• Clinics in Shoulder and Elbow
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• v.25 no.1
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• pp.22-27
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• 2022

Background: In some patients with rotator cuff tear (RCT), the axial view of magnetic resonance imaging (MRI) shows subtle posterior decentering (PD) of the humeral head from the glenoid fossa. This is considered to result from a loss of centralization that is typically produced by rotator cuff function. There are few reports on PD in RCT despite the common occurrence of posterior subluxation in degenerative joint disease. In this study, we investigated the effect of PD in arthroscopic rotator cuff repair (ARCR). Methods: We conducted a retrospective study of consecutive patients who underwent ARCR at our institute and were followed-up for at least 1 year. PD was identified as a 2-mm posterior shift of the humeral head relative to the glenoid fossa in the axial MRI view preoperatively. The tear size and fatty degeneration (FD, Goutallier classification) were also evaluated using preoperative MRI. Retears were evaluated through MRI at 1 year postoperatively. Results: We included 135 shoulders in this study. Ten instances of PD (including seven retears) were observed preoperatively. Fifteen retears (three and 12 retears in the small/medium and large/massive tear groups, respectively) were observed postoperatively. PD was significantly correlated with tear size, FD, and retear occurrence (p<0.01 each). The odds ratio for PD in retears was 34.1, which was greater than that for tear size ≥3 cm and FD grade ≥3. Conclusions: We concluded that large tear size and FD contribute to the occurrence of PD. Furthermore, PD could be a predictor of retear after ARCR.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2009.03a
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• pp.220-220
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• 2009

In fencing, athletes must hit opponents by the sword of fencing, so they need long reach between their foot and their tip of the sword. We thought the motion of shoulder joint, mainly scapula, is one of the important roles in this action and noticed the difference of right and left side in muscles around scapula caused by this action. We evaluated these muscles with MRI imaging in 5 high-level athletes of fencing who aims at the next Olympics (3 men and 2 women, their average age is 21 years). Besides we observed their physical measurement related with these muscles. We reported the characteristics of these results.

• Clinics in Shoulder and Elbow
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• v.8 no.2
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• pp.181-186
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• 2005

An anterior dislocation of the elbow without a fracture of the olecranon is an extremely rare injury. This paper reports a 36-year-old male who stumbled and fell on his outstretched hand during a soccer game. The anteroposterior and lateral radiographs indicated a simple anterior dislocation of the elbow, which was reduced using a closed method. The elbow joint was stable in the range of motion, but the sensation of the two ulnar digits was still reduced. MRI was useful for the identification of the pathoanatomy. At the follow-up examination three months after the initial trauma, the hypesthesia has fully recovered and the patient regained the full range of the elbow and forearm motion without pain and instability. After 18 months, the patient had a normal elbow function, and could play various sports. If an anterior elbow dislocation is detected early, a closed reduction with careful pathoanatomical considerations would be successful.

• The Journal of the Korean bone and joint tumor society
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• v.15 no.2
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• pp.151-154
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• 2009

Bronchogenic cyst is rare lesion that arises from maldevelopment of the primitive foregut, and is usually found in the lung and mediastinum. Cutaneous or subcutaneous bronchogenic cyst is rare and occur unusually in the shoulder region. We report here a case of 20-month-old boy with a bronchogenic cyst on his left shoulder region. He underwent incisional biopsy and curettage for a tender cystic mass at a department of dermatology, diagnosed as a epidermal inculsion cyst. But, additional cystic mass was palpated during wound care. MRI showed a well-defined subcutaneous cystic mass. The excised cyst was lined with pseudostratified ciliated columnar epithelium with occasional goblet cells and diagnosed as a bronchogenic cyst.

• Clinics in Shoulder and Elbow
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• v.17 no.2
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• pp.80-83
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• 2014

A 29-year-old man visited our clinic owing to a persistent swelling in the anterior part of the left elbow joint that began one year ago. Through magnetic resonance imaging (MRI), we observed tenosynovitis with multiple rice bodies, and so we performed an excisional biopsy and tenosynovectomy. Through pathology and culture tests, we identified tuberculosis in the tissue biopsy that we harvested intraoperatively. Following the anti-tuberculosis medication relieved the patient's symptoms without recurrence. Since tuberculosis of the elbow occurs only rarely, and the symptoms mimic those of rheumatoid synovitis or of non-specific chronic synovitis, early diagnosis and appropriate treatment are often delayed. The authors report this rare case of tuberculous tenosynovitis of the elbow with a review of the relevant literature.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.35 no.3
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• pp.176-181
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• 2009

Synovial chondromatosis is a rare, benign, monoarticular arthropathy that is characterized by the development of highly cellular, metaplastic cartilaginous nodules in the synovial membrane. It commonly affects larger joints such as the knee, elbow, wrist, shoulder, and hip. Synovial chondromatosis of the temporomandibular joint(TMJ) is rare. Moreover, the temporal involvement of synovial chondromatosis without connection with joint is greatly rare. A 44-year-old women had experienced pain of the right TMJ area and limitation of mouth opening. MRI and CT revealed multiple calcified loose bodies and widening in right upper joint space of TMJ and osteolytic lesion in right temporal bone. Treatment consisted of removal of multiple loose bodies, resection of the osteolytic lesion through the preauricular approach. She was diagnosed with primary transitional synovial chondromatosis of TMJ with involvement of temporal bone. In spite of remaining of the loose bodies, pain and mouth opening improved and there have been no recurrence of signs and symptoms for 5 years follow up.

