• Title/Summary/Keyword: Elbow pain

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Osteochondritis Dissecans of Elbow Joint (박리성 골연골염, 주관절)

  • Oh Jeong-Hwan;Choi Jin-Hyung;Park Jin-Young
    • Clinics in Shoulder and Elbow
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    • v.8 no.2
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    • pp.63-67
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    • 2005
  • Osteochondritis dissecans is a common cause of lateral elbow pain in throwing athletes and gymnasts between the age of 10 and 15 years. The pain frequently is insidious and progressive in nature and is relieved with rest in most cases. Compressive forces at the radiocapitellar joint along with a tenuous blood supply to the region may play a role in the etiology of this condition. Treatment is directed according to presenting symptoms, radiographic findings and status of the involved segment. Surgical management involves either an excision of a loose lesion and removal of loose bodies or reattachment of an osteochondral fragment. The role of subchondral penetration of debridement of the defect after fragment excision is unclear. Whether to excise and debride or to fix an unstale fragment is a highly controversial topic. The clinician should recognize osteochondritis dissecans of the elbow as a potentially disabling condition where the prognosis for return to sport is guarded

Prosthetic resurfacing of engaging posterior capitellar defects in recurrent posterolateral rotatory instability of the elbow

  • Dani Rotman;Jorge Rojas Lievano;Shawn W. O'Driscoll
    • Clinics in Shoulder and Elbow
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    • v.26 no.3
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    • pp.287-295
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    • 2023
  • Background: Posterolateral rotatory instability (PLRI) is a common mechanism of recurrent elbow instability. While the essential lesion is a deficiency in the lateral ulnar collateral ligament (LUCL), there are often associated concomitant bony lesions, such as an Osborne-Cotterill lesions (posterior capitellar fractures) and marginal radial head fractures, that compromise stability. Currently, there is no standard treatment for posterior capitellar deficiency associated with recurrent PLRI. Methods: We conducted a retrospective review of five patients with recurrent PLRI of the elbow associated with a posterior capitellar impaction fracture engaging with the radial head during normal range of motion. The patients were treated surgically with LUCL reconstruction or repair and off-label reconstruction of the capitellar joint surface using a small metal prosthesis designed for metatarsal head resurfacing (HemiCAP toe classic). Results: Five patients (three adolescent males, two adult females) were treated between 2007 and 2018. At a median follow-up of 5 years, all patients had complete relief of their symptomatic instability. No patients had pain at rest, but two patients had mild pain (visual analog scale 1-3) during physical activity. Three patients rated their elbow as normal, one as almost normal, and one as greatly improved. On short-term radiographic follow-up there were no signs of implant loosening. None of the patients needed reoperation. Conclusions: Recurrent PLRI of the elbow associated with an engaging posterior capitellar lesion can be treated successfully by LUCL reconstruction and repair and filling of the capitellar defect with a metal prosthesis. This treatment option has excellent clinical results in the short-medium term. Level of evidence: IV.

The effects of cryotherapy on delayed onset muscle soreness (지연발생 근육통의 냉치료 효과에 대한 연구)

  • Kim, Sang-Yeob
    • Journal of Korean Physical Therapy Science
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    • v.8 no.2
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    • pp.1065-1071
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    • 2001
  • Delayed onset muscle soreness is a sensation of discomfort that occurs 24 h after exercise, and it is associated with the performance of unfamiliar and high force muscle work, such as eccentric contractions. The injury to the muscle has been well described but the mechanism underlying the injury is not fully understood. Although the pathophysiological processes underlying delayed onset muscle soreness are not completely understood, many researchers have investigated various treatments in a attempt to reduce the soreness. Physical therapy is the most importance techniques to reduce delayed onset muscle soreness. The purpose of this study is to investigate the effect of a cryotherapt on DOMS. Thirty subjects were randomly assigned to experimental group : control, cryotherapy, and placebo group. Elbow flexion range, mechanical pain threshold. and subjective pain were measured 30 min before DOMS was induced and 24, 48, 72 hours after DOMS was induced. The results of this study were as follows: 1. Elbow flexion range showed significant difference each time, especially at 48 and 72 hours 2. Mechanical pain thershold and subjectively pain showed no significant difference between group.

