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Background: Data regarding controlled aliasing in parallel imaging results in higher acceleration (CAIPIRINHA) T2-weighted sampling perfection with application optimized contrast evolution (SPACE) with fourfold acceleration factor for assessing long head of biceps tendon (LHBT) disorder is lacking. Purpose: To investigate the feasibility of 3D CAIPIRINHA SPACE with fourfold acceleration in assessing LHBT disorder. Material and Methods: A total of 42 consecutive patients underwent shoulder magnetic resonance (MR) examinations including CAIPIRINHA SPACE with fourfold acceleration, and non-CAIPIRINHA SPACE with twofold acceleration, and 2D fast spin echo (FSE). A subjective score of depiction of LHBT was given to 3D sequence according to a 4-point scale (0–3, "poor" to "excellent"). The Wilcoxon signed rank test was used to compare depiction scores between 3D sequences. Three statuses of LHBT were defined in the study: normal, tendonitis, and tear. McNemar's test was used compare diagnostic accuracy. Results: LHBT was better depicted with CAIPIRINHA SPACE versus non-CAIPIRINHA SPACE (2.1 ± 0.4 vs. 1.5 ± 0.4; P < 0.001). Inter-modality agreement between CAIPIRINHA SPACE and 2D FSE was almost perfect (kappa = 0.884 ± 0.064). The sensitivity and specificity in detecting LHBT disorder were 95% (20/21) and 95% (20/21), respectively, for CAIPIRINHA SPACE, and 71% (15/21) and 76% (16/21), respectively, for non-CAIPIRINHA SPACE (P = 0.039). Conclusion: Fourfold acceleration CAIPIRINHA is feasible in reducing the acquisition time of SPACE MR in the shoulder. 3D CAIPIRINHA SPACE with fourfold acceleration is highly accurate in detecting LHBT disorder. [ABSTRACT FROM AUTHOR]

Objectives: We investigated the correlation of aponeurotic expansion of the supraspinatus tendon (AESST) with shoulder pathologies such as long head of biceps tendon (LHB), supraspinatus tendon (SST), and subscapularis tendon (SSc). Methods: We retrospectively evaluated 47 healthy patients and 163 patients with shoulder symptoms from August 2014 to March 2021. First, the presence of AESST was evaluated based on Moser et al.'s classification. Second, the presence of abnormal findings of including LHB tendinitis, LHB subluxation, SST tendinitis, SST tear, SSc tendinitis, and SSc tendon tear was evaluated. We analyzed the prevalence and type of AESST between the two study groups and the relationship between abnormal findings and the presence of AESST. Results: The prevalence of AESST for readers 1 and 2 was 26.1% and 30.4% in the asymptomatic group, respectively, and 22.8% and 31.3% in the symptomatic group. Type 1 was most common (17.3–23.9%) followed by types 2a and 2b. There were no significant differences in the distribution of aponeurosis type between the two groups. In the AESST-positive groups, 45.9% and 47.1% had SST tears on examination by readers 1 and 2, respectively, whereas only 26.4% and 27.9% had SST tears in the AESST-negative group suggesting AESST is associated with SST tear. The odds ratio for SST tear in the presence of AESST was 2.370 and 2.294 (readers 1 and 2). Conclusions: There is an association between SST tears and the presence of AESST. Key Points: • We evaluated the prevalence of aponeurotic expansion of the supraspinatus tendon (AESST) on MR imaging by type in both symptomatic and asymptomatic groups. • We investigated the correlation of AESST with shoulder pathologies such as biceps tendon and supraspinatus tendon tears. • There is an association between SST tears and the presence of AESST. • Radiologists should be aware of the risk of rotator cuff pathology if AESST is detected. [ABSTRACT FROM AUTHOR]

Background: About sixty percent of all shoulder discomfort cases are caused by supraspinatus tendonitis. Extracorporeal shock wave therapy (ESWT), which has been shown to be effective in treating a number of musculoskeletal conditions, including enthesopathies, seems to be a potential alternative. Supraspinatus tendinopathy is treated with a variety of progressive exercises. Objective: In order to effectively treat chronic supraspinatus tendonitis, this study evaluated the therapeutic effects of SWT, at-home exercises, and their combination. Patients and Methods: This study was a clinical trial study and was carried out on patients with chronic supraspinatus tendinitis and were randomly divided into three groups according to the line of treatment. Shockwave therapy group included 26 patients. Home exercises program group included 26 patients. Combined shockwave therapy and home exercises program group included 26 patients. Diagnosis of supraspinatus tendinitis was confirmed by diagnostic musculoskeletal ultrasonography. Results: There were improvement in all groups but combined therapy group was superior to other groups. Shockwave therapy group showed improvement in shoulder pain, tenderness, active abduction and disability but home exercises group had better effects while combined therapy group showed more improvements in all shoulder parameters relative to the baseline and between groups. Conclusion: Shockwave therapy and home exercises have been proved to be effective for the treatment of chronic supraspinatus tendinitis, improving shoulder pain, tenderness, active abduction and disability. They also reduced the treatment cost. Adding home exercises to shock wave therapy interventions increases the gained improvements in all shoulder parameters relative to the baseline and between groups. [ABSTRACT FROM AUTHOR]

