• Title/Summary/Keyword: Tendinitis

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Etiology of Achilles Tendinopathy: Inflammation versus Overuse (아킬레스 건염? 염증이라고 다 같은 염증이 아니야)

  • Kim, Dae-Yoo;Lee, Dong Yeon
    • Journal of Korean Foot and Ankle Society
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    • v.25 no.2
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    • pp.61-65
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    • 2021
  • It is widely acknowledged that Achilles tendinopathy and resultant degeneration of the Achilles tendon could be either due to vigorous physical exertion or due to inflammation of the tendon associated with systemic disease. The overuse injuries are generally multifactorial in origin and are caused by repetitive strain of the affected tendon till the tendon can no longer endure the tensile stress. Various alignment and biomechanical faults are claimed to play a causative role. Only 2% of patients complaining of Achilles tendon pain are caused by systemic disease. However, to ensure the right approach to treatment, it is necessary to rule out inflammatory tendinitis caused by systemic diseases such as rheumatoid arthritis, gout, and seronegative spondyloarthrosis.

Arthroscopic Treatment in Calcific Tendinitis of the Shoulder (견관절 석회성 건염의 관절경적 치료)

  • Rhee Yong Girl;Kim Young Hwan;Park Moo Song
    • Clinics in Shoulder and Elbow
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    • v.3 no.2
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    • pp.68-74
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    • 2000
  • The purpose of this study is to evaluate the final outcome after arthroscopic calcific removal in the calcific tendinitis of the shoulder joint and to analyze the influencing factors to affect the surgical treatment on the final results. From September, 1993 to March, 2000, arthroscopic removal of the calcific deposit in the shoulder joint was performed in 34 consecutive patients who had had typical symptoms and failed with the conservative treatment and 21 cases of 20 patients could be followed up at least 2 years. Fourteen cases(67%) were located in the supraspinatus, 5 cases(24%) in the infraspinatus and 2 cases(9%) in the subscapularis. Preoperative severity of symptoms was correlated with higher postoperative score. Pain was relieved from 7.6 to 0.9(Visual Analogue Scale:VAS) and UCLA score improved from 13.9 preoperatively to 32.0 postoperatively, but there was no statiscally significant difference in according to the deposit size(P=0.386). Pain and UCLA score improved from 7.9 to 0.4 and from 12.7 to 33.0 respectively when a calcific deposit was located in the supraspinatus, from 7.6 to 1.0 and from 14.8 to 33.4 in the infraspinatus but pain relieved from 6.5 to 4.0 and UCLA score improved from 20.0 to 22.5 in the subscapularis and these outcomes were shown a statiscal significance(P=0.001). Completeness of removal did not affect the final results(P>0,05). Excellent was 23.8% in 5 cases, good 66.7% in 14 cases, fair 4.8% in 1 and poor 4.8% in 1, and patients were satisfied with their final results in 81 %.

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Isolated Ruptures of the Infraspinatus: Clinical Characteristics and Outcomes

  • Lee, Kwang Yeol;Kim, Sae Hoon;Oh, Joo Han
    • Clinics in Shoulder and Elbow
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    • v.20 no.1
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    • pp.30-36
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    • 2017
  • Background: Isolated infraspinatus tear is very rare and clinical features are not as well known, therefore the purpose of this study was to evaluate clinical characteristics and outcomes of isolated infraspinatus tear that authors experienced. Methods: Authors reviewed 288 cases of full-thickness rotator cuff tear involving infraspinatus between 2010 and 2015, and retrospectively analyzed six cases of isolated infraspinatus tear. Perioperative clinical characteristics, postoperative functional outcomes of 6 months were investigated. Functional evaluation included visual analogue scale (VAS), range of motions, American Shoulder and Elbow Surgeons (ASES) score, and Constant score. Results: Calcific tendinitis was accompanied in 4 cases (66.7%). Three of them received steroid injection or aspiration or extracorporeal shockwave therapy. Mean preoperative pain VAS was 7.1 (range, 5-9), and mean postoperative pain VAS at 6 months later was 1.6 (range, 0-5). Preoperative muscle strength by isokinetic muscle performance test showed 52% deficit of abduction and 37.6% deficit of external rotation. All 6 patients had arthroscopic repair of the infraspinatus tendon. All the patients at the 6 months follow-up exhibited clinical improvement in the Constant score (67.8 [range, 45-77] to 89.3 [range, 81-100], p=0.029), and ASES score (52.3 [range, 30-77] to 90.0 [range, 80-100], p=0.002). There was no healing failure on imaging. Conclusions: Isolated infraspinatus tendon tear was frequently accompanied by calcific tendinitis, but pathophysiologic relationship should need more study. To rule out neurogenic etiology, magnetic resonance imaging and electromyography would be helpful. Arthroscopic infraspinatus tendon repair and supraspinatus debridement showed relatively good result in painful shoulder.

