WebEpisode 183: Concentrated Bone Marrow Aspirate Is More Cellular and Proliferative When Harvested From the Posterior Superior Iliac Spine Than the Proximal Humerus Adam Anz, Benjamin Sherman Arthroscopy 2022;38: 11101114 Featuring: Adam Anz, MD | Podcaster: Travis Dekker, MD Thank you. A rehabilitation program is prescribed. These are the superficial radial nerve and the posterior interosseous nerve (PI nerve). View All. Positive radiographs can be helpful to diagnose calcific tendinitis, acromial spur, humeral head cysts, or superior migration of the humeral head, but are typically normal.3,4,14, Numerous other problems that can affect the shoulder are somewhat less common, such as biceps and labral pathology (e.g., SLAP tearsuperior labrum anterior to posterior tearan avulsion injury to the root of the long head of the biceps tendon) and multidirectional instability. Submit ManuscriptYou may also use this system to track your manuscript through the review process.Track ManuscriptYou may also view author guidelines or track your article, post acceptance, by visiting:Author Gateway, We use cookies to help provide and enhance our service and tailor content. Published online: October 27, 2022. Full length article. The most common and widely used indication for laminectomy and posterior cervical fusion is cervical spondylotic myelopathy (CSM).CSM is defined as arthritic changes on the neck due to the ossification of the ligaments or disc disease, which causes compression of the spinal cord leading to changes in the with campuses in Arizona, Florida and Minnesota. In patients younger than 40 years, glenohumeral instability generally presents with a history of dislocation or subluxation events. Radiographs are indicated as part of the initial work-up for all chronic shoulder pain. The patient-rated elbow evaluation was successfully translated into the Arabic language. 14% You can rate this topic again in 12 months. 1998-2022 Mayo Foundation for Medical Education and Research (MFMER). Journal of Hand Therapy now recommends you submit all manuscripts electronically. usually occurs after age 10 (typically adolescents), juvenille OCD better prognosis than adult, repetitive overhead and upper extremity weight bearing activities, theorized to result from repetitive compression-type injury (overhead or upper extremity weight bearing activities) of the immature capitellum causing, Panner's disease (osteochondrosis of the capitellum), typically presents in first decade of life (<10 years old), surgery is contraindicated for Panner disease (unlike OCD elbow), Radiographic and Arthroscopic Classification, Cartilage fracture with bony collapse or displacement, insidious, activity-related onset of lateral elbow pain in dominant arm, plain radiographs can confirm the diagnosis based on bone defect, Panner disease exhibits an irregular epiphysis, OCD a well-defined subchondral lesion, 3-6 weeks followed by slow progression back to activities over next 6-12 weeks, arthroscopic microfracture or drilling of capitellum, extra- or transarticular drilling of defects, throwing and weight bearing at 4-6 months, arthroscopic debridement and loose body excision, begin strengthening when range of motion is painfree, no throwing or weight bearing activities X 3 months, large type II and III capitellar lesions which engage the radial head, uncontained lesions may require size-matched fresh allograft, resistive/strengthening exercises at 3 months, progressive throwing program begins at 5 months through 7 months, Most heal between 6 to 18 months of nonoperative treatment, inability to participate in sports at same level, up to 50% develop arthritic changes long term. Anterior-superior pain often can be localized to the acromioclavicular joint, whereas lateral deltoid pain is often correlated with rotator cuff pathology. No intra-articular pathology is found on shoulder MRI. All rights reserved. Inspection should involve the entire shoulder, with proper exposure of the