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Clin Orthop Relat Res 2021 May 5. Epub 2021 May 5.

Z. Rijs, Department of Orthopedic Surgery, Leiden University Medical Center, Leiden, the Netherlands.

Background: Shoulder injections for conditions such as adhesive capsulitis are commonly performed and can be administered through image-based or landmark-based injection approaches. Ultrasound-guided injections are widely used and accurate because ultrasound allows real-time visualization of the needle and injected contrast. Landmark-based injections would be advantageous, if they were accurate, because they would save the time and expense associated with ultrasound. Read More

Musculoskelet Surg 2021 Mar 23. Epub 2021 Mar 23.

Department of Orthopaedic Surgery, National University Hospital, 1E Kent Ridge Road, Singapore, 119228, Singapore.

Purpose: Symptomatic acromioclavicular joint (ACJ) osteoarthritis causes pain and limitations in activities of daily living. Open and arthroscopic distal clavicle excision techniques have been described with good outcomes. However, both techniques have their own sets of advantages and disadvantages. Read More

Knee Surg Sports Traumatol Arthrosc 2021 Jan 2. Epub 2021 Jan 2.

University of Brescia, Brescia, Italy.

Purpose: To conduct a scoping review to clarify the management of acromioclavicular joint osteoarthritis, as well as to identify any existing gaps in the current knowledge.

Methods: Studies were identified by electronic databases (Ovid, Pubmed) from their inception up to April 2nd, 2020. All studies reporting functional outcomes after conservative or surgical treatment of acromioclavicular joint osteoarthritis, either primary or secondary to trauma or distal clavicle osteolysis, were included. Read More

BMJ Open 2020 12 10;10(12):e034439. Epub 2020 Dec 10.

Departmental of Rheumatology, Vendée Departmental Hospital Center, La Roche sur Yon, France.

Introduction: Degenerative acromioclavicular joint pain accounts for about 4% of shoulder pain. Various medical and non-medical treatment strategies are available for acromioclavicular joint disease but it is difficult to conduct a comparative evaluation of these treatments. The few studies dealing with the medical management of the disease have conducted no comparative assessment of drug therapies, physiotherapy, joint manipulation and corticosteroid injections. Read More

Int J Surg Case Rep 2020 16;75:390-393. Epub 2020 Sep 16.

Department of Orthopaedic Surgery, University of Tor Vergata, Viale Oxford 81, 00133, Rome, Italy. Electronic address:

Introduction: Acromioclavicular joint cyst (AJC) is a very uncommon condition of the shoulder observed in elderly patients, caused by a degenerative acromioclavicular (AC) joint, frequently associated to a rotator cuff tendon tear. There are two possible cause for the cyst formation. We report two different cases of a AC synovial cyst, with and without rotator cuff tear. Read More

Orthop Traumatol Surg Res 2020 Oct 3;106(6):1141-1151. Epub 2020 Aug 3.

Division of Orthopedic Surgery, University of Toronto, Toronto, Canada. Electronic address:

Background: Ultrasound imaging offers a non-invasive method to visualize the anatomy and function of the musculoskeletal system. Despite its benefits and widespread adoption in medicine, ultrasonography is still not well utilized by orthopaedic surgeons. The purpose of this systematic review was to provide a better understanding of the diagnostic accuracy and clinical utility of ultrasound of the shoulder for orthopaedic surgeons. Read More

J Shoulder Elbow Surg 2021 Jan 9;30(1):16-26. Epub 2020 Jun 9.

Rhön-Klinikum Campus Bad Neustadt, Department for Shoulder and Elbow Surgery, Bad Neustadt a. d. Saale, Germany.

Background: Cutibacterium acnes (C acnes) is a mysterious member of the shoulder microbiome and is associated with chronic postoperative complications and low-grade infections. Nevertheless, it is unclear whether it represents a contaminant or whether it accounts for true infections. Because it can persist intracellularly in macrophages at several body sites, it might in fact be an intra-articular commensal of the shoulder joint. Read More

J Ultrasound 2020 Sep 15;23(3):317-325. Epub 2020 Jul 15.

Istituto Di Radiologia, IRCCS Policlinico S. Matteo, Pavia, Italy.

Acromioclavicular joint osteoarthritis is often a cause of shoulder pain. On the other hand, imaging frequently leads to such a diagnosis, especially in elderly patients, and some authors believe it to have a poor correlation with the clinical picture. It is, however, widely accepted that such a condition can be the cause of rotator cuff impingement. Read More

Acta Orthop Belg 2020 Mar;86(1):162-165

Heterotopic ossification is a well-known complication after orthopaedic surgical procedures, with a pre-dilection of the hip and elbow. Heterotopic ossification is a rare complication after shoulder arthroscopy and is rarely clinically significant. We report a case of a 65-year old Caucasian man with a slow and painful recovery after arthroscopic shoulder surgery encompassing rotator cuff repair, biceps tenotomy and acromioplasty, with recurrence of impingement symptoms unresponsive to conservative therapy (physiotherapy and one sub- acromial injection). Read More

FP Essent 2020 Apr;491:27-32

WellSpan York Hospital Sports Medicine Fellowship, 1001 S George St, York, PA 17403.

