AIM To systematically search literature and determine a preferable surgical procedure in patients with failed conservative treatment of calcifying tendinitis of the shoulder.METHODS The electronic online databases MED...AIM To systematically search literature and determine a preferable surgical procedure in patients with failed conservative treatment of calcifying tendinitis of the shoulder.METHODS The electronic online databases MEDLINE(through PubMed), EMBASE(through OVID), CINAHL(through EBSCO), Web of Science and Cochrane Central Register of Controlled Trials were systematically searched in May 2016. Eligible for inclusion were all available studies with level Ⅱ and level Ⅲ evidence(LoE). Data was assessed and extracted by two independent review authors using a specifically for this study designed data extraction form.RESULTS Six studies(294 surgically treated shoulders) were included in this review. No significant differences between the three available treatment options(acromioplasty with the removal of the calcific deposits, acromioplasty or solely the removal of the calcific deposits) were detected regarding the functional and clinical outcome. The followup ranged from 12 mo to 5 years. Complication rates were low. No reoperations were necessary and the only reported complication was adhesive capsulitis, which in all cases could be treated conservatively with full recovery. CONCLUSION We found that all three available treatment options show good functional and clinical outcomes in the short and midterm. However, a favorable procedure is difficult to determine due to the lack of high-quality comparing studies.展开更多
背景:大量的研究发现雌激素与肌腱病具有一定的相关性,但长期以来雌激素在肌腱病中的实验研究成果与总结较少,不方便专科从业者及相关领域学者全面了解研究近况。目的:综述目前临床或临床前原始研究,以期对雌激素在肌腱病中的作用进行总...背景:大量的研究发现雌激素与肌腱病具有一定的相关性,但长期以来雌激素在肌腱病中的实验研究成果与总结较少,不方便专科从业者及相关领域学者全面了解研究近况。目的:综述目前临床或临床前原始研究,以期对雌激素在肌腱病中的作用进行总结,并对未来雌激素在肌腱病中的评估和管理进行一定的展望。方法:通过计算机对PubMed、Web of Science、中国知网、万方和维普数据库中的相关文献进行检索。检索时间为2008年1月至2023年9月,英文检索词为“Oestrogen,Estrogen,Estrogen receptor,Tendinopathy,Tendonopathy,Sinew,Tendon,Tendons,Myotenositis”;中文检索词为“雌激素,雌激素受体,肌腱病,肌腱,肌腱炎”。依据入选标准对检索结果进行筛选排除,最终纳入60篇文献进行综述分析。结果与结论:①体内研究表明,雌激素可促进肌腱的合成代谢。也有体外实验证明多种雌激素对肌腱能够起到促进肌腱细胞增殖、减轻炎症反应和细胞凋亡的作用,但实验大都局限于动物模型。②雌激素受体β更多的在肌腱损伤和修复过程起作用,而雌激素受体α暂未发现能够在肌腱损伤过程中产生主要影响。雌激素受体β的表达通过影响脂肪形成、Ⅰ型胶原蛋白的沉积和减少肌腱细胞凋亡来修复肌腱,而其过度表达则可能会促进炎症和血管生成,从而推进炎症进程,在肌腱损伤中发挥作用。③动物研究显示,雌激素缺乏可能会降低肌腱的胶原合成效率,肌腱弹性下降,抑制肌腱的合成代谢,不利于肌腱损伤修复,而正常水平的雌激素可能对肌腱中Ⅰ型胶原合成有刺激作用,促进肌腱细胞增殖和代谢。④目前雌激素在肌腱损伤中作用的分子机制尚未完全阐释,更多实验围绕肌腱胶原合成、细胞增殖凋亡,仅有少量文献研究了雌激素受体β缺陷调控干扰素调节因子5-趋化因子配体3轴、E2调控雌激素受体α和PI-3K-A展开更多
BACKGROUND Ulcerative colitis(UC)is an idiopathic,chronic inflammatory bowel disease(IBD)most often located in the rectum,but may involve the entire colon.Extra intestinal manifestations(EIMs)occur with varying freque...BACKGROUND Ulcerative colitis(UC)is an idiopathic,chronic inflammatory bowel disease(IBD)most often located in the rectum,but may involve the entire colon.Extra intestinal manifestations(EIMs)occur with varying frequency depending on the affected organ.The most common ones are musculoskeletal EIMs,affecting up to 33%-40%of IBD patients.These include,among others,inflammatory back pain,tendinitis,plantar fasciitis and arthritis.Only a few case reports in literature discuss Achilles tendinitis.CASE SUMMARY This report describes a patient with UC and Achilles tendinitis in whom after many unsuccessful attempts of treatment with sulfasalazine,mesalazine,glucocorticosteroids,infliximab and tofacitinib,a complete UC remission and resolution of Achilles tendinitis were achieved with the use of dual biologic therapy(DBT)-ustekinumab and adalimumab(ADA).CONCLUSION This case mentions rare EIMs of UC and suggests that DBT may be an alternative for patient with ulcerative colitis and EIMs.展开更多
