超声在滑囊炎诊断中的应用

本文对７０例四肢大关节处滑囊炎进行定位诊断，其中肘部３例，臀部２例，膝前部２０例，窝部４４例，足踝部１例，均经手术、穿刺及病理证实。超声诊断与手术符合率９７．６％。本组讨论滑囊炎的影像表现及滑囊与关节腔的关系，认为根据滑囊炎的定位诊断，对治疗方案及手术入路的选择有重要意义。     

Trochanteric area pain,the result of a quartet of bursal inflammation

Bursitis is quite responsive to therapeutic intervention, once the afflicted area is accurately identified. This is especially notable for some hip complaints. Patients’ use of the term “hip” can relate to anything from the low back to groin to lateral thigh pain. Trochanteric area surface localization of “hip” pain may afford an opportunity for immediate cure. Effectiveness of therapeutic intervention is predicated upon injection of not one or two, but all four peri-trochanteric bursa with a depot (minimally water-soluble) corticosteroid. The term trochanteric bursitis suggests that the inflammation is more focal than what is clinically observed. While easier to express, perhaps it is time to refer to inflammation in this area, naming all four affected bursae.     

推拿·针灸·火罐治疗肩周炎

本病的形成,多因年老体虚,气血不足,筋失濡养;或因汗出当风,睡卧露肩,感受风寒湿邪,经脉拘急;慢性劳损或外来暴力所致的急性损伤（气血瘀滞）,未作彻底治疗等因素。其病理改变为肩关节周围筋肉组织的退行性病变表现力、痉挛、挛缩、粘连、腱鞘肿胀、肥厚活肌腱与关节囊紧密结合,限制了肩关节的正常功能活动。后期可出现肩部肌肉萎缩和肩关节严重粘连,其运动由肩胛骨所代替。又称“露肩风”、“冻结肩”、“肩凝症”、“五十肩”等。本病是以肩部疼痛和肩关节活动受限为主症的一种常见疾病。临床上多见于四十五岁以上年龄的女性。本人通过推拿·针灸·火罐等综合疗法治疗肩周炎取得令人满意的疗效、论述如下。     

推拿理疗治疗肩周炎78例

肩周炎患者肩部疼痛各有其重点,功能障碍亦有偏重,在手法治疗时应掌握其重点。注意区别肩周炎发病所处的早、中、后三期。早期症状为疼痛较甚,夜不能寐,故应以轻柔和缓的手法活血通络止痛,慎用扳、摇、拨等被动手法,否则使肩部疼痛加重;中期疼痛较缓,肩部功能活动受限,应以轻柔手法与被动手法兼施,以达到活血通络止痛、松解关节粘连、恢复肩关节正常功能的目的;后期肩部疼痛基本消失,肩关节功能严重受限,主要以被动手法松解粘连,而辅以轻柔手法以止痛。另外,嘱患者作肩部功能的自我锻炼,注意保暖,能加强疗效,避免反复,早日康复。     

Prepatellar <Emphasis Type="Italic">Brucella melitensis</Emphasis> bursitis: case report and literature review

Bursal infection is an uncommon clinical presentation of brucellosis. We herein report a case of Brucella melitensis bursitis that was successfully treated. Other reported cases of brucella bursitis were reviewed. A high degree of suspicion in the right clinical setting is required for the diagnosis of brucella bursitis.     

Rapidly developed huge bursitis associated with scapular osteochondroma of the multiple exostosis: a case report

Osteochondroma is the most common benign bone tumor and present as multiple masses in the hereditary disorder of multiple hereditary exostosis. It is usually painless without specific symptoms. However, it rarely causes symptoms such as mass effects that produce several mechanical problems, and malignant transformation of the cartilaginous cap. The deformities and interference with major joint function are the most frequent musculoskeletal complaints dependent on the location of the mass. Large bursa formation with mechanical symptom has been very rarely reported in osteochondroma in which bursa is over the cap. Here, we first described a patient with multiple hereditary exostosis who had developed huge bursitis on chest wall around the osteochondroma arising from the anterior surface of the right scapula after dumbbell lifting exercise for 3 months, and suggest that cystic mass can develop in any site of osteochondroma and should be early differentiated from malignant transformation of osteochondroma.     

Shoulder injury related to vaccine administration (SIRVA) after COVID-19 vaccination

ObjectiveThe global fight against COVID-19 has required mass vaccination clinics as well as mass recruitment of personnel, including many who may not regularly administer intramuscular deltoid immunizations, potentially increasing the incidence of improper intramuscular injection. Shoulder injury related to vaccine administration (SIRVA) is a well-described, preventable injury resulting from improper injection into anatomic structures adjacent to the deltoid muscle leading to mechanical and chemical trauma augmented by an inflammatory immune response to the vaccine and/or adjuvants. SIRVA is best described in the setting of influenza vaccination, and little is known about it as it pertains to COVID-19 vaccination. This study aims to describe SIRVA in the current pandemic, increase clinician awareness, and offer considerations for prevention.MethodsTo identify clinical characteristics of patients with post-COVID-19-vaccination shoulder injuries, we performed a systematic review of the cases of vaccination-related shoulder injuries reported in the literature and conducted a review of the public Vaccine Adverse Event Reporting System (VAERS).ResultsWe identified 305 cases of SIRVA in the VAERS database and 28 cases of SIRVA in the setting of COVID-19 vaccination from the literature (n = 333). Patients had a mean age of 51.8 years and a median of 51.5 (range: 19–90) years. Of these, 76.3% were female and 23.7% male. Most patients sought medical evaluation with 54 of the 305 VAERS cases reporting utilizing emergency services. Of patients with imaging-confirmed SIRVA (n = 95), the most common diagnoses were adhesive capsulitis and bursitis, and the most common symptoms were pain (97.7%) and limited range of motion (68.1%). Most patients reported requiring treatment with the majority receiving physical therapy (56.3%), followed by cortisone injection (34.4%). Other modalities used were non-steroidal anti-inflammatory drugs, oral steroids, and surgery. Only 5 patients from this group reported recovery while 60 stated they had not yet recovered. Of those, 23.3% reported disability.ConclusionSIRVA should be regarded as an under-reported, significant cause of post-vaccination morbidity. In the setting of COVID-19 mass vaccination, clinicians must be aware of signs and symptoms of SIRVA as well as appropriate diagnostic modalities and treatment options. Additionally, standardization and proper education regarding injection technique and appropriate needle length is imperative to reducing harm.     

小针刀加推拿疗法治疗肩周炎

肩周炎是由寒湿侵入形成的慢性无菌性炎症,软组织广泛粘连,微循环障碍.小针刀能松解粘连,疏通阻滞,但局限性在于不能针对广泛粘连.推拿能利滑关节,增大肌肉伸展性,使变性组织改善,对结节及肌肉挛缩又有其局限.而先行小针刀再实施推拿,两者相辅相成取得了95%的优良率.