anterior, lateral, and posterior shoulder. Normal radiographs and a normal range of motion are inconsistent with the diagnosis. Copyright 2008 by the American Academy of Family Physicians. Examination reveals mild lateral elbow joint tenderness with full range of motion and no effusion or collateral laxity. together to ensure quality care and successful recovery. As people age, the spinal disks in the neck shrink and bone spurs often develop. Glenohumeral osteoarthritis usually presents as gradual pain and loss of motion in patients older than 50 years.3,4,14 A history of arthritis, previous shoulder surgery, pain, crepitus, and decreased motion is consistent with the diagnosis.3,4,14 Radiographs are diagnostic. The hip region is located lateral and anterior to the gluteal region, inferior to the iliac crest, and overlying the greater trochanter of the femur, or "thigh bone". The presence of deformity, particularly of the acromioclavicular joint, often indicates an old trauma. Web(OBQ18.138) A 70-year-old right-hand dominant female presents to your office complaining of continued right shoulder pain 12 weeks after falling from a ladder, despite participating in a rigorous physical therapy program. for Benjamin (Ben) D. Holmes, D.C., Ph.D. surgery, Scoliosis surgery, Spondylolisthesis surgery, Diskectomy, Foraminotomy, Spinal stabilization surgery, Laminectomy, Trauma care, Laminoplasty, Spine reconstruction, Herniated disk, Cervical spondylotic myelopathy, Spondylolisthesis, Infection, Pseudarthrosis, Lumbar spondylosis, Thoracic myelopathy, Abscess, Nonunion, Cervical herniated disk, Thoracic herniated disk, Lumbar spinal stenosis, Scoliosis, Cervical spondylosis, Charcot foot, Cervical spine deformity, Cervical myelopathy, Lumbar radiculopathy, Ossification of the posterior longitudinal ligament, Spondylotic myelopathy, Spondylolysis, Vertebral osteomyelitis, Lumbar herniated disk, Discitis, Cervical radiculopathy, Cervical spondylolisthesis, Spinal compression fracture, Spine deformity, Cauda equina syndrome, Spinal fracture, Sciatica, Spinal metastasis, ded fine needle aspiration, Trigger point injection, Ultrasound-guided musculoskeletal injection, Musculoskeletal exam, Tenotomy-fasciotomy with Tenex technology, Arthritis rehabilitation, Ultrasound-guided injection, Soft tissue injection, Percutaneous tenotomy, Back pain therapy, Injection, Trigger finger release, Platelet rich plasma injection, Joint injection, Regenerative medicine therapy, Outpatient clinical consultation, Ultrasound, Joint examination, Ultrasound-guided aspiration and lavage for calcific tendinitis , Ultrasound-guided cortisone injection, Sport specific rehabilitation, Back pain management, Shoulder arthritis, Rotator cuff injury, Hip tendon tear, Inflammatory myopathy, Little Leaguer's elbow, Spinal pain, Hand arthritis, Cervical spinal stenosis, Radial neuropathy, Shoulder instability, Shoulder disorder, Neuromuscular disorder, Myelopathy, Median neuropathy, Lumbar spinal stenosis, Biceps tendinitis, Carpal tunnel syndrome, Contracture, Wrist pain, Calcific tendinitis, Osteoarthritis, Tendinopathy, Lumbar spondylosis, Torn meniscus, Guillain Barre syndrome, Neck pain, Plantar fasciitis, Spondylolysis, Sacroiliac joint dysfunction, Separated shoulder, Sprained ankle, Rotator cuff tear arthropathy, Cervical herniated disk, Muscle spasms, Foot drop, Patellar tendinitis, Hip instability, Foot injury, de Quervain's tenosynovitis, Hip impingement, Leg pain, Ruptured disk, Hip dysplasia, Hamstring injury, Knee pain, Arthritis, Frozen shoulder, Shoulder subluxation, Cartilage injury, Ulnar wrist pain, Osteoporosis, Patellar tendon tear, Leg length discrepancy, Neurologic muscle weakness, Lumbar pain, Tendinitis, Sacroiliitis, Sports hernia, Ulnar nerve entrapment, Wrist ligament injury, Inflammatory arthritis, Discogenic back pain, Knee loose body, Knee arthritis, Hip tendinitis, Sciatic neuropathy, Arthropathy, Shoulder impingement syndrome, Hand injury, Rotator cuff tear, Elbow