Ultrasound-guided hydrodilatation for adhesive capsulitis - a step-by-step guide
|
|
- Julia Malone
- 7 years ago
- Views:
Transcription
1 Ultrasound-guided hydrodilatation for adhesive capsulitis - a step-by-step guide Poster No.: C-1817 Congress: ECR 2015 Type: Educational Exhibit Authors: P. Heire, R. Braham, M. Mubashar, W. Bhatti ; Manchester/ UK, Stockport, Cheshire/UK Keywords: Musculoskeletal joint, Ultrasound, Dilation, Treatment effects, Inflammation, Dilatation DOI: /ecr2015/C-1817 Any information contained in this pdf file is automatically generated from digital material submitted to EPOS by third parties in the form of scientific presentations. References to any names, marks, products, or services of third parties or hypertext links to thirdparty sites or information are provided solely as a convenience to you and do not in any way constitute or imply ECR's endorsement, sponsorship or recommendation of the third party, information, product or service. ECR is not responsible for the content of these pages and does not make any representations regarding the content or accuracy of material in this file. As per copyright regulations, any unauthorised use of the material or parts thereof as well as commercial reproduction or multiple distribution by any traditional or electronically based reproduction/publication method ist strictly prohibited. You agree to defend, indemnify, and hold ECR harmless from and against any and all claims, damages, costs, and expenses, including attorneys' fees, arising from or related to your use of these pages. Please note: Links to movies, ppt slideshows and any other multimedia files are not available in the pdf version of presentations. Page 1 of 13
2 Learning objectives The aim of this e-poster is to describe, with the aid of images, the techniques employed in ultrasound-guided hydrodilatation of the shoulder for adhesive capsulitis at University Hospital of South Manchester. Background Adhesive capsulitis ("frozen shoulder") is a common but poorly understood disorder which causes severe pain and stiffness of the glenohumeral joint [1]. There is an incidence of 3-5% in the general population which increases to approximately 20% in diabetic patients and is one of the most common musculoskeletal disorders presenting to orthopaedic th th surgeons. Females in their 5-7 decades are most commonly affected [2]. Adhesive capsulitis is often self-limiting but can take a prolonged course lasting up to 3 years, thereby causing significant disability in affected patients [3]. Treatment options for adhesive capsulitis include analgesia, steroid injections, physiotherapy, manipulation under anaesthesia and surgical release [2]. Hydrodilatation is treatment method which involves distending the shoulder capsule using a mixture of corticosteroid, long-acting local anaesthetic and saline solution. This procedure has been shown to provide improved relief from symptoms with long term effects up to 2 years [4] without risks of anaesthesia or surgery. Hydrodilatation may be performed under fluoroscopic or ultrasound guidance and both methods have comparable outcomes. However, ultrasound-guided hydrodilatation avoids the use of ionizing radiation, is quicker, cheaper and allows assessment of the rotator cuff muscles [5]. At our institution hydrodilatation of the shoulder is routinely performed under ultrasound rather than fluoroscopy for these reasons. Findings and procedure details A standard ultrasound assessment of the shoulder and rotator cuff is performed first to eliminate the presence of a rotator cuff tear. If no other cause for shoulder pain is identified then hydrodilatation is undertaken. Informed consent is obtained and the risk of complications including pain, infection and bleeding are explained and documented in the final report. It is explained that the relief of symptoms could be variable from complete Page 2 of 13
3 resolution to no relief and this could be temporary or permanent. The equipment required is listed below (figure 1). Fig. 1: Equipment required to perform ultrasound-guided hydrodilatation. References: University Hospital South Manchester - Manchester/UK 1. Orange needle 2. Pink drawing needle 3. Long green needle 4. 5ml syringe 5. 10ml syringe 6. 3x10ml prepacked normal saline syringes 7. Extension set and 3 way stopcock Page 3 of 13
4 8. Sterile drape 9. Probe cover 10. Sterile gel 11. Sterile pack with sterile gloves 12. Antiseptic cleaning stick ml 1% lignocaine ml of 0.5% marcaine mg/1ml Kenalog 16. Adhesive dressing 17. Ultrasound machine with 9 and 14MHz probes Anterior and posterior approaches are possible in hydrodilatation but a posterior approach is preferred at our institution. For the posterior approach, patient lies in lateral position, with the symptomatic shoulder superior and the couch inclination adjusted to ensure patient and operator comfort (figures 2 and 3). Page 4 of 13
5 Fig. 2: The lateral position required for hydrodilatation of the right shoulder. References: University Hospital South Manchester - Manchester/UK Page 5 of 13