Background: Previous longitudinal cohort studies have reported the conflicting results of the relationship between statin use and the development of tendinopathy disorder. It is unclear if there is a relationship between statin use, particularly the type or cumulative doses, and the development of tendinopathy disorder. Purpose: To investigate an association between statin treatment and the development of tendinopathy. Study Design: Cohort study; Level of evidence, 3. Methods: A total of 594,130 participants were enrolled in this study in 2002 and evaluated until 2015. There were 84,102 statin users and 168,204 nonusers (controls) selected at a ratio of 1:2 using propensity score matching analysis. The types of included tendinopathy were as follows: (1) trigger finger, (2) radial styloid tenosynovitis, (3) elbow epicondylitis, (4) rotator cuff tendinopathy, and (5) Achilles tendinitis. Cox proportional hazards models with time-varying covariates were constructed to identify the association between statin use and tendinopathy development. Results: Statin treatments regardless of statin types were associated with a significantly greater risk of all types of tendinopathy development (hazard ratio, 1.435; 95% CI, 1.411-1.460) compared with no statin treatment. A trend toward risk reduction was observed according to cumulative statin doses, which was indicated by hazard ratios of 2.337 (95% CI, 2.269-2.406), 2.210 (95% CI, 2.132-2.290), and 1.1 (95% CI, 1.098-1.146) in patients with cumulative defined daily doses of 90, 91-180, and >180, respectively. Conclusion: This nationwide population-based cohort study suggests that statin use regardless of the statin type was associated with a greater risk of tendinopathy compared with that of nonusers. The risk of tendinopathy development was diluted with the increasing cumulative defined daily dose. [ABSTRACT FROM AUTHOR]

Objective: to evaluate the effectiveness of shock wave therapy in the complex treatment of athletes with lateral epicondylitis in comparison with standard methods of treatment.Materials and methods: On outpatient treatment in the period from 2019 to 2022. There were 168 athletes diagnosed with Lateral epicondylitis, including 78 women (46.4 %) and 90 men (53.6 %) aged 20 to 45 years. The mean age of the patients was 31.48 ± 6.72 years. The average duration of the disease was 33.68 ± 28.17 days. To achieve the set goals and objectives, a prospective randomized controlled clinical trial was conducted. We used a clinical examination of patients, a study of carpal dynamometry of the affected arm, an assessment of the level of pain and quality of life using the QuickDash and Patient-Rated Tennis Elbow Evaluation (PRTEE) scales, statistical research methods, as well as the use of standard treatment for lateral epicondylitis and radial shock wave therapy with an assessment of effectiveness one month after treatment.Results: shock wave therapy in the complex treatment of athletes with lateral epicondylitis, compared with standard methods of treatment, improved the quality of life and reduced pain three weeks after the start of treatment and has a more pronounced effect in the long term (p < 0.05); allowed to reduce the intensity of the signal from the bone tissue (trabecular edema) according to the results of magnetic resonance imaging.Conclusion: the expediency of using shock wave therapy in the complex treatment of athletes with lateral epicondylitis is substantiated, which makes it possible to recommend its use in practical healthcare.

The study aimed to assess the race performance after injury of the palmar metacarpal tendon region in Thoroughbred and Arabian racehorses. A special scoring system was established to evaluate the performance of the horses for each race after the injury, objectively in this study. Thus, individual total race earnings, the rates of ranking among the top four in at least two and three races and the number of participated races after injury were also analysed. The performance scores after injury were found to be lower in tendinitis cases compared to peritendinitis cases (P=0.0004). It was found that the success rate was lower in cases with tendon lesions than in cases without lesions in terms of race performance after injury (P=0.006). Injuries causing tendon thickening and also tendon echogenicity alterations had negative effects on race performances after injury (P=0.01 and P=0.04, respectively). Also individual total race earnings were lower in cases with tendon thickening compared to those without thickening (P=0.02). According to the results of this study, it is recommended to take prophylactic measures for tendinitis in cases with tendon thickening and echogenicity changes detected by ultrasound in the early stages of tendinitis to be able to display a good race performance after injury.

Background : Steroid injection after percutaneous irrigation of calcific deposits is a common method for the treatment of rotator cuff calcific tendinitis (RCCT). However, steroids may prevent calcification resorption and cause potentially irreversible damage to tendons. Recent studies have confirmed the positive effects of ozone injection in shoulder tendinopathies, but no RCCTs have been reported. Thus, our study aims to evaluate the non-inferiority of ozone versus steroid injection. Methods: This is a prospective, randomized, parallel control and non-inferiority trial. A total of 100 patients with unilateral symptomatic RCCT will be enrolled and randomized in a 1:1 ratio to two groups: ultrasound-guided injection with ozone or corticosteroid. The primary outcome is the numeric rating scale for pain (NRS) at 1 week and 3 months following the procedure. Secondary outcomes include a multi-dimensional evaluation of shoulder disability and quality of life improvement, the degree of calcification absorption after treatment, and the number of multiple treatments. Discussion: The results of this study will provide short-term and long-term evidence for the effectiveness of ozone treatment in RCCT in relieving pain or improving shoulder function. Trial registration: Chinese Clinical Trial Registry ChiCTR2200063469. Registered on 7 September 2022. [ABSTRACT FROM AUTHOR]

This study aimed to characterize aging‐induced tendinopathy in mouse Achilles tendon and also to assess the treatment effects of metformin (Met) on aging tendon. We showed that compared to young tendon, aging tendon was in an inflammatory and senescent state as shown by increased expression of inflammatory disulfide HMGB1 (dsHMGB1), inflammatory macrophage marker CD68, and senescent cell markers SA‐β‐gal, p53, and p16. Moreover, aging tendon was degenerated marked by accumulation of proteoglycans and lipids in its interior. However, treatment of aging tendon by intraperitoneal (IP) injection of Met, a specific inhibitor of HMGB1, reduced dsHMGB1 levels, decreased the expression of CD68, SA‐β‐gal, CCN1, and p16 in vitro and in vivo. Furthermore, Met treatment also increased the number of NS, SSEA‐1, and CD73 positive stem cells in culture and improved the tendon structure in aging mouse. These findings of this study indicate that Met exerts anti‐inflammatory and anti‐senescent effects on aging tendon. Clinical significance: Metformin may be used as a therapeutic to aging‐induced tendinopathy in clinics. [ABSTRACT FROM AUTHOR]