• Clinics in Shoulder and Elbow
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• v.13 no.1
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• pp.99-105
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• 2010

Purpose: Here we report clinical results for surgical treatment of 2 cases of pyogenic arthritis and 1 case of tubercular arthritis, which only rarely develops in the sternoclavicular joint. Materials and Methods: From September 2003 to September 2008, we did early marginal resection and thorough debridement of osteomyelitis of the sternum and distal clavicle in 3 patients and evaluated clinical results after short-term follow up. Results: All 3 patients were satisfied with their clinical results and none had any recurrences according to follow up X-rays and laboratory datas. The follow up MRI showed bone edema in the distal clavicle and proximal sternum and a little fluid retention around the sternoclavicular joint. Conclusion: Even though diagnosis of these diseases are made earlier, infection of the adjacent bone and osteomyelitis could already have developed. We did early marginal resection and thorough debridement of osteomyelitis of the sternum and distal clavicle and achieved satisfactory results.

• Journal of the Korean Arthroscopy Society
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• v.13 no.3
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• pp.276-279
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• 2009

Fibroma of tendon sheath is an uncommon benign soft tissue tumor with a predilection for the hand or upper extremities with extremely rare intra-articular involvement. It is mostly comprised of slow-growing fibrous lobules made up of scattered fibroblasts in a dense stroma with slit-like vascular channels. An unique case in a 54-year-old male patient involving the glenohumeral joint arising from postersuperior joint capsule is reported. Magnetic Resonance Imaging (MRI) reveals a focal nodular mass with decreased signal intensity on all pulse sequences and pathology confirmation was made with arthroscopic excision. Intra-articular fibroma of tendon sheath should be considered in the differential diagnosis of intra-articular soft tissue masses during shoulder arthroscopy.

• Journal of the Korean Society of Radiology
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• v.18 no.2
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• pp.127-133
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• 2024

The elbow joint is made up of three different bones. X-rays or other radiological exams are commonly used to diagnose elbow injuries or disorders caused by physical activity and external forces. Previous research on the elbow joint reported a new examination method that meets the imaging evaluation criteria in the tilt position by Z-axis elevation of the forearm. Therefore, this study aims to design an optimized instrument and develop an aid applicable to other upper extremity exams. After completing the 2D drawing and 3D modeling design, the final design divided into four parts was fabricated with a 3D printer using ABS plastic and assembled. The developed examination aid consists of a four-stage Z-axis elevation tilt angle function (0°, 5°, 10°, and 15°) and can rotate and fixate 360° in 1-degree increments. It was designed to withstand a maximum equivalent stress of 56.107 Pa and a displacement of 1.6548e-5 mm through structural analysis to address loading issues caused by cumulative frequency of use and physical utilization. In addition to X-ray exams of the elbow joint, the developed aid can be used for shoulder function tests by rotating the humerus and also be applied to MRI and CT exams as it is made of non-metallic materials. It will contribute to the accuracy and efficiency of medical imaging diagnosis through clinical applications of various devices and medical imaging exams in the future.

• Clinics in Shoulder and Elbow
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• v.14 no.1
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• pp.67-72
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• 2011

Purpose: There are various known methods for arthroscopic rotator cuff repair. The purpose of this retrospective study is to report on the clinical results and anatomical results of UU repair surgery, which is a new repair method. Materials and Methods: We enrolled 156 patients (88 men and 68 women) who underwent UU repair for rotator cuff tears from January 2009 to May 2010 in our hospital. Their average age was 55 years old (range: 38~75 years old) and the average follow-up period was 12 months (range: 6~23 months). For determining the results, we evaluated the VAS for pain, the daily living index (ADL) in the ASES scores, the UCLA and KSS scores, and all these tests were conducted at the first hospital visit and 6 months and 1 year after surgery and at the final follow-up. During the follow-up period, MRI was performed 3 and 6 months after surgery only in the patients who consented to MRI scans to confirm the presence of re-rupture. Results: The average scores of the VAS as a pain indicator decreased from 7.0 before surgery to 2.7 after surgery (p<0.05). The UCLA and KSS scores increased from 22.2 to 32.5 and from 83.7 to 91.5, and the changes was significant (p<0.05). For the active joint range of motion, the average forward flexion was improved from 125 to 175 degrees, the average lateral external rotation was improved from 38 to 58 degrees, and the average abduction was improved from 104 to 169 degrees. Out of a total of 156 patients, re-rupture was observed in 4 cases (3%) of 117 cases (75%) for which MRI was performed (with consent) between 3 and 6 months after surgery. Conclusion: UU repair surgery as arthroscopic repair of rotator cuff tear is a good repair method that shows excellent clinical results and a low re-rupture rate.