• Title/Summary/Keyword: shoulder-arm pain

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Desmoplastic Fibroblastoma of the Scalp Accompanied by Severe Pain; Unusual Location and Symptom

  • Yang, Ji Hoon;Chae, Je-Byeong;Huh, Chang-Hun;Na, Jung-Im;Park, Kyoung-Chan;Shin, Jung-Won
    • Annals of dermatology
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    • v.30 no.6
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    • pp.712-715
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    • 2018
  • Desmoplastic fibroblastoma is a rare fibrous tumor that usually presents as a painless, slow-growing mass in the subcutaneous tissues and skeletal muscles. It has a wide anatomic distribution, with the most common involvement being the arm and shoulder. Here, we report a case of a tiny painful desmoplastic fibroblastoma arising on the scalp. According to a microscopic examination, this tumor was composed of spindle-shaped fibroblasts in the dense collagenous stroma. On immunohistochemical staining, tumor cells were positive for vimentin and negative for smooth muscle actin, CD34, and S100. Our case is unique in that desmoplastic fibroblastoma developed on the scalp and there was presence of pain despite its small size.

A Comparative Study of the Effect of Resisted Exercise Using Thera-bands according to Grip Type: Pain and Range of Motion of the Shoulder in a Patient with Lymphedema after Mastectomy (그립 유형에 따른 탄력밴드 저항운동 효과의 비교 연구 ; 유방절제술로 발생한 팔 림프부종 환자에 대한 통증 및 어깨관절가동범위에 대하여)

  • Jo, Yejin;Lee, Sangryul
    • Journal of The Korean Society of Integrative Medicine
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    • v.8 no.1
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    • pp.47-56
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    • 2020
  • Purpose : The purpose of this study was to determine the effects of upper extremity volume, pain, and range of motion after participation in thera-band exercises according to the hand grip type in patients with breast cancer with upper extremity edema. We also aimed to determine the most efficient type of grip. Methods : The subjects were 10 female patients diagnosed with stage 2 breast cancer who had stage 2 lymphedema. Randomly, 5 patients each were allocated to the experimental and control groups. For six weeks, the patients in both the experimental and control groups exercised daily. In both groups, manual lymph drainage was applied for 1 hour. Afterward, patients in the experimental group placed their hands in the thera-band ring and exercised with their fingers outstretched. Patients in the control group exercised while holding the thera-band ring with a finger. Both the experimental group and the control group underwent measurements of the circumference of the upper extremity, pain, and range of motion of the shoulder joint at weeks 1, 2, 4, and 6 before and after exercise. Results : The upper arm circumference decreased by more in the experimental group in all weeks than before than that in the control group, and there was a statistically significant difference at 6 weeks. Compared with the difference between pre-exercise and 6 weeks post-exercise, the change in pain significantly decreased in the experimental group and showed a statistically significant difference. The shoulder range of motion increased in extension, external rotation, and internal rotation compared with that in the control group, and there was a statistically significant difference. Although the operating range increased in flexion and abduction, there were no statistically significant differences. Conclusion : In this study, we found that thera-band exercises with an open-hand grip are more efficient than thera-band exercises with a closed-hand grip in edema reduction, pain, and range of motion. In addition, it was found that it was more effective to continue the thera-band exercises with open-hand grip extended for at least 6 weeks rather than for a short time.

Posterior Internal Impingement of the Shoulder in Baseball Players -Preliminary Report of 5 Cases Study- (야구 선수에서의 견관절 내부 후방 충돌 -5예에 대한 예비보고-)

  • Kim, Young-Kyu;Choi, Kwang-Woon
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.4 no.1
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    • pp.36-42
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    • 2005
  • Purpose: To investigate the arthroscopic findings, and to evaluate the clinical outcomes of the treatment of posterior internal impingement of the shoulder in baseball players. Materials and Methods: We followed up 5 cases who were diagnosed as posterior internal impingement for the mean 15 months. All of the cases complained of the pain in the posterior shoulder at late cocking, and were positive in the relocation test added by hyper-horizontal abduction at $120^{\circ}$ abduction of the arm. We sutured posterior labral tear and SLAP lesion arthroscopically, and conducted debridement for rotator cuff. Three cases were performed of anterior capsular plication and the other two were performed of thermal capsular shrinkage. Pain, range of motion, and level of return to sports activity were assessed for the results. Results: As to the arthroscopic findings, all the five cases showed the fraying in posterosuperior labrum, and two of them was accompanied with the flap tear in posterosuperior labrum and the other one was accompanied with type 2 SLAP lesion. All the cases showed the fraying in supraspinatus, and one case showed partial tear. Meanwhile, in all the cases, the rotator cuff was impinged to the labrum at $90^{\circ}{\sim}120^{\circ}$ of abduction and external rotation. As to the postoperative results, all the cases did not complain of pain or instability while pitching, and the competition was recovered to be the mean 88%($80{\sim}100%$) of that before the injury. Conclusion: Definite diagnosis for the posterior internal impingement would be possible through arthroscopic examination. Favorable outcomes could be obtained with capsular plication or shrinkage for anterior microinstability and stretching exercise for posterior capsule tightness inducing the internal impingement.

