Scapulothoracic bursitis, an uncommon lesion, has been reported to be a painful disorder of scapulothoracic articulation. The articulation may become inflamed secondary to trauma when overused because of sports or work that requires repetitive or constant movement of the scapula against the posterior chest wall. The bursitis usually appears as a growing mass at the scapulothoracic interface and is often confused with a soft tissue tumor. We report on a patient with scapulothoracic bursitis who underwent surgical excision.
Bursa, Synovial ; Bursitis* ; Humans ; Scapula ; Sports ; Thoracic Wall

BACKGROUNDLower extremity bursae are very vulnerable to injury during strenuous physical exercises. Understanding the imaging characteristics of normal bursae is essential for early diagnosis of morphological abnormalities. Therefore, we evaluated the normal range of lower extremity bursae in healthy young men using high-resolution ultrasound (HR-US) imaging.

METHODSBursae in the lower extremities were examined by HR-US in 290 Chinese healthy young men with a median age of 18 years (range, 18-23 years). The bilateral suprapatellar bursa (SPB), deep infrapatellar bursa (DIPB), popliteal bursa (PB), and retrocalcaneal bursa (RCB) were imaged and measured for analysis.

RESULTSThe HR-US identification rates of the SPB, DIPB, PB, and RCB were 89.0% (517/580), 55.0% (319/580), 29.4% (171/580), and 49.5% (287/580), respectively. With the assumption that the bursae were normal in 95% of the study participants, the length and width values at the maximal cross-section of the SPB, DIPB, PB, and RCB were ≤18.00 and 6.09 mm, 8.10 and 2.11 mm, 7.67 and 3.93 mm, and 7.82 and 2.04 mm, respectively.

CONCLUSIONSUsing HR-US imaging, we were able to analyze lower extremity bursae with high detection rates in healthy young men. The normal ranges of lower extremity bursa dimensions in healthy young men measured by HR-US in this study could be used as reference values for evaluation of bursa abnormalities in the lower extremity.

Adolescent ; Adult ; Bursa, Synovial ; pathology ; Cross-Sectional Studies ; Humans ; Lower Extremity ; pathology ; Male ; Young Adult

Adult ; Arthroscopy ; Bursa, Synovial ; surgery ; Chondroma ; surgery ; Female ; Humans ; Middle Aged

Popliteal cyst is a common peri-knee cyst, also known as a Baker's cyst. With the current development of popliteal cysts, the pathogenesis is mainly due to increased pressure in the knee joint caused by various reasons, leading to a fluid-filled sac that can form behind the knee as a result of enlargement of the gastrocnemius-semimembranosus bursa. The current diagnostic methods include X-ray computed, ultrasound, and magnetic resonance. Among them, magnetic resonance imaging is considered the gold standard for the diagnosis of popliteal cysts. There are various treatments, including conservative treatment, traditional surgical resection and arthroscopic surgery. In recent years, the focus of the treatment of popliteal cysts has gradually shifted from the simple removal of cysts to arthroscopic treatment of intra-articular lesions and the treatment of joint-cyst communication, and achieved a good effect. However, there are still controversies about the most effective treatment, and the best surgery method is still uncertained. It is hoped that high quality prospective studies will be able to directly compare different surgery methods, so as to select the best treatment for popliteal cyst. This article reviews past literature research and describes in detail the epidemiology, pathological mechanism, clinical manifestations and signs, auxiliary examination, diagnosis and differential diagnosis and clinical treatment of popliteal cysts. Different diagnosis methods and treatment methods are compared and summarized to provide basis for clinical diagnosis and treatment.
Arthroscopy ; Bursa, Synovial ; Humans ; Knee Joint ; Popliteal Cyst ; diagnosis ; therapy ; Prospective Studies

OBJECTIVETo investigate the morphological changes of the roof of the subacromial bursa (SAB) and its involvement extent after rotator cuff tear.

METHODSIn the experimental group, the roof of SAB was obtained from 30 cases of rotator cuff tear both at the tear site and a site 2.5-3.0 cm distal to the tear site during rotator cuff repair. In the control group, the roof of SAB was obtained from the exposed site of recurrently dislocated shoulder or fractured humeral shaft of 8 cases. The specimens were stained with hematoxylin and eosin and observed under a transmission electron microscope. The cell number was quantitated through counting the blue-stained nucleus in SAB with a computer image analysis system.