Background: Extracortical single-button (SB) inlay repair is a commonly used distal biceps tendon technique. However, complications (eg, neurovascular injury) and nonanatomic repairs have led to the development of intracortical fixation techniques. Purpose: To compare the biomechanical stability of extracortical SB repair with an anatomic intracortical double-button (DB) repair technique. Study Design: Controlled laboratory study. Methods: The distal biceps tendon was transected in 18 cadaveric elbows from 9 donors. One elbow of each donor was randomly assigned to the extracortical SB or anatomic DB group. Both groups were cyclically loaded with 60 N over 1000 cycles between 90° of flexion and full extension. The elbow was then fixed in 90° of flexion and the repair construct loaded to failure. Gap formation and construct stiffness during cyclic loading and ultimate load to failure were analyzed. Results: When compared with the extracortical SB technique after 1000 cycles, the anatomic DB technique showed significantly less gap formation (mean ± SD, 2.7 ± 0.8 vs 1.5 ± 0.9 mm; P =.017) and significantly more construct stiffness (87.4 ± 32.7 vs 119.9 ± 31.6 N/mm; P =.023). Ultimate load to failure was not significantly different between the groups (277 ± 93 vs 285 ± 135 N; P =.859). The failure mode in the anatomic DB group was significantly different from that of the extracortical SB technique (P =.002) and was due to fracture avulsion of the cortical button in 7 of 9 specimens (vs none in the SB group). Conclusion: Our study shows that the intracortical DB technique produces equivalent or superior biomechanical performance to that of the SB technique. The DB technique may offer a clinically viable alternative to the SB repair technique. Clinical Relevance: This study suggests, at worst, an equivalent and, at best, a superior biomechanical performance of intracortical anatomic DB footprint repair at the time of surgery. However, the mode of failure suggests that this technique should not be used in patients with poor bone quality. [ABSTRACT FROM AUTHOR]

Rotator cuff (RC) tendinopathy is a common recurrent cause of shoulder pain, and resistance exercise is the first-line recommended intervention. Proposed causal mechanisms of resistance exercise for patients with RC tendinopathy consist of four domains: tendon structure, neuromuscular factors, pain and sensorimotor processing, and psychosocial factors. Tendon structure plays a role in RC tendinopathy, with decreased stiffness, increased thickness, and collagen disorganization. Neuromuscular performance deficits of altered kinematics, muscle activation, and force are present in RC tendinopathy, but advanced methods of assessing muscle performance are needed to fully assess these factors. Psychological factors of depression, anxiety, pain catastrophizing, treatment expectations, and self-efficacy are present and predict patient-reported outcomes. Central nervous system dysfunctions also exist, specifically altered pain and sensorimotor processing. Resisted exercise may normalize these factors, but limited evidence exists to explain the relationship of the four proposed domains to trajectory of recovery and defining persistent deficits limiting outcomes. Clinicians and researchers can use this model to understand how exercise mediates change in patient outcomes, develop subgroups to deliver patient-specific approach for treatment and define metrics to track recovery over time. Supporting evidence is limited, indicating the need for future studies characterizing mechanisms of recovery with exercise for RC tendinopathy. [ABSTRACT FROM AUTHOR]

Introduction: Tendinopathy, the most common form of chronic tendon disorder, leads to persistent tendon pain and loss of function. Profiling the heterogeneous cellular composition in the tendon microenvironment helps to elucidate rational molecular mechanisms of tendinopathy. Methods and results: In this study, through a multi-modal analysis, a single-cell RNA- and ATAC-seq integrated tendinopathy landscape was generated for the first time. We found that a specific cell subpopulation with low PRDX2 expression exhibited a higher level of inflammation, lower proliferation and migration ability, which not only promoted tendon injury but also led to microenvironment deterioration. Mechanistically, a motif enrichment analysis of chromatin accessibility showed that FOXO1 was an upstream regulator of PRDX2 transcription, and we confirmed that functional blockade of FOXO1 activity induced PRDX2 silencing. The TNF signaling pathway was significantly activated in the PRDX2-low group, and TNF inhibition effectively restored diseased cell degradation. Discussion: We revealed an essential role of diseased cells in tendinopathy and proposed the FOXO1-PRDX2-TNF axis is a potential regulatory mechanism for the treatment of tendinopathy. [ABSTRACT FROM AUTHOR]

