Symptomatic Osseous Abnormalities at the Posteromedial Tubercle of the Talus: Magnetic Resonance Imaging Features.

Osseous alterations adjacent to the posteromedial tubercle of the talus that lead to posterior ankle impingement and their imaging findings have been much less well described than alterations of the posterolateral tubercle. We present 5 cases of osseous abnormalities at the posteromedial tubercle of the talus depicted on magnetic resonance imaging in subjects with chronic symptoms at this location, with no history of local trauma, who had presented with posteromedial mechanical pain and/or tarsal tunnel syndrome. The symptoms were related to mechanical changes of the bony and soft tissue structures, leading to posterior impingement, and to neurovascular bundle entrapment at the tarsal tunnel, leading to tarsal tunnel syndrome.

[Complex outpatient care to patients with osteoarthrosis and degenerative-dystrophic diseases of juxtaarticular soft tissues].

The aim of the article is an evaluation of effectiveness of the complex outpatient care to patients with osteoarthrosis and degenerative-dystrophic diseases ofjuxtaarticular soft tissues. Recent researches showed that the key factors of the pathogenesis of diseases were degenerative-dystrophic and inflammatory changes in the synovio-entheseal complex ofparaarticular muscles' tendon. 411 patients with osteoarthrosis of 531 synovial joints and degenerative-dystrophic diseases of periarticular soft tissues underwent sequential corticosteroid therapy combined with hyaluronic acid injections.

Successful injection of the acromioclavicular joint with use of ultrasound: anatomy, technique, and follow-up.

Background: Injection into the acromioclavicular (AC) joint is often inaccurate (approximately 50%) even in experienced hands. In light of new anatomic observations, we evaluate accuracy of an innovative ultrasound-guided method and follow the clinical course of successful therapeutic injections.

Method: Relevant anatomy was investigated in 200 three-dimensional computed tomography scans, 100 magnetic resonance images, and 14 cadavers.

Intra-articular and soft tissue injections, a systematic review of relative efficacy of various corticosteroids.

The comparative efficacy of various Corticosteroid (CS) injections commonly used to treat musculoskeletal conditions has not been systematically studied. Our objective is to synthesize data about comparative efficacy of various CS used for intra-articular and periarticular soft tissue injections. Online databases were searched including MEDLINE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Database of Abstracts of Reviews of Effectiveness, and bibliographies of studies till November 2013.

Ultrasound monitoring of the treatment of clinically significant knee osteoarthritis.

Objectives: The study presented an ultrasound (US) monitoring of treatment as a new imaging US method with the results of therapy of clinically significant knee osteoarthritis.

Background: X-ray is widely used for knee osteoarthritis classification, which does not involve the evaluation of the soft tissue. High frequency and high resolution US of joints (arthrosonography, echoarthrography) assess not only morphologic but also functional changes in the knee joint.

Intra-articular, bursa, and tendon sheath injections: a survey of practice patterns among members of the American College of Rheumatology.

Objective: The objective of this study was to survey members of the American College of Rheumatology (ACR) regarding intra-articular and soft tissue (musculoskeletal [MSK]) injections and to determine if injection techniques vary depending on type of practice and years of experience.

Methods: A survey was e-mailed to the members of the ACR to obtain demographics of the respondents, MSK injection practices, and adverse events seen.

Results: The most common indications for MSK injections were rheumatoid arthritis, osteoarthritis, and bursitis.

Palpation versus ultrasound-guided corticosteroid injections and short-term effect in the distal radioulnar joint disorder: a randomized, prospective single-blinded study.

The aim of this study was to conduct a randomized, prospective single-blinded clinical study on the mid-term benefits and accuracy rate of the ultrasound (US)-guided versus palpation-guided intra-articular (IA) injections for the treatment of distal radioulnar joint (DRUJ) disorder. Subjects with DRUJ disorder (n = 60) were randomly assigned to undergo US-guided or palpation-guided IA injection. Primary outcomes were measured with Disability of the Arm, Shoulder, and Hand questionnaire (DASH) and secondary outcomes included Verbal Numeric Pain Scale (VNS), Modified Mayo Wrist Score (MMWS), range of motion (ROM), and accuracy rate between two groups; 1.

Comparison of ultrasound-guided intra-articular injections by long axis in plane approach on three different sites of the knee.

Objective: The objective of this study was to examine the accuracy of ultrasound-guided intra-articular (IA) injections on three different sites of the knee using midmedial, midlateral, and superolateral portals.

Design: Ultrasound-guided IA injection and a radiographic evaluation were performed on 120 knees with osteoarthritis. Five milliliters of a mixed material consisting of 1% lidocaine (1 ml), 20 mg of triamcinolone (1 ml), and nonionic contrast (3 ml) was injected into the IA space of the knee through three different portals.

Efficacy of musculoskeletal injections by primary care providers in the office: a retrospective cohort study.

Background: Musculoskeletal joint pain of varied etiology can be diagnosed and treated with joint and soft-tissue corticosteroid injections.

