de los pacientes estudiados tuvo una interpretación cualitativa de pobre (<70 puntos) antes de iniciar el tratamiento; posteriormente, solo 8,6 por ciento permanecieron con esa puntuación. Conclusiones: La terapia con las ondas de choque es una técnica no invasiva, segura y eficaz. Posibilitó una rápida recuperación de los pacientes atendidos y su incorporación a las actividades diarias(AU)

ABSTRACT Introduction: Shock wave therapy is acoustic waves present in daily situations. This method is currently used to treat trochanteric bursitis. Objective: To evaluate the effectiveness of shockwave therapy in the treatment of trochanteric bursitis. Methods: A descriptive, cross-sectional study was conducted with 46 patients diagnosed with trochanteric bursitis. They were treated with Piezolith-3000 equipment (extracorporeal shock waves) at Frank País International Orthopedic Scientific Complex, from March 2014 to April 2018. The analysis of the variables (age, sex, pain and Harris scale) was performed. The absolute and relative frequencies were obtained. Tables and graphs were prepared to summarize the statistical information of the investigation. Results: There was a predominance of the female sex (86.9 percent) and the age group of 46-55 years (50 percent). All patients had pain before receiving shock waves. After treatment this situation was reversed; the pain stopped in 69.5 percent of the patients. According to Harris scale, 50 percent of the patients studied had a poor qualitative interpretation (<70 points) before starting treatment; subsequently, only 8.6 percent remained at that score. Conclusions: Shockwave therapy is a non-invasive, safe and effective technique. It enabled a rapid recovery of patients and their return into daily activities(AU)

RÉSUMÉ Introduction: Les ondes de choc extracorporelles sont des ondes acoustiques présentes dans des situations de la vie quotidienne. C'est une technique actuellement utilisée pour traiter la bursite trochantérienne. Objectif: Évaluer l'efficacité de la thérapie par ondes de choc dans le traitement de la bursite trochantérienne. Méthodes: Une étude transversale descriptive de 46 patients diagnostiqués de bursite trochantérienne, et traités par ondes de choc extracorporelles à l'aide de l'appareil Piezolith-3000, a été réalisée dans le Complexe scientifique international d'orthopédie « Frank Pais¼, pendant la période de mars 2014 et avril 2018. On a effectué une analyse des variables (âge, sexe, douleur, score de Harris). On a obtenu les fréquences absolues et relatives, et grâce à elles, on a élaboré les tableaux et graphiques abrégeant l'information statistique de la recherche. Résultats: Le sexe féminin (86.9 pourcent) et la tranche d'âge de 46-55 ans (50 pourcent ) ont prédominé. Tous les patients soufraient de douleur avant l'application des ondes de choc. Après le traitement, cette situation s'est inversée, et 69.5 pourcent des malades ont cessé de la ressentir. D'après le score de Harris, les résultats obtenus dans 50 pourcent des patients ont été considérés comme mauvais (<70 points) avant le commencement du traitement ; puis après, seulement 8.6 pourcent des patients ont conservé cette évaluation. Conclusions: La thérapie par ondes de choc extracorporelles est donc une technique non invasive, fiable et efficace. Elle a permis la récupération des patients et leur retour aux activités de la vie quotidienne(AU)