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Are you suffering from Hip Bursitis?

Hip Bursitis

Hip Bursitis

Pain along the side of the hip is still a common spot for bursitis (also known as greater trochanter pain syndrome. A large tendon passes over the bony bump on the side of the hip called the greater trochanter.

Inflammation in the bursa (a protective gel sac) between the tendon and […]

Operative-Indications

After conservative treatment measures have failed, if the patient continues to have biceps associated symptoms, surgical management should be considered. The imaging studies previously discussed should be utilized prior to considering surgical treatment because of the significant overlap of biceps disorders and other shoulder conditions.

Biceps tendinitis is commonly associated with impingement syndrome and rotator […]

Impingement: Secondary

Individuals with shoulder instability or other underlying pathology can develop significant abnormal mechanics that can lead to rotator cuff functional disability, eventual fatigue and loss of humeral head containment. When this occurs, rather than the coracoacromial arch moving toward the cuff, the cuff migrates cephalad as containment is compromised.

In addition to articular-sided internal impingement-type […]

Pathoanatomy

Before describing the mechanics of rotator cuff pathology, post-mortem studies provide an interesting backdrop to the issue of etiology. There is little doubt that rotator cuff tearing is a function of age among other factors. Post-mortem studies have indicated an incidence of full or partial thickness tears ranging from 5% to nearly 40% . Fukuda […]

The Rotator Cuff

Key Points The majority of symptomatic rotator cuff disease patients respond to a nonoperative program emphasizing the restoration of normal biomechanics, unrestricted motion, and functional force couples.Early surgical management should be considered for acute rotator cuff tears in physiologically young and very active individuals.

The ability to recognize the complex layered anatomy in addition to […]

Absolute Indications for Open Surgery

Absolute indications for open stabilization procedures include significant degrees of glenoid or humeral bone loss, capsular deficiencies, or irreparable rotator cuff tears, particularly those of the subscapularis. In individuals with significant anterior glenoid erosion, an osseous reconstruction should be performed.

In the rare case where a large humeral head defect (Hill-Sachs lesion) plays a […]

Results

The results of arthroscopic subacromial decompression have been well documented. Ellman was one of the first to publish results comparable with the previous good results seen with an open technique. His subsequent 2 to 5 year results yielded on overall 89% satisfaction.

These excellent results have been reproduced and expanded upon in terms of patient […]

Differential Diagnosis

It is important to carefully evaluate for other sources of shoulder pain. These may include acromioclavicular arthrosis rotator cuff tear (partial or complete), instability, adhesive capsulitis, glenohumeral arthritis, biceps tendonosis, labral pathology, and cervical radiculopathy. It is also important to remember that there can be more than one source of pain. The two most common […]

Anatomy and Pathophysiology

In the normal shoulder, the coordinated muscle tension within the rotator cuff compresses the humeral head, keeping it centered within the glenoid fossa. By coupling with the force of the deltoid, a fulcrum is created that allows strength through a wide arc of motion.

The overlying subacromial bursae reduces friction between the tendonous cuff and […]

Evaluation-Imaging

Several tests may be necessary to rule out other causes of shoulder pain, because isolated axillary nerve injury and quadrilateral space syndrome are rare. Plain radiographs typically are ordered, but these are useful in these cases only with a history of trauma that is consistent with a possible proximal humerus fracture, scapular neck fracture, or […]