BACKGROUND Supraspinatus tendinitis recurs easily after treatment.One of the main reasons is the lack of objective tools for the efficacy evaluation.Shear wave elastography(SWE)can quantitatively analyze the tissue el...BACKGROUND Supraspinatus tendinitis recurs easily after treatment.One of the main reasons is the lack of objective tools for the efficacy evaluation.Shear wave elastography(SWE)can quantitatively analyze the tissue elasticity of region of interest by measuring the Young’s modulus(YM)value.AIM To explore the role of SWE in the efficacy and prognostic evaluation of supraspinatus tendinitis.METHODS Eighty-seven patients with supraspinatus tendinitis treated in Jiading District Central Hospital Affiliated Shanghai University of Medicine and Health Sciences were recruited.Another 30 healthy volunteers were enrolled as the control group.The visual analogue scale(VAS)and Constant-Murley Score(CMS)were recorded before treatment.All participants were scanned by SWE scan,and the YM value of the region of interest were recorded.Spearman correlation analysis was performed on YM values with VAS and CMS.Univariate repeated measures analysis of variance was used to calculate the changing trend of VAS,CMS and SWE under different treatment courses.After treatment,the patients were further grouped based on who achieved significantly effective and curative treatment.The patients in the continued treatment group continued to receive treatment according to the YM value,and the remaining patients who stopped receiving treatment were included in the stopped treatment group.All patients were followed up for 1 year,and the difference in recurrence rates between the continued treatment group and the stopped treatment group were compared.RESULTS The SWE images of supraspinatus muscle in healthy volunteers were mainly blue,while those of patients with supraspinatus tendinitis showed regional red and green areas.The average YM value of the supraspinatus muscle in healthy volunteers was 26.12±4.03 kPa.The average YM value of patients with supraspinatus muscle was greater than that of healthy volunteers(average YM=60.61±11.53 kPa,t=26.344,P<0.001).The YM value was positively correlated with VAS(r=0.564,P<0.001)and negatively correlated wit展开更多
We present a case of a woman with refractory lower back pain and forearm tendinitis, which improved dramatically after morphological modification of natural teeth. The subject was a 35-year-old Japanese woman, who was...We present a case of a woman with refractory lower back pain and forearm tendinitis, which improved dramatically after morphological modification of natural teeth. The subject was a 35-year-old Japanese woman, who was suffering from lower back pain when bending forward and she had severe pain from her right thumb to her wrist. These symptoms were not improved by massage and orthopedic treatment. On the other hand, once modifying the morphology of natural teeth, those symptoms improved dramatically. No side effects were observed, and the prognosis was good. Our observation suggested a close relationship between the oral situation and remote musculoskeletal conditions, and further multidisciplinary studies are needed to clarify the mechanisms.展开更多
