Specialists

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Imaging

Imaging of the soft tissue injury in pectoralis major ruptures can be difficult. Plain x-rays can reveal bone avulsions, or loss of the pectoralis shadow. Ultrasound exam can demonstrate intra-muscular injury or loss of continuity of the tendon . CT scan can outline the muscle, but has difficulty visualizing the distal soft tissue of the […]

Impingement: Primary

Impingement of the tendinous portion of the rotator cuff as it passes under the coracoacromial arch is a classic cause of rotator cuff injury. The impingement syndrome, as originally described by Neer, encompasses a spectrum of pathologic changes involving the rotator cuff and associated bony changes within the coracoacromial arch, affecting primarily those 40 years […]

Etiology

When considering the possible causes of rotator cuff disease, mechanical impingement of the rotator cuff is considered the most common recognizable source of recurring pain and disability in the active population. Neer’s classic work served to organize the clinician’s approach to rotator cuff disease and, most importantly, to define rotator cuff pathology as a spectrum […]

Imaging Evaluation

X-ray films are an integral part of the work up and necessary to gain additional information. The views that are the most valuable are anterior-posterior (AP) view, supraspinatous outlet view, and axillary lateral. A 15-degree cephalic view of the AC joint, and an AP view with humeral internal rotation can also be helpful.

It is […]

Incidence and Natural History

Shoulder pain is a common presenting complaint for patients of all ages and activity levels. In clinical frequency it is exceeded only by low back pain and neck pain. About 50% of the adult population will have at least one episode of shoulder pain each year.

The most common source of shoulder pain originates in […]

Evaluation-Imaging

For any significant neck injury, radiography of the cervical spine should be performed, including AP, lateral, bilateral oblique, lateral flexion, and extension views. Imaging may be deferred in cases of recurrent burners in which symptoms resolve, but radiography should be considered for any athlete with first-time symptoms. Radiographs should be evaluated for loss of cervical […]

Elbow Instability (Rupture of the Medial Collateral Ligaments)

The valgus stress overload syndrome can cause medial tension resulting in torsion of the medial (ulnar) collateral ligament (MCL). This ligament, especially its anterior band, is of great importance for elbow stability. It is composed of two parts: the origin of the anterior band is posterior to the axis of elbow rotation, while the origin […]

Shoulder Impingement Syndrome

Basics Description Shoulder pain with overhead activities is a common musculoskeletal complaint. Impingement syndrome: Inflammatory condition of the soft tissues of the subacromial space Most common cause of presentation for shoulder complaints to a physician’s office (>50% of all shoulder complaints) Represents a continuum, progressing from acute bursitis, to chronic bursitis, to partial-thickness tears […]

Compartment Syndrome of the Foot

Basics Description Compartment syndrome of the foot occurs when bleeding and interstitial edema in the muscle compartments of the foot cause a substantial decrease in capillary perfusion, resulting in myoneural ischemia and eventual necrosis. General Prevention Prevention of the long-term sequelae of compartment syndrome requires a high level of suspicion for the diagnosis. Epidemiology […]