• 대한족부족관절학회지
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• 제16권3호
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• pp.193-196
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• 2012

Calcific tendinitis usually occurs in the supraspinatus tendon of the shoulder. Calcific tendinitis of the peroneus longus tendon has not been reported on the Korean journals. Differential diagnosis includes bipartitis os peroneum, os peroneum fracture and peroneal tendinitis. We report a rare case of calcific tendinitis of the peroneus longus tendon which responded well with the conservative treatment.

• Journal of Acupuncture Research
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• 제38권3호
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• pp.242-244
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• 2021

LI15 is an important acupuncture point to treat shoulder pain. There are 4 needling methods for LI15 in the textbook; 1 method requires the insertion of the needle horizontally between the acromion and the great tuberosity of the humerus with the arm lowered for supraspinatus tendonitis. This method is also applicable for all conditions of rotator cuff disease, but it has not previously been described in detail. Providing X-ray scans and describing needle direction and depth of insertion will provide evidence for needling with the arm down as an effective stimulation of the subacromial space. Firstly, for this technique, with the arm raised, a concave point is located between the front edge of the acromion and the humerus, and the lower upper arm. Secondly, the acupuncture needle is inserted slightly posteriorly towards the supraspinous fossa, in the direction of the supraspinatus tendon and to a depth of 30-40 mm.

• 대한영상의학회지
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• 제83권1호
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• pp.252-252
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• 2022

• Clinics in Shoulder and Elbow
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• 제22권4호
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• pp.216-219
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• 2019

Background: Progression of the tear size and erosion of the greater tuberosity (femoralization) in the supraspinatus tear makes it difficult to repair or increases the risk of a re-tear. This study examined the proximal articular surface and greater tuberosity of the humeral head in plain radiography. Methods: Two-hundred forty-seven cases, whose anteroposterior (AP) radiographs were taken correctly, were included from 288 cases, in whom the status of the supraspinatus had been confirmed by surgery. After downloading the plain AP radiograph as DICOM, the radius of the circle apposed at the superior half of the articular surface of the head, and the distance between the circle and the farthest point of the greater tuberosity ('height' of the greater tuberosity) were calculated using the software (TechHime, Korea). MRI checked the number of torn tendons and degree of muscular atrophy. Results: The following were encountered: 93 intact supraspinatus, 50 partial-thickness tears, and 104 full-thickness tears. In the analysis using the 93 intact cases, the average radius of the rotation center was 25.3 mm in male and 22.3 mm in female. The average height of the greater tuberosity from the circle with the same rotation center was 4.3 mm in male and 4.2 mm in female with no statistical significance. The correlation between the reparability of supraspinatus and height of the greater tuberosity, fatty infiltration, and muscular atrophy was confirmed. Conclusions: The height of the greater tuberosity from the circle with the same rotation center was 4.3 mm in male and 4.2 mm in female. This height was strongly correlated with muscular atrophy and fatty infiltration of the supraspinatus tendon.

• Clinics in Shoulder and Elbow
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• 제18권1호
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• pp.47-51
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• 2015

Iatrogenic damage of the rotator cuff followed by postoperative shoulder function loss is a potential complication after antegrade intramedullary nailing (AIN) for a humeral fracture. The authors present a case of arthroscopic rotator cuff repair and subacromial decompression of a non-healed rotator cuff tendon (mainly supraspinatus) and secondary impingement syndrome caused either by the tear or a proud nail after AIN for a mid-shaft humeral fracture. At presentation, the patient complained of right shoulder pain and 'snapping', especially during forward elevation and abduction of the shoulder, of 4 years duration. Right shoulder pain started sometime after pain due to the humeral shaft fracture, operation had subsided, and persisted after nail removal. Arthroscopic findings showed a longitudinal rotator cuff tear at the nail entry point that had not healed and severe fibrous hypertrophy on the acromion underspace, which is a unique finding since most longitudinal splits of tendon fibers are more likely to heal than conventional rotator cuff tears detached from bone. The torn rotator cuff was repaired after debridement and placing side-to-side sutures. At his 34-month follow-up after rotator cuff repair, the patient showed complete recovery and had excellent clinical scores.

• Clinics in Shoulder and Elbow
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• 제18권4호
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• pp.197-205
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• 2015

Background: The purpose of this study was to evaluate the postoperative magnetic resonance imaging (MRI) results of minimal-tying (one medial-row tie among 4 medial-row sutures) on the medial-row in double-row suture-bridge configuration ($2{\times}2$ anchor with $4{\times}4$ suture stands). Methods: From 2011 March to 2012 July, 79 patients underwent arthroscopic rotator cuff repair using $2{\times}2$ anchor double-row configuration. The mean age was 61.3 years (range, 31-81 years). Two double-loaded suture anchors were used for medial-row. Four medial-row stitches were made with only one medial-row knot-tying (the most anterior suture). Lateral-row was secured using the conventional suture-bridge anchor technique; all 4 strands were used for each anchor. Repair integrity was evaluated with MRI at mean 6.2 months postoperatively. Retear and the pattern of retear, change of fatty infiltration, and muscle atrophy of supraspinatus were evaluated using pre- and postoperative MRI. Results: Repaired tendon integrity was 38 for type I, 30 for type II, 6 for type III, 4 for type IV, and 1 for type V, according to Sugaya classification. Considering type IV/V as retear, the rate was 6.3% (5 out of 79 patients). Medial cuff failure was observed in 4 patients. Fatty atrophy of supraspinatus was significantly improved postoperatively according to Goutallier grading (p=0.01). The level of muscle atrophy of supraspinatus was not changed significantly after surgery. Conclusions: Minimal tying technique with suture configuration of four-by-four strand double-row suture-bridge yielded a lower retear rate (6.3%) in medium to large rotator cuff tears.

