Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Shoulder surgery is well recognised as having the potential to cause severe postoperative pain. The aim of this review is to assess critically the evidence relating to the effectiveness of regional anaesthesia techniques commonly used for postoperative analgesia following shoulder surgery. Subacromial/intra-articular local anaesthetic infiltration appears to perform only marginally better than placebo, and because the technique has been associated with catastrophic chondrolysis, it can no longer be recommended. All single injection nerve blocks are limited by a short effective duration. Suprascapular nerve block reduces postoperative pain and opioid consumption following arthroscopic surgery, but provides inferior analgesia compared with single injection interscalene block. Continuous interscalene block incorporating a basal local anaesthetic infusion and patient controlled boluses is the most effective analgesic technique following both major and minor shoulder surgery. However, interscalene nerve block is an invasive procedure with potentially serious complications and should therefore only be performed by practitioners with appropriate experience.
 ...
PMID:Postoperative analgesia for shoulder surgery: a critical appraisal and review of current techniques. 2787 Jan 84

Slipped capital femoral epiphysis is the most common hip disorder in adolescents, and it has a prevalence of 10.8 cases per 100,000 children. It usually occurs in children eight to 15 years of age, and it is one of the most commonly missed diagnoses in children. Slipped capital femoral epiphysis is classified as stable or unstable based on the stability of the physis. The condition is associated with obesity and growth surges, and it is occasionally associated with endocrine disorders such as hypothyroidism, growth hormone supplementation, hypogonadism, and panhypopituitarism. Patients usually present with limping and poorly localized pain in the hip, groin, thigh, or knee. Diagnosis is confirmed by bilateral hip radiography, which needs to include anteroposterior and frog-leg lateral views in patients with stable slipped capital femoral epiphysis, and anteroposterior and cross-table lateral views in patients with the unstable form. The goals of treatment are to prevent slip progression and avoid complications such as avascular necrosis and chondrolysis. Stable slipped capital femoral epiphysis is usually treated using in situ screw fixation. Treatment of unstable slipped capital femoral epiphysis usually involves in situ fixation, but there is controversy about the timing of surgery, value of reduction, and whether traction should be used.
 ...
PMID:Slipped capital femoral epiphysis: diagnosis and management. 2067 90

Postarthroscopic glenohumeral chondrolysis (PAGCL) is a rare complication in which the articular cartilage of the shoulder undergoes rapid, degenerative changes shortly after arthroscopic surgery. Patients with PAGCL are often young (eg, aged 10 to 40 years) and develop deep shoulder pain with progressive loss of motion that begins months after the initial arthroscopic surgery. PAGCL should be considered in the differential diagnosis in the patient with deep, unexplained shoulder pain following arthroscopic surgery. Although the etiology of PAGCL is not yet fully understood, the pathophysiology is likely multifactorial. Inherent patient factors and risk factors for PAGCL have been identified, but it is unclear how these factors interact. Current surgical practices need to be examined and new practices developed to prevent PAGCL. Proud placement of nonabsorbable suture anchors during surgery to correct instability, as well as the use of thermal devices and intra-articular pain pumps, should be avoided.
 ...
PMID:Postarthroscopic glenohumeral chondrolysis. 2230 48

Influenza vaccination is a common annual event among individuals in the United States. Complications, although infrequent, are usually mild and self-limiting. This article describes the case of a 46-year-old man who experienced progressive osteolysis and surface chondrolysis of the proximal humerus following routine influenza vaccination. The patient presented with shoulder pain and limited range of motion 3 weeks following vaccination in the deltoid area. No skin changes were noted, inflammatory markers were normal, and the patient's pain and disability persisted despite nonsteroidal anti-inflammatory drugs and occupational therapy. Plain radiographs revealed a small lytic area involving the greater tuberosity of the humeral head. Magnetic resonance imaging (MRI) showed abnormal uptake and cystic changes involving the greater tuberosity of the humeral head; repeat MRI at 5 months showed progression in the cystic changes. Diagnostic arthroscopy of the shoulder revealed a hyperemic joint capsule and extensive, full-thickness chondrolysis of the humeral head. Cystic biopsy demonstrated inflammatory cells and granulation tissue, consistent with foreign body response. Cultures were negative. Surgical debridement of the cystic areas and resurfacing of the humeral head yielded a good outcome. To our knowledge, this is the first reported complication of influenza vaccination requiring surgical intervention. Physicians need to be aware of the potential for osteolysis and chondrolysis, which may require aggressive forms of management.
 ...
PMID:Progressive osteolysis and surface chondrolysis of the proximal humerus following influenza vaccination. 2231 Apr 21