Background: Fabella is a natural occurring sesamoid bone, cartilage or a mixture of both that is usually located at the posterolateral corner (PLC) of the knee [1]. Recently the PLC of the knee has been extensively in...Background: Fabella is a natural occurring sesamoid bone, cartilage or a mixture of both that is usually located at the posterolateral corner (PLC) of the knee [1]. Recently the PLC of the knee has been extensively investigated because it is a common site of injuries and diseases [2] [3]. The complexity of PLC anatomy needs to be fully understood because the fabella could be missed diagnosis as an osteochondral defect, osteochondritis dissecans (OCD), calcific tendinitis, or foreign body. We present a case report of fabella syndrome triggered by trauma and also performed a review of literature for the various diagnoses that might be confused with fabella syndrome. Case presentation: A 29-year-old, Sudanese male presented to the trauma center in King Khalid Hospital in KSA, complaining of pain and partial swelling in his left knee joint due to trauma. Fabella was detected in the posterior lateral corner (PLC) of the knee joint embedded in the lateral head of the gastrocnemius muscle. All other pathological conditions were excluded. Conclusion: Fabella is sesamoid bone with variable size, found in the PLC. Commonly if present it causes periodic pain especially in the fully extended knee or it remains asymptomatic. Trauma, surgery, sports or heavy extreme activities may trigger the pain of asymptomatic fabella. Clinicians should consider that pain in the PLC of the knee can result from the presence of the fabella in a condition called fabella syndrome.展开更多
Achilles tendinopathy is a very common pathology, especially in the athletic population. Its etiology is multifactorial and the underlying pathophysiology is still not fully understood. For non-insertional tendinopath...Achilles tendinopathy is a very common pathology, especially in the athletic population. Its etiology is multifactorial and the underlying pathophysiology is still not fully understood. For non-insertional tendinopathy is increasingly recognized the influence of paratendinopathy in the genesis of patients symptoms, so various surgical treatments have been accordingly developed;they are indicated when conservative treatment fails. The Achilles tendoscopy is one of these techniques, it has the advantages of minimally invasive surgery, resulting in a low complication rate and good functional results. In relation to this procedure we review the surgical technique, which is exemplified by the case of a high performance athlete treated satisfactorily.展开更多
Acute calcific tendinitis of the shoulder is a well-known condition, but it is rare in the hand or finger. It is often misdiagnosed when it occurs outside the shoulder. We report an unusual case of acute calcific tend...Acute calcific tendinitis of the shoulder is a well-known condition, but it is rare in the hand or finger. It is often misdiagnosed when it occurs outside the shoulder. We report an unusual case of acute calcific tendinitis of the flexor digitorum superficialis insertion of the 4th finger in a young female martial art athlete after minor trauma history, and discuss with a review of the literature.展开更多
Background: Corticosteroid, hyaluronic acid (HA) injections and Anti-inflammatory agents are considered as non-invasive treatments for knee osteoarthritis (OA), Chronic Tendinitis (CT) and Tennis elbow (TE) that are s...Background: Corticosteroid, hyaluronic acid (HA) injections and Anti-inflammatory agents are considered as non-invasive treatments for knee osteoarthritis (OA), Chronic Tendinitis (CT) and Tennis elbow (TE) that are supposed to provide symptomatic relief and to help surgical delay intervention. Platelet rich plasma (PRP) is a biological component shown to be beneficial for different orthopedic dysfunctionalities treatment. The presence of GFs in PRPs such as transforming growth factor-β, insulin-like growth factor 1co-stimulate the mesenchymal stem cells and fibroblasts secretions and promotes the fibrin matrix formation which