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A Case Report on Kienb$\ddot{o}$ck's Disease by Korean Medical Treatments (한방 치료를 이용한 키엔벡 병의 치험 1례)

  • Lee, Yong Eun;Kim, Jae Soo;Lim, Seong Chul;Lee, Yun Kyu;Lee, Bong Hyo;Jung, Tae Young;Lee, Hyun Jong
    • Journal of Acupuncture Research
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    • v.30 no.5
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    • pp.203-209
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    • 2013
  • Objectives : The purpose of this study is to report the clinical effects of Korean medical treatment for Kienb$\ddot{o}$ck's disease. Methods : The patient was treated using acupuncture, electroacupuncture, herbal medicine, pharmacopuncture treatment, and other treatments including moxibustion, physical rehabilitation for 6 weeks. And we evaluated the patient through verbal rating scale(VRS), disability of the arm, shoulder and hand(DASH), range of motion(ROM). Results : After treatment, VRS is changed from 7 to 3, DASH is changed from 37.93 to 20.69. And ROM is changed from $60^{\circ}$ to $70^{\circ}$ in wrist flexion, and from $10^{\circ}$ to $15^{\circ}$ in radial deviation. Conclusion : These results suggest that Korean medical treatment is effective to the patient complaining pain and dysfunction.

Long-Term Clinical and Radiologic Outcomes of Minimally Invasive Posterior Cervical Foraminotomy

  • Kwon, Young-Joon
    • Journal of Korean Neurosurgical Society
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    • v.56 no.3
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    • pp.224-229
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    • 2014
  • Objective : To report long-term clinical and radiological outcomes of minimally invasive posterior cervical foraminotomy (MI-PCF) performed in patients with unilateral single-level cervical radiculopathy. Methods : Of forty-six patients who underwent MI-PCF for unilateral single-level radiculopathy between 2005 and 2013, 33 patients were included in the study, with a mean follow-up of 32.7 months. Patients were regularly followed for clinical and radiological assessment. Clinical outcome was measured by visual analogue scale (VAS) for the neck/shoulder and arm, and the neck disability index (NDI). Radiological outcome was measured by focal/global angulation and disc height index (DHI). Outcomes after MI-PCF were evaluated as changes of clinical and radiological parameters from the baseline. Mixed effect model with random patients' effect was used to test for differences in the clinical and radiological parameters repeat measures. Results : There were no complications and all patients had an uneventful recovery during the early postoperative period. VAS scores for neck/shoulder and arm improved significantly in the early postoperative period (3 months) and were maintained with time (p<0.001). NDI improved significantly post-operatively and tended to decrease gradually during the follow-up period (p<0.001). There were no statistically significant changes in focal and global angulation at follow-up. Percent DHIs of the upper adjacent or operated disc were maintained without significant changes with time. During the follow-up, same site recurrence was not noted and adjacent segment disease requiring additional surgery occurred in two patients (6%) on the contra-lateral side. Conclusion : MI-PCF provides long-term pain relief and functional restoration, accompanied by good long-term radiological outcome.

Cervical Fibrous Dysplasia Presenting as a Pathologic Fracture in an Older Patient

  • Lee, Su-Heon;Han, In-Ho;Kang, Dong-Wan;Choi, Byung-Kwan
    • Journal of Korean Neurosurgical Society
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    • v.50 no.2
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    • pp.139-142
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    • 2011
  • Vertebral involvement of fibrous dysplasia (FD) is rare, especially in the cervical spine. Moreover, cervical FD presenting as a pathologic fracture in older patients is extremely rare. We report a case of symptomatic cervical FD associated with pathologic fracture in a 63-year-old man. The patient presented with progressive weakness of the left arm and pain in the shoulder and arm. Radiologic studies revealed a collapsed and typical 'ground glass' radiolucency of C4. Multiple lytic lesions involved the odontoid process of C2 and the body, left pedicle, and posterior elements of C4. Combined anterior and posterior decompression and reconstruction were performed. Post-operatively, the histopathologic examination confirmed FD. On the post-operative follow-up examination, the neurologic deficits had completely resolved.

Comparison of the EMG Activities of Scapular Upward Rotators and Other Scapular Muscles Among Three Lower Trapezius Strengthening Exercises (아래등세모근 근력강화 운동방법들 사이의 어깨뼈 위쪽 돌림근과 다른 어깨 근육들의 근활성도 비교)

