ABOUT THE EXPERT April Armstrong, BSc(PT), MD, MSc, FRCSC, is a professor of orthopedics, acting chair, and chief of the shoulder service at Penn State Health in Hershey, Pennsylvania. She…
Introduction The management of degenerative rotator cuff disease is controversial, and surgical indications vary widely. With increasing utilization of surgical management for rotator cuff disease, ensuring a complete understanding of…
The first documented protocol for using musculoskeletal (MSK) ultrasound to evaluate the shoulder was published in 1984 by Middleton et al. Since 1984, there have been ongoing advances in ultrasound…
Epidemiology Anterior shoulder instability can arise from primarily three different etiologies: trauma, congenital laxity, and acquired laxity. Determining the difference between instability and laxity is essential. Matsen proposed most patients…
Rotator cuff structure Anatomic overview The rotator cuff consists of four muscle-tendon units: the subscapularis, infraspinatus, supraspinatus, and teres minor ( Fig. 50.1 ). These four muscles have their origins…
Presentation Pain, loss of motion, and effusion are early signs of infection. However, shoulder effusion is difficult to detect and is often missed. Motion is painful, and the arm is…
ABOUT THE EXPERT Hiroyuki Sugaya, MD, served as Chairman of Sports Medicine & Joint Center in Funabashi Orthopaedic Hospital for 18 years. Dr. Sugaya opened Tokyo Sports & Orthopaedic Clinic…
Traditionally the classification of shoulder instability has been based primarily on etiology and the direction of the instability. In other words, traumatic versus atraumatic in onset and anterior, posterior, or…
Surgical anatomy of the sternoclavicular joint The sternoclavicular (SC) joint is a diarthrodial joint and is the only true articulation between the upper extremity and axial skeleton. Because less than…
Microanatomy and cell biology The hyaline cartilage of the articular surface is essentially acellular and consists of horizontally arranged collagen fibers in proteoglycan macromolecules. The boundaries of the joint cavity…
