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  • Author: Przemysław Lubiatowski x
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Shoulder arthropathy secondary to syringomyelia: systematic review

Anna Wawrzyniak and Przemysław Lubiatowski

Purpose

  • The purpose of this study was to collect and evaluate clinical and radiological evidence on shoulder neuroarthropathy (NA) in syringomyelia (SM) that may support the management and treatment of patients with this condition.

Materials and methods

  • This systematic review is based on the analysis of reports available in PubMed, Embase, Cochrane Database of Systematic Reviews and Cochrane Central Register of Controlled Trials using the following keywords: syringomyelia, neuroarthropathy, Charcot joint and shoulder degeneration. Thirty-nine publications were found presenting case reports or case series meeting our criteria. Pooled data included a group of 65 patients and 71 shoulders with NA secondary to SM.

Results

  • The most commonly reported symptoms were range of motion (ROM) limitation, weakness, swelling, pain and dissociated sensory loss. NA is usually monolateral and concerns only the shoulder. The average active shoulder ROM was flexion −59.2° (s.d. 37.9), internal rotation −29.8° (s.d. 22.6) and external rotation −21.1° (s.d. 23.6). Most of the patients (75%) presented with complete or nearly complete proximal humerus degeneration, while the degree of glenoid preservation varied. Fifty-two neuroarthropathic shoulders were treated conservatively with physiotherapy, anti-inflammatory medication and splinting. Eighteen patients were treated by surgical intervention.

Conclusion

  • Shoulder NA due to SM is a devastating and progressive condition, and its course is often unpredictable. Patients with unexplained shoulder degeneration should be evaluated for SM, especially if there are additional neurological symptoms. Conservative treatment usually reduces shoulder pain without improving ROM. For select patients, shoulder arthroplasty may be a better option for restoring function.

Category:
Review Article
DOI:
https://doi.org/10.1530/EOR-22-0008
Volume 8: Issue 1,
Pages:
26–34 (9 total)
Taxonomy:
Shoulder & Elbow

Synovial plica of the elbow and its clinical relevance

Przemysław Lubiatowski, Joanna Wałecka, Marcin Dzianach, Jakub Stefaniak, and Leszek Romanowski

  • A synovial plica (fold) is normal anatomic finding, and occurs in 86–100% of cases; however, symptomatic plica is much less common (7.2–8.7% of all elbow arthroscopies).

  • Synovial plica syndrome is a painful elbow condition related to symptomatic synovial plica.

  • Synovial plica syndrome is diagnosed by clinical examination (lateral elbow pain) commonly accompanied by local tenderness, pain at terminal extension and/or painful snapping.

  • Synovial plica syndrome may be mimicked by other elbow conditions, commonly tennis elbow, loose bodies, and degenerative arthritis.

  • Magnetic resonance imaging or ultrasound scan may support diagnosis in correlation with clinical findings, but symptomatic plica may also be diagnosed as unexpected during elbow arthroscopy.

  • The arthroscopic resection is effective and safe if conservative treatment fails.

Cite this article: EFORT Open Rev 2020;5:549-557. DOI: 10.1302/2058-5241.5.200027

Category:
Review Article
DOI:
https://doi.org/10.1302/2058-5241.5.200027
Volume 5: Issue 9,
Pages:
549–557 (9 total)
Taxonomy:
Shoulder & Elbow

Clinical and radiological examination of bony-mediated shoulder instability

Jakub Stefaniak, Przemyslaw Lubiatowski, Anna Maria Kubicka, Anna Wawrzyniak, Joanna Wałecka, and Leszek Romanowski

  • The coexistence of glenoid and humeral head bone defects may increase the risk of recurrence of instability after soft tissue repair.

  • Revealed factors in medical history such as male gender, younger age of dislocation, an increasing number of dislocations, contact sports, and manual work or epilepsy may increase the recurrence rate of instability.

  • In physical examination, positive bony apprehension test, catching and crepitations in shoulder movement may suggest osseous deficiency.

  • Anteroposterior and axial views allow for the detection of particular bony lesions in patients with recurrent anterior shoulder instability.

  • Computed Tomography (CT) with multiplanar reconstruction (MPR) and various types of 3D rendering in 2D (quasi-3D-CT) and 3D (true-3D-CT) space allows not only detection of glenoid and humeral bone defects but most of all their quantification and relations (engaging/not-engaging and on-track/off-track) in the context of bipolar lesion.

  • Magnetic resonance imaging (MRI) is increasingly developing and can provide an equally accurate measurement tool for bone assessment, avoiding radiation exposure for the patient.

Cite this article: EFORT Open Rev 2020;5:815-827. DOI: 10.1302/2058-5241.5.200049

Category:
Review Article
DOI:
https://doi.org/10.1302/2058-5241.5.200049
Volume 5: Issue 11,
Pages:
815–827 (13 total)
Taxonomy:
Shoulder & Elbow