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Abstract Intramuscular hemangiomas (IHs) are benign soft-tissue tumors that represent less than 1% of all hemangiomas. This clinical entity is rarely considered as a differential diagnosis in cases of musculoskeletal pain. A healthy 38-year-old woman presented to our office with complaint of left omalgia, with 8 months of evolution, limiting her daily activities. She reported the appearance of tumefaction in the previous 4 months. She was medicated with analgesic and antiinflammatory drugs with no clinical improvement. The objective examination showed limitation of left shoulder abduction (0–90°). The patient underwent a magnetic resonance imaging (MRI), in which a well-circumscribed nodular formation was detected in the deltoid muscle. Then, she underwent a biopsy, which confirmed the diagnosis of hemangioma. The patient was referred for sclerotherapy. Intramuscular hemangiomas are usually observed in young patients. The gold-standard examination for diagnosis is MRI, which often forestalls the need for a biopsy. In many cases, IHs are asymptomatic and tend to involute over time. Despite the low frequency of this clinical entity, it is important to place it as a diagnostic hypothesis in cases of chronic pain of the limbs in young patients with poor therapeutic response to antiinflammatory drugs and analgesia.

Shoulder pain is one of the most common conditions in primary care, especially in elderly patients. Ultrasound stands out as an effective and cost-efficient tool for assessing these injuries, allowing real-time dynamic visualization of the affected anatomical structures. There is clear evidence that ultrasound is an effective diagnostic tool in the hands of a properly trained family physician. The tendons of the rotator cuff, especially the supraspinatus, are the most commonly affected. Ultrasound is crucial in detecting its pathology. Generally, the age and degenerative process itself stand out as the most influential factors in the pathogenesis. This review provides an overview of shoulder ultrasound anatomy, its exploration methodology, and the diagnosis of various injuries and pathologies., (Copyright © 2024 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.)

La lipomatosis arborescente, también conocida como ‘proliferación de vellosidades de la membrana sinovial’, es una entidad que se caracteriza por la proliferación difusa de vellosidades con reemplazo del tejido sinovial por adipocitos maduros. La presentación típica es una enfermedad monoarticular que afecta a la rodilla, con predilección por la bolsa suprapatelar, aunque también se describe afectación mono o biarticular de articulaciones grandes como las caderas, los tobillos, los codos y los hombros. La resonancia magnética nuclear (RMN) es el método de imagen de elección para hacer el diagnóstico. El tratamiento consiste en practicar sinovectomía, ya sea abierta o artroscópica. En este estudio se presenta un caso de lipoma arborescente con afectación simultánea de la bursa subacromial-subdeltoidea, vaina del tendón de la porción larga del bíceps y articulación glenohumeral, que se asoció a lesión del manguito de los rotadores valorado en la Unidad de Alta Resolución de Hombro de nuestro servicio de rehabilitación.

Laparoscopic surgery causes a disturbance substantially less intense and prolonged compared to the corresponding open procedure, but having multiple advantages turn disadvantages, like the case of shoulder pain (omalgia). Given its high incidence and poor response to conventional treatments, it is proposed this multimodal approach to decrease the incidence and intensity. [ABSTRACT FROM AUTHOR]

The shoulder is a complex system consisting of several joints and adjacent structures ensuring stability and a large range of upper limb momentum. In inflammatory rheumatic diseases such as rheumatoid arthritis, juvenile idiopathic arthritis, spondyloarthritis, and systemic connective tissue diseases, the affection of the shoulder occurs at different frequencies, but in any case represents a serious impairment of the patient's functional ability. The pathogenesis of the disorder is varied from synovialitis, through entezitis, rotator cuff lesions, calcification processes and osteonecrosis to coexisting osteoarthritis. The gold standard for the shoulder display is an X-ray image in the front and axial projection. Sonographic examination allows static and dynamic imaging especially of soft tissues as well as distinction of the levels of inflammation, similarly as the nuclear magnetic resonance (NMR) does. However, it is more accessible and cheaper. Nevertheless, the role of NMR in the detection of early stages of osteonecrosis is irreplaceable. Therapy requires an interdisciplinary approach and includes not only the reduction of the activity of the underlying disease, but also local administration of glucocorticoids, targeted rehabilitation and surgical intervention. [ABSTRACT FROM AUTHOR]