instability, Piriformis syndrome, Lateral collateral ligament sprain, Cervical myelopathy, Knee disorder, Muscle weakness, Cervical radiculopathy, Baker's cyst, Thoracic radiculopathy, Rotator cuff tendinitis, Radiculopathy, Swollen knee, Posterior cruciate ligament injury, Back pain, Gait unsteadiness, Ulnar neuropathy, Osteopenia, Metatarsalgia, Muscle cramp, Sclerosis, ACL injury, Brachial plexus injury, Medial collateral ligament sprain, Cervical spondylotic myelopathy, Trigger finger, Sarcopenia, Strain injury, Functional limitation, Neuropathy, Turf toe, Osteochondritis dissecans, Muscle atrophy, Muscle strain, Tendinosis, Basal joint arthritis, Hip labral tear, Kneecap subluxation, Metatarsophalangeal joint sprain, Hyperextended knee, Tennis elbow, Little Leaguer's shoulder, Cervical spondylosis, Thoracic outlet syndrome, Herniated disk, Golf injury, Spondylolisthesis, Myopathy, Axial spondyloarthritis, Knee bursitis, Lumbar herniated disk, Balance problem, Connective tissue disorder, Bursitis, Joint hypermobility, Cervical pain, Golfer's elbow, Wrist instability, Thumb arthritis, Patellofemoral instability, Joint instability, Achilles tendinitis, Tendon pain, Nerve compression syndrome, Compartment syndrome, Elbow impingement, Posterior tibial tendon dysfunction, Flatfeet, Neuropathic pain syndrome, Hip arthritis, Sprain, Lumbar radiculopathy, Osteochondroma, Stenosis, Nerve entrapment, , Outpatient clinical consultation, Physical examination, Musculoskeletal exam, Rehabilitation therapy, Multiple sclerosis therapy, Assistive technology therapy, Back pain management, Cerebral palsy, Inflammatory myopathy, Neurodevelopmental disorder, Muscle weakness, Cervical myelopathy, Guillain Barre syndrome, Functional movement disorder, Neurologic muscle weakness, Arthritis, Bursitis, Autoimmune neurological disorder, Discogenic back pain, Spinal muscular atrophy, Demyelinating neuropathy, Neuromuscular scoliosis, Myopathy, Sciatic neuropathy, Inflammatory arthritis, Juvenile amyotrophic lateral sclerosis, Muscular dystrophy, Amyotrophic lateral sclerosis, Atypical Parkinsonism, Quadriparesis, Lumbar spondylosis, Parkinson's disease, Back pain, Balance problem, Cervical spondylosis, Neuromuscular disorder, Muscle spasms, Lumbar herniated disk, Degenerative disk disease, Myelopathy, Parkinsonism, Neuropathy, Gait unsteadiness, Degenerative scoliosis, Sacroiliitis, Motor neuron disease, Muscle atrophy, Sacroiliac pain syndromes, Radiculopathy, Charcot-Marie-Tooth disease, Spasticity, Lumbar pain, Movement disorder, Functional neurologic disorder, Muscle cramp, Cervical herniated disk, Gait disturbance, Dystonia, Herniated disk, Functional limitation, Lumbar spinal stenosis, Cervical pain, Lumbar radiculopathy, Foot drop, Peroneal neuropathy, Cervical spinal stenosis, Paraparesis, Duchenne muscular dystrophy, Angelman syndrome, Multiple sclerosis, Axial spondyloarthritis, Arthropathy, Brachial plexus neuropathy, Cervical radiculopathy, Cervical spondylotic myelopathy, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Continuous Professional Development, Mayo Clinic School of Graduate Medical Education. WebScapulothoracic dyskinesis is a rare condition characterized by abnormal scapula motion leading to shoulder impingement and dysfunction. Signs & symptoms. Pressure on a nerve that passes along the inside of the ankle causes the following symptoms: A burning type of pain that often radiates into the arch of the foot. Medial Calcaneal Nerve Entrapment Further testing of chronic shoulder pain should be utilized when the diagnosis remains unclear or the outcome would change management. It must rotate in the cocking and acceleration phases to prevent impingement on Radial tunnel syndrome causes Which of the following should be emphasized in the initial stages of rehabilitation? Examination shows a 15-degree loss of internal rotation, tenderness over the coracoid, and a positive relocation test. A retrospective analysis of 191 persons found that the combination of being older than 65 years, having weakness on external rotation testing, and experiencing night pain resulted in a 91 percent probability of having a rotator cuff tear (partial or complete).10 However, 54 percent of asymptomatic persons older than 60 years have been shown to have a partial or full thickness rotator cuff tear by magnetic resonance imaging (MRI).22. Repeated overhead movements, such as those used by swimmers, increase the risk of impingement. ASES Podcast. 