• Journal of Yeungnam Medical Science
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• v.38 no.1
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• pp.19-26
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• 2021

Adhesive capsulitis of the shoulder joint is a common disease characterized by pain at the insertional area of the deltoid muscle and decreased range of motion. The pathophysiological process involves fibrous inflammation of the capsule and intraarticular adhesion of synovial folds leading to capsular thickening and contracture. Regarding the multidirectional limitation of motion, a limitation in external rotation is especially prominent, which is related to not only global fibrosis but also to a localized tightness of the anterior capsule. Ultrasound and magnetic resonance imaging studies can be applied to rule out other structural lesions in the diagnosis of adhesive capsulitis. Hydraulic distension of the shoulder joint capsule provides pain relief and an immediate improvement in range of motion by directly expanding the capsule along with the infusion of steroids. However, the optimal technique for hydraulic distension is still a matter of controversy, with regards to the infusion volume and rupture of the capsule. By monitoring the real-time pressure-volume profile during hydraulic distension, the largest possible fluid volume can be infused without rupturing the capsule. The improvement in clinical outcomes is shown to be greater in capsule-preserved hydraulic distension than in capsule-ruptured distension. Moreover, repeated distension is possible, which provides additional clinical improvement. Capsule-preserved hydraulic distension with maximal volume is suggested to be an efficacious treatment option for persistent adhesive capsulitis.

• Clinics in Shoulder and Elbow
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• v.4 no.1
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• pp.1-12
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• 2001

Purpose: To evaluate the histologic effect(LM and EM findings)of nonablative LASER and thermal energy on knee joint capsule of rabbit. Material and Methods: The nonablative LASER and thermal energy was applied to the rabits(average age 36 weeks, weight 5 ㎏). There were divided into 4 groups with 6 rabbits in each. The group I received 6 watts of LASER, group Ⅱ 12 watts of LASER, group Ⅲ 60° of thermal energy, and group Ⅳ 70° of thermal energy. The histologic study included H-E, Massons trichrome stain and electron microscopy at immediate, 3 weeks and 6 weeks after operation. Results: The histologic finding in immediate after operation was shown a fibrous degeneration of collagen on all groups and related to the energy level. The histologic finding after 3 weeks showed fibrosis and this fibrosis related the level of energy. Especially the group IV was shown flattening of capsule and deep fibrosis. The histologic finding after 6 weeks was shown marked recovery of collagen arrangement and capillary proliferation in group Ⅰ,Ⅱ and Ⅲ. But in the group Ⅳ not recovered. Conclusion: The nonablative LASER or thermal energy can cause degeneration, fibrosis and contracture of joint capsular collagen.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.11 no.2
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• pp.62-66
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• 2015

Temporomandibular joint dislocation causes considerable pain, discomfort, and swelling. The anatomic construction of the articular fossa and the eminentia articularis may predispose to dislocation, and weakness of the connective tissue forming the capsule is believed to be a predisposing factor. The capsule may be stretched and, more rarely, torn. Dislocation may be unilateral or bilateral and may occur spontaneously after stretching of the mouth to its extreme open position, such as during a yawn or during a routine dental operation. Manual reduction with the patient under muscle-relaxing condition or anesthesia is recommended method. After the reduction of an acute dislocation, immobilization of the jaw is recommended to allow the stretched and sometimes torn capsule to heal, thus preventing recurrence. A Barton's bandage may be applied for 2 to 3 weeks to prevent the patient from opening the jaw too wide. But, it results in recurrent dislocation in the neurologically disabled patient, because of loose intermaxillary fixation. This is a case report about management of recurrent temporomandibular joint dislocation by multiple loop wirings and intermaxillary elastics in cerebrovascular accident patient.