The clavicle is the most commonly fractured bone, and the most frequently fractured part of the clavicle is the middle third (ie, midshaft). X-ray usually is the first-line imaging modality for clavicle injuries. Conservative management is preferred for patients with uncomplicated and nondisplaced clavicular fractures. Read More

Orthopedics 2020 Jul 12;43(4):e215-e218. Epub 2020 Apr 12.

Intra-articular glenohumeral joint injections are commonly performed in the clinical setting for diagnostic and therapeutic purposes. Multiple approaches are described, including the anterior and posterior approaches and the less studied superomedial (Neviaser) approach. The purpose of this study was to determine the length of needle required to enter the shoulder joint via the Neviaser approach by radiography and magnetic resonance imaging (MRI) measurements. Read More

Open Forum Infect Dis 2020 Mar 12;7(3):ofaa089. Epub 2020 Mar 12.

Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.

Background: The clinical spectrum of septic arthritis in the era of the opioid crisis is ill-defined.

Methods: This is a retrospective chart review of 1465 cases of culture-positive native joint septic arthritis at Boston teaching hospitals between 1990 and 2018.

Results: Between 1990-2008 and 2009-2018, the proportion of septic arthritis cases involving people who inject drugs (PWID) rose from 10. Read More

Arthroscopy 2020 06 11;36(6):1535-1541. Epub 2020 Feb 11.

Department of Orthopedic Surgery, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China. Electronic address:

Purpose: To arthroscopically evaluate the trans-coracoacromial ligament glenohumeral (GH) injection technique by understanding intra-articular needle-tip placement and potential misplacement and complications.

Methods: The technique relies on the palpation of 3 bony landmarks: anterolateral corner of the acromion, superolateral border of the coracoid tip, and curved depression of the distal clavicle. The skin entry site lies on the line connecting the curved depression of the distal clavicle and superolateral border of the coracoid tip, two-thirds of the way from the former and one-third of the way from the latter. Read More

Am J Emerg Med 2020 05 19;38(5):1038. Epub 2019 Nov 19.

Department of Emergency Medicine, Veterans Health Service Medical Center, 53, Jinhwangdo-ro 61-gil, Gangdong-gu, Seoul 05368, Republic of Korea.

Spinal Cord Ser Cases 2019 13;5:46. Epub 2019 May 13.

1Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, 183 S. Orange Avenue BHSB F-1556, Newark, NJ 07103 USA.

Introduction: Shoulder pain is common in persons with chronic spinal cord injury (SCI), with a prevalence reported as high as 70%. Current treatment of shoulder pain includes conservative measures such as physical therapy, pain medications, patient education, injections, and assistive devices. When conservative treatments fail, shoulder surgery is often the next option. Read More

Am J Emerg Med 2020 01 14;38(1):162.e3-162.e5. Epub 2019 Aug 14.

Alameda Health System/Highland General Hospital, Department of Emergency Medicine, United States of America. Electronic address:

We present the first documented case of an emergency clinician treating the pain of an acute Acromioclavicular (AC) joint separation through ultrasound (US) guided injection of an anesthetic agent. A 41 year old male presented with an acute traumatic grade III AC joint separation after falling off a scooter, and his pain was not significantly improved with oral medication. The AC joint was located by US, and bupivacaine was injected into the joint effusion under US guidance, yielding near complete resolution of pain. Read More

Arthroscopy 2019 08 23;35(8):2274-2281. Epub 2019 Jul 23.

Department of Orthopaedic Surgery, Centre Hospitalier Universitaire de Reims, Reims, France.

Purpose: To compare the accuracy of distal suprascapular nerve (dSSN) blockade performed with the use of ultrasound-guided regional anesthesia (USRA) versus with a landmark-based approach (LBA). A secondary aim was to describe the anatomic features of the sensory branches of the dSSN.

Methods: USRA and LBA were performed in 15 shoulders each from 15 cadavers (total of 30 shoulders). Read More

Muscle Nerve 2019 07 11;60(1):1-6. Epub 2019 May 11.

Department of Rehabilitation and Regenerative Medicine, Columbia University College of Physicians and Surgeons, New York, New York, USA.

High frequency ultrasound is a valuable tool for assessing soft tissue injuries about the shoulder. It has advantages over other imaging modalities including relatively low cost, portability, and dynamic real-time visualization. It has a high sensitivity for identifying tendon degeneration, bursitis, and rotator cuff tears. Read More

J Shoulder Elbow Surg 2019 Jul 4;28(7):1291-1297. Epub 2019 Mar 4.

Department of Orthopedic Surgery, Hôpital Pierre-Paul Riquet, Toulouse, France.