Background: We have developed a novel technique for managing rotator cuff calcific tendonitis, involving arthroscopic debridement of calcific tendonitis with localization assistance from a breast biopsy needle under ultrasound guidance. While we have demonstrated encouraging results at six-month follow-up, the medium-term outcomes and the long-term outcomes of this technique at 2 years or beyond are unknown. The aim of this paper was to determine if this technique was successful in resolving symptoms after two years and beyond. Study Design: Retrospective Cohort Study. Methods: Patients who underwent arthroscopic debridement of calcific tendonitis with localization assistance from a breast biopsy needle under ultrasound guidance by a senior surgeon were evaluated using patient-rated pain scores and functional status with the use of the Likert scales and via examiner-rated shoulder range-of-motion and strength at the pre-operative visit, at 1, 6, 12, and 24 weeks post-operatively, and long-term at a mean of 249 weeks after surgery. Results: At a mean follow-up period of 4.8 years (range, 2–10 years), 31 patients (33 shoulders) experienced significant improvement in the severity of pain at rest, with overhead activities, and during sleep compared to their pre-operative presentation (p < 0.001). The patient experienced less frequent pain during activities and sleep, and a decreased frequency of extreme pain (p < 0.001). Passive range of abduction (p = 0.003), forward flexion (p < 0.001), and supraspinatus strength (p = 0.018) improved compared to the presurgical presentation. Out of 27 patients, 24 patients (89%) had complete resolution of calcific tendonitis, and 26 patients (96%) had an intact rotator cuff. Conclusion: Arthroscopic debridement of calcific tendonitis with localization assistance from a breast biopsy needle under ultrasound guidance was very effective. Patients had significant pain relief, improved range of motion, and a reduction in stiffness at a mean post-operative period of 4.8 years. Patients had a significant reduction in residual calcification, and rotator cuff integrity was largely preserved by long-term follow-up. What is known about this subject: Calcific tendonitis of the rotator cuff is one of the most painful and debilitating disorders of the shoulder. This condition is characterized by the deposition of calcium-phosphate crystals within the rotator cuff tendons. Arthroscopic debridement and excision of rotator cuff calcifications have proven to be efficacious treatments with regards to clinical and functional outcomes in the short and medium term. Identifying the calcific lesion intra-operatively, however, can prove to be challenging. Furthermore, inadequate excision of the calcific deposit has been shown to have poorer clinical outcomes. We designed a technique that utilizes the assistance of ultrasound to guide a localization-biopsy wire to the calcific lesion. This technique aids in precisely identifying the location of the lesion intra-operatively to optimize accuracy in removing the maximum amount of calcific deposit possible. A short-term follow-up study by us has demonstrated successful outcomes with regards to the return of function and relief of pain. However, there have been no studies evaluating the effectiveness of this particular technique beyond six months. What this study adds to current knowledge: At a mean of 4.8 years, arthroscopic debridement of calcific tendonitis, using our technique, was successful in relieving the severity and frequency of pain with overhead activities, pain at rest, and pain during sleep, as well as improving range of motion. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Lateral epicondylitis is a common disorder in the community. Identification of risk factors plays an important role in the prevention and treatment of the disease. In our study, the relationship between risk factors in lateral epicondylitis and blood group, which has not been mentioned before in the literature, will be examined. PATIENTS AND METHODS: In our study, patients’ age, height, weight, body mass index (BMI), dominant upper extremity, affected upper extremity, duration of symptoms, duration between onset of symptoms and hospital admission, occupation, number of children and youngest child age (if the patient is a mother), smoking, alcohol use, presence of additional diseases, sports activities, job requiring repetitive movements and strength in the upper extremities in daily life, marital status, where he/she lives and his/her blood type were questioned. In our study, there were 304 patients in the patient group and 304 patients in the control group. RESULTS: In our study, blood type 0 was significantly more common in the patient group (p<0.001). CONCLUSIONS: In our study, it was concluded that there is a relationship between 0 blood group and lateral epicondylitis. [ABSTRACT FROM AUTHOR]

Background and purpose: Soong classification is used to estimate volar locking plate prominence and evaluate the risk for flexor tendon ruptures after surgical treatment of distal radius fractures (DRFs). However, the scientific community has questioned the Soong classification due to lacking evidence. Therefore, this study aimed to evaluate the accuracy of Soong grading as a predictor for flexor tendon issues and plate removal. Patients and methods: We performed a retrospective single-center review of adult distal radius fracture patients treated with a volar locking plate between 2009 and 2019. In total, 2779 patients were included in the study. The primary outcome was a flexor tendon issue (flexor tendon rupture, tendinitis, or flexor irritation), whereas plate removal was a secondary outcome. Using Soong grade 0 as a reference, we used univariable and multivariable logistic regression to calculate odds ratios (OR) with 95% confidence intervals (CI) for flexor tendon issues and plate removal. Results: In total, 756 (27%) patients were graded as Soong 0, 1679 (60%) Soong 1, and 344 (12%) Soong 2, respectively. There were 32 (1.2%) patients with flexor tendon issues, of which 4 were flexor tendon ruptures, 8 tendinitises, and 20 flexor irritations. The adjusted OR for flexor tendon issues was 4.4 (CI 1.1–39.7) for Soong grade 1 and 9.7 (CI 2.2–91.1) for Soong grade 2. The plate was removed from 167 (6.0%) patients. Soong grade 1 had a univariable OR of 1.8 (CI 1.2–2.8) for plate removal, and Soong grade 2 had an OR of 3.5. (CI 2.1–5.8), respectively. Conclusion: Flexor tendon ruptures are rare complications after the volar plating of DRFs. A higher Soong grade is a risk factor for flexor tendon issues and plate removal. Trial registration: The trial was retrospectively registered. [ABSTRACT FROM AUTHOR]

Background: Rotator cuff tendinopathy is a common diagnosis among patients with shoulder pain and dysfunction. Laser therapy is recommended for the treatment of this tendon disease due to the possibility of increasing tissue biostimulation. The aim of this study was to investigate the effects of HELT (high-energy laser therapy) in relation to the wavelengths of 650 nm, 810 nm, 980 nm, and 1064 nm administered. Methods: The study design was prospective and observational. Thirty patients with shoulder tendinopathy were recruited and treated in one of two high-energy laser therapy groups (5 Watt/cm2, 450 Joule, super-pulsed mode). Group A received a high-energy laser therapy protocol with a single wavelength (1064 nm); group B received a high-energy laser therapy program with four wavelengths (650 nm, 810 nm, 980 nm, and 1064 nm). Pain (VAS), function (ASES), and disability (DASH) were monitored at the time of recruitment (T0), 1 month later (T1), and 6 months later (T2). Roles and Maudsley scores were also evaluated at T1 and T2. Results: Both protocols resulted in improvement of pain and in functional and disability recovery at the two times of assessment, without statistically significant differences. In group B, treated with the four wavelengths, a trend emerged, bordering on statistical significance, for a greater reduction in pain. Conclusions: The high-energy laser proved to be an effective therapy for the treatment of rotator cuff tendinopathy. The possibility of modulating the choice of wavelengths could allow the customization of the protocol in relation to the patient's clinical condition. [ABSTRACT FROM AUTHOR]

Osteoid osteoma (OO) is a benign bone tumor that rarely occurs in the bones of the hand. Due to the comparatively non-specific symptoms when occurring in the hand, OO is often misdiagnosed at first presentation, posing a diagnostic challenge. In the present case study, six cases of phalangeal and carpal OO, treated surgically at our department between 2006 and 2020, were retrospectively reviewed. We compared all cases regarding demographic data, clinical presentation, imaging findings, time to diagnosis, surgical treatment, and clinical outcome in follow-up examinations. When OO occurs in the bones of the hand, it can lead to swelling and deformities, such as enlargement of the affected bone and nail hypertrophy. Initial misdiagnoses such as primary bone tumors other than OO, tendinitis, osteomyelitis, or arthritis are common. Most of the presented cases showed a prolonged time until diagnosis, whereby the primarily performed imaging modality was often not sensitive. CT proved to be the most sensitive sectional imaging modality for diagnosing OO. With adequate surgical treatment, complications and recurrence are rare. [ABSTRACT FROM AUTHOR]