6 Fig. 3: Images showing the position of the needle and ultrasound probe required for hydrodilatation of the right shoulder. References: University Hospital South Manchester - Manchester/UK The skin, subcutaneous tissues and deeper tissues are infiltrated with lignocaine along the line of the needle tract. The ultrasound guidance is used to enter the glenohumeral joint and confirm intraarticular position by visualisation the "flow artefact" (figures 4 and 5). Fig. 4: The left hand image shows the position of the needle which should be visualised during the procedure. Annotations have been added on the right hand image. The red dashed line shows the path of the needle which should not be advanced too far once the capsule is entered in order to avoid damage to the glenoid labrum. The green dashed line shows the region along the humeral head which should be targeted with the needle in order to administer safe intra-articular injection. References: University Hospital South Manchester - Manchester/UK Page 6 of 13
7 Fig. 5: This video shows the appearance of the "flow artefact" which confirms the intraarticular position of the needle during injection. References: University Hospital South Manchester - Manchester/UK The needle should be mildly oblique or perpendicular to the ultrasound waves (if possible) in order to be able to visualise the needle under ultrasound. The needle should not be advanced too far into the glenohumeral joint to reduce the risk of injury to the glenoid labrum. The 3-way stopcock with extensor set is flushed with saline, attached to the needle and injection of the steroid and marcaine is given, followed by gentle insufflation of normal saline solution until a pop is felt or 30ml-40ml has been introduced. Typically, the joint capsule is seen to distend as showin in figure 6. Page 7 of 13
8 Fig. 6: Distention of the glenohumeral joint with saline solution. References: University Hospital South Manchester - Manchester/UK The 3-way stopcock enables high pressures to be maintained within the joint capsule during the procedure. The injection is monitored under ultrasound as the joint becomes progressively distended, at which point there may or may not be capsular rupture, demonstrated by sudden collapse of the distended joint. The procedure may be stopped before this if the patient is experiencing severe pain. At this point the needle is removed and an adhesive dressing applied to the needle site. Patients are requested to refrain from physical exertion for the next 48 hours but should then attend early and intensive physiotherapy. The importance of physiotherapy is stressed to patients as it has been shown that combining physiotherapy with hydrodilatation significantly improves long term outcome [4]. Images for this section: Page 8 of 13
9 Fig. 1: Equipment required to perform ultrasound-guided hydrodilatation. Page 9 of 13
10 Fig. 2: The lateral position required for hydrodilatation of the right shoulder. Fig. 3: Images showing the position of the needle and ultrasound probe required for hydrodilatation of the right shoulder. Page 10 of 13
11 Fig. 4: The left hand image shows the position of the needle which should be visualised during the procedure. Annotations have been added on the right hand image. The red dashed line shows the path of the needle which should not be advanced too far once the capsule is entered in order to avoid damage to the glenoid labrum. The green dashed line shows the region along the humeral head which should be targeted with the needle in order to administer safe intra-articular injection. Page 11 of 13
12 Fig. 5: This video shows the appearance of the "flow artefact" which confirms the intraarticular position of the needle during injection. Fig. 6: Distention of the glenohumeral joint with saline solution. Page 12 of 13
13 Conclusion Ultrasound-guided hydrodilatation is a new, safe and effective treatment option for frozen shoulder and we have detailed the technique used at our institution. It has been shown to be superior to manipulation under anaesthesia with respect to range of movement up to 6 months, and does not carry the risks of anaesthetic or proximal humeral fracture [6], making this procedure attractive for clinicians and patients alike. Hydrodilatation is becoming an increasingly used first line treatment option for frozen shoulder and is gaining popularity among physical therapists, musculoskeletal radiologists and shoulder surgeons. At our institution fluoroscopic guided hydrodilatation has been very successfull with audited benefit in pain reduction and improved range of movement in up to 90% and 70% of patients respectively. We are currently in the process of auditing the outcomes of our ultrasound-guided hydrodilatation procedure but are seeing similar results to the fluroscopic group, without ionizing radiation or the risk of adverse contrast reactions. Ultrasound-guided hydrodilatation also seems better tolerated by patients than when using fluoroscopy. Personal information References Idiopathic adhesive capsulitis. A Prospective Functional Outcome Study of Non-operative Treatment. Griggs S, Ahn A, Green A. J Bone Joint Surg Am. Oct (10); Diagnosis and Management of Adhesive Capsulitis. Manske R, Prohaska D. Curr Rev Musculoskelet Med. Dec 2008; 1(3-4): Brief note. The natural history of "idiopathic" frozen shoulder. Grey, R. G. J. Bone and Joint, June 1978; Surg., 60-A: 564. Hydrodilatation (distension arthrography): a long#term clinical outcome series. Watson L, Bialocerkowski A, Dalziel R, Balster S, Burke F, Finch C. Br J Sports Med. Mar 2007; 41(3): Comparison of Sono-guided Capsular Distension with Fluoroscopically Capsular Distension in Adhesive Capsulitis of Shoulder; Park K, Nam H, Kim T, Kang S, Lim M, Park Y. (2012). Ann Rehabil Med.36; Thawing the frozen shoulder; A randomised trial comparing manipulation under anaesthesia with hydrodilatation. Quraishi N, Johnston P, Bayer J,Crowe M, Chakrabarti A. J Bone Joint Surg [Br]; 2007; 89-B, Page 13 of 13
