• Clinics in Shoulder and Elbow
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• v.17 no.4
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• pp.197-200
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• 2014

Reports of osteomyelitis in the proximal humerus with pyogenic glenohumeral arthritis of adjacent joints mostly involve pediatric patients. Nowadays, osteomyelitis that is secondary to adjacent pyogenic glenohumeral arthritis is extremely rare, even more so in adults than in pediatrics. We report a rare case of the pyogenic glenohumeral arthritis followed by osteomyelitis of the proximal humerus in an elderly patient. Initially, we diagnosed a case of pyogenic glenohumeral arthritis only, which, despite arthroscopic synovectomy, did not resolve and severe pain continued. Subsequent radiological imaging, performed after our suspicion of a secondary involvement, allowed us to diagnose osteomyelitis combined with the pyogenic glenohumeral arthritis, which we had overlooked because of the extreme rarity of the condition in adults since the antibiotic era began.

• Journal of the Korean Society of Radiology
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• v.9 no.6
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• pp.331-335
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• 2015

Consideration of Glenohumeral joint's image with the Changed Body angle of the Glenohumeral joint's Oblique Position in Erect Position. Glenohumeral joint's of Grashey method is a shoulder oblique method available to view the shoulder joint. Grashey method projects AP view of the Glenohumeral joint's so that the Humerus head's subluxation or joint degeneration can be easily visualized. However in this view, the patients, erect position, have to keep their body obliquely. Oblique position is will be needed to get the good quality Glenohumeral joint's view. Therefore, we thought of examining a method which shows the Glenohumeral joint's well by angling the patient one side upward in erect position. For this study, total 20 subject with no history of neurological or psychiatric illness, were recruited for examinations. They consisted of 13 mails and 7 femails, Statistic group analysis was performed with ANOVA test. Score of the evaluation of the expects were $30^{\circ}$ at $0.40{\pm}0.499$, $35^{\circ}$ at $1.34{\pm}0.657$, $40^{\circ}$ at $1.84{\pm}0.573$, $45^{\circ}$ at $0.76{\pm}0.649$, and they were significant(P<0.05). The degree of $40^{\circ}$ views were shown to yield good quality shoulder oblique images.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2004.11a
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• pp.129-135
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• 2004

만약 Glenoid side를 해부학적으로 정확하게 치환하고, 상완골측의 prosthesis를 삽입할 때 실제 골두의 크기와 같은 prosthetic head를 쓰고, humeral stem의 위치 및 높이를 정확하게 맞추어 삽입하여, humeral head component의 center와 glenoid component의 center가 일치되고 lateral glenohumeral offset이 정상에 가깝게 수술을 시행하면 인공 치환물로 대치된 glenohumeral joint가 정상에 가장 가까운 kinematics를 가질 수 있다 (당연한 얘기지만 이렇게 수술하려면 많은 경험이 필요). 따라서 Glenohumeral joint의 인공 관절 치환술은 항상 technique-dependant 수술이며, 아무리 좋은 치환물도 훌륭한 수술 기법보다 더 중요할 수는 없다.

• Clinics in Shoulder and Elbow
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• v.25 no.3
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• pp.240-243
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• 2022

Isolated deltoid paralysis is a rare pathology that can occur after axillary nerve injury due to shoulder trauma or infection. This condition leads to loss of deltoid function that can cause glenohumeral instability and inferior subluxation, resulting in rotator cuff muscle fatigue and pain. To establish dynamic glenohumeral stability, a novel technique was invented. Humeral suspension is achieved using a double button implant with non-resorbable high strength cords between the acromion and humeral head. This novel technique was used in two patients with isolated deltoid paralysis due to axillary nerve injury. The results indicate that the humeral suspension technique is a method that supports centralizing the humeral head and simultaneously dynamically stabilizes the glenohumeral joint. This approach yielded high patient satisfaction and reduced pain. Glenohumeral alignment was improved and remained intact 5 years postoperative. The humeral suspension technique is a promising surgical method for subluxated glenohumeral joint instability due to isolated deltoid paralysis.

• The Journal of Korean Physical Therapy
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• v.12 no.3
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• pp.433-444
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• 2000

The purpose is paper was to discuss current concepts related to anatomic stabilizing structures of the shoulder joint complex and their clinical relevance to shoulder instability. The clinical syndrome of shoulder instability represents a wide spectrum of symtoms and signs which may produce various levels of dysfunctions, from subtle subluxations to gross joint instability. The glenohumeral joint attains functional stability through a delicate and intricate interaction between the passive and active stabilizing structures. The passive constraints include the bony geometry, glenoid labrum, and the glenohumeral joint capsuloligaments structure. Conversely, the active constraints, also referred to as active mechanism, include the shoulder complex musculature, the projprioceptive system, and the musculoligamentous relationship. The interaction of the active and passive mechanism which provide passive and active glenohumeral joint stability will be throughtly discussed in this paper

• Clinics in Shoulder and Elbow
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• v.24 no.4
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• pp.272-278
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• 2021

Anatomical total shoulder arthroplasty (TSA) has been used widely in treatment of glenohumeral osteoarthritis and provides excellent pain relief and functional results. Reverse total shoulder arthroplasty (RSA) was created to treat the complex problem of rotator cuff tear arthropathy. RSA also has been performed for glenohumeral osteoarthritis even in cases where the rotator cuff is preserved and has shown good results comparable with TSA. The indications for RSA are expanding to include tumors of the proximal humerus, revision of hemiarthroplasty to RSA, and revision of failed TSA to RSA. The purposes of this article were to describe comprehensively the conditions under which RSA should be considered in glenohumeral osteoarthritis, to explain its theoretical background, and to review the literature.