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Context: Reduction of the subacromial space (SAS) during arm elevation may contribute to rotator cuff (RC) tendinopathy. The effects of scapular taping on the SAS in athletes with and without RC tendinopathy are unknown. Objective: To investigate the immediate effects of scapular taping on the SAS in athletes with and without RC tendinopathy. Design: Randomized controlled study with repeated measures. Setting: University laboratory. Participants: A total of 43 male volleyball players (17 asymptomatic and 26 with RC tendinopathy, mean age = 22.9 [3.5] y) participated in the study. Intervention: Three scapular taping protocols—no taping (control), taping with tension (therapeutic taping), and taping without tension (sham taping). Main Outcome Measures: Ultrasound measurements of the SAS with the arm at 0° and 60° of shoulder abduction, and the change in the SAS between 0° and 60° of shoulder abduction (SAS0°–60°) were calculated. Results: Athletes with RC tendinopathy demonstrated larger SAS with therapeutic taping at 60° of shoulder abduction (6.9 [1.9] mm vs 5.8 [1.7] mm, mean difference = 1.1 mm, 95% confidence interval, −1.80 to −0.39, P =.002) when compared with the no taping condition. The tendinopathy group also showed less reduction in the SAS with therapeutic taping during SAS0°–60° (2.0 [1.4] mm vs 2.8 [1.4] mm, P =.02) when compared with the no taping condition. When tape was applied to the scapula in asymptomatic athletes, our results showed a relatively small increase in the SAS with therapeutic taping during arm resting at 0° of abduction when compared with the no taping condition (8.7 [0.9] mm vs 8.3 [0.8] mm, mean difference = 0.4 mm, 95% confidence interval, −0.71 to −0.11, P =.01). Conclusions: Athletes with RC tendinopathy demonstrated less reduction of the SAS with rigid scapular taping during early arm abduction. Such observation was not evidenced in asymptomatic athletes. [ABSTRACT FROM AUTHOR]

Context: Current evidence suggests that, despite returning to full participation, physically active adults with a previous knee injury experience lower health-related quality of life (HRQOL) than those with no knee injury history. It is unknown if this relationship is present in adolescent athletes. Objective: To determine the impact of knee injury history on HRQOL in adolescent athletes who were medically cleared for full participation. Design: Cross-sectional. Setting: Athletic training clinics. Participants: A convenience sample of 183 adolescent athletes, who were medically cleared for full participation, were grouped by self-report of a previous knee injury: positive knee injury history (HIS; n = 36, age = 15.7 [1.4] y, height = 168.0 [11.9] cm, and weight = 71.8 [11.9] kg) and no knee injury history (NO-HIS; n = 147, age = 15.5 [1.4] y, height = 166.0 [10.5] cm, and weight = 67.6 [14.6] kg). Interventions: Participants completed the Pediatric International Knee Documentation Committee form and Pediatric Quality of Life Inventory during their preparticipation examination. Main Outcome Measures: Generalized linear models were used to compare group differences for the total and subscale scores of the Pediatric International Knee Documentation Committee and Pediatric Quality of Life Inventory. Results: Main effects of injury group indicated that the HIS group reported significantly lower scores than the NO-HIS group for the Pediatric International Knee Documentation Committee total score (P <.001; HIS = 79.2 [21.7], NO-HIS = 95.8 [8.6]) and for the Pediatric Quality of Life Inventory total (P =.001; HIS = 85.7 [10.9], NO-HIS = 90.9 [7.3]), physical functioning (P =.002; HIS = 86.7 [13.6], NO-HIS = 92.1 [8.2]), school functioning (P =.01; HIS = 80.6 [12.4], NO-HIS = 86.8 [12.2]), and social functioning (P =.01; HIS = 89.3 [12.4], NO-HIS = 94.6 [8.9]) scores. No group differences were reported for the emotional functioning subscale (P =.13; HIS = 85.7 [17.7], NO-HIS = 89.7 [13.1]). No interactions or main effects of sex were reported (P >.05). Conclusions: Our findings suggest that, despite returning to full sport participation, adolescent athletes with a previous knee injury generally experience lower HRQOL than their peers with no knee injury history, specifically for knee-specific HRQOL, physical functioning, school functioning, and social functioning. Our results are similar to previous findings reported in college athletes and military cadets. [ABSTRACT FROM AUTHOR]

Lateroplantar foot pain may be caused by various entities, whereby painful os peroneum syndrome should be included in the differential diagnosis. Physical examination and multimodal imaging enable a definitive diagnosis. We report on a 59-year-old man with severe, load-dependent pain, corresponding to an os peroneum syndrome, triggered by a pes planovalgus with consecutively induced focal inflammation and tendovaginitis of the tendon of the peroneus longus muscle. Multifactorial conservative measures including infiltration and shockwave therapy finally led to a restoration of the original condition. [ABSTRACT FROM AUTHOR]

Acute calcific tendinitis (ACT) of the longus colli muscle (LCM) is an inflammatory response due to deposition of calcium hydroxyapatite crystals. It is typically correlated with whiplash and overuse injuries. A common presentation of this inflammatory response is acute but progressive neck pain. It is a rare but important cause of neck pain that should be considered on a differential diagnosis when distinguishing between life-threatening conditions and non–life-threatening causes of neck pain. A 51-year-old woman presented to the emergency department (ED) reporting a mild sore throat that progressed to acute neck pain and stiffness. She also reported fatigue, fever, myalgias, and nausea. In the ED, the patient was tachycardic, hypertensive, and mildly febrile with normal oxygen saturation. Examination revealed meningismus and was negative for lymphadenopathy, oropharyngeal findings, and neurologic deficits. Laboratory studies were significant for leukocytosis. Computed tomography (CT) neck was obtained and was notable for calcification of the superior left longus colli muscle with prevertebral and retropharyngeal space edema along the muscle body. ACT of the LCM is a benign, self-limited condition that can present with features overlapping emergent causes of acute neck pain. Correct diagnosis relies on characteristic radiographic findings on CT. Fortunately, patients may be discharged home with a short course of anti-inflammatories and corticosteroids with near-complete resolution of symptoms. Emergency physicians, therefore, can rule out life-threatening causes of neck pain, while also making a definitive diagnosis and initiating effective management for this pathology. [ABSTRACT FROM AUTHOR]

