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

Arthrography is a proven and well-established diagnostic aid in the evaluation and treatment of lesions in several joints; it provides useful information in the treatment of shoulder and wrist lesions. The procedure can be used whenever the cause of shoulder pain is in doubt. Arthrography of the shoulder can aid in the diagnosis of a variety of lesions: rotator cuff tear, subluxation of the shoulder, recurrent dislocation, subluxation and tear of the biceps tendon, the frozen shoulder, anterior capsular derangements, and combinations of these abnormalities. Arthrography has occasional, but definite use in the wrist, particularly in recurrent ganglion, painful ganglion on the flexor aspect of the wrist, and in the evaluation of the post-traumatic wrist with unexplained pain.
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PMID:Upper extremity arthrography. 113 88

Postoperative shoulder pain should be adequately treated not only because of the high severity of the symptomatology often observed, but also because pain and muscle contraction render impossible an early rehabilitation programme. Regional anaesthesia, by virtue of its beneficial effects on the pathophysiology of pain and its influence on the rehabilitative problems of shoulder surgery, is the most adequate technique for the control of postoperative pain.
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PMID:[Postoperative pain in shoulder surgery]. 129 5

This case illustrates the importance of intraoperative monitoring of neuronal function to help separate tumor tissue from neural tissue in a 54-year-old patient with left shoulder pain resulting from a desmoid tumor. Preoperative nerve conduction and electromyographic studies showed a lesion in the lateral cord of the brachial plexus, which was found to be intimately involved with the tumor mass and was splayed into a very thin effaced sheet of neural tissue. Stimulation of the tumor/nerve tissue mass proximal to the lesion was impossible due to the invasion of the brachial plexus by the tumor. The technique that was adapted for this unusual presentation was to stimulate the tumor/nerve tissue mass itself and record compound muscle action potentials distally. With the technique described, a subtotal resection of an aggressive fibromatosis enmeshed in the proximal brachial plexus was possible, and excellent relief of pain symptoms and retention of functional capabilities of the involved extremity were achieved.
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PMID:Intraoperative monitoring of an unusual brachial plexus tumor. 131 17

Cervicogenic headache is characterized by unilaterality without sideshift, and the pain attack starts in the neck, in contradistinction to what is the case in common migraine. Signs of neck involvement (e.g. reduction of the range of motion; mechanical precipitation of attacks; ipsilateral, diffuse arm/shoulder pain) are typical in cervicogenic headache but not in common migraine. These and many other features aid in distinguishing these two headaches.
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PMID:Cervicogenic headache: the controversial headache. 132 Apr 94

Subacromial bursal tissue was studied in 12 patients operated on for painful (10 patients with constant pain and 2 patients with pain on motion) rotator cuff tendinitis/impingement syndrome. The Neer acromioplasty technique was used. Six patients had moderate inflammatory changes and one had a slight inflammation. In three of the five remaining patients, the subacromial bursa did not show any signs of inflammatory involvement, but patients experienced pain at rest and at night, reflecting clinical inflammation in tissues other than the bursa. The two patients with pain only on strain did not show inflammation of the bursa. Immunohistochemical typing of the bursal tissue disclosed a typical chronic mononuclear cell infiltrate consisting mainly of CD2-positive T lymphocytes (50-80% of all inflammatory cells), accompanied by less frequent CD11b (C3bi receptor)-positive monocyte/macrophages (10-40%). The relative paucity of plasmablasts/plasma cells expressing PCA-1 suggests this to be an inflammatory rather than an immune response. Active involvement of some of the local cells is suggested to be the source of algogenic and hyperalgesic substances contributing to pain in chronic shoulder pain syndromes.
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PMID:Inflammation of the subacromial bursa in chronic shoulder pain. 136 Feb 27

Shoulder pain of more than three months' duration is regarded as chronic. Activity with an elevated arm is a risk factor, due to reduced local flow of blood to the supraspinatus muscle. Knowledge about normal shoulder biomechanics and dysfunctional behaviour patterns is essential when treating patients with chronic pain. It is necessary to consider psychosocial factors in addition to local pathology. The clinical examination should enable the physician to distinguish between referred and true shoulder pain and between restricted and free passive range of movement. Diagnoses may be classified into eight groups. The association between pain and degenerative changes has yet to be solved. This emphasizes the danger of deciding treatment without matching findings from radiological examinations with clinical signs and symptoms.
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PMID:[Etiology and diagnosis of chronic shoulder pain]. 141 43