Background: A bone landmark-based approach (LBA) to the distal suprascapular nerve (dSSN) block is an attractive "low-tech" method available to physicians with no advanced training in regional anesthesia or ultrasound guidance. The primary aim of this study was to validate the feasibility of an LBA to blockade of the dSSN by orthopedic surgeons using anatomic analysis. The secondary aim was to describe the anatomic features of the sensory branches of the dSSN. Read More

Clin J Sport Med 2021 Jan;31(1):78-85

School of Public Health, University of Sydney, Sydney, Australia.

Background: The use of local anesthetic painkilling injections to improve player availability is common practice in elite-level sport.

Objective: To document the published use of local anesthetic injections in sport, according to number of injections, sites of injections, and complications reported.

Data Sources: A systematic search of MEDLINE, Embase, CINAHL, AMED, Cochrane Database of Systematic reviews, SportDiscus, EBSCO Host, and Google Scholar. Read More

J Ultrason 2018 ;18(74):234-239

Oxford University and St Lukes Radiology Oxford Ltd, Oxford, UK.

Diagnosis is crucial in decision-making when treating a patient with shoulder pain. Ultrasound is also very important in the diagnostic and therapeutic pathway, especially when surgery is being considered. This article outlines the diagnostic pathway using the patient's history, physical examination and ultrasound examination. Read More

J Pain Res 2018 11;11:2311-2322. Epub 2018 Oct 11.

Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey.

Shoulder pain is a common musculoskeletal disorder of variable etiology, ranging from rotator cuff pathology to peripheral nerve entrapment. Advances in ultrasound (US) technology have allowed static and dynamic evaluation of shoulder problems and most importantly, offer real-time, radiation-free guidance for interventions. The present review aims to describe shoulder anatomy in detail using information from cadaveric models and to illustrate US-guided techniques using clearly labeled figures and videos. Read More

J Ultrasound Med 2019 Mar 31;38(3):605-612. Epub 2018 Aug 31.

Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan.

Objectives: Prolotherapy is an injection-based complementary treatment for various musculoskeletal diseases. The aim of this study was to evaluate the therapeutic efficacy of ultrasound-guided prolotherapy in the treatment of acromial enthesopathy and acromioclavicular joint arthropathy.

Methods: Thirty-one patients with chronic moderate-to-severe shoulder pain were recruited from September 2015 to September 2017. Read More

Am J Orthop (Belle Mead NJ) 2018 Jul;47(7)

Midwest Orthopaedics at Rush, Chicago, IL.

Despite advancements in surgical technique and understanding of throwing mechanics, controversy persists regarding the treatment of grade III acromioclavicular (AC) joint separations, particularly in throwing athletes. Twenty-eight major league baseball (MLB) orthopedic team physicians were surveyed to determine their definitive management of a grade III AC separation in the dominant arm of a professional baseball pitcher and their experience treating AC joint separations in starting pitchers and position players. Return-to-play outcomes were also evaluated. Read More

J Am Acad Orthop Surg 2018 May;26(9):303-312

From the Department of Orthopaedic Surgery, University of Pittsburgh Medical Center for Sports Surgery, Pittsburgh, PA.

In the past 30 years, the use of ultrasonography in the field of orthopaedics has evolved. As ultrasonography has been refined, smaller machines with higher fidelity and better transducers have become available at a lower cost. Diagnostic and therapeutic applications of ultrasonography in the shoulder and elbow have expanded imaging options and provided alternatives to surgical management. Read More

Orthop J Sports Med 2018 Feb 22;6(2):2325967118756576. Epub 2018 Feb 22.

Department of Family Community Medicine, Penn State Hershey Medical Center, Hershey, Pennsylvania, USA.

Office-based ultrasonography has become increasingly available in many settings, and its use to guide joint and soft tissue injections has increased. Numerous studies have been conducted to evaluate the use of ultrasound-guided injections over traditional landmark-guided injections, with a rapid growth in the literature over the past few years. A comprehensive review of the literature was conducted to demonstrate increased accuracy of ultrasound-guided injections regardless of anatomic location. Read More

Sports Health 2018 Sep/Oct;10(5):453-461. Epub 2018 Feb 22.

Department of Orthopedics, University of Colorado School of Medicine, Aurora, Colorado.

Background: Previous studies have analyzed the treatment patterns used to manage injuries in National Football League (NFL) players.

Hypothesis: Treatment patterns for injuries in NFL players will have changed over the study period.

Study Design: Descriptive epidemiology study. Read More

Sports Health 2018 May/Jun;10(3):234-243. Epub 2018 Jan 3.

Department of Orthopedics, University of Colorado School of Medicine, Aurora, Colorado.

Background: Previous studies have analyzed the treatment patterns used to manage injuries in National Collegiate Athletic Association (NCAA) Division I football players.

Hypothesis: Treatment patterns used to manage injuries in NCAA Division I football players will have changed over the study period.

Study Design: Descriptive epidemiology study. Read More