Lateral epicondylitis is a common pathology of the musculoskeletal system resulting from repeated microtrauma of the extensor muscles of the forearm and their tendons. Lateral epicondylitis was previously thought to be tendinitis, which is an inflammatory reaction in the tendon. However, histopathologically, it has been shown to be low in inflammatory elements: macrophages and neutrophils. Thus, it is now believed that this pathology is a tendinosis, which is defined as a degenerative rather than an inflammatory process.

The treatment of chronic Achilles tendinopathy (CAT) remains challenging. We report three cases of CAT treated with autologous peripheral blood stem cells (PBSCs), following principles developed for chondrogenesis of the knee joint. Outcome measurement with a minimum of one and a half years follow-up showed significant improvement of Victorian Institute of Sport Assessment-Achilles questionnaire (VISA-A) scores, with reduction of tendon thickness and inflammation on MRI scan.

This article discusses a case of acute calcific tendinitis of the longus colli muscle, a rare cause of neck pain. The patient, a previously healthy 30-year-old woman, presented with severe right-sided neck pain and limited neck motion. Computed tomography (CT) revealed calcification in the longus colli muscle and effusions in the retropharyngeal and prevertebral spaces. The patient was treated with nonsteroidal anti-inflammatory drugs and showed improvement within 3 days. The article emphasizes the importance of considering acute calcific tendinitis as a potential diagnosis for acute neck pain and highlights the effectiveness of CT in detecting this condition. [Extracted from the article]

Polydeoxyribonucleotide (PDRN) is a proprietary and registered drug with several beneficial effects, including tissue repairing, anti-ischemic action, and anti-inflammatory properties. The present study aims to summarize the current evidence about PRDN's clinical effectiveness in the management of tendon disorders. From January 2015 to November 2022, OVID-MEDLINE®, EMBASE, Cochrane Library, SCOPUS, Web of Science, Google Scholar and PubMed were searched to identify relevant studies. The methodological quality of the studies was evaluated, and relevant data were extracted. Nine studies (two in vivo studies and seven clinical studies) were finally included in this systematic review. Overall, 169 patients (male: 103) were included in the present study. The effectiveness and safeness of PDRN has been investigated in the management of the following diseases: plantar fasciitis; epicondylitis; Achilles tendinopathy; pes anserine bursitis; chronic rotator cuff disease. No adverse effects have been recorded in the included studies and all the patients showed an improvement in clinical symptoms during the follow-up. PDRN are a valid emerging therapeutic drug in the treatment of tendinopathies. Further multicentric randomized clinical studies are needed to better define the therapeutic role of PDRN, especially in combined clinical protocols. [ABSTRACT FROM AUTHOR]