effectively drive the healing process, induces regenerative response and lead to the damage structure repair in orthopedics trauma. Methods: Three groups of a total of 30 patients presenting OA, CT and TE diagnosis, non-responding to corticosteroid, HA and non-steroid anti-inflammatory treatments were randomized to undergo one intra-articular injections of single high dose of PRP. The efficacy of Intra-articular PRP Injections was evaluated before the injection and one month after. The efficiency assessment score was based on [1] Knee injury and Osteoarthritis Outcome Score, [2] Physical Function Short Form (KOOS-PS) Arabic (KSA) version LK 1.0, [3] HOOS-Physical Function Short form (HOOS-PS), and [4] Macdermid patient-rated Tennis Elbow. Results: A significant reduction of pain and a marked improvement in movements was observed in the 3 patient’s groups, PRP-injected patients showed significantly higher values compared with baseline: (p < 0.005 vs baseline), improve functional status and reduce clearly the articular dysfunctions over the time. In our study, single High dose injection of PRP provided an overall superior clinical improvement compared with HA and corticosteroid treatments over the time and the different follow-up checkpoints of the study.展开更多
文摘AIM To systematically search literature and determine a preferable surgical procedure in patients with failed conservative treatment of calcifying tendinitis of the shoulder.METHODS The electronic online databases MEDLINE(through PubMed), EMBASE(through OVID), CINAHL(through EBSCO), Web of Science and Cochrane Central Register of Controlled Trials were systematically searched in May 2016. Eligible for inclusion were all available studies with level Ⅱ and level Ⅲ evidence(LoE). Data was assessed and extracted by two independent review authors using a specifically for this study designed data extraction form.RESULTS Six studies(294 surgically treated shoulders) were included in this review. No significant differences between the three available treatment options(acromioplasty with the removal of the calcific deposits, acromioplasty or solely the removal of the calcific deposits) were detected regarding the functional and clinical outcome. The followup ranged from 12 mo to 5 years. Complication rates were low. No reoperations were necessary and the only reported complication was adhesive capsulitis, which in all cases could be treated conservatively with full recovery. CONCLUSION We found that all three available treatment options show good functional and clinical outcomes in the short and midterm. However, a favorable procedure is difficult to determine due to the lack of high-quality comparing studies.
文摘背景:大量的研究发现雌激素与肌腱病具有一定的相关性,但长期以来雌激素在肌腱病中的实验研究成果与总结较少,不方便专科从业者及相关领域学者全面了解研究近况。目的:综述目前临床或临床前原始研究,以期对雌激素在肌腱病中的作用进行总结,并对未来雌激素在肌腱病中的评估和管理进行一定的展望。方法:通过计算机对PubMed、Web of Science、中国知网、万方和维普数据库中的相关文献进行检索。检索时间为2008年1月至2023年9月,英文检索词为“Oestrogen,Estrogen,Estrogen receptor,Tendinopathy,Tendonopathy,Sinew,Tendon,Tendons,Myotenositis”;中文检索词为“雌激素,雌激素受体,肌腱病,肌腱,肌腱炎”。依据入选标准对检索结果进行筛选排除,最终纳入60篇文献进行综述分析。结果与结论:①体内研究表明,雌激素可促进肌腱的合成代谢。也有体外实验证明多种雌激素对肌腱能够起到促进肌腱细胞增殖、减轻炎症反应和细胞凋亡的作用,但实验大都局限于动物模型。②雌激素受体β更多的在肌腱损伤和修复过程起作用,而雌激素受体α暂未发现能够在肌腱损伤过程中产生主要影响。雌激素受体β的表达通过影响脂肪形成、Ⅰ型胶原蛋白的沉积和减少肌腱细胞凋亡来修复肌腱,而其过度表达则可能会促进炎症和血管生成,从而推进炎症进程,在肌腱损伤中发挥作用。③动物研究显示,雌激素缺乏可能会降低肌腱的胶原合成效率,肌腱弹性下降,抑制肌腱的合成代谢,不利于肌腱损伤修复,而正常水平的雌激素可能对肌腱中Ⅰ型胶原合成有刺激作用,促进肌腱细胞增殖和代谢。④目前雌激素在肌腱损伤中作用的分子机制尚未完全阐释,更多实验围绕肌腱胶原合成、细胞增殖凋亡,仅有少量文献研究了雌激素受体β缺陷调控干扰素调节因子5-趋化因子配体3轴、E2调控雌激素受体α和PI-3K-A