A Case Report of Supraspinatus Tendinitis and Subdeltoid Bursitis Patient Improved by Korean Medicine Treatment with Shinbaro3 Pharmacopuncture (신바로3 약침시술을 병행한 한방치료로 호전된 극상근건염 및 삼각근하 점액낭염 환자 치험 1례)

  • Yun, Yeong-Ung;Chung, Jai-Hyeon;Cheong, Seong-Hyun;Moon, Byung-Heon;Choi, Young-Jun;Yoo, Su-Bin;Lee, Jung-Hun;Shin, Dong-Jae
    • Journal of Korean Medicine Rehabilitation
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    • v.25 no.4
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    • pp.161-167
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    • 2015
  • Objectives The objective of this study is to report the improved case of Korean medicine treatment with Shinbaro3 pharmacopuncture for supraspinatus tendinitis and subdeltoid bursitis. Methods We used Shinbaro3 pharmacopuncture with other Korean medicine treatment (acupuncture, herbal medicine, cupping and chuna) for this patient. This case is measured and assessed by Numerical Rating Scale (NRS), shoulder range of motion (ROM) and shoulder physical examination. Results The NRS decreased from 10 to 2 and the patient showed nearly full shoulder range of motion. Also physical examination of shoulder was improved. Conclusions Korean medicine treatment with Shinbaro3 pharmacopuncture is proved to be helpful to relieve pain and recover function on shoulder joint.

Ginsenoside Rg1 enhances the healing of injured tendon in achilles tendinitis through the activation of IGF1R signaling mediated by oestrogen receptor

  • Wu, Tianyi;Qi, Wenxiao;Shan, Haojie;Tu, Bin;Jiang, Shilin;Lu, Ye;Wang, Feng
    • Journal of Ginseng Research
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    • v.46 no.4
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    • pp.526-535
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    • 2022
  • Background: During the pathogenesis of tendinopathy, the chronic inflammation caused by the injury and apoptosis leads to the generation of scars. Ginsenoside Rg1 (Rg1) is extracted from ginseng and has anti-inflammatory effects. Rg1 is a unique phytoestrogen that can activate the estrogen response element. This research aimed to explore whether Rg1 can function in the process of tendon repair through the estrogen receptor. Methods: In this research, the effects of Rg1 were evaluated in tenocytes and in a rat model of Achilles tendinitis (AT). Protein levels were shown by western blotting. qRT-PCR was employed for evaluating mRNA levels. Cell proliferation was evaluated through EdU assay and cell migration was evaluated by transwell assay and scratch test assay. Results: Rg1 up-regulated the expression of matrix-related factors and function of tendon in AT rat model. Rg1 reduced early inflammatory response and apoptosis in the tendon tissue of AT rat model. Rg1 promoted tenocyte migration and proliferation. The effects of Rg1 on tenocytes were inhibited by ICI182780. Rg1 activates the insulin-like growth factor-I receptor (IGF1R) and MAPK signaling pathway. Conclusion: Rg1 promotes injured tendon healing in AT rat model through IGF1R and MAPK signaling pathway activation.