CT findings in Differential Diagnosis between Tuberculous Pleurisy and Malignant Effusion
CT findings in Differential Diagnosis between Tuberculous Pleurisy and Malignant Effusion Poster No.: E-0084 Congress: ESTI 2012 Type: Scientific Exhibit Authors: S. S. Shim, Y. Kim; Seoul/KR Keywords:
More informationOA related pain medication intake in subjects from the OAI incidence cohort - association with focal knee lesions and cartilage T2 measurements
OA related pain medication intake in subjects from the OAI incidence cohort - association with focal knee lesions and cartilage T2 measurements Poster No.: C-0007 Congress: ECR 2012 Type: Scientific Exhibit
More informationAn Image Based Semiautomatic Online Cancer Staging Program for Common Female Pelvic Malignancies
An Image Based Semiautomatic Online Cancer Staging Program for Common Female Pelvic Malignancies Poster No.: C-1050 Congress: ECR 2012 Type: Educational Exhibit Authors: R. Talanow; Lexington, KY/US Keywords:
More informationUtilization management for successful process optimization in radiology
Utilization management for successful process optimization in radiology Poster No.: C-0737 Congress: ECR 2011 Type: Scientific Paper Authors: H.-P. Busch 1, W. Frewer 1, A. van Est 2 ; 1 Trier/DE, 2 Eindhoven/NL
More informationAcute abdominal pain in the elderly patient: Impact of early MDCT examination on diagnosis and management
Acute abdominal pain in the elderly patient: Impact of early MDCT examination on diagnosis and management Poster No.: C-1464 Congress: ECR 2010 Type: Topic: Scientific Exhibit GI Tract Authors: A. Pinto,
More informationMRI scanning of the claustrophobic patients
MRI scanning of the claustrophobic patients Poster No.: C-0549 Congress: ECR 2014 Type: Educational Exhibit Authors: M. minov, A. Doreski, M. Popovska, G. Markoski, S. 1 2 3 2 2 1 2 2 3 Jovanoska, I. miladinovski
More informationCONSENT FOR STEROID INJECTION
CONSENT FOR STEROID INJECTION What is Cortisone? Cortisone is the name used to describe a group of drugs correctly known as corticosteroids. Cortisone is used to treat pain in various parts of the body
More informationDetermination of bone age using MRI of hand/wrist: a pilot study
Determination of bone age using MRI of hand/wrist: a pilot study Poster No.: C-0963 Congress: ECR 2011 Type: Scientific Exhibit Authors: E. Tomei, M. Marini, A. Stagnitti, A. sartori, L. bertana, N. Al
More informationEye lens dose measurements in Interventional Cardiology
Eye lens dose measurements in Interventional Cardiology Poster No.: 479 Congress: ESCR 2014 Type: Scientific Poster Authors: N. Kollaros 1, E. Carinou 2, C. Plemmenos 1, I. Stathopoulos 1, V. Keywords:
More informationNeedle crystal detector technology in mammography further dose reduction and clinical image quality with
Needle crystal detector technology in mammography further dose reduction and clinical image quality with different beam qualities (W/Rh vs. Mo/Rh) Poster No.: C-1461 Congress: ECR 2013 Type: Scientific
More informationPatterns of nodal spread in thoracic malignancies
Patterns of nodal spread in thoracic malignancies Poster No.: C-0977 Congress: ECR 2010 Type: Educational Exhibit Topic: Chest Authors: R. dos Santos, M. Duarte, J. Alpendre, J. Castaño, Z. Seabra, Â.
More informationComparison of radiation dose from X-ray, CT, and PET/ CT in paediatric patients with neuroblastoma using a dose monitoring program
Comparison of radiation dose from X-ray, CT, and PET/ CT in paediatric patients with neuroblastoma using a dose monitoring program Poster No.: C-0591 Congress: ECR 2015 Type: Authors: Keywords: DOI: Scientific
More informationDiffuse infiltration in multiple myeloma treatment response assessment with "total-spine" contrast enhanced MR imaging
Diffuse infiltration in multiple myeloma treatment response assessment with "total-spine" contrast enhanced MR imaging Poster No.: C-0276 Congress: ECR 2011 Type: Scientific Paper Authors: P. P. Arcuri,
More informationPreoperative evaluation of future remnant liver function by the contrast enhance ratio in hepatocellular image.
Preoperative evaluation of future remnant liver function by the contrast enhance ratio in hepatocellular image. Poster No.: C-0564 Congress: ECR 2011 Type: Scientific Exhibit Authors: S. Matsushima, Y.
More informationRole of 3D volumetry CT in the correlation between postoperative gastric volume and weight loss in obese patients undergoing gastric sleeve surgery.
