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Query: UMLS:C1762617 (weakness)
 37,932 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We present two cases of shoulder pain and weakness following influenza and pneumococcal vaccine injections provided high into the deltoid muscle. Based on ultrasound measurements, we hypothesize that vaccine injected into the subdeltoid bursa caused a periarticular inflammatory response, subacromial bursitis, bicipital tendonitis and adhesive capsulitis. Resolution of symptoms followed corticosteroid injections to the subacromial space, bicipital tendon sheath and glenohumeral joint, followed by physical therapy. We conclude that the upper third of the deltoid muscle should not be used for vaccine injections, and the diagnosis of vaccination-related shoulder dysfunction should be considered in patients presenting with shoulder pain following a vaccination.
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PMID:Vaccination-related shoulder dysfunction. 1706 24

Entrapment of the suprascapular nerve is a rare peripheral neuropathy, which can be easily overlooked in the differential diagnosis of shoulder pain and dysfunction. Entrapment of the suprascapular nerve can occur at different locations along the pathway of the nerve. The primary symptoms are pain, weakness, and atrophy of the supraspinate and infraspinate muscles. Differential diagnosis should include brachial plexopathy, disorders of the cervical spine, cervical discopathy, glenohumeral pathology, tendonitis, and rotator cuff tear. Accurate diagnosis facilitates appropriate and timely treatment.
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PMID:Entrapment of the suprascapular nerve: anatomy, etiology, diagnosis, treatment. 1751 77

Extraneural metastases of intracranial germinoma are rarely reported. The authors describe the first case of metastatic lung germinoma of the thoracic spine. A 27-year-old man presented with right shoulder pain and right upper limb weakness. He had a history of repetitive radiation therapy - nine (whole-abdomen; 15Gy), 12 (whole brain; 30Gy, whole spine 42Gy) and 14 years ago (local; 32Gy) - for abdominal metastasis, temporal and fourth ventricle metastasis and spinal dissemination and metastatic pineal germinoma, respectively. Magnetic resonance imaging revealed a lung mass invading the thoracic spine that was diagnosed as a germinoma by tumor biopsy. He was treated by irradiation with 54Gy and two cycles of chemotherapy with cisplatin and etoposide. He did not have any sign of tumor eight years later.
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PMID:Late intrathoracic relapse of pineal germinoma connected to intraspinal canal. 1755 21

Isolated spinal accessory nerve palsy after coronary artery bypass graft (CABG) surgery is a rare complication. We report a case of a 52-yr-old male patient who presented with right shoulder weakness, drooping of shoulder, and weakness of forward elevation after CABG. A program of neuromuscular electrical stimulation and exercises was started after the diagnosis of right isolated spinal accessory nerve palsy by physical examination and electromyographic study. Involved muscle function recovered after 6 mos of physical therapy and rehabilitation. This case report suggests that isolated spinal accessory nerve palsy should be considered in cases of shoulder pain or weakness after CABG, and conservative treatment is recommended if palsy develops.
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PMID:Isolated spinal accessory nerve palsy after coronary artery bypass: an unusual complication. 1758 78

We report a man with Parkinson's disease who developed right spinal accessory neuropathy after right subthalamic nucleus deep brain stimulator and infraclavicular pulse generator implantation. He complained of right shoulder pain and weakness in the post-operative period. He was subsequently diagnosed with a right spinal accessory nerve injury, confirmed by neuromuscular electrodiagnostic studies - electromyography (EMG) and nerve conduction (NC) -, possibly caused by a stretch injury to the nerve at the time of creation of the subcutaneous tunnel for placement of the extension lead of the deep brain stimulator system. However, he had near complete clinical resolution of the spinal accessory neuropathy within nine months after surgery. As a result of this complication, we now map the spinal accessory nerve electrophysiologically during deep brain stimulation surgery.
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PMID:Spinal accessory neuropathy after deep brain stimulation for Parkinson's disease. 1770 83

