- Email: [email protected]
Osteolysis of the distal end of the clavicle: A case report
J. Shoulder Elbow Surg. Volume 4, Number 1, Part 2
89
EVALUATION OF SONOGRAPHIC FINDINGS OF THE NORMAL ROTATOR CUFF OF THE SHOULDER K. Sempo,Dept. of Orthop. Surg., Kyoto Pref. Rehabi. Hosp. for the Disabled. M. Kurokawa and Y. Hirasawa, Dept. of Orthop. Surg, Kyoto Pref. Univ. of Med. The authors evaluated sonographic findings in the normal rotator cuffs and compared them with the rotator cuff tears. The subjects were 200 volunteers with normal healthy shoulders and 100 patients with rotator cuff tears. Ultrasonography was performed with a 7.5 MHz linear scanner and examined with the shape of bursal surface, the change of thickness of the cuff (The distance between the subacromial bursa and the humeral head=DSH) , echogenicity and homogeneity of the cuff layer, nonvisualization of the cuff, and irregularity of the greater tuberosity. Concaved shape of bursal surface was not shown in any case. DSH of the normal cuff was 6.2 + 0.9mm and constant under 70 years old and there was only one case with less than 4mm of DSH, but DSH was gradually decreasing over 7 0 . Echogenicity in normal rotator cuffs was lower than long head of biceps and higher than deltoid muscle and tends to get lower as aging. DSH of the normal rotator cuff was constant under 70 years, and so, DSH is useful to diagnose as massive rotator cuff tear, if DSH is less than 4mm. Low echo area is most specific finding for the rotator cuff tear, because there was no low echo area in the normal rotator cuffs. But echo-genicity of the normal cuff layer tends to get lower as aging, careful examination is necessary for diagnosis as rotator cuff tears.
Abstracts
90
$89
OSTEOLYSIS OF THE DISTAL END OF THE CLAVICLE : A CASE REPORT. A. Takayama, MD, Y. Shirai, MD, H. Ito,MD, T. Shibasaki,MD, H. Hashiguchi,MD, K. Ide,MD, F. Mizue,MD, H. Maruyama, MD, * Dept. of Orthopaedic Surgery, Nippon Medical School, Tokyo We presented a case of osteolysis of the distal clavicle which progress to osteoarthritic change in acromioclavicular joint (AC jt). A 58-year-old male carpenter had a 7 month history of right shoulder joint pain after a fall.His pain was severe in degree when protracting the shoulder girdle or climbing a ladder.Physical examination revealed tenderness over the AC jt.He had a positive horizontal test and instability of the AC jt .Plain radiograph showed osteolysis of the distal clavicle associated with acromial spur.T2weighted MRI demonstrated fluid density in the site of the AC jt. Arthrogram of the AC jt showed ballooning of the capsule.Because of persisted pain he underwent a surgery at which there was no cartilaginous disc in the A C j t and sclerotic change of the distal clavicle .About 1 cm distal clavicle and capsule including granulation tissue were resected.Acromial attachment with a bone tip of the coracoacromial ligament was transffered to the distal clavicle following by repaire of supraspinatus tendon with anterior acromioplasty.Nine months after surgery he had no pain and had to return work.
89
EVALUATION OF SONOGRAPHIC FINDINGS OF THE NORMAL ROTATOR CUFF OF THE SHOULDER K. Sempo,Dept. of Orthop. Surg., Kyoto Pref. Rehabi. Hosp. for the Disabled. M. Kurokawa and Y. Hirasawa, Dept. of Orthop. Surg, Kyoto Pref. Univ. of Med. The authors evaluated sonographic findings in the normal rotator cuffs and compared them with the rotator cuff tears. The subjects were 200 volunteers with normal healthy shoulders and 100 patients with rotator cuff tears. Ultrasonography was performed with a 7.5 MHz linear scanner and examined with the shape of bursal surface, the change of thickness of the cuff (The distance between the subacromial bursa and the humeral head=DSH) , echogenicity and homogeneity of the cuff layer, nonvisualization of the cuff, and irregularity of the greater tuberosity. Concaved shape of bursal surface was not shown in any case. DSH of the normal cuff was 6.2 + 0.9mm and constant under 70 years old and there was only one case with less than 4mm of DSH, but DSH was gradually decreasing over 7 0 . Echogenicity in normal rotator cuffs was lower than long head of biceps and higher than deltoid muscle and tends to get lower as aging. DSH of the normal rotator cuff was constant under 70 years, and so, DSH is useful to diagnose as massive rotator cuff tear, if DSH is less than 4mm. Low echo area is most specific finding for the rotator cuff tear, because there was no low echo area in the normal rotator cuffs. But echo-genicity of the normal cuff layer tends to get lower as aging, careful examination is necessary for diagnosis as rotator cuff tears.
Abstracts
90
$89
OSTEOLYSIS OF THE DISTAL END OF THE CLAVICLE : A CASE REPORT. A. Takayama, MD, Y. Shirai, MD, H. Ito,MD, T. Shibasaki,MD, H. Hashiguchi,MD, K. Ide,MD, F. Mizue,MD, H. Maruyama, MD, * Dept. of Orthopaedic Surgery, Nippon Medical School, Tokyo We presented a case of osteolysis of the distal clavicle which progress to osteoarthritic change in acromioclavicular joint (AC jt). A 58-year-old male carpenter had a 7 month history of right shoulder joint pain after a fall.His pain was severe in degree when protracting the shoulder girdle or climbing a ladder.Physical examination revealed tenderness over the AC jt.He had a positive horizontal test and instability of the AC jt .Plain radiograph showed osteolysis of the distal clavicle associated with acromial spur.T2weighted MRI demonstrated fluid density in the site of the AC jt. Arthrogram of the AC jt showed ballooning of the capsule.Because of persisted pain he underwent a surgery at which there was no cartilaginous disc in the A C j t and sclerotic change of the distal clavicle .About 1 cm distal clavicle and capsule including granulation tissue were resected.Acromial attachment with a bone tip of the coracoacromial ligament was transffered to the distal clavicle following by repaire of supraspinatus tendon with anterior acromioplasty.Nine months after surgery he had no pain and had to return work.