Tendonopathies

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AIM: To assess the relationship between the severity of full-thickness supraspinatus tendon tears and the development of subcoracoid impingement. MATERIALS AND METHODS: Fifty-one magnetic resonance imaging (MRI) shoulder examination reports with full-thickness supraspinatus tears were retrospectively identified and reviewed by two dedicated musculoskeletal radiologists. The appearances of the rotator cuff muscles, biceps tendon and the lesser tubercle were recorded...

OBJECTIVE: To compare the magnetic resonance (MR) imaging findings of a group of patients with clinically diagnosed peroneal tendonopathy and peroneal tenosynovitis with the MR imaging findings of a control group of patients with no clinical evidence of peroneal tendon disorder. SUBJECTS AND METHODS: The MR examinations of 24 patients with symptomatic peroneal tendinopathy or peroneal tenosynovitis and 70 patients with no clinical evidence of peroneal tendon disorder were retrospectively reviewed to determine the presence or absence of four MR imaging findings: 1) predominantly or uniform intermediate signal intensity within the peroneal tendons on one or more axial proton density-weighted images, 2) predominantly or uniform intermediate signal intensity within the peroneal tendons on three consecutive axial proton density-weighted images, 3) intermediate T2 signal intensity within the peroneal tendons, and 4) circumferential fluid within the common peroneal tendon sheath greater than 3 mm in maximal width...

Collagen deposition is an important process that occurs during wound healing. We and others have shown that nitric oxide (NO) is important in tendon healing. The mechanisms whereby healing is enhanced are, however, undetermined. The aim of this study was to investigate whether NO could enhance collagen synthesis in cultured human tendon cells via exogenous NO and via an adenovirus containing the gene for inducible nitric oxide synthase (Ad-iNOS). Tendon cells from the torn edge of the tendons of patients undergoing rotator cuff repair surgery were cultured following collagenase digestion, and stimulated with exogenous NO (SNAP), transfected with Ad-iNOS, and treated with the NOS inhibitor, L-NMMA...

OBJECTIVE: Surgical repair of the spring ligament is becoming recognized as an important management component of adult-acquired flatfoot, yet little literature exists on the MRI appearance of spring ligament abnormalities. In this article, we describe the MRI appearance of surgically proven spring ligament tears. CONCLUSION: MRI findings present in surgically proven spring ligament tears include an abnormal spring ligament caliber, signal intensity, waviness, a full-thickness gap, and posterior tibial tendonopathy...

OBJECTIVES: To assess the distribution of microvascular response on colour Doppler (CD) and power Doppler (PD) ultrasound (US) of the tendo Achilles (TA) in tendonopathy, and to look for any relationship between tendon morphology and symptoms. DESIGN AND PATIENTS: A retrospective, observational study was carried out on consecutive ambulant US patients with suspected tendonopathy, presenting with pain or an Achilles mass. Exclusion criteria were: use of steroids, and previous or possible rupture or surgery in either tendon or arthropathy...

Injuries to the Achilles tendon are common in primary care. Insertional tendonitis, retrocalcaneal bursitis, and paratenonitis are acute injuries usually treated conservatively with rest, ice, anti-inflammatory measures, and physical rehabilitation. Causative factors such as improper training or biomechanical abnormalities must be corrected to prevent reoccurrence. Achilles tendinosis is a chronic condition that does not always cause clinical symptoms. When symptoms occur, they are thought to be due to microtrauma or progressive failure resulting in inflammation...

PURPOSE: The purpose of this study was to examine preoperative shoulder magnetic resonance imaging (MRI) and intraoperative arthroscopic findings in throwing athletes with a clinical diagnosis of internal impingement. TYPE OF STUDY: Retrospective review. METHODS: A retrospective review of the surgical indications for 769 shoulder arthroscopic procedures performed from 1997 to 2000 revealed 9 throwing athletes with a diagnosis of severe internal impingement...

Arthroscopic biceps tenodesis is indicated for the treatment of severe biceps tendonopathy, partial- or full-thickness tendon tears, or biceps instability typically associated with rotator cuff tear, although there has been considerable debate on tenotomy versus tenodesis. We advocate tenodesis, for the following reasons: to re-establish the resting muscle length so as to avoid scaring and spasm, to allow biceps use for complex elbow motion, and to avoid cosmetic defects in cases in which deformity can sometimes equal disability...