Thirteen patients with hemodialysis-related shoulder arthropathy were treated either with arthroscopic synovectomy or with open surgery. Arthroscopic synovectomy was performed in eight patients who had shoulder pain, shoulder immobility or both but did not have cystic bone lesions. The therapy was effective for pain relief and improvement of shoulder function for six months but in 12 months the shoulder pain reappeared in most of the patients. Open surgery was done in 5 patients who, in addition to shoulder pain and immobility, had humeral head bone cysts. Resection of the deposited mass on the biceps tendon sheath, of hypertrophied synovium and bursa as well as curettage of cysts and calcium hydroxyapatite ceramic implantation were performed. The therapy was effective for pain relief throughout the follow-up period (12 months). No adverse effects were noted for either procedure. Resected specimens of the synovia contained amyloid as indicated by a positive Congo-red stain by light microscopy and the presence of amyloid fibrils by electron microscopy. Deposition of amyloid in the biceps tendon sheath, synovium and bursa and invasion of the humeral head by amyloid were observed upon open surgery. The results suggest that the resection of deposited material induces the improvement of the shoulder arthropathy.
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PMID:Surgical treatment of hemodialysis-related shoulder arthropathy. 142 10

Shoulder pain frequently superimposes substantial disability on a limb already limited by hemiplegia. The subscapularis muscle is a major internal rotator of the shoulder and, therefore, plays a role in the flexor synergy pattern commonly seen in spastic hemiplegia. Thirteen patients with spastic hemiplegia, limited range of motion, and painful shoulders underwent percutaneous phenol blocks to the nerves to the subscapularis. Patients' ages ranged from 22 to 76 (x 46 years) and the duration of hemiplegia from two to 13 months. Immediate and significant (p < 0.01) improvements in range of motion were observed in abduction (21 degrees), flexion (40 degrees), and external rotation (38 degrees). Relief of pain was also noted with the previously painful movement. Subscapularis nerve block is a new and potentially useful technique in the management of the painful hemiplegic shoulder.
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PMID:Subscapular nerve block in the painful hemiplegic shoulder. 144 68

A 56-year-old man developed left shoulder pain three weeks after starting a cardiac rehabilitation program, which consisted of submaximal aerobic and progressive resistive exercises. Pain in the left shoulder intensified and weakness developed one week later. He sought medical attention ten weeks after the onset. Physical examination showed only weakness of left shoulder abduction and external rotation with mild atrophy of the left supraspinatus and infraspinatus muscles. Electrodiagnostic study showed fibrillation potentials and positive sharp waves in the left supraspinatus and infraspinatus muscles with delayed conduction to the supraspinatus. The left suprascapular notch was injected with local steroid. Within one week, improvement occurred, and one month later the patient was pain free and stronger. The motor latency returned to normal, and no fibrillations nor positive waves were seen. The patient returned to his previous functional level. Suprascapular neuropathy should be considered as a cause of shoulder pain and weakness in a person involved in any strengthening exercise program. A steroid injection of the suprascapular notch performed early may avoid the need for surgery.
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PMID:Suprascapular neuropathy during progressive resistive exercises in a cardiac rehabilitation program. 144 79

The suprascapular nerve passes through the spinoglenoid notch with a risk of entrapment. This results in distal nerve lesion characterized by isolated paralysis of the infraspinatus muscle and, most often, by shoulder pain. We report 7 clinical and electromyographical cases of pure infraspinatus muscle paralysis. The value of the electrodiagnosis, which demonstrated prolonged suprascapular distal nerve latencies (over 5 milliseconds) in the infraspinatus muscle affected while latencies were normal in the supraspinatus muscle, is emphasized. Mechanical factors were associated with paralysis in 5 cases. Compressive synovial cysts were found in 2 patients operated upon. Surgical enlargement of the spinoglenoid notch regularly and rapidly relieves pain and sometimes helps in recovery of the infraspinatus muscle.
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PMID:[Suprascapular nerve entrapment at the spinoglenoid notch]. 144 51


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