Is it Possible to predict the Characteristics of Calcific Deposition in Calcific Tendinitis of Shoulder Joint? (단순 방사선 검사를 이용하여 석회성 건염에서 발생하는 석회 침착물의 성상에 대한 예측이 가능한가?)

  • Kim, Sung-Jae;Lee, Hee Jae;Lee, Kwang-Hyun;Park, Dong-Hyeok;Lee, Bong Geun
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.7 no.2
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    • pp.77-83
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    • 2014
  • Purpose: The purpose of current study was to evaluate the validity of the existing radiological classifications as a diagnostic modality for predicting characteristics of calcific deposition in calcific tendinitis of the shoulder joint. For that purpose, we determined the inter-observer reliability for evaluating diagnostic precisions of the classification and also evaluated diagnostic accuracy of predicting the toothpaste type calcific deposition. Materials and Methods: We performed retrospective study with total 26 patients surgically treated with calcific tendinitis of the shoulder joint from March 2010 to October 2013. Two independent observers reviewed preoperative radiographs of shoulder joints, and classified the characteristics of calcific depositions according to the criteria of Gartner, DePalma and Patte. Cohen's kappa were calculated for each classifications to evaluate inter-observer reliability. Sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio were determined for type of calcific depositions with Gartner type III, DePalma type I, and Patte type II for predicting toothpaste type calcific deposition. Results: The values of Cohen's kappa were the highest in the classification of Patte, 0.62, and the values for the classifications of DePalma and Gartner were 0.56 and 0.36, respectively. The sensitivities for predicting toothpaste type calcific deposition in Gartner Type III, DePalma type I and Patte type II were 83.3%, 91.7%, and 58.3%, respectively. Specificities were 85.7% 50.0% and 64%, positive likelihood ratios were 5.833, 1.833 and 1.633, negative likelihood ratios were 0.194, 0.167 and 0.648, and diagnostic odds ratios were 30.00, 11.00 and 2.52, respectively. Conclusion: There were no radiologic classifications of calcific tendinitis which has both high precision and accuracy. Further studies with other diagnostic modalities such as ultrasonography are needed for predicting characteristics of calcific deposition in calcific tendinitis of the shoulder joint.

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Ultrasound-Guided Local Steroid Injection Therapy for Acute Calcific Tendinitis of Shoulder (초음파를 이용한 급성 극상근 석회화 건염의 스테로이드 국소 주사 요법)

  • Kim, Jung-Man;Nam, Ho-Jin;Ra, Ki-Hang;Kang, Min-Ku
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.2 no.2
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    • pp.85-89
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    • 2009
  • Purpose: To analyze the clinical outcome after ultrasound guided multiple dry needlings and local steroid injection for acute calcific tendinitis of shoulder. Materials and Methods: Twenty patients with acute episode of pain by calcific tendinitis of shoulder with average age 58.2 (50~70 years) and follow-up of 18 months in average (range, 12~24) were included in study. There were 18 patients with right and 2 with left sided involvement. All patients had calcific deposits in the supraspinatus tendon. All patients underwent standardized nonoperative treatment protocol, consisting of 5~12 MHz high resolution ultrasound guided multiple dry needlings with 18 guage needle, followed by 2% lidocaine 1cc and 40 mg/ml depomedrol 1cc injection at site of calcific tendinitis. The outcome was assessed by UCLA shoulder score, range of motion and VAS score. A statistical analysis with ANOVA and Tukey's post-hoc test with the significance level at 5% was performed using SAS 9.1 software (SAS Institute, Cary, NC). Results: All patients got continuous relief of pain right after the procedures until final follow-up. Before the procedures, the UCLA scores were fair in 15 patients and poor in 5. After the procedures, the UCLA scores were excellent in 16 patients and good in 4. All cases revealed no limitation of shoulder function. The average VAS score decreased from 8.9 before the procedures to 0.5 at final follow-up (p<0.0001). No complication was encountered. Conclusion: An ultrasound guided local steroid injections following multiple dry needlings would be one of the useful treatment modality for the acute calcific tendinitis of shoulder.

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