Role of 3D volumetry CT in the correlation between postoperative gastric volume and weight loss in obese patients undergoing gastric sleeve surgery. Poster No.: C-2145 Congress: ECR 2014 Type: Scientific
More informationNormal vascular variants of the upper extremity
Normal vascular variants of the upper extremity Poster No.: C-1039 Congress: ECR 2014 Type: Educational Exhibit Authors: P. Paixao, A. P. Gomes, M. S. C. Sousa, I. Santiago, A. S. C. C. Germano; Amadora/PT
More informationDevelopment and implementation of a help desk system in a radiology department in a high complexity hospital: a South American experience
Development and implementation of a help desk system in a radiology department in a high complexity hospital: a South American experience Poster No.: C-2409 Congress: ECR 2013 Type: Authors: Keywords:
More informationMusculoskeletal: Acute Lower Back Pain
Musculoskeletal: Acute Lower Back Pain Acute Lower Back Pain Back Pain only Sciatica / Radiculopathy Possible Cord or Cauda Equina Compression Possible Spinal Canal Stenosis Red Flags Initial conservative
More informationAngio-CT preoperative planning of inferior limb free flaps in plastic surgery
Angio-CT preoperative planning of inferior limb free flaps in plastic surgery Poster No.: C-3046 Congress: ECR 2010 Type: Educational Exhibit Topic: Vascular Authors: L. Saba, M. Atzeni, D. Ribuffo, G.
More information1 of 6 1/22/2015 10:06 AM
1 of 6 1/22/2015 10:06 AM 2 of 6 1/22/2015 10:06 AM This cross-section view of the shoulder socket shows a typical SLAP tear. Injuries to the superior labrum can be caused by acute trauma or by repetitive
More informationPancreatic masses: What is there besides cancer
Pancreatic masses: What is there besides cancer Poster No.: C-0201 Congress: ECR 2010 Type: Educational Exhibit Topic: Abdominal Viscera (Solid Organs) Authors: M. A. Portilha, C. Ruivo, I. Santiago, M.
More informationDr. Benjamin Hewitt. Shoulder Stabilisation
Please contactmethroughthegoldcoasthospitaswityouhaveanyproblemsafteryoursurgery. Dr. Benjamin Hewitt Orthopaedic Surgeon Shoulder Stabilisation The shoulder is the most flexible joint in the body, allowing
More informationJ F de Beer, K van Rooyen, F Lam, D Bhatia FROZEN SHOULDER
J F de Beer, K van Rooyen, F Lam, D Bhatia FROZEN SHOULDER Frozen Shoulder is a condition with no known cause in the majority of cases, with spontaneous onset. It is most common in females (40-50 years)
More informationMetastatic malignant melanoma revisited
Metastatic malignant melanoma revisited Poster No.: C-2446 Congress: ECR 2010 Type: Educational Exhibit Topic: Musculoskeletal Authors: C. Paulino, B. Gonçalves, P. Marques, M. Gonçalo, F. CaseiroAlves;
More informationShoulder Arthroscopy
Copyright 2011 American Academy of Orthopaedic Surgeons Shoulder Arthroscopy Arthroscopy is a procedure that orthopaedic surgeons use to inspect, diagnose, and repair problems inside a joint. The word
More informationShoulder Impingement/Rotator Cuff Tendinitis
Copyright 2011 American Academy of Orthopaedic Surgeons Shoulder Impingement/Rotator Cuff Tendinitis One of the most common physical complaints is shoulder pain. Your shoulder is made up of several joints
More informationFrozen shoulder (adhesive capsulitis)
Patient information Frozen shoulder (adhesive capsulitis) This information has been produced to help you gain the maximum benefit and understanding of your operation. It includes the following information:
More informationThe Role of Acupuncture with Electrostimulation in the Prozen Shoulder
The Role of Acupuncture with Electrostimulation in the Prozen Shoulder Yu-Te Lee A. Aim To evaluate the efficacy of acupuncture with electrostimulation in conjunction with physical therapy in improving
More informationDICOM metadata-mining in PACS for computed radiography X-Ray exposure analysis: a mammography multisite study
DICOM metadata-mining in PACS for computed radiography X-Ray exposure analysis: a mammography multisite study Poster No.: B-0276 Congress: ECR 2014 Type: Authors: Keywords: DOI: Scientific Paper M. R.