PURPOSE: To examine the prognostic indicators associated with outcome following rotator cuff surgery. METHODS: A retrospective evaluation of records on 1120 shoulders (1067 patients) with rotator cuff tear treated by surgery was performed. Preoperative, intra-operative and postoperative factors were analysed by Kendall's Tau-b correlation analysis and logistic regression analysis. RESULTS: Positive correlations were seen between the type of tear and the number of tendons involved, retraction, age, degeneration, subacromial bone spur, surgical technique, preoperative and postoperative muscle power, surgical outcome, and preoperative abduction on Kendall's Tau-b analysis...

For 4 years we followed a group of football players in the youth division of a professional club, ranging in age from 9 to 19 years, and analyzed the major injuries, i.e., those which required them to be sidelined for at least 4 weeks. We observed 23 sprains, 16 fractures, 16 cases of osteochondrosis, 7 muscle lesions, 6 cases of groin pain (athletic pubalgia), and 4 tendonopathies. The most frequent sites were the knee (n=30) and the ankle (n=11); the trauma factor was predominant (65.2%) with respect to overuse; noncontact traumas were more numerous (63...

A patient is reported with a history of multiple tendon ruptures including biceps, flexor hallucis longus and achilles tendons. He presented with closed rupture of the flexor carpi radialis tendon following long standing tendonopathy and scapho-trapezio-trapezoid arthrosis. Non-operative treatment was elected because of low physical demands on the upper extremity. Early management of scapho-trapezio-trapezoid arthritis can prevent flexor carpi radialis tendon rupture.

The most widely used clinical magnetic resonance imaging techniques for the diagnosis of parenchymal disease employ heavily T(2)-weighted sequences to detect an increase or decrease in the signal from long T(2) components in tissue. Tissues also contain short T(2) components that are not detected or only poorly detected with conventional sequences. These components are the majority species in tendons, ligaments, menisci, periosteum, cortical bone and other related tissues, and the minority in many other tissues that have predominantly long T(2) components...

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The aim of this study was to investigate the involvement of apoptosis (programmed cell death) in the pathogenesis of rotator cuff disorders. The edges of torn supraspinatus rotator cuff tendons were collected from patients with rotator cuff tear (n = 25). Samples of the intra-articular portion of subscapularis tendons were collected from patients without rotator cuff tear as control (n = 6). To minimize individual variance, we also collected six pairs of supraspinatus tendon and subscapularis tendon from six patients with rotator cuff tears...

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Twenty-two patients (23 limbs) with chronic lateral elbow tendonopathy were examined retrospectively after surgical management. Thirteen men and 9 women with an average age of 43 years (range, 32-54 years) had a mean follow-up time of 41.2 months (range, 9-97 months). All patients underwent at least 6 months of nonsurgical treatment without favorable response. V-Y slide of the common extensor origin was done for all patients. Sixteen patients (17 elbows) were examined after surgery and 6 were interviewed by telephone...

There are numerous foot and ankle's pathologies and also numerous imaging technics. In fact, it often appears an inadequacy between the suspected pathology and the diagnostic tool used for its study. Aims. Know the qualities and the faults of each foot and ankle imaging technic. Know the best way of using these technics, according to the clinical problem, of a medical and economic point of view, in main skeletal pathologies, mechanical arthropathies of the hindfoot, tendonopathies, infections, and forefoot diseases...

Corticosteroids have been used extensively in the practice of orthopedics and podiatry. It is the authors' opinion that the issue of corticosteroids and their effect on the healing of tendon pathology has not been addressed sufficiently or answered adequately. Few studies have used a well-controlled injury model. Steroid dosage and steroid selection also appear to be random. Clinical experience in conjunction with a complete review of the literature, however, leads the authors to believe that the use of local corticosteroid injection is a valid treatment option...

A case report of radionuclide bone scan findings in a patient with peroneus brevis tendonitis is presented. Peroneal tendonopathy is a common cause of lateral ankle pain. Although magnetic resonance imaging (MRI) findings have been described in the literature, we know of no other detailed report of three-phase bone scan findings, which we believe can provide an alternate means to diagnose this condition. The positive findings consist of a curvilinear band of increased activity that corresponded to the anatomic position of the peroneus brevis tendon and was detected only on the first two phases of the study...