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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In addition to the well-known common trauma in the practice of rock climbing, free climbing at top level has given rise to a new specific pathology affecting the flexor apparatus of the fingers. The cases of 23 top level climbers (performance level 6a to 8a) have been reviewed. 1/3 of them had severe pain in their fingers caused by traction movements. 1 climber out of 4 were referred to us for the above symptomatology. The diagnosis was either tendinitis or tenosynovitis, and the treatment was always conservative. Understanding the pathogenesis of the conflict between tendon and pulley movements will permit partly to cure these lesions, but our aim should be to prevent them.
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PMID:[Stress syndrome of the fingers related to rock climbing]. 234 73

Sixty rheumatoid wrists operated on for tendon articular synovectomies and resection of the ulnar head have been reviewed with an average follow-up of 5 years and 4 months. One-third of these patients who presented an average follow-up of 8 years and 8 months have been isolated for the radio-clinical analysis. The results on pain are good (78 per cent of patients are painless at 5 years and 67 per cent at 8 years); 80 per cent present no recurrence of tenosynovitis, and 75 per cent show a functional improvement. The study of mobility sectors shows a loss of 28 per cent on the sagittal plane and 21 per cent on the frontal plane at 5 years, which increases respectively at 33 per cent and 41 per cent at 8 years, with however a sector of useful mobility preserved. The prehension strength decreases but the parameter must take into account the polyarticular evolution of the disease. If long-term results are clinically satisfactory, isolated synovectomy does not prevent radiological aggravation which is due to the evolution of the disease. This is the reason why, prevently, intracarpal arthrodeses or tendon transfers must also be performed, when there are signs of instability or partial wrist destructions.
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PMID:[Long-term results of surgical synovectomies of the rheumatoid wrist. Apropos of 60 cases]. 279 8

The radiographic modalities discussed in this article are useful adjunctive techniques in the evaluation of arthritic disease. None of these modalities should be considered for baseline study. Rather, they should be considered following plain film examination when further information is required. The one modality that may be considered for a screening examination is radionuclide imaging. It is most useful when early diagnostic information regarding the extent of pathology is required. A pattern of activity can provide important information to the clinician, enabling an accurate diagnosis. Arthrography is best reserved for the evaluation of articular cartilage of a particular joint. A double-contrast arthrogram should be performed in this case. The technique has little application in the evaluation of polyarticular disease. Tenography is most useful in differentiating tenosynovitis from stenosing tenosynovitis. The differentiation is important because a diagnosis of stenosing tenosynovitis usually necessitates surgical intervention. Spontaneous rupture can be evaluated with tenography, but is is probably best evaluated with MRI. CT may be used in the evaluation of both soft-tissue and articular pathology. It is perhaps best employed in the evaluation of articular pathology of the rearfoot. This technique should not be used as a screening examination for vague foot pain. MRI is the newest and most exciting imaging modality available. The excellent soft-tissue contrast provides an accurate means of evaluating the extraarticular manifestations of arthritic disease. MRI may aid in differentiating rheumatoid nodules from neuromas in rheumatoid patients with excessive forefoot disease. It is also useful in the evaluation of tendon pathology, particularly spontaneous ruptures. This technique is only in its infancy, but technologic advances are rapidly making it a major force in the field of diagnostic imaging.
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PMID:Special radiographic techniques in the evaluation of arthritic disease. 296 25

The characteristic work actions of female shoe manufacturing assembly line workers were analyzed by the records of 8-mm cine-films. The relationship between cervicobrachial disorders and work actions was investigated as a cross-sectional factor control study by using sex-age matched pairs for non-assembly line workers (102 pairs). The following conclusions were obtained: 1) The assembly line workers handled about 3,400 sneaker shoes per day on the assembly line. A completed shoe weighed 200-500 g. The metal last weighted 400-1,200 g. As the lines were not completely mechanized, the workers passed shoes to the next worker by hand. 2) In the line selected for the study of work actions, 28 female workers and one male worker were engaged. The work direction of the line was one-way (from left to right or vice versa). The actions of the workers were classified into four fundamental actions: i) grasping the shoe or tool, ii) extending or iii) bending of the arms, and iv) keeping the arms in a certain position. These fundamental actions were repeated more than 3,400 times per day by each worker. The time spent in holding a shoe in the left hand was longer than that of the right hand in holding a shoe or tool. 3) Results of medical examinations showed a higher prevalence in assembly line workers than that in non-assembly line workers. Especially the prevalence rate of tapping test, pain sensibility test, vibratory sensibility test, Morley's test, tenosynovitis in the fingers, tenderness at spinal muscle around the thoracic vertebrae, levator muscle of scapula, trapezius muscle, rhomboid muscle, infraspinatus muscle, greater pectoral muscle, anterior scalene muscle, thenar eminence, biceps muscle of arm, brachioradial muscle, and antebrachial flexor muscle were found to be different significantly by McNemar's test between the two groups. These disorders were appeared in the left shoulder, arm and hand. 4) As the non-assembly line workers were not engaged in compulsory work or in one-way work direction, they injured the right side (skillful side). On the contrary, it is considered that compulsory transfer of shoes and one-way work direction imposes a heavier load on the left side of the body in assembly line workers, and consequently they injured the left side more severely. 5) It is concluded that the sustained task of handing over shoes to the next worker or one-way work direction caused cervicobrachial disorders of assembly line workers, especially on the left side of the body.
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PMID:Characteristics of work actions of shoe manufacturing assembly line workers and a cross-sectional factor-control study on occupational cervicobrachial disorders. 326 Feb 99