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Arthroscopic Treatment for Calcific Tendinitis of Origin of Long Head of Triceps

  • Kim, Woo;Song, Byung Wook;Rhie, Tae-Yon;Kwon, Jieun
    • Clinics in Shoulder and Elbow
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    • v.19 no.4
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    • pp.245-248
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    • 2016
  • A 55-year-old female experienced acute left shoulder pain without specific trauma. Radiography showed calcific deposits in the inferior part of the glenoid fossa. Magnetic resonance arthrography showed calcific deposits in the origin of the long head of triceps brachii muscle. Conservative treatment failed to resolve the symptoms; therefore, arthroscopic surgery was performed. The patient experienced immediate and dramatic pain relief, and normal shoulder motion was demonstrated 1 year after surgery. In conclusion, although rare, calcific tendinitis of the triceps brachii muscle, which causes shoulder pain, should be included in the differential diagnosis of acute shoulder pain. Arthroscopic surgery is a treatment option for chronic cases and those resistant to conservative treatment.

Arthroscopic Excision of Intra-articular Osteochondroma of the Elbow: A Case Report

  • Jang, Suk-Hwan;Song, Han-Eui
    • Clinics in Shoulder and Elbow
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    • v.19 no.3
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    • pp.172-175
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    • 2016
  • Osteochondromas are one of the most common benign bone tumors usually involving extraarticular metaphysis of long bone. Solitary intra-articular osteochondroma arising from the elbow joint has rarely been reported. We present a case of 23-year-old female who had pain and limited motion of the left elbow as a result of intraarticular osteochondroma of the distal humerus. Arthroscopic excision of the osteochondroma yielded complete relief of symptoms. Absence of recurrence was confirmed radiographically at two years after surgery. To the best of our knowledge, this is the first report of osteochondroma of the elbow successfully treated arthroscopically.

Ultrasound-guided Pulsed Radiofrequency Lesioning of the Ulnar Nerve in a Patient with Cubital Tunnel Syndrome -A case report- (팔꿉굴증후군 환자에서 초음파를 이용한 척골신경의 박동성고 주파술의 경험 -증례보고-)

  • Ghil, Bo-Gyoung;Kil, Ho-Yeong
    • The Korean Journal of Pain
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    • v.21 no.3
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    • pp.224-228
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    • 2008
  • Ulnar nerve compression in the cubital tunnel is a common entrapment syndrome of the upper limb. Pulsed radiofrequency lesioning (PRFL) has been reported as a treatment method for relieving neuropathic pain. Since the placement of the electrode in close proximity to a targeted nerve is very important for the success of PRFL, ultrasound seems to be well suited for this technique. A 36-year-old woman presented with complaints of numbness and pain on the medial aspect of the elbow and the pain radiated down to the $4^{th}$ and $5^{th}$ fingers for 10 years after she suffered an elbow contusion, we then scheduled this woman for the ultrasound guided PRFL of the ulanr nerve. The initial ultrasound examination demonstrated a swollen nerve, loss of the fascicular pattern and an increased cross sectional area of the ulnar nerve. After confirmation of the most swollen site of the nerve via ultrasound, two sessions of PRFL were performed. The postprocedural 10 cm visual analog scale score decreased from 8 to 1 after the two sessions of PRFL.

Total elbow arthroplasty for active primary tuberculosis of the elbow: a curious case of misdiagnosis

  • Pattu, Radhakrishnan;Chellamuthu, Girinivasan;Sellappan, Kumar;Chendrayan, Kamalanathan
    • Clinics in Shoulder and Elbow
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    • v.25 no.2
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    • pp.158-162
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    • 2022
  • The incidence of musculoskeletal tuberculosis (TB) is on the rise due to the current Acquired Immunodeficiency Syndrome (AIDS) pandemic. Spine is the most common osseous site, followed by other joints. TB identified in the elbow accounts for 2%-5% of skeletal TB cases, which are secondary to pulmonary TB. Primary elbow TB is rare. We report a case of primary TB of the elbow which had a negative synovial biopsy. A 46-year-old right-hand dominant female patient with chronic pain and disability of the right elbow was diagnosed with chronic non-specific arthritis based on an arthroscopic synovial biopsy. The case was diagnosed retrospectively as active TB from bone cuts post total elbow arthroplasty. Anti-tuberculosis treatment (ATT) was given postoperatively for 12 months. The patient reported good functional outcomes at 3 years of follow-up. Such atypical presentations of osteoarticular TB are challenging to diagnose. Therefore, particularly in endemic areas, clinicians should be careful before excluding such a diagnosis even after a negative biopsy. Further research should investigate whether active TB of small joints such as the elbow can be treated with ATT, and early arthroplasty should be a focus of this research.

