Publications by authors named "Steffie E J M Klemann-Harings"

2 Publications

  • Page 1 of 1

Phenotyping the shoulder patient based on ultrasound-detected pathologies: a cross-sectional study in general practice.

Fam Pract 2021 06;38(3):313-320

Department of Family Medicine, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands.

Background: Shoulder complaints arise from a single pathology or a combination of different underlying pathologies that are hard to differentiate in general practice. Subgroups of pathologies have been identified on the basis of ultrasound imaging that might affect treatment outcomes.

Objective: Our aim was to validate the existence of different subgroups of patients with shoulder complaints, based on ultrasound-detected pathology, and compare clinical features among them. Profiling shoulder patients into distinct shoulder pathology phenotypes could help designing tailored treatment trials.

Methods: This was a cross-sectional study in general practice. Data were extracted from 840 first visit patient records at a single diagnostic centre in the Netherlands. Exclusion criteria were age <18 years and previous shoulder surgery. Latent class analysis was used to uncover cross-combinations of ultrasound detected pathologies, yielding subgroups of shoulder patients. The uncovered subgroups were compared for demographic and clinical characteristics.

Results: We uncovered four distinct subgroups of patients with shoulder complaints: (i) Frozen shoulder group (11%), (ii) Limited pathology group (44%), (iii) Degenerative pathology group (31%) and (iv) Calcifying tendinopathy group (15%). Group comparisons showed significant differences in demographic and clinical characteristics among subgroups, consistent with the literature.

Conclusion: In a general practice population, we uncovered four different phenotypes of shoulder patients on the basis of ultrasound detected pathology. These phenotypes can be used designing tailored treatment trials in patients with shoulder complaints.
View Article and Find Full Text PDF

Download full-text PDF

Source Listing
June 2021

[Suspected traumatic posterior shoulder luxation].

Ned Tijdschr Geneeskd 2019 10 11;163. Epub 2019 Oct 11.

Zuyderland Medisch Centrum, afd. Orthopedie, Heerlen.

BACKGROUND An obstetric brachial plexus lesion arises during childbirth as a consequence of excessive lateral traction of the neonate's head during shoulder dystocia. A small number of patients do not experience spontaneous recovery and secondary glenohumeral deformities can arise due to rotator cuff imbalance. CASE DESCRIPTION A 34-year-old man of Syrian descent with a history of a conservatively treated right-sided obstetric brachial plexus lesion went to the accident and emergency department (A and E) with acute pain in the right shoulder. Additional X-ray diagnostics suggested a posterior shoulder luxation, but attempts to relocate the glenohumeral joint in A and E failed. An additional CT scan of the shoulders revealed a severe right-sided dysplasia of the glenohumeral joint, with severe retroversion and posterior luxation of a rotated humeral head. After 3 weeks of relative rest through use of a sling and pain relief with an NSAID the pain had diminished and the patient had resumed his daily activities. CONCLUSION Posterior shoulder luxation can occur as a complication of obstetric brachial plexus lesion. Closed reduction is not of any use in these cases. The expertise of a specialized multidisciplinary team is indispensable for providing a patient with obstetric brachial plexus lesion with the best advice on treatment.
View Article and Find Full Text PDF

Download full-text PDF

October 2019