More informationArthroscopic rotator cuff repair
Arthroscopic rotator cuff repair The aim of this leaflet is to help answer some of the questions you may have about having an arthroscopic rotator cuff repair. It explains the benefits, risks and alternatives
More informationARTHROSCOPIC (KEY-HOLE) SHOULDER SURGERY
ARTHROSCOPIC (KEY-HOLE) SHOULDER SURGERY Information Leaflet Your Health. Our Priority. Page 2 of 8 What is arthroscopic ( key-hole ) surgery? Key-hole surgery is the technique of performing surgery though
More informationA Simplified Approach to Common Shoulder Problems
A Simplified Approach to Common Shoulder Problems Objectives: Understand the basic categories of common shoulder problems. Understand the common patient symptoms. Understand the basic exam findings. Understand
More information.org. Shoulder Pain and Common Shoulder Problems. Anatomy. Cause
Shoulder Pain and Common Shoulder Problems Page ( 1 ) What most people call the shoulder is really several joints that combine with tendons and muscles to allow a wide range of motion in the arm from scratching
More informationArthroscopic subacromial decompression and rotator cuff repair
Further sources of information http://www.patient.co.uk/showdoc/553/ http://www.shoulderdoc.co.uk/article.asp?section=11 http://www.medic8.com/healthguide/articles/painfulshoulder.html http://www.cks.nhs.uk/patientinformationleaflet/shoulderpainarc/st
More information.org. Posterior Tibial Tendon Dysfunction. Anatomy. Cause. Symptoms
Posterior Tibial Tendon Dysfunction Page ( 1 ) Posterior tibial tendon dysfunction is one of the most common problems of the foot and ankle. It occurs when the posterior tibial tendon becomes inflamed
More informationBankart Repair using the Smith & Nephew BIORAPTOR 2.9 Suture Anchor
Shoulder Series Technique Guide *smith&nephew BIORAPTOR 2.9 Suture Anchor Bankart Repair using the Smith & Nephew BIORAPTOR 2.9 Suture Anchor Gary M. Gartsman, M.D. Introduction Arthroscopic studies of
More informationTOWN CENTER ORTHOPAEDIC ASSOCIATES P.C. Labral Tears
Labral Tears The shoulder is your body s most flexible joint. It is designed to let the arm move in almost any direction. But this flexibility has a price, making the joint prone to injury. The shoulder
More informationNerve Blocks. What is a Nerve Block? What are some common uses of the procedure?
Scan for mobile link. Nerve Blocks A nerve block is an injection to decrease inflammation or "turn off" a pain signal along a specific distribution of nerve. Imaging guidance may be used to place the needle
More informationTibial Intramedullary Nailing
Tibial Intramedullary Nailing Turnberg Building Orthopaedics 0161 206 4898 All Rights Reserved 2015. Document for issue as handout. Procedure The tibia is the long shin bone in the lower leg. It is a weight
More information.org. Rotator Cuff Tears: Surgical Treatment Options. When Rotator Cuff Surgery is Recommended. Surgical Repair Options
Rotator Cuff Tears: Surgical Treatment Options Page ( 1 ) The following article provides in-depth information about surgical treatment for rotator cuff injuries, and is a continuation of the article Rotator
More informationUltrasound-guided steroid injections in joints and soft tissues. Rheumatology Patient Information Leaflet
Ultrasound-guided steroid injections in joints and soft tissues Rheumatology Patient Information Leaflet Welcome to The Dudley Group Rheumatology department. This leaflet will provide you with information
More informationArthritis of the Shoulder
Arthritis of the Shoulder In 2011, more than 50 million people in the United States reported that they had been diagnosed with some form of arthritis, according to the National Health Interview Survey.
More informationRehabilitation Guidelines for Post-Operative Stiff Shoulder
Rehabilitation Guidelines for Post-Operative Stiff Shoulder Please note that this is advisory information only. Your experiences may differ from those described. A fully qualified Physiotherapist must
More informationComparison between photoacoustic mammography images of breasts cancers and histological staining patterns of CD31 and carbonic anhydrase IX
Comparison between photoacoustic mammography images of breasts cancers and histological staining patterns of CD31 and carbonic anhydrase IX Poster No.: C-1893 Congress: ECR 2013 Type: Scientific Exhibit
More informationArthroscopic shoulder stabilisation. Patient Information to be retained by patient
PLEASE PRINT WHOLE FORM DOUBLE SIDED ON YELLOW PAPER Patient Information to be retained by patient affix patient label Shoulder instability The shoulder is the most common joint in the body to dislocate.
More informationOPERATION:... Proximal tibial osteotomy Distal femoral osteotomy
AFFIX PATIENT DETAIL STICKER HERE Forename.. Surname NHS Organisation. Responsible surgeon. Job Title Hospital Number... D.O.B.././ No special requirements OPERATION:..... Proximal tibial osteotomy Distal
More informationOrthopaedic Spine Center. Anterior Cervical Discectomy and Fusion (ACDF) Normal Discs
Orthopaedic Spine Center Graham Calvert MD James Woodall MD PhD Anterior Cervical Discectomy and Fusion (ACDF) Normal Discs The cervical spine consists of the bony vertebrae, discs, nerves and other structures.