  • Yong, Joon-Hyoung;Weon, Jong-Hyuck
    • Physical Therapy Korea
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    • v.20 no.3
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    • pp.27-35
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    • 2013
  • The aim of this study was to compare the electromyographic (EMG) activity levels of the scapular upward rotators [upper trapezius (UT), lower trapezius (LT), and serratus anterior (SA)] and other scapular muscles [posterior deltoid (PD), levator scapulae (LS), and infraspinatus (IS)] during isometric lower trapezius exercises. Twenty males with no medical history of shoulder pain or upper extremity disorders were recruited for this study. EMG activity was recorded from the UT, LT, SA, PD, LS, and IS while subjects performed three different exercises: Prone arm lift (PAL), Backward rocking diagonal arm lift (BRDAL), Modified Prone Cobra (MPC). One-way analysis of variance (ANOVA) was used to determine any significant differences among the three exercises. A lower relative activation of UT, LT, and SA was seen with the MPC than with the other exercises (p<.05). The relatively lower activation of the UT identified, the MPC exercise as the preferred choice for preferential strengthening the LT (p<.05). However, a higher activation in the PD, LS, and IS occurred with the MPC than with the other exercises (p>.05). The recruitment pattern of synergist varied depending on the exercise posture. These findings suggest that exercise posture is an important factor in the selection of strengthening exercise for weak muscle.

Late-onset Brachial Artery Occlusion caused by Subclavian Artery Stenosis after Clavicular Fracture: A Case Report

  • Cho, Chul-Hyun;Song, Kwang-Soon;Min, Byung-Woo;Bae, Ki-Cheor
    • The Academic Congress of Korean Shoulder and Elbow Society
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    • 2008.03a
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    • pp.175-175
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    • 2008
  • We report a rare case of late-onset brachial artery occlusion caused by subclavian artery stenosis with excessive scar tissue after open reduction and plate fixation for clavicular fracture. When he referred to us, the right hand were pale and the radial and ulnar pulses at the wrist were absent. CT-angiogram showed compression of subclavian artery by excessive scar tissue beneath the fracture site and angiography revealed stenosis of subclavian artery with thrombus and complete obstruction of blood flow in the brachial artery with emboli. Therefore, we performed embolectomy. 2 years after operation, patient was essentially asymptomatic except mild pain after long standing elevation of arm. We recommend that minimal soft tissue dissection should be needed in the operative treatment of clavicular fracture, especially soft tissue beneath the clavicle should be protected maximally.

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The Effect of Health Promotion Program on Health of the Clients with Arthritis in Primary Health Care Center (관절염 대상자를 위한 건강증진 프로그램의 효과 -보건진료소를 중심으로-)

  • Choi, Sun-Ha
    • Research in Community and Public Health Nursing
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    • v.12 no.2
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    • pp.344-360
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    • 2001
  • A quasi-experimental study was conducted to investigate the effects of health promotion program on health of the clients with arthritis. In this study. the health promotion program consisted of self appointment and confirmation. discussion, health education. group counsel, and exercise. And the program focused on self - help group meeting. A total of 68 subjects was randomly assigned into either the control group(n = 24) or the intervention group(n =44). The results of the study analyzed using a SPSS win, were as follows: 1) In physical function of physical health. there was a significant improvement in flexibility of the shoulder joint(hold the hand upward and downward behind the back). sit and reach, extension of the knee joint in the intervention group, compared to the control group, while no difference in flexibility of the shoulder joint(raising the arm), flexion of the knee joint, and grip strength. There was a significant improvement in physical functional disability in the intervention group, compared to the control group, but no difference in fatigue and pain. 2) The health promotion program resulted in improvement in psychosocial health(e.g. increase of self-efficacy and decreases of social functional disability) in the intervention group, compared to the control group. It was concluded that the health promotion program(weekly session for 6 weeks) employed in this study was appropriate for the clients with arthritis in primary health care center and had a positive effect on health in general.

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Mapping between Musculoskeletal Patient-Reported Outcome Measures and KCF: Physical Therapy Perspective (근육뼈대계 환자보고식 결과 측정과 KCF의 연결: 물리치료 중심으로)

  • Ju-Min Song
    • Journal of the Korean Society of Physical Medicine
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    • v.19 no.1
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    • pp.143-154
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    • 2024
  • PURPOSE: The present study was conducted to improve the understanding of the Korean Standard Functional, Disability, and Health Classification (KCF) and its ease of use in the clinical domain of the musculoskeletal system by comparing, analyzing, and linking the KCF codes with items from patient-reported outcome measures (PROMs), which are currently mainly used to evaluate patients with neck, shoulder, waist, and knee pain. METHODS: The items of the most widely used PROMs, the Neck Disability Index (NDI), Disabilities of the Arm, Shoulder, and Hand (DASH) scores, Oswestry Disability Index (ODI), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the codes of the KCF were linked by two experts according to the linking rules. RESULTS: The concordance between the items of each of the PROMs and the KCF code linked by the two experts was NDI,86.4%86.4%, DASH 83.3%, ODI 92.0%, and WOMAC 80.7%. The NDI, DASH, and WOMAC indexes were found to comprise items corresponding to physical function, activity, and participation areas, and were linked to 22, 43, and 31 KCF codes, respectively. In addition to these two areas, the ODI included items related to environmental factors and was linked to 25 codes (duplicated codes are treated as one). CONCLUSION: This research can be used by adding the KCF code to the questions of the currently used evaluation tool. This coding can be easily applied and will contribute to the easy understanding of the KCF.