• Clinics in Shoulder and Elbow
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• 제1권1호
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• pp.35-39
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• 1998

From May 1994 to May 1995, we performed a prospective controlled double-blind clinical study of 85 patients(85 shoulders). For inclusion in the study all patients met the following criteria: 1) a diagnosis of impingement syndrome by lidocaine injection test; 2) symptoms for at least three months; 3) no previous subacromial injection; 4) no evidence of rotator cuff tear. We excluded the patients from the study who showed a instability or other clear primary cause. The patients were randomized to receive either 5/subcc/ 2% lidocaine with 4ee of 20mg/cc Depomedrol(Group 1) in 45 cases or 5/subcc/ 2% lidocaine solely(Group 2) in 40 cases. At three month follow-up, all results were better in steroid group than control group. But at one year, improvement of pain and daily activity showed no difference between two groups. So we conclude that the use of subacromial steroid injection is effective for short-term therapy in the treatment of subacromial impingement syndrome, but the long-term effectiveness is doubtful.

• 대한한의학방제학회지
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• 제18권2호
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• pp.259-265
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• 2010

Objectives : The purpose of this study is to report the improvement after Sweet BV herbal acupuncture therapy of shoulder impingement syndrome with Subacromial bursitis. Methods : We treated a patient having shoulder pain due to shoulder impingement syndrome with Sweet BV herbal acupuncture therapy. We checked visual analogue scale (VAS) score and range of movement (ROM). Results : We treated shoulder pain. Thereafter ROM improved and VAS score dropped to the level 3 points from 10 points at onset. Conclusions : This report shows Sweet BV herbal acupuncture therapy has effectiveness on shoulder impingement syndrome with Subacromial bursitis.

• Clinics in Shoulder and Elbow
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• 제10권2호
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• pp.232-235
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• 2007

다발성 미립체는 만성 류마토이드 관절염이나 만성 점액낭염의 합병증으로 드물게 발생하는 질환으로 어떤 기저 질환 없이도 발생할 수 있다. 활막 연골종증과 유사하기 때문에 수술 전 정확한 진단을 위해 단순 방사선과 자기 공명 영상 소견이 필요한 것으로 알려져 있다. 저자들은 우 견관절의 통증과 운동 제한을 주소로 내원한 37세 남자에서 견봉하 점액낭에 점액낭염을 동반한 다량의 미립체를 발견하고 관절경적으로 치료 후 좋은 결과를 얻었기에 문헌 고찰과 함께 보고하고자 한다.

• PNF and Movement
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• 제20권3호
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• pp.399-408
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• 2022

Purpose: This study investigated the differences in winged scapula between the symptomatic side and asymptomatic side, the reliability of the winged scapula test, and the correlation between winged scapula and the stability of the scapula in patients with subacromial impingement syndrome. Methods: Twenty-four patients with unilateral subacromial impingement syndrome participated in this study. Winged scapula was compared between the symptomatic and asymptomatic sides using a scapulometer. The reliability of the scapulometer was assessed by calculating the intraclass correlation coefficient (ICC), standard error of measurement (SEM), and minimal clinically important difference (MCID). The correlation between winged scapula and the results of the upper quarter Y-balance test were also obtained. Conclusion: Winged scapula was significantly greater on the symptomatic side compared with the asymptomatic side (p < 0.05). High to excellent ICCs were obtained for the winged scapula test, and SEM and MCID values were obtained for winged scapula (SEM: 0.2-0.3 cm, MCID: 0.6-0.8 cm); however, winged scapula and the results of the upper quarter Y-balance test were not correlated. Conclusion: The scapulometer is useful for measuring winged scapula in patients with subacromial impingement syndrome.

• Clinics in Shoulder and Elbow
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• 제21권3호
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• pp.138-144
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• 2018

Background: Subacromial erosion remains a major concern after surgical fixation of acromioclavicular (AC) joint using a clavicular hook plate. To minimize postoperative subacromial erosion, we investigated the structural relationship between distal clavicle and acromion around the AC joint by considering the surgical fixation of the joint using the hook plate technique. Methods: Computed tomography scans of 101 AC joints without any inherent pathology were analyzed. The angle between the distal clavicle and acromion around the AC joint (AC angle), depth of the acromion, differences in height between distal clavicle and acromion (AC height difference), and thickness of distal clavicle and acromion at the AC joint were measured. Descriptive statistics were calculated for each anatomical parameter, and all results were compared between gender groups. Results: The mean AC angle was $17.1^{\circ}$(range, $-8.0^{\circ}$ to $39.0^{\circ}$), and the mean AC height difference was 3.5 mm (range, -0.7 to 8.7 mm). Both factors showed very high variability (coefficients of variation=62.6% and 46.6%, respectively). The mean AC angle was significantly higher in the female gender than in the male gender ($19.8^{\circ}$ vs. $13.8^{\circ}$, p=0.048). The mean acromion thickness and distal clavicular thickness were both significantly thinner in the female group than in the male group (p<0.001). Conclusions: Taken together, we believe our results might be helpful in minimizing postoperative subacromial erosion when performing surgical fixation of the AC joint using the hook plate, and be valuable in improving future design of the hook plate.