Introducción: El síndrome del espacio cuadrilátero (QSS) es un cuadro clínico causado por la compresión nerviosa y/o vascular a nivel del espacio axilar lateral. La prevalencia de este síndrome se desconoce y se cree que es baja, sin embargo, formas de presentación incompleta podrían llevar a que el mismo sea subdiagnosticado. Objetivo: Describir un protocolo diagnóstico utilizado en una serie de casos consecutivos de pacientes con omalgia inespecífica y sospecha de QSS. Materiales y Métodos: De manera prospectiva se evaluaron 10 pacientes con omalgia agravada con la rotación externa forzada, uno de ellos con síntomas bilaterales. Se realizó electromiografía (EMG) de deltoides y redondo menor bilaterales, con estudios de conducción nerviosa. Los valores se compararon con el hombro sano, y con un grupo control. El diagnóstico se confirmó mediante resonancia magnética nuclear (RMN). Resultados: El EMG mostró en todos los casos atrapamiento con compromiso axonal de la rama para el redondo menor, con preservación de la inervación del deltoides. La RMN mostró en los 11 hombros afectados atrofia selectiva del redondo menor. Conclusión: El QSS en sus formas incompletas suele ser subdiagnosticado, siendo necesario mantener un alto índice de sospecha clínica frente a un cuadro de omalgia inespecífica. Palabras Claves: espacio cuadrilátero, omalgia, electromiografía, redondo menor, nervio axilar. Introduction: The quadrilateral space syndrome (QSS) has clinical features caused by a nervous and /or vascular compression at the lateral axillary space. The prevalence of this syndrome is unknown but it is believed to be low. Nevertheless, some cases with an incomplete clinical presentation might be misdiagnosed. Purpose: To describe a diagnostic protocol used in a series of consecutive cases of patients with non-specific omalgia and suspected QSS. Materials and Methods: Ten patients of both genders suffering shoulder pain aggravated by forced external rotation were prospectively evaluated. One of them had bilateral symptoms. Evaluation included clinical examination, electromyography (EMG) and nerve conduction studies of the deltoid and teres minor bilaterally. The results were compared with an age-matched control group. Diagnosis was confirmed by magnetic resonance imaging (MRI). Results: The EMG showed in all the cases a selective entrapment of the branch for the teres minor, with preservation of the innervation of the deltoid. The RMN showed in the 11 affected shoulders selective atrophy of the teres minor. Conclusion: Incomplete presentations of the QSS are usually underdiagnosed, making it necessary to maintain a high index of clinical suspicion in front of any non-specific omalgia case. Key words: quadrilateral space, omalgia, electromyography, teres minor, axillary nerve.

Copyright of Revista Argentina de Anatomía Clínica is the property of Asociacion Argentina de Anatomia Clinica (Revista Argentina de Anatomia Clinica) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To explore whether acupuncture intervention can reduce the concurrent omalgia of ischemic stroke patients and initially explore the feasibility of follow-up research on long-term acupuncture. Methods Three hundred patients who conformed to the research criteria and voluntarily took part in the research were randomized into an acupuncture group and a regular therapy group with envelope method. The 150 cases in the acupuncture group received the combined treatment of electroacupuncture (EA) and moxibustion based on regular treatments for a total of 4 weeks. The 150 cases in the regular therapy group received regular treatments. The omalgia incidence number were observed at 1, 2, 3, 6, 12 months follow-up, simplified Fugl-Meyer of the upper-extremity was evaluated 4 weeks after treatment, modified Rankin Scale was conducted to assess the number of relatively independent patients and the patients acceptance for acupuncture therapy at 6 months follow-up. Results After 4 weeks of treatments, although the comparative deviations of the omalgia incidence number and the simplified Fugl-Meyer in the two groups had no statistical significance ( P »0.05), the omalgia incidence numbers in the acupuncture group at 2nd, 3rd, 6th and 12th month follow-ups were different significantly compared with those in the regular therapy group ( P <0.05); meanwhile, at 6 months follow-up, the relatively independent number of the patients assessed by modified Rankin Scale in the acupuncture group was superior to that in the regular therapy group ( P <0.05). The number of patients who adhered to the acupuncture rehab therapy in the acupuncture group was greater than that in the regular therapy group ( P <0.05). Conclusion Acupuncture intervention during the acute stage of ischemic stroke can not only effectively reduce the incidence of omalgia complication, but also play an assisting role in improving the patients' ability of independent living; meanwhile, the systematic visits and treatments of acupuncture may feature assisting significance in the construction of the special disease and special skills of the acupuncturology. [ABSTRACT FROM AUTHOR]

Copyright of Cirugía y Cirujanos is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Laparoscopy cholecystectomy for the surgical treatment of cholelithiasis has been considered the gold standard. The referred pain to the shoulder (omalgia) may be present to 63% of the patients and limits outpatient management., Objective: The study was to evaluate the usefulness of acetazolamide associated with ketorolac for reduction of the omalgia to minimally invasive treatment., Methods: We performed a clinical trial, randomized, double blind in patients undergoing laparoscopic cholecystectomy to assess the reduction of post-operative omalgia comparing ketorolac and ketorolaco+acetazolamida. 31 patients in each group were studied. The study group: 250 mg of acetazolamide before anesthetic induction and 30 mg of ketorolac in the immediate postoperative period., Control Group: one tablet of placebo prior to the anesthetic induction and 30 mg of ketorolac in the immediate postoperative. The presence of omalgia was assessed using the analog visual scale. The variables recorded included: age, sex, flow of carbon dioxide intra-abdominal pressure, surgical time, urgent or elective surgery, omalgia, severity of pain evaluated by analog visual scale, addition analgesia., Results: Both groups were homogeneous and statistical analysis showed no differences in the variables studied. The omalgia in the study group was presented at 9.67% and in the group control was the 58.06% (p < 0.001)., Conclusion: 250 mg oral acetazolamide associated 30 mg of ketorolac reduces significantly the development of omalgia in patients undergoing laparoscopic cholecystectomy.