Purpose: The purpose of our study was to compare patients' bodily pain and quality of life (QOL), in addition to the procedural benefit and patient satisfaction, before and after musculoskeletal injections in the office setting.

Patients And Methods: Patients were eligible for recruitment if they were over age 18 and had an injection for musculoskeletal pain from a primary care provider in an office procedural practice.

Clinical anatomy of the elbow and shoulder.

The elbow patients herein discussed feature common soft tissue conditions such as tennis elbow, golfers' elbow and olecranon bursitis. Relevant anatomical structures for these conditions can easily be identified and demonstrated by cross examination by instructors and participants. Patients usually present rotator cuff tendinopathy, frozen shoulder, axillary neuropathy and suprascapular neuropathy.

[Soft tissue swelling of the sternoclavicular joint].

A 73-year-old woman presented with a swelling of the right sternoclavicular joint the size of a hens egg which had persisted for 2 years. After a corticosteroid injection 8 months previously the swelling was asymptomatic. The magnetic resonance imaging (MRI) scan showed synovialitis of the sternoclavicular joint with edema of the adjacent bone.

[Ultrasound-guided joint injections in patients with rheumatic diseases].

Joint and soft tissue injections are routinely performed in daily rheumatology practice to establish the diagnosis or as part of the treatment in patients suffering from rheumatic diseases. Consequently, joint injections have been included in the rheumatology further training curriculum. Despite numerous studies demonstrating a poor accuracy and outcome of joint injections guided only by clinical examination, most of the injection procedures are still performed in a "blind" fashion based on clinical judgment.

[Musculoskeletal puncture, injection and infiltration: swiss rheumatologists' point of view].

Arthrocentesis, injection and infiltration of joints and soft tissues belong to the basic procedures in rheumatology. The indications and the practical performance are based on experience and tradition. Nowadays, a crucial reappraisal and adaption of indications and technical aspects appear important in the light of new evidence and technical developments.

[Steroid infiltrations in orthopedics].

For the past 60 years intraarticular infiltrations have been performed with variable results. However, they have improved with time as a result of the innovations seen in the techniques and the glucocorticoids used, according to reports by several authors. We report the experience and results obtained in 10 years in 793 patients applying 5 mg of betamethasone dipropionate and 2 mg of betamethasone sodium phosphate (Diprospan).

The snapping scapula: diagnosis and treatment.

As a largely under-recognized problem, snapping scapula stems from the disruption of normal mechanics in scapulothoracic articulation. It is especially common in the young, active patient population, and symptoms are frequently seen with overhead and throwing motions. Understanding the anatomy of the scapula and surrounding neurovascular structures is crucial in making a differential diagnosis and providing both nonoperative and surgical treatments.

BMP type I receptor inhibition reduces heterotopic [corrected] ossification.

Fibrodysplasia ossificans progressiva (FOP) is a congenital disorder of progressive and widespread postnatal ossification of soft tissues and is without known effective treatments. Affected individuals harbor conserved mutations in the ACVR1 gene that are thought to cause constitutive activation of the bone morphogenetic protein (BMP) type I receptor, activin receptor-like kinase-2 (ALK2). Here we show that intramuscular expression in the mouse of an inducible transgene encoding constitutively active ALK2 (caALK2), resulting from a glutamine to aspartic acid change at amino acid position 207, leads to ectopic endochondral bone formation, joint fusion and functional impairment, thus phenocopying key aspects of human FOP.

[True intra-articular lipoma in a rheumatoid knee].

Introduction: Lipoma is a frequent benign tumor of the soft tissue, but intra-articular locations are rare. We report a case that occurred in a rheumatoid knee.

Case: A 50-year-old woman had been treated for 17 years for seronegative deforming rheumatoid arthritis.

Functional problems and treatment solutions after total hip arthroplasty.

Dissatisfaction after total hip arthroplasty (THA) is linked to complications due to comorbitities, radiographic loosening, and poor prosthetic alignment. However, some patients have functional problems without obvious causes. This study elucidated soft tissue abnormalities that may lead to THA dysfunction and assessed the efficacy of customized physical therapeutic modalities.

Variations in corticosteroid/anesthetic injections for painful shoulder conditions: comparisons among orthopaedic surgeons, rheumatologists, and physical medicine and primary-care physicians.

Background: Variations in corticosteroid/anesthetic doses for injecting shoulder conditions were examined among orthopaedic surgeons, rheumatologists, and primary-care sports medicine (PCSMs) and physical medicine and rehabilitation (PMRs) physicians to provide data needed for documenting inter-group differences for establishing uniform injection guidelines.

Methods: 264 surveys, sent to these physicians in our tri-state area of the western United States, addressed corticosteroid/anesthetic doses and types used for subacromial impingement, degenerative glenohumeral and acromioclavicular arthritis, biceps tendinitis, and peri-scapular trigger points. They were asked about preferences regarding: 1) fluorinated vs.