Browsing by Subject "Shoulder"

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    A simple technique for shoulder arthrography
    (SAGE Publications, 2006-09) Redondo, M.V.; Martínez Martínez, Francisco; Reus, M.; Alonso, J.; Parrilla, A.; Campos, P.A.; Berná Serna, Juan De Dios; Cirugía, Pediatría y Obstetricia y Ginecología
    Purpose: To present a systematic approach to teaching a technique for arthrography of the shoulder. Using an adhesive marker-plate with radiopaque coordinates, precise sites for puncture can be identified and the need for fluoroscopic guidance obviated. Material and Methods: Forty-six glenohumeral arthrograms were performed in 45 patients; in 1 case involving examination of both shoulders. The stages of the technique are described in detail, as are the fundamental aspects of achieving an effective glenohumeral injection. Pain intensity was measured in all patients using a verbal description scale.Results: Shoulder arthrography was successful in all cases. Average time taken for the procedure was 7 min, with no difference in the respective times required by an experienced radiologist and a resident. The procedure was well tolerated by most patients, with slight discomfort being observed in a very few cases.Conclusion: The arthrographic technique used in this study is simple, safe, rapid, and reproducible, and has the advantage of precise localization of the site for puncture without need for fluoroscopic guidance. The procedure described in this study can be of help in teaching residents and can reduce the learning curve for radiologists with no experience in arthrographic methods. It also reduces the time of exposure to fluoroscopy.
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    Fiber type composition of the architecturally distinct regions of human supraspinatus muscle: A cadaveric study
    (F. Hernández y Juan F. Madrid. Universidad de Murcia. Departamento de Biología Celular e Histología, 2013) Kim, S.Y.; Lunn, D.D.; Dyck, R.J.; Kirkpatrick, L.J.; Rosser, B.W.C.
    The human supraspinatus muscle is clinically important as it is frequently injured in older adults and the elderly. We have previously shown that the supraspinatus has a complex architecture with two distinct regions each consisting of three parts. Further we have found dynamic changes in architectural parameters such as fiber bundle length markedly vary between these regions. Fiber types of the supraspinatus have not been thoroughly investigated throughout its volume and are of interest to clinicians treating supraspinatus pathologies. In this study we investigated the distribution of fiber types within the distinct regions and parts of supraspinatus. Samples of supraspinatus were excised from six distinct parts of each muscle from five formalin embalmed specimens (one male, four female; mean age 77±11.1 years) free of tendon pathology. Samples were frozen in liquid nitrogen and then cryosectioned. Serial sections were labeled using immunohistochemical techniques and antibodies against fast or slow myosin heavy chain isoforms. The mean percentage of Type I (slow) fibers ranged from 56.73% to 63.97%. Results demonstrated significant variations in fiber type distribution. The middle part of the anterior region has a significantly greater percentage of Type I fibers compared to that of the posterior. The superficial part of the anterior region has a greater percentage of Type II (fast) fibers compared to the middle and deep parts. Findings aid in highlighting the distinct functions of the anterior and posterior regions, and prompt the need to re-evaluate assessment and treatment techniques established on a limited understanding of the fiber type distribution.
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    MR arthrography of the shoulder using an anterior approach: optimal injection site
    (American Roentgen Ray Society, 2012-11-23) Redondo, María V.; Campos, Pedro A.; Reus, Manuel; Martínez Martínez, Francisco; Campos, Matilde; Domenech, Ernesto; Berná Serna, Juan De Dios; Cirugía, Pediatría y Obstetricia y Ginecología
    OBJECTIVE. The purpose of our study was to optimize anterior MR arthrography of the shoulder by comparing three injection sites. MATERIALS AND METHODS. Seventy-eight patients were divided into three groups of 26 each, according to the injection site selected: the upper third of the medial part of the humeral head, the lower third of the medial part of the humeral head, or the area between the middle and lower thirds of the glenohumeral joint. A marker plate with radiopaque coordinates was used in performing the technique. Radiologist time and exposure time were recorded, and the intensity of the patient's pain was measured using a Visual Analogue Scale (VAS). Groups were compared using variance analysis and the least significant difference method. RESULTS. Shoulder arthrography was considered satisfactory for all three injection sites. Mean exposure time was 20.9 ± 7.8 (SD) milliseconds, and mean radiologist time was 6.4 ± 0.8 minutes. Mean pain intensity registered by the VAS was 1.7 ± 0.9, the lowest values tending to be those recorded by patients who received an injection in the upper third. Exposure and radiologist times were lower for these latter patients; differences between the upper third and the other two areas were statistically significant (p < 0.005). CONCLUSION. The optimal injection site for anterior MR arthrography of the shoulder is the upper third of the humeral head, a simple, rapid procedure that is well tolerated by patients and reduces the radiation dose administered.
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    Optimización de las dosis de radiación en la artrografía de hombro
    (Elsevier, 2009-05-01) Campos, P.A.; Redondo, M.V.; Reus, M.; Martínez Martínez, Francisco; Berná Serna, Juan De Dios; Cirugía, Pediatría y Obstetricia y Ginecología
    Objetivo: El objetivo de este estudio fue reducir la dosis de radiación recibida por los pacientes sometidos a una artrografía de hombro y en los que se utiliza como sistema de guiado una placa con coordenadas radiopacas situada sobre el área de interés. Material y métodos: La dosis a la entrada se obtuvo en 34 pacientes con edades comprendidas entre 15 y 75 años, media de 44 años. La dosis a órganos de riesgo y la dosis efectiva se estimaron mediante técnicas de Monte Carlo, donde los parámetros de entrada son: anatomía del paciente, geometría de la exploración y kerma en aire a la entrada del paciente sin retrodispersión. Las artrografías se realizaron en un equipo telemando y las imágenes se obtuvieron mediante adquisición digital sin fluoroscopia. Resultados: El espesor medio de los hombros estudiados fue 14,6±2,1 cm (9–20 cm). Las imágenes se obtuvieron con 80±10 kVp (60–85 kVp) y 6,5±3,5 mAs (1,4–17 mAs). El tiempo medio de irradiación para cada paciente fue 20±6 ms (6,9–47,9 ms). El kerma en aire calculado fue de 0,41±0,19 mGy y la dosis efectiva de 0,79±0,40 μ Sv. Conclusiones: La técnica descrita en este trabajo ha permitido reducir la dosis de radiación al paciente respecto a otros procedimientos descritos en la bibliografía y que el radiólogo que realiza la artrografía no se irradie durante el procedimiento.