• Clinics in Shoulder and Elbow
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• 제22권1호
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• pp.3-8
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• 2019

Background: This study aimed to compare the subscapularis muscle volume between the intact groups (group I) and supraspinatus tendon tear groups (group T) based on the sex and three different age groups. Methods: Subjects with a group I and subjects with group T without any other lesions were retrospectively evaluated from among patients who received a magnetic resonance imaging (MRI) scan between January 2011 and December 2013. The MRI scans were studied by a consultant radiologist. The subscapularis muscle volume was compared according to the age and sex; the age groups were categorized as patients in their 40s, 50s, and 60s. The volume of subscapularis muscle was measured by three-dimensional reconstructed images acquired through the axial section of 1.5T MRI. Results: No statistically significant differences were observed between subscapularis muscle volume of the group I and group T, except for male patients in their 50s (group I: $100,650mm^3$ vs. group T: $106,488mm^3$) and 60s (group I: $76,347mm^3$ vs. group T: $99,549mm^3$) (p<0.05). Males had a larger mean volume of subscapularis muscle than females, and the subscapularis muscle volume decreased in a linear manner with increasing age. Conclusions: Decrease in subscapularis muscle volume was observed with increasing age, and the impact of supraspinatus tear on subscapularis muscle volume is age and sex dependent.

• 한국산학기술학회논문지
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• 제22권4호
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• pp.513-519
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• 2021

봉합 나사못을 이용한 견관절 수술 환자들의 예후를 확인하기 위하여 MRI(Magnetic Resonance Imaging)를 이용하여 추적검사를 시행한다. 봉합나사못을 삽입한 경우에는 임상적 관찰을 용이하게 하기 위하여 지방소거법을 이용한 영상촬영 기법이 이용되는데, 이때 이용되는 지방 신호 억제 기법으로 CHESS(Chemical Shift Selective), STIR(Short Tau Inversion Recovery), Dixon 기법 등이 주로 이용되고 있다. 봉합나사못은 비자성 재료를 이용해서 제작되지만, 환부에 삽입되는 티타늄 재질의 금속물질은 비자성체임에도 불구하고 국소자장을 왜곡시켜 결과 영상의 기하학적인 왜곡은 물론 심각한 영상신호의 감소 현상을 발생시킨다. 봉합나사못을 삽입하여 환부를 관찰하는 경우에는 뼈 혹은 뼈 인접 부위의 영상을 획득하여야 하는데 뼈와 주변 조직의 임상적 관찰을 위해서는 뼈의 지방 신호를 억제할 필요가 있다. 이때 이용되는 지방 신호 억제 기법은 금속 삽입물로 인한 자기장 불균일의 영향을 받는다. 본 연구에서는 3가지 지방억제 영상기법(CHESS, STIR, Dixon)을 이용하여 금속물질을 삽입한 환자로부터 영상을 획득하여 비교, 분석하였으며, 그 결과로 봉합나사못을 삽입한 환자의 병변 관찰 및 수술 후 예후를 관찰하기 위한 영상기법으로 STIR 영상기법이 가장 적합함을 알 수 있었다. 연구 결과에 따르면 금속 물질을 인체에 삽입한 환자의 경우, 지방 신호 억제가 필요한 MRI 검사에서는 STIR 기법을 이용하는 것이 임상적 가치가 높은 영상을 얻을 수 있을 것이다.

• 대한정형외과 초음파학회지
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• 제5권1호
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• pp.31-35
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• 2012

석회성 건염은 건의 부착부 주변에 발생하는 병변으로 견관절에서는 주로 극상근의 대결절 부착 부위의 근위부에 발생하는 경우가 대부분이다. 저자들은 류마티스 관절염을 가진 환자에서 발생한 상완 이두근 단두건과 오구상완근의 연합건의 석회성 건염을 초음파 검사를 통해 진단한 증례를 경험하여 보고하는 바이다.

• 대한방사선기술학회지:방사선기술과학
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• 제23권1호
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• pp.21-27
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• 2000

To evaluation of patients who have shoulder impingement syndrome is by diagnostic radiography. Shoulder impingement is a problem which occurs in young, active individuals as well as older individuals. In fact, the pain is probably caused by repetitive stress placed on the shoulder joint either through recreational activities of your occupation. Impingement series approach to radiographic examination of the shoulder is take five projections. First anteroposterior oblique projection. Second standard anteroposterior projection. Third superoinferior axial projection. Fourth supraspinatus outlet projection offers a view of the outlet of the supraspinatus tendon unit as it passes under the coraacromial arch. Fifth anteroposterior $30^{\circ}$ caudal projection will adequately demonstrate the anterior acromial spur or ossification in the coraacromial ligament and more reliable to demonstrate spurring of the anterior acromion than supraspinatus outlet projection. This decreased the need for additional radiographic veiws, reduces the patient's exposure to x - ray radiation and decreases use of film. This can lower the cost of the evaluation and improve patient satisfaction.