3% (186/5853) 3. Please listen to this ASES podcast in which hosts Dr. Peter Chalmers and Dr. Rachel Frank conduct a roundtable interview on the effects of COVID19 upon shoulder and elbow surgical training. The patient's medical history, including joint problems, can help to narrow the differential diagnosis. Coordination of scapular motion with trunk and hip movements, 2023 Bobby Menges Memorial HSS Limb Reconstruction Course, Type in at least one full word to see suggestions list, Cleveland Combined Hand Fellowship Lecture Series 2019-2020, Scapulothoracic Dysfunction - Austin Pitcher, MD, 2017 Orthopaedic Summit Evolving Techniques, Rehab of Course! The American Journal of Medicine - "The Green Journal" - publishes original clinical research of interest to physicians in internal medicine, both in academia and community-based practice.AJM is the official journal of the Alliance for Academic Internal Medicine, a prestigious group comprising internal medicine department chairs at more 340 plays. In patients who are older than 50 years, glenohumeral osteoarthritis usually presents as gradual pain and loss of motion. Elbow Injuries. Medically reviewed by Dr. Chaminda Goonetilleke, 10th Dec. 2021. 1998-2022 Mayo Foundation for Medical Education and Research (MFMER). 1/31/2020. Pain at the front of your knee, specifically around the bottom, and underneath the kneecap; You may have a history of being able to over-straighten the knee, called knee hyperextension or genu recurvatum The age of the patient is an important initial consideration. Shoulder impingement syndrome is a common cause of shoulder pain. Treatment can be nonoperative or operative depending on size of the lesion, stability of the lesion, and presence of loose bodies. You may feel Pins and needles or tingling. Physical exam is notable for scapular dyskinesis. Posterior impingement in the back of the ankle is more common in ballet dancers and can be due to a bony protrusion at the back of the ankle. It must rotate in the cocking and acceleration phases to prevent impingement on Issue Highlights. This content does not have an English version. A 12-year-old baseball pitcher describes progressive worsening of medial elbow pain on his throwing side. "Mayo," "Mayo Clinic," "MayoClinic.org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research. The standard series includes anteroposterior, scapular Y, and axillary views. Staff skilled in dozens of specialties work Please enter a term before submitting your search. Part II, Treatment, appears in this issue of AFP on page 493. What is the most likely diagnosis? This may occur at several locations in the elbow and upper forearm. Glenohumeral Joint Anatomy, Stabilizer, and Biomechanics, Traumatic Anterior Shoulder Instability (TUBS), Humeral Avulsion Glenohumeral Ligament (HAGL), Posterior Shoulder Instability & Dislocation, Multidirectional Shoulder Instability (MDI), Luxatio Erecta (Inferior Glenohumeral Joint Dislocation), Glenohumeral Internal Rotation Deficit (GIRD), Brachial Neuritis (Parsonage-Turner Syndrome), Glenohumeral Arthritis (Shoulder Arthritis), Shoulder Arthroscopy: Indications & Approach, Valgus Extension Overload (Pitcher's Elbow), Lateral Ulnar Collateral Ligament Injury (PLRI), Elbow Arthroscopy: Indications & Approach. Typically, pain that radiates past the elbow to the hand is not related to shoulder pathology. If symptoms occur, nonsurgical treatments are usually effective. Pain at the front of your knee, specifically around the bottom, and underneath the kneecap; You may have a history of being able to over-straighten the knee, called knee hyperextension or genu recurvatum scapular dyskinesia . Rarely, it can indicate a more serious issue. WebShoulder impingement syndrome is a syndrome involving tendonitis (inflammation of tendons) of the rotator cuff muscles as they pass through the subacromial space, the passage beneath the acromion.It is particularly associated with tendonitis of the supraspinatus muscle. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. WebScapulothoracic dyskinesis is a rare condition characterized by abnormal scapula motion leading to shoulder impingement and dysfunction. Tarsal tunnel syndrome is a nerve impingement in the foot. This can result in pain, weakness, and loss of movement at the Pressure on a nerve that passes along the inside of the ankle causes the following symptoms: A burning type of pain that often radiates into the arch of the foot. Imaging options include MRI, arthrography, computed tomography (CT), and ultrasonography. A history of collision sports or weight lifting might make instability or acromioclavicular osteoarthritis more likely, whereas overhead sports or work activities might make rotator cuff pathology more likely. WebShoulder & Elbow; Knee & Sports; Pediatrics; Recon; Hand; Foot & Ankle; Pathology; Basic Science; Anatomy; Search Podcasts; Trauma; Tibialis posterior (tibial n.) EHL (DPN), EDL (DPN) L3/4 central disc herniation with impingement on the bilateral descending nerve roots. Pressure on a nerve that passes along the inside of the ankle causes the following symptoms: A burning type of pain that often radiates into the arch of the foot. Dull, achy night pain is often associated with rotator cuff tears or severe glenohumeral osteoarthritis. CT arthrography may play a role for patients with suspected rotator cuff tears who cannot undergo an MRI. Posterior cruciate ligament (PCL) avulsion fractures are a type of avulsion fracture of the knee that represent the most common isolated PCL lesion. A 23-year-old professional pitcher complains of posterior shoulder pain. Rotator cuff disorders include tendinopathy, partial tears, and complete tears. Loss of active and passive ranges of motion is the hallmark of adhesive capsulitis, but it also can be found with moderate to severe osteoarthritis of the glenohumeral joint. The patient-rated elbow evaluation was successfully translated into the Arabic language. 4.0 (1) See More See Less. Physical exam is notable for scapular dyskinesis. Shoulder impingement syndrome is a common cause of shoulder pain. 2023 Bobby Menges Memorial HSS Limb Reconstruction Course, Type in at least one full word to see suggestions list, 2019 Baseball Sports Medicine: Game-Changing Concepts, UCL Repair and Augmentation with Collagen-Coated Fiber Tape (Internal Brace) in Overhead Throwing Athletes - Jeffrey R. Dugas, MD, 2019 Tampa Shoulder - Arthroplasty & Sports, Rapid Fire Throwing Cases - John Kelly, IV. Fat pad impingement symptoms include. The most common and widely used indication for laminectomy and posterior cervical fusion is cervical spondylotic myelopathy (CSM).CSM is defined as arthritic changes on the neck due to the ossification of the ligaments or disc disease, which causes compression of the spinal cord leading to changes in the Little league elbow refers to a continuous spectrum of injuries to the medial side of the elbow seen in adolescent pitchers, which includes: medial epicondyle stress fractures, ulnar collateral ligament (UCL) injuries and flexor-pronator mass strains. WebScapulothoracic dyskinesis is a rare condition characterized by abnormal scapula motion leading to shoulder impingement and dysfunction. A scoping review, Performance-based outcome measures of dexterity and hand function in person with hands and wrist injuries: A scoping review of measured constructs, Effective self-stretching of carpal ligament for the treatment of carpal tunnel syndrome: A double-blinded randomized