• Clinics in Shoulder and Elbow
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• 제1권2호
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• pp.160-166
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• 1998

The purpose of this study was to assess the results of arthroscopic subacromial decompression in patients with chronic impingement and to evaluate the results according to the rotator cuff pathology. We evaluated the clinical results of treatment for chronic impingement syndrome in 28 patients from Feb 1996 to Feb 1997. There were twenty men and eight women in age from 24 to 72 years (mean age 51) with dominant arm involvement in sixteen patients. Follow up evaluations averaged 15(range 12-24)months. The average duration of symptoms were 15(range 6­60)months. The final diagnoses which were based on the physical examination, plain radiographs and arthroscopic findings, were stage II impingement in 16 patients and stage ill impingement in 12 patients. We excluded the patients with acromioclavicular arthritis or glenohumeral instability in this study. All patients were managed non-operatively a minimum of six months. During the operation we performed contouring and smoothing the acromial undersurface and only resecting of the anterolateral band of the coracoacromial ligament. The clinical results were quantitated using UCLA shoulder rating score. Satisfactory results were obtained in 23(80%) patients. Unsatisfactory results were obtained in 5(18%) patients with posterior cuff tear. The average UCLA pain score showed significant improvement from 2.8(constant pain) to 7.2(present during heavy activities) at final follow up. The function and active forward flexion scores also increased from their preoperative value. There was no significant differences according to the surface and severity of tear and NeeI' stage (P>0.05). These results compared favorably with those reported following open acromioplasty. While arthroscopic subacromial decompression is a demanding technique with a learning curve, it is a reliable treatment for chronic impingement syndrome. A less aggressive approach to subacromial decompression and preserving the posteromedial band of the coracoacromialligament does not appear to compromise results.

• Clinics in Shoulder and Elbow
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• 제2권2호
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• pp.93-98
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• 1999

Purpose: The purpose of this study was to analyze the prognostic factors for arthroscopic subacromial decompres­sion and rotator cuff debridement in impingement syndrome. Materials and Methods : Arthroscopic subacromial decompression with or without rotator cuff debridement was performed in 46 cases of 44 consecutive patients with either stage n or stage ill impingement syndrome. The patients were classified by Neer's stage and size of tear according to the criteria of Cofield. The results were assessed with UCLA rating scale. We used repeated measures ANOVA and Chi-square test to assess correlation between the results and six variables including stage, rotator cuff tear size, age at the operation, duration of symptom, throwing sports activity, and trauma history. The follow-up period averaged 53 months(range, 27 to 92 months). Results: Lower stage by Neer's stage was correlated with higher postoperative scores and with significant difference between preoperative and postoperative scores of UCLA rating scale. However, other factors did not show significant influence upon the results. The patients with complete rotator cuff who showed satisfactory results after procedures were older and had shorter symptom duration, small cuff size. Conclusions : In patients with impingement syndrome treated by arthroscopic debridement and subacromial decompression, superior results were obtained when belonged to a lower Neer stage and when the rotator cuff was only partially tom. In cases with complete rotator cuff tear, higher success rates were obtained with smaller tear sizes. Age at operation, duration of symptoms, throwing athlete, traumatic tear did not affect the results.

• Clinics in Shoulder and Elbow
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• 제27권1호
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• pp.11-17
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• 2024

Background: Rotator cuff tears are often associated with synovitis, but the ability of noninvasive ultrasonography to predict the severity of synovitis remains unclear. We investigated whether ultrasound parameters, namely peak systolic velocity in the anterior humeral circumflex artery and Doppler activity in the glenohumeral joint and subacromial space, reflect synovitis severity. Methods: A total of 54 patients undergoing arthroscopic rotator cuff repair were selected. Doppler ultrasound was used to measure peak systolic velocity in the anterior humeral circumflex artery and Doppler activity in the glenohumeral joint and subacromial space, and these values were compared with the intraoperative synovitis score in univariate and multivariate analyses. Results: Univariate analyses revealed that tear size, peak systolic velocity in the anterior humeral circumflex artery, and Doppler activity in the glenohumeral joint were associated with synovitis in the glenohumeral joint (P=0.02, P<0.001, P=0.02, respectively). In the subacromial space, tear size, peak systolic velocity in the anterior humeral circumflex artery, and Doppler activity in the subacromial space were associated with synovitis severity (P=0.02, P<0.001, P=0.02, respectively). Multivariate analyses indicated that tear size and peak systolic velocity in the anterior humeral circumflex artery were independently associated with synovitis scores in both the glenohumeral joint and the subacromial space (all P<0.05). Conclusions: These findings demonstrate that tear size and peak systolic velocity in the anterior humeral circumflex artery, which can both be measured noninvasively, are useful indicators of synovitis severity.

• Clinics in Shoulder and Elbow
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• 제19권2호
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• pp.96-100
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• 2016

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.

• Journal of Acupuncture Research
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• 제38권3호
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• pp.242-244
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• 2021

LI15 is an important acupuncture point to treat shoulder pain. There are 4 needling methods for LI15 in the textbook; 1 method requires the insertion of the needle horizontally between the acromion and the great tuberosity of the humerus with the arm lowered for supraspinatus tendonitis. This method is also applicable for all conditions of rotator cuff disease, but it has not previously been described in detail. Providing X-ray scans and describing needle direction and depth of insertion will provide evidence for needling with the arm down as an effective stimulation of the subacromial space. Firstly, for this technique, with the arm raised, a concave point is located between the front edge of the acromion and the humerus, and the lower upper arm. Secondly, the acupuncture needle is inserted slightly posteriorly towards the supraspinous fossa, in the direction of the supraspinatus tendon and to a depth of 30-40 mm.