• Physical Therapy Korea
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• v.28 no.1
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• pp.13-17
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• 2021

A normal range of motion is essential for performing activities of daily living. The capsular pattern is the proportional motion restriction in range of motion during passive exercises due to tightness of the joint capsule. Although the capsular pattern is widely referred to in clinical practice, there is no scientific evidence to support the concept. In this review, the appropriateness of the capsular pattern for evaluation of joint pathology was assessed. In the Textbook of Orthopaedic Medicine written by Cyriax, the capsular pattern did not specify how much reduction in angular motion is considered motion restriction. As the definition proposed initially was unclear, different methods have been used in previous studies investigating capsular pattern. In addition, the capsular pattern described all the major joints of the human body, but only the hip joint, knee joint, and shoulder joint were studied in experimental studies. Sensitivity and specificity were reported in one study and were meaningful in specific pathologies (loss of extension to loss of flexion). There was no consensus on the reliability and validity. In summary, the capsular pattern suggested by Cyriax or Kaltenborn is not supported or applies only to certain conditions. Various components around a joint complement each other and provide stability to the joint. It is recommended that the therapist perform multiple assessments rather than rely on a single assessment when evaluating joints.

• Journal of the Korean Arthroscopy Society
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• v.5 no.2
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• pp.135-139
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• 2001

Purpose : Repair of the posterior capsule tear at the time of the operation for the chronic postero-lateral or postero-medial rotary instability has not been reported. We describe the arthroscopic repair of the posterior capsule tear using the posterior trans-septal portal. Method : After conducting basic arthroscopic examination of the knee, postero-medial and postero-lateral portals are secure to make the posterior trans-septal portal, through which the postero-medial and postero-lateral capsule tears are repaired using the suture hook under the arthroscopic guidance. Conclusion : When arthroscopic reconstruction of PCL insufficiency or postero-lateral rotaty instability that accompanies postero-medial or postero-lateral capsular tears. rising the posterior traits-septal portal could ensure better visualization of the capsule and a subsequent more accurate repair of the capsule. Since it significantly lessened instability, it could contribute to an achievement of successful clinical results.

• Archives of Craniofacial Surgery
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• v.15 no.1
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• pp.40-42
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• 2014

Ganglion cysts are most common on the dorsum of the hand or wrist, but they can occur in any part of the body. There have been few papers reporting ganglion cysts originating from the sternoclavicular joint, with most of these cases developing in children. A 76-year-old woman was referred to our department because of a painless mass over the right sternoclavicular joint. The mass was excised along with the portion of the sternoclavicular joint capsule surrounding the stalk. Histopathologic examination showed the cyst wall to be composed of compressed collagen fibers without evidence of an epithelial or synovial lining, which was consistent with ganglion cyst. To our knowledge, this is the first report of such a cyst in an adult. We consider this to be a useful report for surgeons that treat mass lesions occurring in almost any part of the body surface.

• Journal of the Korean Society of Radiology
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• v.81 no.1
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• pp.2-20
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• 2020

MRI is a valuable imaging technique for the evaluation of intraarticular diseases. Accurate interpretation of joint MRI necessitates sound knowledge of anatomy. In the field of joint anatomy, in addition to the discovery of new structures, previously reported joint components of unexplained function are also detected. In this review, joint anatomy researched actively over the last decade is discussed. Joint components including the rotator cable and the superior capsule of the shoulder, posterolateral corner and the anterolateral ligament complex of the knee, and the distal tibiofibular syndesmosis of the ankle joint are introduced and correlated with their MRI features.

• Physical Therapy Korea
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• v.3 no.2
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• pp.95-105
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• 1996