Twenty-one cases of hamulus fracture are presented. Diagnosis depends on clinical acuity. The most common symptom is pain in the palm that is aggravated by grasp. Weakness of grasp and dorsal wrist pain are also common. Ulnar nerve paresthesia or weakness and mild carpal tunnel syndrome are frequently present. Tenderness directly over the hamulus is always present, and grip strength typically is diminished. Tenosynovitis, tendon fraying, or tendon rupture may be demonstrated in 25% of the cases and is not related to the use of steroids. Lateral trispiral tomography is clearly superior to the other diagnostic methods. Excision produced generally excellent results, particularly in patients with an athletic injury or with no associated additional injury. A nonathletic injury or the presence of associated trauma adversely affected results. Immediate immobilization of acute fractures may result in fracture healing and obviate operative intervention. Open reduction and internal fixation is feasible but offers little advantage over excision.
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PMID:Fracture of the hamate hook. 335 Dec 18

A patient with soleus muscle anomaly and symptoms simulating retrocalcanear bursitis or peritendinitis of the Achilles tendon is reported. A soft bulge was observed anteromedially to the Achilles tendon some weeks after the onset of symptoms in soccer training. A clinical diagnosis of retrocalcanear bursitis was made and the patient received physiotherapy and two injections of corticosteroids during six months without pain relief. Due to the continuing symptoms surgery was performed and large mass of the anomalic soleus muscle in the Kager's triangle was removed. At the follow-up the patient was asymptomatic and had resumed his physical exercises and soccer training.
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PMID:Soleus muscle anomaly in a patient with exertion pain in the ankle. A case report. 335 67

During a 5-year period, 33 patients with pain in the palmar aspect of the wrist and forearm with and without features of carpal tunnel syndrome were diagnosed as having restrictive thumb-index flexor tenosynovitis. The pathognomonic sign in this condition was the simultaneous flexion of the index finger with active flexion of the thumb across the palm. Treatment included either steroid injection into the tendon sheath of the flexor pollicis longus or surgical exploration of the palmar aspect of the distal forearm and wrist region. Twenty-six wrists in 24 patients were surgically explored, and all had hypertrophic tenosynovium between the flexor pollicis longus and index profundus tendons. More than half of the explored wrists had a tendinous connection between the flexor pollicis longus and the flexor profundus of the index digit. Of 17 wrists with follow-up of more than 6 months, 13 were improved by surgical management. Steroid injection did not have a long-term effect.
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PMID:Symptomatic restrictive thumb-index flexor tenosynovitis: incidence of musculotendinous anomalies and results of treatment. 337 62

The authors present two cases of completely adhesed peroneus brevis and extensor carpi ulnaris tendon that have failed to respond to extensive conservative therapy. They found that the complete adhesions restricted tendon motion and thus prevented the conservative measures from providing relief. They demonstrate that surgery is a valid treatment for chronic persistent adhesive tenosynovitis that has not responded to conservative measures, resolving pain and restoring full range of motion.
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PMID:Complete tenosynovial adhesions complication of conservative care. Peroneus brevis, extensor carpi ulnaris tendon. 345 50

The authors report an uncommon' case of carpal tunnel syndrome in a ten year old girl. Symptoms are typical with noctural paresthesias. The nerve conductor studies show a important compression with thenar atrophy. In consideration of the importance of nocturnal pain and amyotrophy an operation was decided. At operation, the median nerve is found constricted under tickened transverse carpal ligament. At the wrist, the volume of nerve is normal, there are not anomalous muscles or inflammatory tenosynovitis. In fact, the appearance of median nerve is identical to the cases of carpal tunnel syndrome in adult. After surgery symptomsare abolished. The mother of the young girl, 37 year old, also present a bilateral carpal tunnel syndrome with onset at the age of 10 years. There is a important thenar atrophy. At operation, the nerve is very constricted with a tickened transverse carpal ligament; no other anomaly is noted. A study of literature complete these observations.
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PMID:[Carpal tunnel syndrome in childhood. Apropos of a familial and idiopathic case]. 359 26

Disabling trapeziometacarpal osteoarthritis is often associated with other skeletal or soft tissue pathology that necessitates simultaneous treatment. In this study of 100 trapezium arthroplasties, 65% of the patients required at least one concurrent operative procedure and, overall, 75% have received treatment for related problems before, during, or after the arthroplasty. In order of frequency, scaphotrapezial arthritis, carpal tunnel syndrome, hyperextension deformity of the thumb metacarpophalangeal joint, trigger digits, and tenosynovitis of the wrist have been the most prevalent concomitant conditions requiring surgery. Awareness that trapeziometacarpal arthritis is frequently the focal site of a widespread inflammatory process involving other structures of the hand--termed herein the "basal joint pain syndrome"--is essential to optimal management of patients with pain at the base of the thumb.
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PMID:The basal joint pain syndrome. 359 11


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