• Investigative Magnetic Resonance Imaging
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• v.23 no.3
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• pp.228-240
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• 2019

Purpose: The aim of this study is to evaluate the T2 value of the articular cartilage of the glenohumeral joint in rotator cuff disease displayed on 3.0T MRI and to apply it in clinical practice. Materials and Methods: This study involved sixty-two patients who underwent shoulder MRI containing T2 mapping. The mean T2 value was measured by placing a free hand ROI over the glenoid or humeral cartilage from the bone-cartilage interface to the articular surface on three consecutive, oblique coronal images. The drawn ROI was subsequently divided into superior and inferior segments. The assessed mean T2 values of the articular cartilage of the glenohumeral joint were compared and evaluated based on the degree of rotator cuff tear, the degree of fatty atrophy of the rotator cuff, and the acromiohumeral distance. Results: ICC values between two readers indicated moderate or good reproducibility. The mean T2 value for the articular cartilage of the glenoid and humeral head cartilage failed to show any significant difference based on the degree of rotator cuff tear. However, the mean T2 values of articular cartilage, based on fatty atrophy, tended to be higher in fatty atrophy 3 or fatty atrophy 4 groups while some subregions displayed significantly higher mean T2 values. There was no correlation between the acromiohumeral distance and the mean T2 values of the articular cartilage of the glenoid and humeral head. Conclusion: T2 mapping of the glenohumeral joint failed to show any significant difference in quantitative analysis of the degenerative change of the articular cartilage based on the degree of rotator cuff tear. However, it also offers quantitative information on the degenerative change of cartilage of the glenohumeral joint in patients with rotator cuff tear and severe fatty atrophy of the rotator cuff.

• Clinics in Shoulder and Elbow
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• v.18 no.3
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• pp.120-127
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• 2015

Background: We prospectively compared the response to blind and ultrasound-guided glenohumeral injection of corticosteroids for treatment of shoulder stiffness. Methods: A total of 77 patients with shoulder stiffness between April 2008 and March 2012 were recruited. Patients were randomized to receive either a blind (group 1, n=39) or ultrasound-guided (group 2, n=38) glenohumeral injection of 40 mg triamcinolone. The clinical outcomes and shoulder range of motion (ROM) before injection, at 3, 6, and 12 months after injection and at the last follow-up were assessed. The same rehabilitation program was applied in both groups during the follow-up period. Results: There was no significant difference in demographic data on age, sex, ROM, and symptom duration before injection between groups (p>0.05). There were no significant differences in ROM including forward flexion, external rotation at the side, external rotation at $90^{\circ}$ abduction, and internal rotation, visual analogue scale for pain and functional outcomes including American Shoulder and Elbow Surgeons score, Simple Shoulder test between the two groups at any time point (p>0.05). Conclusions: Based on the current data, the result of ultrasound-guided glenohumeral injection was not superior to that of blind injection in the treatment of shoulder stiffness. We suggest that ultrasound-guided glenohumeral injection could be performed according to the patient's compliance and the surgeon's preference. Once familiar with the non-imaging-guided glenohumeral injection, it is an efficient and reliable method for the experienced surgeon. Ultrasound could be performed according to the surgeon's preference.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2009.03a
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• pp.175-175
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• 2009

Despite its importance for the understanding of joint kinematics in vivo, there has been few studies about shoulder joints. The purpose of this study is to analyze the glenohumeral joint during internal and external rotation at 90 degrees of abduction using in vivo noninvasive motion analysis system. MRI was performed for the following seven positions from maximum internal rotation to maximum external rotation at intervals of 30 degrees. We used 3D-gradient echo sequencing (TR: 12 ms, TE: 5.8 ms, 0.8 mm-slice thickness). Our method is based on matching three-dimensional MR images by the similarity of the image intensity. We analyzed the in vivo three-dimensional motions of the glenohumeral and scapulothoracic joint during this motion. In scapla plane, the mean rotation angle of the glenohumeral join was 105.5 degrees ($SD{\pm}39.0^{\circ}$). The mean rotation angle of the scapulothracic joint was 27.5 degrees ($SD\;{\pm}\;7.7^{\circ}$). The contribution ratio is almost 3.8:1 of glenohumeral and scapulothracic joint respectively.

• Journal of International Academy of Physical Therapy Research
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• v.6 no.1
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• pp.824-827
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• 2015

The purpose of this study was to investigate the effects of joint position on the distraction distance in patients with adhesive capsulitis of glenohumeral joint. The study was conducted upon 20 adults in their 40's with the findings of adhesive capsulitis of glenohumeral joint. These subjects were subdivided into 3 groups, which were a group with neutral position(n=7), second group with resting position(n=7) and third group with end-range position(n=6). After having the subject wearing sleeveless shirts exposing armpit and lying straight on the plinth, a physical therapist with OMT qualification pulled glenohumeral joint at the Grade III of Kaltenborn-Evjenth traction; and the distance between glenoid fossa and humeral head was measured with ultrasound. Following the application of traction, the group with resting position($.67{\pm}0.29$) exhibited the longest distance between humeral head and glenoid fossa, and it was followed by neutral position($.50{\pm}0.25$) and end-range position($.35{\pm}.21$) in this order. From the comparison of these groups, there was no significant difference in distraction distance between resting position and neutral position; and there was again no significant difference in distraction distance between end-range position and neutral position. However, there was a significant difference in distraction distance between end-range position and resting position(p<.05). Upon application of the Grade III of Kaltenborn-Evjenth traction, it was evident that the distance between humeral head and glenoid fossa can be varied depending on the location of the joint.