文摘BACKGROUND Ulcerative colitis(UC)is an idiopathic,chronic inflammatory bowel disease(IBD)most often located in the rectum,but may involve the entire colon.Extra intestinal manifestations(EIMs)occur with varying frequency depending on the affected organ.The most common ones are musculoskeletal EIMs,affecting up to 33%-40%of IBD patients.These include,among others,inflammatory back pain,tendinitis,plantar fasciitis and arthritis.Only a few case reports in literature discuss Achilles tendinitis.CASE SUMMARY This report describes a patient with UC and Achilles tendinitis in whom after many unsuccessful attempts of treatment with sulfasalazine,mesalazine,glucocorticosteroids,infliximab and tofacitinib,a complete UC remission and resolution of Achilles tendinitis were achieved with the use of dual biologic therapy(DBT)-ustekinumab and adalimumab(ADA).CONCLUSION This case mentions rare EIMs of UC and suggests that DBT may be an alternative for patient with ulcerative colitis and EIMs.
基金Medical Guidance Project of Shanghai Science and Technology Commission,No.134119b2300Key Medical Discipline of Jiading District,Shanghai,No.2017ZD04.
文摘BACKGROUND Supraspinatus tendinitis recurs easily after treatment.One of the main reasons is the lack of objective tools for the efficacy evaluation.Shear wave elastography(SWE)can quantitatively analyze the tissue elasticity of region of interest by measuring the Young’s modulus(YM)value.AIM To explore the role of SWE in the efficacy and prognostic evaluation of supraspinatus tendinitis.METHODS Eighty-seven patients with supraspinatus tendinitis treated in Jiading District Central Hospital Affiliated Shanghai University of Medicine and Health Sciences were recruited.Another 30 healthy volunteers were enrolled as the control group.The visual analogue scale(VAS)and Constant-Murley Score(CMS)were recorded before treatment.All participants were scanned by SWE scan,and the YM value of the region of interest were recorded.Spearman correlation analysis was performed on YM values with VAS and CMS.Univariate repeated measures analysis of variance was used to calculate the changing trend of VAS,CMS and SWE under different treatment courses.After treatment,the patients were further grouped based on who achieved significantly effective and curative treatment.The patients in the continued treatment group continued to receive treatment according to the YM value,and the remaining patients who stopped receiving treatment were included in the stopped treatment group.All patients were followed up for 1 year,and the difference in recurrence rates between the continued treatment group and the stopped treatment group were compared.RESULTS The SWE images of supraspinatus muscle in healthy volunteers were mainly blue,while those of patients with supraspinatus tendinitis showed regional red and green areas.The average YM value of the supraspinatus muscle in healthy volunteers was 26.12±4.03 kPa.The average YM value of patients with supraspinatus muscle was greater than that of healthy volunteers(average YM=60.61±11.53 kPa,t=26.344,P<0.001).The YM value was positively correlated with VAS(r=0.564,P<0.001)and negatively correlated wit
文摘We present a case of a woman with refractory lower back pain and forearm tendinitis, which improved dramatically after morphological modification of natural teeth. The subject was a 35-year-old Japanese woman, who was suffering from lower back pain when bending forward and she had severe pain from her right thumb to her wrist. These symptoms were not improved by massage and orthopedic treatment. On the other hand, once modifying the morphology of natural teeth, those symptoms improved dramatically. No side effects were observed, and the prognosis was good. Our observation suggested a close relationship between the oral situation and remote musculoskeletal conditions, and further multidisciplinary studies are needed to clarify the mechanisms.