Type I, II, III are regarded as "true" joint receptors, type IV is considered a class of pain receptor. Type I, II and III mechanoreceptors, via static and dynamic input, signal joint position, intraarticular pressure changes, and the direction, amplitude, and velocity of joint movements. Type I mechanoreceptor subserve both static and dynamic physiologic functions. Type I are found primarily in the stratum fibrosum of the joint capsule and ligaments. Type I receptors have a low threshold for activation and are allow to adapt to changes altering their firing frequency. Type II receptors have a low threshold for activation. These dynamic receptors respond to joint movement. Type II receptors are thus termed rapidly adapting. Type II joint receptors are located at the junction of the synovial membrane and fibrosum of the joint capsule and intraarticular and extraarticular fat pads. Type III receptors have been found in collateral ligaments of the joints of the extremities. Morphologically similar to Golgi tendon organ. These dynamic receptors have a high threshold to stimulation and are slowly adating. Type IV receptors possess free nerve ending that have been found in joint capsule and fat pads. They are not normally active, but respond to extreme mechanical deformation of the joint as well as to direct chemical or mechanical irritation. Small amplitude oscillatory and distraction movements(joint mobilization) techniques are used to stimulate the mechanoreceptors that may inhibit the transmission of nociceptors stimuli at the spinal cord or brain stem levels.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.2 no.1
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• pp.9-19
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• 1996

Type I, II, III are regarded as "true" joint receptors, type IV is considered a class of pain receptor. Type I, II and III mechanoreceptors, via static and dynamic input, signal joint position, intraarticular pressure changes, and the direction, amplitude, and velocity of joint movements. Type I mechanoreceptor subserve both static and dynamic physiologic functions. Type I are found primarily in the stratum fibrosum of the joint capsule and ligaments. Type I receptors have a low threshold for activation and are allow to adapt to changes altering their firing frequency. Type II receptors have a low threshold for activation. These dynamic receptors respond to joint movement. Type II receptors are thus termed rapidly adapting. Type II joint receptors are located at the junction of the synovial membrane and fibrosum of the joint capsule and intraarticular and extraarticular fat pads. Type III receptors have been found in collateral ligaments of the joints of the extremities. Morphologically similar to Golgi tendon organ. These dynamic receptors have a high threshold to stimulation and are slowly adating. Type IV receptors possess free nerve ending that have been found in joint capsule and fat pads. They are not normally active, but respond to extreme mechanical deformation of the joint as well as to direct chemical or mechanical irritation. Small amplitude oscillatory and distraction movements(joint mobilization) techniques are used to stimulate the mechanoreceptors that may inhibit the transmission of nociceptors stimuli at the spinal cord or brain stem levels.

• Journal of Veterinary Clinics
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• v.18 no.3
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• pp.243-248
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• 2001

Radiographic findings of degenerative joint disease (DJD) in the coxofemoral joints were studied in 108 dogs referred to Veterinary Medical Teaching Hospital, College of Veterinary Medicine, Seoul National University. Radiographic findings were identified with a extended ventrodorsal projection. Clinical signs such as pain in the affected joint, exercise intolerance, lameness, crepitation on flexion and extension of the joint and decreased range of motion, were shown in 40% and radiographic changes of bilateral coxofemoral joints were identified in 69% of a group of dogs. There are no sex predilections. Thirty-seven dogs were diagnosed as canine hip dysplasia (CHD; 10 cases), avascular necrosis of the femoral head (Legg-Calves-Perthes disease [LCPD]; 12 cases), fracture of the acetabulum (1 case), luxation(10 cases) and subluxation (15 cases), however, luxation and subluxation were identified in 11 dogs affected with CHD and LCPD. Causes of DJD in others (71case) were not identified. Radio-graphic findings identified included osteophyte formation at the attachment of the joint capsule (70%), sclerosis of the subchondral bone of the cranial acetabular edge (47%), remodeling of the femoral head (34%), thickening of the femoral neck(31%), perichondral osteophyte formation (31%), joint laxity (30%) and so on. All of the dogs diagnosed as CHD were large breed such as Retriever, Germain Shepherd, and Weimaraner and their age was under 1 year. This condition occurred bilaterally in 70% of affected animals. Dogs diagnosed as LCPD were young (under 1 year), small breed dogs. The incidence of LCPD is greater in Yorkshire Terrier, Miniature Pinscher and Poodle. This condition occurred unilaterally in 67% of affected animals. Clinical signs of dogs with unknown cause were shown in 15% and this condition occurred bilaterally in 75% of affected animals. Radiographic findings varied with patient's age and breed, however, the most common finding was osteophyte formation at the attachment of the joint capsule.