Background: Although Extracorporeal Shock Wave Therapy (ESWT) is a widely used treatment option in patellar tendinopathy (PT), treatment protocols are not clearly defined. There is no consensus on the type of shock wave or the energy level, number of shocks, pressure, and frequency values. For this reason, this study will, on the one hand, aim to contribute to the confusion of whether ESWT is effective in the treatment of PT and, on the other hand, try to define the most effective ESWT protocol in the treatment of PT, rather than choosing one at random. Methods: Eighty-six patients with PT randomised to 'Controlled Unfocused/Radial' ESWT (r-ESWT), 'Large-Focused' ESWT (f-ESWT) and sham ESWT (s-ESWT) groups and the data of seventy-eight patients who could reach the last control were evaluated statistically. The patients received the ESWT application once a week for a total of three sessions. Patients were evaluated with Visual Analog Scale (VAS) and Victorian Institute of Sports Assessment-Patella (VISA-P) scores just before the treatment (baseline), one day after the end of treatment (week 3), one month after the end of treatment (week 7) and three months after the end of treatment (week 15). Results: VAS and VISA-P scores have significantly improved at 3th, 7th, and 15th weeks in the r-ESWT group (p<0.05) and at 7th, and 15th weeks in the f-ESWT group (p<0.05). In terms of baseline-3th week, baseline-7th week and baseline-15th week differences of VAS and VISA-P scores, r- ESWT was superior to f-ESWT (p<0.05). Conclusions: Although both r-ESWT and f- ESWT were effective in the treatment of PT according to the results of this study, the efficacy of r-ESWT was superior to f-ESWT. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to report the results of subacromial arthroscopic decompression (SAD) without removal of the calcific deposits in patients with calcifying tendinitis. Methods: All patients between 2016 and 2019 were included if they were aged between 18 and 60 years and had an isolated calcific deposit. The Constant–Murley score (CMS), Disabilities of the Arm, Shoulder and Hand (Quick DASH) score, the Shoulder Pain and Disability Index (SPADI), the simple shoulder test (SST), and the single assessment numeric evaluation (SANE) were used for assessment. Time to return to work was recorded. Results: 24 patients (13 pilots, 11 cabin crew) with a mean age of 47.1 ± 7.8 years were included. Quick Dash improved from 68.8 preoperative, to 8.4 at 3 months, and 0.1 at 24 months. CMS improved from 37.4 preoperative, to 83 at 3 months, and 94 at 24 months. SPADI improved from 73.8 preoperative, to 5.4 at 3 months, and 1 at 24 months. SST improved from 22.5 preoperative, to 94.2 at 3 months, and 100 at 24 months. SANE improved from 33.5 preoperative, to 78.7 at 3 months, and 95.6 at 24 months. MCID, SCB, and PASS reached values above 83% at 3 months and 100% at 6 months, with the exception of SANE which reached 29% at 3 months and plateaued to 96% at 6 months. The mean time to return to work was 7.1 ± 2.1 weeks. Pilots returned at a mean of 6.9 ± 1.8 weeks; cabin crew returned to work at a mean of 7.8 ± 2.5 weeks. Conclusions: The results of this study suggest excellent short- and mid-term clinical outcomes can be achieved in patients with calcific tendinitis undergoing arthroscopic debridement and subacromial decompression without removal of calcific deposits. In this patient population, early surgical intervention was a potentially viable alternative to nonoperative treatment, and allowed early return to work. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to describe the epidemiology of Achilles tendon rupture (ATR) and its relationship with socioeconomic deprivation status (SEDS). The hypothesis was that ATR occurs more frequently in socioeconomically deprived patients. Secondary aims were to determine variations in circumstances of injury between more and less deprived patients. Methods: A 6-year retrospective review of consecutive patients presenting with ATR was undertaken. The health-board population was defined using governmental population data and SEDS was defined using the Scottish Index of Multiple Deprivation. The primary outcome was an epidemiological description and comparison of incidence in more and less deprived cohorts. Secondary outcomes included reporting of the relationship between SEDS and patient and injury characteristics with univariate and binary logistic regression analyses. Results: There were 783 patients (567 male; 216 female) with ATR. Mean incidence for adults (≥ 18 years) was 18.75/100,000 per year (range 16.56–23.57) and for all ages was 15.26/100,000 per year (range 13.51 to 19.07). Incidence in the least deprived population quintiles (4th and 5th quintiles; 18.07 per 100,000/year) was higher than that in the most deprived quintiles (1st and 2nd; 11.32/100,000 per year; OR 1.60, 95%CI 1.35–1.89; p < 0.001). When adjusting for confounding factors, least deprived patients were more likely to be > 50 years old (OR 1.97; 95%CI 1.24–3.12; p = 0.004), to sustain ATR playing sports (OR 1.72, 95%CI 1.11–2.67; p = 0.02) and in the spring (OR 1.65, 95%CI 1.01–2.70; p = 0.045) and to give a history of preceding tendinitis (OR 4.04, 95%CI 1.49–10.95; p = 0.006). They were less likely to sustain low-energy injuries (OR 0.44, 95%CI 0.23–0.87; p = 0.02) and to be obese (OR 0.25–0.41, 95%CI 0.07–0.90; p ≤ 0.03). Conclusions: The incidence of ATR was higher in less socioeconomically deprived populations and the hypothesis was therefore rejected. Significant variations in patient and predisposing factors, mechanisms of injury and seasonality were demonstrated between most and least deprived groups, suggesting that circumstances and nature of ATR may vary with SEDS and these are not a homogenous group of injuries. Level of Evidence: Prognostic Study Level III. [ABSTRACT FROM AUTHOR]

Introduction: Longus colli calcific tendonitis (LCCT) is a calcium deposition disease that causes acute or subacute atraumatic neck pain. It is important for the emergency physician to consider LCCT in the differential diagnosis because the clinical presentation of this benign condition may mimic life-threatening disease processes that require invasive diagnostic measures. Case Report: We present a case of a 63-year-old female with atraumatic right-sided neck pain. On exam she had tenderness to palpation in the neck, as well as difficulty ranging her neck and opening her mouth. She underwent computed tomography of her neck with intravenous contrast, which showed calcific tendonitis of the longus colli muscle with retropharyngeal edema. She was seen by otolaryngology, underwent nasopharyngolaryngoscopy, and ultimately was discharged with antibiotics and corticosteroids. Conclusion: The presentation of LCCT can mimic symptoms of dangerous causes of neck pain including retropharyngeal abscess and meningitis. Early diagnosis in the ED can potentially avoid more invasive diagnostic and therapeutic measures. While LCCT is thought to be self-limiting, it can be treated with non-steroidal anti-inflammatory medications and corticosteroids. If pain is controlled, patients can be discharged from the ED with no specialist follow-up required. [ABSTRACT FROM AUTHOR]

Background: Calcific tendinitis of the hip is rare but most commonly occurs in the gluteus medius. It occurs more frequently in women, usually between the ages of 40 and 70 years. Calcific tendinitis of the gluteus medius is associated with pain and tenderness in the greater trochanter region, can be acute or chronic, and should be distinguished from other differential diagnoses, such as trochanteric bursitis. Calcific tendinitis of the gluteus medius is scarcely reported in the literature, and there is no management guideline for this condition. Although it is usually managed conservatively, there are reports of more invasive techniques, such as needle lavage and surgery. Case Report: We report the case of a middle-aged woman who presented with right hip pain of a 1-year duration, mainly on climbing stairs. Plain radiograph and magnetic resonance imaging revealed calcific tendinitis of the right gluteus medius. She underwent a trial of conservative management, which included a triamcinolone injection, but remained symptomatic. She subsequently underwent endoscopic debridement of the calcification and recovered uneventfully after surgery, with complete resolution of her symptoms at the 2-month follow-up. Conclusions: This report has shown the importance of imaging in the diagnosis of calcific tendinitis of the gluteus medius and supports endoscopic debridement as an effective modality in the management of this condition. [ABSTRACT FROM AUTHOR]