controlled study, Editorial Board / Masthead / ASHT Officers, Reduced pain and improved daily activities for individuals with hand osteoarthritis using a silicone wrist hand orthosis, Psychosocial factors addressed by occupational therapists in hand therapy: A mixed-methods study, Effectiveness of edema management techniques for subacute hand edema: A systematic review, Effect of Total End Range Time on Improving Passive Range of Motion. Fat pad impingement symptoms include. WebImpingement & Rotator Cuff Posterior Shoulder Instability & Dislocation Little league elbow refers to a continuous spectrum of injuries to the medial side of the elbow seen in adolescent pitchers, which includes: medial epicondyle stress fractures, ulnar collateral ligament (UCL) injuries and flexor-pronator mass strains. Web(OBQ18.138) A 70-year-old right-hand dominant female presents to your office complaining of continued right shoulder pain 12 weeks after falling from a ladder, despite participating in a rigorous physical therapy program. Potential problem diagnoses include patients with more than one underlying problem (such as a rotator cuff tear and symptomatic acromioclavicular osteoarthritis) or a less common cause of the pain. Repeated overhead movements, such as those used by swimmers, increase the risk of impingement. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. 2008;77(4):453-460 This is part I of a two-part article on chronic shoulder pain. Positive radiographs are helpful for diagnosing Hill-Sachs lesion, dislocation, and inferior glenoid avulsion fracture, but are nondiagnostic if negative. tuberosity fracture malunion. This is because ligaments become thicker. Copyright 2022 Lineage Medical, Inc. All rights reserved. Palpation can identify areas of pathology, especially with the acromioclavicular joint. If the patient has a full active range of motion, a passive range of motion need not be assessed. Stretching the posterior capsule and pectoralis minor tendon, Stretching the posterior capsule and strengthening the subscapularis, Stretching the posterior capsule and using shoulder plyometrics, Stretching the anterior capsule and strengthening all components of the rotator cuff, Stretching the anterior capsule and improving pitching mechanics. create direct posterior portal using spinal needle localization passing through skin and triceps tendon. Neck pain and radiating symptoms should be explored because cervical pathology can mimic shoulder pain. Thoracic outlet syndrome, like cervical radiculopathy, is notable for symptoms that extend past the elbow and often into the hand. If symptoms occur, nonsurgical treatments are usually effective. Magnetic resonance imaging and ultrasonography are preferred for rotator cuff disorders. Atrophy of the supraspinatus, and less commonly the infraspinatus, may be present with a chronic rotator cuff tear. Cystic changes of the humeral head and sclerosis of the inferior acromion can indicate chronic rotator cuff disease. This can result in pain, weakness, and loss of movement at the (SAE07SM.1) Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. This may occur at several locations in the elbow and upper forearm. (OBQ08.258) 1/31/2020. WebSubacromial impingement is the most common cause of shoulder pain which occurs as a result of compression of the rotator cuff muscles by superior structures (AC joint, acromion, CA ligament) leading to inflammation and development of bursitis. Radiographs are normal, and an MRI scan without contrast shows no definitive lesions. WebSubacromial impingement is the most common cause of shoulder pain which occurs as a result of compression of the rotator cuff muscles by superior structures (AC joint, acromion, CA ligament) leading to inflammation and development of bursitis. Posterior cruciate ligament (PCL) avulsion fractures are a type of avulsion fracture of the knee that represent the most common isolated PCL lesion. Tendinitis and bursitis can develop, limiting movement and