This article reports the difference between neuralgic amyotrophy and neuropathy caused by chemotherapy and radiation treatment which manifested with severe shoulder pain followed by marked weakness of bilateral upper arms and involvement of cranial nerves. A 62-year-old man presented with acute severe neuropathic pain at the left shoulder, bilateral shoulder weakness, hoarseness of voice from vocal cord palsy, and respiratory insufficiency from left diaphragm palsy, which all occurred sequentially over a 1-month period. The diagnosis of neuralgic amyotrophy was supported and differentiated from tumor-induced and radiation-induced neuropathy by clinical presentation, electrophysiologic and imaging studies. Unlike previous reports of the onset of neuralgic amyotrophy being associated with initiation of radiation treatment in cancer patients, this report demonstrates that neuralgic amyotrophy can occur at any point of the malignant disease process after radiation and chemotherapy.
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PMID:Bilateral neuralgic amyotrophy presenting with left vocal cord and phrenic nerve paralysis. 1771 4

We report on a case of muscle strain of the subscapularis muscle in a baseball player. An out-fielder (throws right-handed and bats left-handed) hurt his right shoulder while playing baseball. He complained of right-shoulder pain just after he forcefully hit his right hand against the fence in an attempt to jump and catch a flying ball with a glove on the left hand during a baseball game. Fat-suppressed T2-weighted magnetic resonance images (MRIs) of the right shoulder joint revealed muscle strain in the middle part of the subscapularis muscle, and the injury was surmised to have occurred on account of eccentric contraction of the subscapularis muscle. The case was considered to have moderate muscle strain, because he had modest muscle weakness with a negative lift-off test. Active stretching exercises were begun just after his first visit to our clinic, and throwing exercises were started 3 weeks later, by when the right-shoulder pain had completely disappeared. Repeat MRIs of the right shoulder joint obtained 4 weeks after his first visit to our clinic revealed a significant reduction of the high-intensity lesions in the subscapularis muscle. Conservative treatment was effective for managing moderate muscle strain of the subscapularis muscle. Muscle strain of the subscapularis muscle should be taken into consideration in the differential diagnosis of shoulder injuries in athletes.
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PMID:Muscle strain of the subscapularis muscle: a case report. 1790 20

We report a case of suprascapular nerve entrapment at the suprascapular notch combined with a type II SLAP lesion resulting in supraspinatus and infraspinatus muscle weakness and shoulder pain in a 27-year-old female professional handball player. The magnetic resonance imaging scan showed significant atrophy of the supraspinatus and infraspinatus muscles. Electromyography revealed an isolated proximal lesion of the suprascapular nerve. The patient was treated by an arthroscopic release of the superior transverse ligament and repair of the type II SLAP lesion. Follow-up evaluations were performed 6 weeks, 3 months, and 6 months postoperatively. The Constant score improved from 51 to 84 points. Electromyography studies 3 and 6 months after surgery showed significant improvement with normal reinnervation of the supraspinatus and infraspinatus muscles. To our knowledge, this is the first report of proximal suprascapular nerve entrapment with coincidence of a SLAP lesion that was treated arthroscopically. On the basis of this case, we found that arthroscopic release of the superior transverse ligament is an effective procedure for decompression of the suprascapular nerve. Although it is a technically demanding procedure, the arthroscopic approach has the advantage of detecting concomitant lesions such as SLAP lesions.
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PMID:Arthroscopic release of the superior transverse ligament and SLAP refixation in a case of suprascapular nerve entrapment. 1791 87

Pain following stroke is a common but often neglected problem. Headache is present in about one fourth of patients in the acute phase. Later, chronic musculoskeletal pain including shoulder pain may be present, partly due to muscle weakness, posture and stiffness. Central neuropathic pain is a chronic pain, often described as burning or shooting and in some cases associated with pain evoked by light touch or cold. Central pain usually develops within months after the stroke and is located within the area of sensory abnormality corresponding to the CNS region damaged by the stroke.
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PMID:[Poststroke pain]. 1795 64

A 40-year-old Asian female presented with a 2-month history of right shoulder pain and right triceps weakness. MRI revealed an extramedullary, extradural, dumbbell-shaped spinal cord tumor with C6 to C7 iso- and hyperintensity on T1 and T2 weighted imaging, respectively. Histological examination revealed monomorphous spindle cells with a storiform pattern. Immunohistochemistry was positive for CD34, CD99, and negative for EMA, SMA, and S100; solitary fibrous tumor (SFT) was confirmed.
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PMID:A dumbbell-shaped solitary fibrous tumor of the cervical spinal cord. 1830 86


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