More informationX-Plain Subclavian Inserted Central Catheter (SICC Line) Reference Summary
X-Plain Subclavian Inserted Central Catheter (SICC Line) Reference Summary Introduction A Subclavian Inserted Central Catheter, or subclavian line, is a long thin hollow tube inserted in a vein under the
More informationShoulder Capsular Release
Shoulder Capsular Release An information guide for patients Delivering the best in care UHB is a no smoking Trust To see all of our current patient information leaflets please visit www.uhb.nhs.uk/patient-information-leaflets.htm
More informationShoulder Instability. Fig 1: Intact labrum and biceps tendon
Shoulder Instability What is it? The shoulder joint is a ball and socket joint, with the humeral head (upper arm bone) as the ball and the glenoid as the socket. The glenoid (socket) is a shallow bone
More informationJ F de Beer, K van Rooyen, D Bhatia. Rotator Cuff Tears
1 J F de Beer, K van Rooyen, D Bhatia Rotator Cuff Tears Anatomy The shoulder consists of a ball (humeral head) and a socket (glenoid). The muscles around the shoulder act to elevate the arm. The large
More informationLabral Repair Book. Dr. Allan Hunt. 2855 Campus Drive Suite 300 Plymouth, MN 55441. 4010 W 65 th St Edina, MN 55435. www.tcomn.com
Labral Repair Book Dr. Allan Hunt 4010 W 65 th St Edina, MN 55435 2855 Campus Drive Suite 300 Plymouth, MN 55441 www.tcomn.com Normal shoulder function The shoulder is the most flexible joint in the body,
More informationTemple Physical Therapy
Temple Physical Therapy A General Overview of Common Neck Injuries For current information on Temple Physical Therapy related news and for a healthy and safe return to work, sport and recreation Like Us
More information.org. Plantar Fasciitis and Bone Spurs. Anatomy. Cause
Plantar Fasciitis and Bone Spurs Page ( 1 ) Plantar fasciitis (fashee-eye-tiss) is the most common cause of pain on the bottom of the heel. Approximately 2 million patients are treated for this condition
More informationSHOULDER INSTABILITY. E. Edward Khalfayan, MD
SHOULDER INSTABILITY E. Edward Khalfayan, MD Instability of the shoulder can occur from a single injury or as the result of repetitive activity such as overhead sports. Dislocations of the shoulder are
More informationPercutaneous Abscess Drainage
Scan for mobile link. Percutaneous Abscess Drainage An abscess is an infected fluid collection within the body. Percutaneous abscess drainage uses imaging guidance to place a thin needle through the skin
More information.org. Achilles Tendinitis. Description. Cause. Achilles tendinitis is a common condition that causes pain along the back of the leg near the heel.
Achilles Tendinitis Page ( 1 ) Achilles tendinitis is a common condition that causes pain along the back of the leg near the heel. The Achilles tendon is the largest tendon in the body. It connects your
More informationDr Doron Sher MB.BS. MBiomedE, FRACS(Orth)
Dr Doron Sher MB.BS. MBiomedE, FRACS(Orth) Knee, Shoulder, Elbow Surgery PATIENT NOTES ARTHROSCOPIC SHOULDER SURGERY I have suggested that you consider an Arthroscopic procedure to assess and treat your
More informationAdult Forearm Fractures
Adult Forearm Fractures Your forearm is made up of two bones, the radius and ulna. In most cases of adult forearm fractures, both bones are broken. Fractures of the forearm can occur near the wrist at
More informationFROZEN SHOULDER OXFORD SHOULDER & ELBOW CLINIC INFORMATION FOR YOU. Frozen Shoulder FROZEN SHOULDER
OXFORD SHOULDER & ELBOW CLINIC INFORMATION FOR YOU Frozen Shoulder The aim of this information sheet is to give you some understanding of the problem you may have with your shoulder. It has been divided
More information.org. Rotator Cuff Tears. Anatomy. Description
Rotator Cuff Tears Page ( 1 ) A rotator cuff tear is a common cause of pain and disability among adults. In 2008, close to 2 million people in the United States went to their doctors because of a rotator
More informationKinesio Taping for a Frozen Shoulder
Kinesio Taping for a Frozen Shoulder What is a Frozen Shoulder? Also know as adhesive capsulitis is a chronic inflammation in the musculotendinous or synovial tissue such as the rotator cuff, biceps tendon,
More informationTreatment Options for Rotator Cuff Tears A Guide for Adults
Treatment Options for Rotator Cuff Tears A Guide for Adults Is This Guide for Me? YES, if your doctor has told you that you have a rotator cuff tear, which is an injury to one or more of the muscles and
More informationElbow Injuries and Disorders
Elbow Injuries and Disorders Introduction Your elbow joint is made up of bone, cartilage, ligaments and fluid. Muscles and tendons help the elbow joint move. There are many injuries and disorders that
More informationA Patient s Guide to Arthritis of the Big Toe (Hallux Rigidus) With Discussion on Cheilectomy and Fusion
A Patient s Guide to Arthritis of the Big Toe (Hallux Rigidus) With Discussion on Cheilectomy and Fusion The foot and ankle unit at the Royal National Orthopaedic Hospital (RNOH) is a multi-disciplinary