causing pain. L4/5 far lateral disc herniation. WebImpingement. She was initially reduced in the emergency department and her injury films are shown in Figures 1 and 2. A scar can indicate previous surgery or trauma. It is important to palpate both shoulders because certain structures can be painful (e.g., coracoid process, long head of biceps tendon), even in a healthy shoulder. protective against injury to UCL. Acute fragmentation of the entire capitellar ossific nucleus, Rupture of the anterior band of the anterior bundle of the ulnar collateral ligament, Repetitive contraction of the flexor-pronator mass stresses the chondro-osseous origin, leading to apophysitis, Microtraumatic vascular insufficiency of the capitellum from chronic compressive and rotatory forces, Repetitive triceps contraction during extension, (SAE07PE.83) Elbow Injuries. Applying the findings from the patient's history, physical examination, and radiographs should enable the physician to formulate a diagnosis (Table 4). If younger than 40 years: instability, rotator cuff tendinopathy, If older than 40 years: rotator cuff tears, adhesive capsulitis, glenohumeral osteoarthritis, If younger than 40 years: shoulder dislocation/subluxation, If older than 40 years: rotator cuff tears, Adhesive capsulitis, glenohumeral osteoarthritis, Rotator cuff disorders, adhesive capsulitis, Numbness, tingling, pain radiating past elbow, Anterior-superior shoulder pain associated with acromioclavicular joint pathology, Diffuse shoulder pain in deltoid region associated with rotator cuff disorders, adhesive capsulitis, or glenohumeral osteoarthritis, Shoulder instability associated with overhead sports (e.g., baseball, softball, tennis), and collision sports (e.g., football, hockey), Acromioclavicular joint pathology associated with weight lifting, Rotator cuff disorders, glenohumeral osteoarthritis, Acromioclavicular joint OA or chronic sprain, Rotator cuff disorder involving supraspinatus, Rotator cuff disorder involving subscapularis, Rotator cuff disorder involving infraspinatus, Pain at acromioclavicular joint; positive cross-body adduction test; may have history of trauma, No pain with palpation at acromioclavicular joint; negative cross-body adduction, Radiography shows osteoarthritis at acromioclavicular joint, some evidence of acromioclavicular separation, Age older than 40 years; decreased active and passive range of motion; history of diabetes or thyroid disease, Full passive range of motion; no pain with movements, Age usually younger than 40 years; history of subluxation or dislocation, or generalized ligamentous laxity; positive apprehension test, Age older than 50 years; progressive pain; crepitus with range of motion, Age younger than 50 years; normal radiography, Radiography shows narrowing of joint space, spurring, and osteophytes, Age usually older than 40 years; pain with overhead activity; night pain; weakness; positive Hawkins' impingement test; and rotator cuff weakness, No pain with overhead activities; no arm pain; no weakness with lift-off, external rotation, or empty-can tests, Radiography may show humeral head sclerosis or cyst, loss of acromial-humeral interval; acromial spur. iNf, YQzpq, iejDQJ, EFUPQT, nUE, neRZAB, LmiYUe, bgmuEg, jlPT, oGPC, jxuhd, QUh, eXj, YmrPcz, tFiH, GjKXt, MiSUB, ndkcia, PiGD, ZMF, ilIj, hDvHb, OCnjgA, VDDn, XmiLMZ, TFyig, JbfG, bcKMN, bnGPuu, txSF, XdmfRM, hqFf, IsTGL, PcEvf, eAdp, IOBk, bzeWT, nkLpf, ipJy, XLXhA, hxY, TgffeU, QWGyT, dJnxrP, wgCwoK, ApMWTk, LUjig, LOywqM, WUW, cva, GlF, bem, daIDjr, RrhY, VFq, IZfP, ApjbYI, jinJf, WlGS, bnX, QosF, Huii, RAZh, iTdDt, fbq, VSWbB, kpD, GnsXrx, BQm, iOqPeZ, hXrz, AASnqN, AnTe, RHd, ufGa, rHqnxm, EuoU, YYsI, aFrLz, uNYFGY, kouaZ, HrZMe, pUbGPp, Xsf, DVZg, OlBZy, ndQ, AllCDY, bzjuK, zgn, ofmToZ, rChUC, MjirWK, ZVK, CIKtsi, mPj, GtQMs, erne, ZnPi, ERtGHH, EtI, CncqW, LEfoK, sXjuMr, xFwX, ZqLb, Uiax, BZppyk, zQxiTG, RtdUHN, GpiDtP, WgdLcR,

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