文摘Background: Fabella is a natural occurring sesamoid bone, cartilage or a mixture of both that is usually located at the posterolateral corner (PLC) of the knee [1]. Recently the PLC of the knee has been extensively investigated because it is a common site of injuries and diseases [2] [3]. The complexity of PLC anatomy needs to be fully understood because the fabella could be missed diagnosis as an osteochondral defect, osteochondritis dissecans (OCD), calcific tendinitis, or foreign body. We present a case report of fabella syndrome triggered by trauma and also performed a review of literature for the various diagnoses that might be confused with fabella syndrome. Case presentation: A 29-year-old, Sudanese male presented to the trauma center in King Khalid Hospital in KSA, complaining of pain and partial swelling in his left knee joint due to trauma. Fabella was detected in the posterior lateral corner (PLC) of the knee joint embedded in the lateral head of the gastrocnemius muscle. All other pathological conditions were excluded. Conclusion: Fabella is sesamoid bone with variable size, found in the PLC. Commonly if present it causes periodic pain especially in the fully extended knee or it remains asymptomatic. Trauma, surgery, sports or heavy extreme activities may trigger the pain of asymptomatic fabella. Clinicians should consider that pain in the PLC of the knee can result from the presence of the fabella in a condition called fabella syndrome.
文摘Achilles tendinopathy is a very common pathology, especially in the athletic population. Its etiology is multifactorial and the underlying pathophysiology is still not fully understood. For non-insertional tendinopathy is increasingly recognized the influence of paratendinopathy in the genesis of patients symptoms, so various surgical treatments have been accordingly developed;they are indicated when conservative treatment fails. The Achilles tendoscopy is one of these techniques, it has the advantages of minimally invasive surgery, resulting in a low complication rate and good functional results. In relation to this procedure we review the surgical technique, which is exemplified by the case of a high performance athlete treated satisfactorily.
文摘Acute calcific tendinitis of the shoulder is a well-known condition, but it is rare in the hand or finger. It is often misdiagnosed when it occurs outside the shoulder. We report an unusual case of acute calcific tendinitis of the flexor digitorum superficialis insertion of the 4th finger in a young female martial art athlete after minor trauma history, and discuss with a review of the literature.
文摘Background: Corticosteroid, hyaluronic acid (HA) injections and Anti-inflammatory agents are considered as non-invasive treatments for knee osteoarthritis (OA), Chronic Tendinitis (CT) and Tennis elbow (TE) that are supposed to provide symptomatic relief and to help surgical delay intervention. Platelet rich plasma (PRP) is a biological component shown to be beneficial for different orthopedic dysfunctionalities treatment. The presence of GFs in PRPs such as transforming growth factor-β, insulin-like growth factor 1co-stimulate the mesenchymal stem cells and fibroblasts secretions and promotes the fibrin matrix formation which effectively drive the healing process, induces regenerative response and lead to the damage structure repair in orthopedics trauma. Methods: Three groups of a total of 30 patients presenting OA, CT and TE diagnosis, non-responding to corticosteroid, HA and non-steroid anti-inflammatory treatments were randomized to undergo one intra-articular injections of single high dose of PRP. The efficacy of Intra-articular PRP Injections was evaluated before the injection and one month after. The efficiency assessment score was based on [1] Knee injury and Osteoarthritis Outcome Score, [2] Physical Function Short Form (KOOS-PS) Arabic (KSA) version LK 1.0, [3] HOOS-Physical Function Short form (HOOS-PS), and [4] Macdermid patient-rated Tennis Elbow. Results: A significant reduction of pain and a marked improvement in movements was observed in the 3 patient’s groups, PRP-injected patients showed significantly higher values compared with baseline: (p < 0.005 vs baseline), improve functional status and reduce clearly the articular dysfunctions over the time. In our study, single High dose injection of PRP provided an overall superior clinical improvement compared with HA and corticosteroid treatments over the time and the different follow-up checkpoints of the study.