More informationImage-guided abdominal drain insertion Information for patients
Oxford University Hospitals NHS Trust Image-guided abdominal drain insertion Information for patients What is an image-guided abdominal drain insertion? A drain is a thin plastic tube which is inserted
More informationInternal Impingement in the Overhead Athlete: A Correlation of Findings on MRI and Arthroscopic Evaluation
Internal Impingement in the Overhead Athlete: A Correlation of Findings on MRI and Arthroscopic Evaluation Lee D Kaplan, MD J Towers, MD PJ McMahon, MD CH Harner,, MD RW Rodosky,, MD Thrower s shoulder
More informationSHOULDER INSTABILITY IN PATIENTS WITH EDS
EDNF 2012 CONFERENCE LIVING WITH EDS SHOULDER INSTABILITY IN PATIENTS WITH EDS Keith Kenter, MD Associate Professor Sports Medicine & Shoulder Reconstruction Director, Orthopaedic Residency Program Department
More informationArthroscopic Shoulder Procedures. David C. Neuschwander MD. Shoulder Instability. Allegheny Health Network Orthopedic Associates of Pittsburgh
Arthroscopic Shoulder Procedures David C. Neuschwander MD Allegheny Health Network Orthopedic Associates of Pittsburgh Shoulder Instability Anterior Instability Posterior Instability Glenohumeral Joint
More informationSLAP repair. An information guide for patients. Delivering the best in care. UHB is a no smoking Trust
SLAP repair An information guide for patients Delivering the best in care UHB is a no smoking Trust To see all of our current patient information leaflets please visit www.uhb.nhs.uk/patient-information-leaflets.htm
More informationSTANDARDIZED PROCEDURE BONE MARROW ASPIRATION
I. Definition: This protocol covers the task of bone marrow aspiration by an Allied Health Professional. The purpose of this standardized procedure is to allow the Allied Health Professional to safely
More informationX-ray (Radiography) - Bone
Scan for mobile link. X-ray (Radiography) - Bone Bone x-ray uses a very small dose of ionizing radiation to produce pictures of any bone in the body. It is commonly used to diagnose fractured bones or
More informationHand and Upper Extremity Injuries in Outdoor Activities. John A. Schneider, M.D.
Hand and Upper Extremity Injuries in Outdoor Activities John A. Schneider, M.D. Biographical Sketch Dr. Schneider is an orthopedic surgeon that specializes in the treatment of hand and upper extremity
More informationShoulder stabilisation surgery. Information for patients Orthopaedics
Shoulder stabilisation surgery Information for patients Orthopaedics page 2 of 20 Introduction The upper limb unit team wants you and your family to understand as much as possible about the operation you
More informationSHOULDER ACROMIOPLASTY/ SHOULDER DECOMPRESSION
ORTHOPAEDIC WARD: 01-293 8687 /01-293 6602 BEACON CENTRE FOR ORTHOPAEDICS: 01-2937575 PHYSIOTHERAPY DEPARTMENT: 01-2936692 GUIDELINES FOR PATIENTS HAVING A SHOULDER ACROMIOPLASTY/ SHOULDER DECOMPRESSION
More informationARTHROSCOPIC HIP SURGERY
ARTHROSCOPIC HIP SURGERY Hip Arthroscopy is a relatively simple procedure whereby common disorders of the hip can be diagnosed and treated using keyhole surgery. Some conditions, which previously were
More informationAcute Low Back Pain. North American Spine Society Public Education Series
Acute Low Back Pain North American Spine Society Public Education Series What Is Acute Low Back Pain? Acute low back pain (LBP) is defined as low back pain present for up to six weeks. It may be experienced
More informationHerniated Cervical Disc
Herniated Cervical Disc North American Spine Society Public Education Series What Is a Herniated Disc? The backbone, or spine, is composed of a series of connected bones called vertebrae. The vertebrae
More informationRotator Cuff Pathophysiology. treatment program that will effectively treat it. The tricky part about the shoulder is that it is a ball and
Rotator Cuff Pathophysiology Shoulder injuries occur to most people at least once in their life. This highly mobile and versatile joint is one of the most common reasons people visit their health care
More informationSHOULDER INJECTIONS. Joe de Beer, Karin vanrooyen, Deepak N Bhatia
SHOULDER INJECTIONS Joe de Beer, Karin vanrooyen, Deepak N Bhatia Introduction: Injections around the shoulder joint are necessary for diagnostic and therapeutic reasons in the course of evaluation of
More informationMini Medical School _ Focus on Orthopaedics
from The Cleveland Clinic Mini Medical School _ Focus on Orthopaedics Arthritis of the Shoulder: Treatment Options Joseph P. Iannotti MD, PhD Professor and Chairman, Department of Orthopaedic Surgery The
More informationAbdominal CT Perfusion: Effects of Breath Control Technique
Abdominal CT Perfusion: Effects of Breath Control Technique Poster No.: C-0068 Congress: ECR 2014 Type: Scientific Exhibit Authors: T. Yoshikawa, T. Kanda, Y. Ohno, Y. Fujisawa, N. Negi, M. 1 1 2 1 1 1
More information28% have partial tear of the rotator cuff.