The aim of the present study was to assess the prevalence of musculoskeletal injuries in professional soccer players in the state of Acre, Brazil, during the 2016, 2017 and 2018 seasons. Method: The sample consisted of 112 professional soccer players. Data were collected from the medical records of injured players and through interviews (players and/or those responsible for their treatment). The following data on the characteristics of the injuries were collected: injury type, whether the injury occurred during matches or training, injured site, and player position. Results: stretch 38 (33,9%) and contractures 41 (36,6%) were the most common injury types, followed by contusions 9 (8,0%), dislocations 6 (5,4%) and tendonitis 5 (4,5%). The lower limbs were the most affected, with the back of the thigh, knee and ankle being the sites with the highest injury frequencies. Winger and midfielder were the positions with the highest prevalence of injuries. In 2016, the prevalence of injuries was higher during matches than training, and in the subsequent seasons, there was a higher prevalence during training. Conclusion: The prevalence of injuries in soccer players from Acre is high and mainly involves the lower limbs, with a higher frequency among wingers, attacking midfielders and strikers. Methods for preventing such injuries are necessary. [ABSTRACT FROM AUTHOR]

Active Points Test on auricle was renamed Needle Contact Test (or NCT), considered an extremely effective method to select most efficient auricle acupoint for Auricular Acupuncture (or AA) therapy. Our aims were to evaluate NCT efficiency as viable diagnostic option to identify the most appropriate AA acupoints to be selected for SupraSpinatus Tendinopathy (SST) associated shoulder pain treatment and to evaluate which auricle area has greater concentration of NCT positive acupoints in subjects with SST shoulder pain, comparing results with available AA ear maps. 45 subjects with SST diagnosis were enrolled. On 30 subjects in treatment group, NCT was performed on acupoints of the auricle shoulder representation areas (i.e., Scaphoid Fossa), while in 15 subjects of control group, NCT was performed on auricle areas not shoulder associated. Statistically significant lower Numeric Pain Rating Scale scores were seen for study group over time and compared to control. A small sample showed statistically significant increase of SST shoulder maximum abduction range of Movements. NCT identified best SST shoulder pain AA acupoints in Scaphoid Fossa (or SF1 and SF2). In conclusion NCT is a viable tool to efficiently identify the best AA acupoints in SST shoulder pain treatment. [ABSTRACT FROM AUTHOR]

Background: Rotator cuff tendinitis and shoulder impingement are regarded as the frequent intrinsic reasons for shoulder discomfort and disability. Objective: A study was conducted to compare the effects of conventional physical therapy and progressive overload training in patients with shoulder impingement syndrome. Methods: Thirty patients with shoulder impingement syndrome were included. These patients were randomised into two groups. One group received structured, progressive resistance training, and the other received conventional therapy. The intervention group participants participated in progressive resistance training three days per week for six weeks. The numeric pain rating scale was used to assess pain intensity and the range of motion measured by the goniometer. The statistical package for social sciences (SPSS), version 21 for Windows, was used for data analysis. An independent t-test was used to compare the effects between the two groups. Result: Out of 30 participants, there were twenty-four females and six males. The mean age of the participants was 44±5.1 years. Participants from the intervention group had better pain control (P < 0.05) and improved range of motion (P < 0.05) compared to the control group. Conclusion: We conclude in this group of patients, progressive overload training was more effective in alleviating pain and improving the range of motion in patients with shoulder impingement syndrome. [ABSTRACT FROM AUTHOR]

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OBJECTIVE: This study aims to investigate the incidence of adductor tubercle tendinitis (ATT) and demonstrate the effects of intraoperative steroid injections on clinical outcomes in patients undergoing high tibial osteotomy (HTO) due to genu varum (GV). PATIENTS AND METHODS: Of 738 patients who underwent HTO due to GV between 2014- 2021, 454 patients had accompanying preoperative ATT. Of these patients, 324 patients who presented to follow-ups and had adequate medical records were evaluated. Mean patient age was 52.6 years. Patients who received steroid injections to the adductor tubercle during HTO (Group I, n=182) and patients who did not receive injections (Group II, n=142) were compared. Univariate and multivariate logistic regression analyses were performed by evaluating preoperative and postoperative VAS scores and presence of ATT. RESULTS: Preoperative ATT sensitivity was present in 61% of the patients. ATT findings were significantly less in Group I compared to Group II in the early-term (1-3 months) (p=0.0001), while there was no significant difference in the late-term (6-12 months) (p=0.880). There was no statistically significant difference between the preoperative and postoperative VAS scores of the groups (p=0.0001). CONCLUSIONS: Stress and tendinitis often develop in the adductor muscle groups due to increased adductor moment in GV. We believe that tendinitis contributes to increased knee pain. HTO reduces the symptoms of tendinitis in the long term by decreasing the adductor moment, while intra-operative steroid injections contribute to relieving complaints related to tendinitis in the early term. [ABSTRACT FROM AUTHOR]

Introduction: Acute longus colli tendinitis is caused by calcium hydroxyapatite deposition in the tendon of the longus colli muscle with subsequent inflammation. The calcifications are commonly located at the superior oblique portion at the level of the C1–C2 vertebrae. The typical clinical presentation consists of acute neck pain, odynophagia, and painful limitation of neck range of motion. Objectives: We will describe this disease with three that cases presented to our institution and compare the findings on imaging studies. Methods: We retrospectively reviewed the clinical data, radiological features, and laboratory reports of three patients diagnosed with acute longus colli tendinitis. Computed tomography and plain radiographs were reviewed and compared by a single radiologist. A contemporary review of the literature was conducted using PubMed (Medline), Embase, and Cochrane library databases. Results: Computed tomography showed greater sensitivity for the detection of the pathognomonic calcification than plain radiographs and facilitated the exclusion of other more severe conditions by following a systematic interpretation composed of five key elements. Plain radiographs showed non-specific signs of prevertebral soft tissue swelling and a decreased cervical lordotic curve. However, no calcification was identified on plain radiographs. The literature review revealed 153 articles containing 372 cases. Surgical or invasive procedures were mentioned in 13.7% of publications and were performed in 28 patients. Conclusion: Acute longus colli tendinitis can mimic the clinical presentation of more severe conditions that the otolaryngologist may be required to evaluate, such as infectious, traumatic, and neoplastic diseases. Knowledge of this entity, with its pathognomonic imaging findings, can prevent misdirected medical therapy and unnecessary invasive procedures.