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- ItemAcesso aberto (Open Access)Avaliação do ombro em pacientes portadores de espondilite anquilosante por meio de ultra-som(Sociedade Brasileira de Reumatologia, 2008-04-01) Yoshida Junior, Ciro; Kubota, Edson Shinji [UNIFESP]; Torres, Themis Mizerkowski [UNIFESP]; Ciconelli, Rozana Mesquita [UNIFESP]; Fernandes, Artur da Rocha Correa [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)PURPOSE: To describe shoulder involvement and its prevalence with ultrasound in patients with ankylosing spondylitis and correlate the findings with age and duration of disease. METHODS: Ultrasound scans of both shoulders were performed in thirty five selected patients with clinical diagnosis of ankylosing spondylitis. Rotator cuff texture and thickness were evaluated as well as the biceps tendon, acromioclavicular joint, humeral head tuberosities, subacromial-subdeltoid bursa, and posterior glenohumeral joint. Besides the prevalence of shoulder involvement, information about presence of pain and duration of disease were registered. The data were compared with age and duration of disease using chi-square and Student's t tests. RESULTS: The prevalence of rotator cuff disease was 20%; with 10% of tendinosis/tendon calcification and 10% of partial/full thickness tears. The mean rotator cuff thickness was 5.8 mm. Irregularities of the humeral head tuberosities were present in 84.3% of shoulders and acromioclavicular irregularities were present in 54.3% of shoulders. CONCLUSION: There was no change in rotator cuff thickness related with duration of disease. Bony irregularities in humeral head tuberosities and acromioclavicular joint were the main finding associated with duration of disease. There was no relation between duration of disease and presence of tendinous disease.
- ItemAcesso aberto (Open Access)Avaliação por imagem dos elastofibromas da cintura escapular(Sociedade Brasileira de Reumatologia, 2009-06-01) Britto, Allan Valadão De Oliveira [UNIFESP]; Rosenfeld, André [UNIFESP]; Yanaguizawa, Matiko [UNIFESP]; Pinetti, Rogério Zaia [UNIFESP]; Natour, Jamil [UNIFESP]; Fernandes, Artur da Rocha Correa [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Elastofibroma dorsi, a slow-growing, soft-tissue pseudotumor has been more and more remembered in the differential diagnosis of chronic scapular pain. It has also been incidentally diagnosed in routine diagnostic imaging tests. Our approach here is the imaging diagnosis, which can start with the conventional X-ray, but is better characterized by the ultrasound and the magnetic resonance, the latter being the modality of choice.
- ItemAcesso aberto (Open Access)Can clinical observation differentiate individuals with and without scapular dyskinesis?(Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia, 2014-06-01) Miachiro, Newton Y.; Camarini, Paula M. F.; Tucci, Helga Tatiana [UNIFESP]; Mcquade, Kevin J.; Oliveira, Anamaria S.; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP); University of Washington School of MedicineBackground:Altered scapular rotation and position have been named scapular dyskinesis. Visual dynamic assessment could be applied to classify this alteration based on the clinical observation of the winging of the inferior medial scapular border (Type I) or of the prominence of the entire medial border (Type II), or by the excessive superior translation of the scapula (Type III).Objective:The aim of this study was to determine if there were differences in scapular rotations (Type I and II) and position (Type III) between a group of subjects with scapular dyskinesis, diagnosed by the clinical observation of an expert physical therapist, using a group of healthy individuals (Type IV).Method:Twenty-six asymptomatic subjects volunteered for this study. After a fatigue protocol for the periscapular muscles, the dynamic scapular dyskinesis tests were conducted to visually classify each scapula into one of the four categories (Type IV dyskinesis-free). The kinematic variables studied were the differences between the maximum rotational dysfunctions and the minimum value that represented both normal function and a small dysfunctional movement.Results:Only scapular anterior tilt was significantly greater in the type I dyskinesis group (clinical observation of the posterior projection of the inferior angle of the scapula) when compared to the scapular dyskinesis-free group (p=0.037 scapular and p=0.001 sagittal plane).Conclusions:Clinical observation was considered appropriate only in the diagnoses of dyskinesis type I. Considering the lower prevalence and sample sizes for types II and III, further studies are necessary to validate the clinical observation as a tool to diagnose scapular dyskinesis.