Radiograph is the gold standard to establish the diagnosis of osteoarthritis (OA) and to classify patients in function structural severity according to Kellgren and Lawrence's classification. Radiograph should be performed on standing position for weight-bearing joints. In clinical practice, MRI is usually used to eliminate other diagnosis when X-rays are considered as normal and to precise abarticular structures and bone lesions affected in OA. This imaging technic allows to directly visualize articular cartilage damage with an excellent correlation compared to arthroscopy But MRI is also able to depict articular damages associated with OA such as bone marrow lesion (BML), osteophytes, cysts, joint effusion, synovitis, menisci lesions, tendinitis and bursitis. Some of them were associated with pain (BML, synovitis, effusion) while some articular lesions were more implicated in chondrolysis (focal cartilage lesion, BML, menisci lesion, synovitis effusion). In cases of X-ray abnormalities (osteophytes, joint space narrowing, bone condensation, cysts), menisci lesions should not be considered as responsible for pain in knee OA. Thus, MRI is the only imaging technic able to precise which articular structure is affected during the disease (bone, synovial tissue or abarticular tissues) and helps clinician to have a more targeted therapeutic approach.
 ...
PMID:[When should MRI for knee or hip osteoarthritis should be performed?]. 2273 Jul 86

Although postarthroscopic glenohumeral chondrolysis has become a well-known disastrous complication of arthroscopic shoulder surgery, little is known about postarthroscopic humeral head osteonecrosis. This article describes 3 patients who were referred to the authors' practice with end-stage osteonecrosis after an arthroscopic rotator cuff repair or debridement.Three patients (average age, 63.3 years) presented to the authors' practice reporting severe shoulder pain after a rotator cuff debridement or repair was performed at an outside facility. After an interval period of mild improvement, all patients experienced progressive pain and loss of shoulder range of motion at a mean of 4.8 months postoperatively. Plain radiographs and magnetic resonance imaging obtained prior to the index operation showed no evidence of osteonecrosis. Postoperatively, progressive clinical and radiographic evidence showed humeral head osteonecrosis and subsequent glenohumeral destruction with cuff tear arthropathy. The authors managed all patients with a reverse total shoulder arthroplasty due to severe glenohumeral arthrosis and massive rotator cuff tears not amendable to repair. Satisfactory results were achieved in all cases.Although many complications of arthroscopic shoulder surgery are documented, little is known about postarthroscopic humeral head osteonecrosis. Shoulder surgeons should be aware of this potential complication when performing arthroscopic rotator cuff surgery and when evaluating painful and stiff postarthroscopic shoulders.
 ...
PMID:Postarthroscopic humeral head osteonecrosis treated with reverse total shoulder arthroplasty. 2346 61

Injuries to the subtalar joint are often associated with fractures of the talus or calcaneum. These injuries often lead to degenerative changes resulting in pain, restriction of movement and difficulty in weight bearing. This can cause significant deformity and disability for the patient. Occult injury of the subtalar joint has been described as an isolated event or in association with a subluxation/dislocation of this joint. They are difficult to assess with plain radiography therefore, they are generally diagnosed with advanced imaging like CT scan or MRI scan. We present a case of a 66-year-old man who presented with destructive chondrolysis of the subtalar joint 2 years following conservative treatment of a minimally displaced distal fibular fracture. It was treated by subtalar and talonavicular arthrodesis. Overall, the patient made an excellent recovery and was satisfied with the outcome.
 ...
PMID:Destructive post-traumatic chondrolysis of the subtalar joint: a case report and review of the literature. 2350 85

Magnetic resonance arthrography (MRA) is commonly used to detect labral tears of the hip. Complications of MRA are unusual and include minor reactions such as chemical synovitis and urticaria. This paper presents a rapidly progressive chondrolysis of the hip in a young patient after arthrography. The patient had suffered from acute septic arthritis and was treated by emergent arthroscopic surgery followed by appropriate antibiotics. At 18 months of followup, there were no signs of active infection but evidence of joint chondrolysis. Magnetic resonance arthrography (MRA) of the hip is an invasive procedure and should therefore be recommended judiciously. Post-MRA pain is common but often mild and temporary, while post-MRA joint infection is rare; nevertheless, severe joint pain and limitation should raise suspicion for septic hip.
 ...
PMID:Chondrolysis of the Hip following Septic Arthritis: A Rare Complication of Magnetic Resonance Arthrography. 2350 52

Idiopathic chondrolysis of the hip is a rare condition of unknown etiology characterized by progressive destruction of the hyaline cartilage that covers the femoral head and acetabulum. Idiopathic chondrolysis of the hip has an insidious beginning and affects more often female adolescents. Patients report severe hip pain, mobility limitation, and even claudication. This study aimed at reporting one case of that rare disease: an 11-year-old female adolescent with chondrolysis, followed up for three years. Inflammatory activity tests were normal. Imaging tests (radiography, ultrasonography and magnetic resonance) were essential for the diagnosis. The treatment was based on pain control and preservation of the joint mobility, and included low-impact physical activity, non-steroidal anti-inflammatory drugs, and disease-modifying antirheumatic drugs, with good response after 12 months of treatment. Surgery was not necessary.
...
PMID:Chondrolysis of the hip in an adolescent: clinical and radiological outcomes. 2385

Idiopathic chondrolysis of the hip is a rare disorder characterized by pain, stiffness, limp and radiological loss of joint space of the affected hip. The clinical outcome varies from complete recovery to fibrous ankylosis. Management remains controversial. We aim to outline the natural history and pathology of the disease and treatment strategies.
...
PMID:Idiopathic chondrolysis of the hip: presentation, natural history and treatment options. 2427 16


<< Previous 1 2 3 4 5 6 7 Next >>