ROTATOR CUFF TENDON RUPTURE Anatomy: 1. Rotator cuff consists of: Subscapularis anteriorly, Supraspinatus superiorly and Infraspinatus and Teres minor posteriorly. 2 Biceps tendon is present in the rotator
More informationRotator Cuff Tear: When to Repair and When to Smooth and Move the Shoulder
Rotator Cuff Tear: When to Repair and When to Smooth and Move the Shoulder Summary Overview: The rotator cuff is the most commonly torn structure in the shoulder. Rotator cuff tears usually produce symptoms
More informationTotal knee replacement
Patient Information to be retained by patient What is a total knee replacement? In a total knee replacement the cartilage surfaces of the thigh bone (femur) and leg bone (tibia) are replaced. The cartilage
More informationTreatment Guide Wave Goodbye to Shoulder Pain
Treatment Guide Wave Goodbye to Shoulder Pain Shoulder pain and injuries are extremely common whether due to exercise, age, overuse injuries or trauma. In fact, they account for nearly 20 percent of visits
More informationTotal Shoulder Arthroplasty
Specialists in Joint Replacement, Spinal Surgery, Orthopaedics and Sport Injuries Total Shoulder Arthroplasty Ms. Ruth Delaney Consultant Orthopaedic Surgeon www.sportssurgeryclinic.com Introduction Arthritis
More informationEnhanced recovery programme after TKA through multi-disciplinary collaboration
Enhanced recovery programme after TKA through multi-disciplinary collaboration ChanPK(1), ChiuKY(1), FungYK(6), YeungSS(7), NgT(8), ChanMT(5), LamR(4), WongNY(3), ChoiYY(3), ChanCW(2), NgFY(1), YanCH(1)
More informationArthroscopy of the Hip
Arthroscopy of the Hip Professor Ernest Schilders FRCS, FFSEM Consultant Orthopaedic Surgeon Specialist in Shoulder and Hip Arthroscopy, Groin and Sports Injuries Private consulting rooms The London Hip
More informationShouldering the Burden
Shouldering the Burden Wheelchair Athletes and Shoulder Injuries Dr. Julia Alleyne BHSc(PT) MD MScCH Dip Sport Med CMO, 2015 Parapan Games, Toronto Faculty/Presenter Disclosure Faculty: Dr. Julia Alleyne
More informationClinical bottom line. For more detailed evidence on the effectiveness of injections for tennis elbow, please see the CAT on:
Short Question: Specific Question: In patients presenting with acute or chronic tendinopathies, what is the incidence of harm for those receiving steroid injections compared to those receiving usual care?
More informationNotice of Independent Review Decision DESCRIPTION OF THE SERVICE OR SERVICES IN DISPUTE:
Notice of Independent Review Decision DATE OF REVIEW: 12/10/10 IRO CASE #: NAME: DESCRIPTION OF THE SERVICE OR SERVICES IN DISPUTE: Determine the appropriateness of the previously denied request for right
More informationA Patient s Guide to Shoulder Pain
A Patient s Guide to Shoulder Pain Part 2 Evaluating the Patient James T. Mazzara, M.D. Shoulder and Elbow Surgery Sports Medicine Occupational Orthopedics Patient Education Disclaimer This presentation
More informationA Patient s Guide to Post-Operative Physiotherapy. Following Anterior Cruciate Ligament Reconstruction of the Knee
A Patient s Guide to Post-Operative Physiotherapy Following Anterior Cruciate Ligament Reconstruction of the Knee Introduction The anterior cruciate ligament (ACL) is one of the main supporting ligaments
More informationMusculoskeletal System
CHAPTER 3 Impact of SCI on the Musculoskeletal System Voluntary movement of the body is dependent on a number of systems. These include: The brain initiates the movement and receives feedback to assess
More informationAdministration of Medications & Fluids via a Peripheral Intravenous Cannula
Administration of Medications & Fluids via a Peripheral Intravenous Cannula Clinical S.O.P. No.: 22.0 Compiled by: Approved by: Review date: November 2016 Administration of Medications & Fluids via S.O.P.
More information.org. Distal Radius Fracture (Broken Wrist) Description. Cause
Distal Radius Fracture (Broken Wrist) Page ( 1 ) The radius is the larger of the two bones of the forearm. The end toward the wrist is called the distal end. A fracture of the distal radius occurs when
More information.org. Clavicle Fracture (Broken Collarbone) Anatomy. Description. Cause. Symptoms
Clavicle Fracture (Broken Collarbone) Page ( 1 ) A broken collarbone is also known as a clavicle fracture. This is a very common fracture that occurs in people of all ages. Anatomy The collarbone (clavicle)
More informationCase Series on Chronic Whiplash Related Neck Pain Treated with Intraarticular Zygapophysial Joint Regeneration Injection Therapy
Pain Physician 2007; 10:313-318 ISSN 1533-3159 Case Series Case Series on Chronic Whiplash Related Neck Pain Treated with Intraarticular Zygapophysial Joint Regeneration Injection Therapy R. Allen Hooper
More informationHerniated Lumbar Disc
Herniated Lumbar Disc North American Spine Society Public Education Series What Is a Herniated Disc? The spine is made up of a series of connected bones called vertebrae. The disc is a combination of strong
More information