Sports Injury of the Elbow (주관절의 스포츠 손상)

  • Sin, Hyeon-Dae
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.7 no.1
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    • pp.8-14
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    • 2008
  • Elbow joint injuries during exercise mostly occur by repeated stress to the joint than direct trauma. A pitcher who uses his arm above his head is most likely to be injured. So learning the right way to exercise and gaining the strength by maturating the body are essential for diminishing the chance of injury. On lateral ulnar tendon injury, which is most commonly injured area on elbow joint, pitchers generally complain of pain in arm movement above head and reduction of velocity, accuracy, and number of pitching. When there is pain on upper arm in harsh using, the stress fracture must be thought and epicondylar physis fracture of medial arm can occur by repeated abduction stress and contraction of flexors on forearm on children with immature skeleton. Osteochondritis dissecans of capitullum occur in young athletes who use there upper limb continuously lifting weights and gym work. And stress of abduction-extension includes damage of soft tissue and bone components, post medial crush syndrome, lateral ulnar ligament injury, extensor-abductor injury, stress of radius- capitullum are in this category.

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Displaced Scapula Fracture (Ideberg Type IIb) Combined with a Large Rotator Cuff Tear in Anterior Shoulder Dislocation: A Case Report

  • Noh, Young-Min;Kim, Chul-Hong;Lee, Seung-Hyun;Im, Chul-Soon
    • Clinics in Shoulder and Elbow
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    • v.20 no.3
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    • pp.162-166
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    • 2017
  • Traumatic anterior shoulder dislocation combined with scapular fracture in elderly patients is relatively rare. In this case, a patient visited Emergency Room of Dong-A University Hospital for shoulder pain after falling off a ladder. Radiographs demonstrated anterior shoulder dislocation with displaced Ideberg type IIb scapula (glenoid fossa) fracture combined with a large rotator cuff tear on magnetic resonance imaging. We performed arthroscopic rotator cuff repair, but a large fragment in the inferior glenoid was left untreated. At the 1 year follow-up visit, the pain visual analogue scale of the patient was 2, the American Shoulder and Elbow Society score was 88 and the patient had gained nearly full range of motion without any apprehension.

The Effect of Laser and Joint Mobilization Techniques on Tennis Elbow: A Meta-Analysis (테니스 주(tennis elbow)에 대한 레이저치료와 관절가동화기법의 효과: 메타분석)

  • Moon, Mee-Hyang;Nam, Chung-Mo;Chung, Yi-Jung
    • Physical Therapy Korea
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    • v.10 no.3
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    • pp.91-107
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    • 2003
  • We processed meta-analysis to test if the effects of laser therapy and mobilization techniques are evidence-based practice for treating tennis elbow. By researching and collecting the results of previous studies on tennis elbow, we inquired into the difference in the effects of each treatment methods on pain, grip strength, and ROM. A total of 10 international and domestic articles on the treatments of tennis elbow were selected for this study, including 7 articles on the effect of laser therapy and 3 on mobilization techniques. According to the qualitative meta-analysis, all 7 of the articles on laser therapy and 1 of the mobilization technique were double-blinded and randomized the subjects, and all of the 10 studies were designed in a high quality research, using statistics. The results of the studies on laser therapy showed in terms of statistical significance: 4 out of 7 did not decrease pain after therapy, and 3 out of 5 did not increase grip strength after therapy. In the studies on the effects of mobilization technique, both the 2 studies significantly increased grip strength after therapy. For other studies which measured ROM and tension, the mobilization therapy increased ROM significantly, and decreased tension significantly. The results of our study are shown in a diverse form in terms of the effects of different therapy techniques. This is related to the accuracy of the measurement tools for assessments and diagnoses. Further qualitative studies on the evidence-based practice and researches on tennis elbow are needed.

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