RESULTSThe number of cells increased significantly in the roof of SAB in the experimental group compared with that of the control group. However, no difference of the bursal reaction was found among the type of rotator cuff tear, the bursa thickness and the presence of fluid in the bursa. The great majority of cells were type B cells observed under the transmission electron microscope.

CONCLUSIONSThe increase in cell number in the roof of SAB in the experimental group is a reactive increase rather than an inflammatory process and the involvement of SAB is not limited in extent. The change of the roof of SAB is a secondary reaction to the rotator cuff tear.

Adult ; Aged ; Analysis of Variance ; Bursa, Synovial ; pathology ; Female ; Humans ; Inflammation ; Male ; Microscopy, Electron ; Middle Aged ; Rotator Cuff Injuries

OBJECTIVE: To compare the clinical efficacy of total arthroscopic surgery and traditional surgery for popliteal cyst. METHODS: From August 2014 to July 2017, 60 cases of popliteal cyst were treated with total arthroscopy or traditional surgery respectively. In total arthroscopy group, there were 30 patients including 7 males and 23 females with an average age of (55.81±8.53) years old; the duration of the disease was (3.52±1.12) years;according to Rauschning-Lingdgren grading, 7 cases were grade I, 19 cases were grade II, 4 cases were grade III. In traditional surgical group, there were 30 patients including 5 males and 25 females with an average age of (57.93±9.84) years old; the duration of the disease was (3.48±1.34) years; according to Rauschning-Lingdgren grading, 5 cases were grade I, 21 cases were grade II, 4 cases were grade III. Preoperative symptoms involved such as arthralgia and swelling after knee joint and limited mobility. MRI confirmed a popliteal cyst. Arthroscopic surgery and traditional surgical was used respectively. Incision length, operation time, average stay, total hospital cost and Lysholm score of two groups were compared. RESULTS: In the total arthroscopic group, 1 case suffered from nerve injury, and all cases' incision healed well. In the traditional surgical group, there was 1 case of incision infection, 2 cases of poor healing, 1 case of nerve injury and 1 case of recurrence. All 60 cases were followed up for 6 to 30 months with an average of (13.3±6.5) months. After operation, the symptoms of knee joint arthralgia and swelling, discomfort were significantly improved in the two groups. There were statistically significant differences in incision length, operation time, average stay, total hospitalcost and Lysholm score 6 months after surgery(<0.05). CONCLUSIONS The total arthroscopic resection of popliteal cyst, via anterior approach to having a knee joint cavity exploration and treatment of meniscus and bursa, while combined with posteromedial approach for cyst excision would promise a minimal surgery and less pain for patients. Patients will have a rapider recovery, lower recurrence rate and less complication. The total arthroscopic resection easy to accepting for the patient and having a better clinical curative effect is obviously superior to the traditional surgery.
Aged ; Arthroscopy ; Bursa, Synovial ; Female ; Humans ; Knee Joint ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Popliteal Cyst ; Treatment Outcome

BACKGROUND: Some surgeons consider the abscission of a part of the articular bursa around the point of the input of ganglion's nape (average 1-2 cm diameter) to be very important with excellent results. However, a literature search revealed disagreement as to whether it is essential to repair a bursa defect. This study examined the effectiveness of this method without repairing the articular defect. An attempt was made to identify the anatomical origin of wrist ganglia during the surgical procedure. METHODS: This study evaluated 124 wrist ganglia that had been treated surgically during 2004-2009 using this technique and without repairing the bursa defect (1-2 cm in diameter). The variables studied were age, gender, time from the occurrence till abscission of the ganglia, former surgical interventions, preoperative and postoperative pain, insertion of the ganglion's nape and complications. Sixty-six patients with a mean follow-up of 42 months and minimum 12 months were examined. RESULTS: At the time of the follow-up, 80.3% had no pain whereas 92.2% showed a remarkable improvement. Seven cases of recurrence (10.6%) were found 2 to 85 months after surgery, of which most appeared during the first year (71.4%). It is important to mention that the majority of the dorsal ganglia (42.8%) originated from the capitate-lunate joint. None of the patients presented with scapholunate or other instability. CONCLUSIONS: This surgical method is a simple and safe with excellent long-term results and a lower recurrence rate compared to other surgical approaches. Overall, repair of the articular bursa is unnecessary.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Bursa, Synovial/*surgery ; Female ; Humans ; Ligaments, Articular/pathology ; Male ; Middle Aged ; Recurrence ; Synovial Cyst/pathology/*surgery ; Wrist/*surgery ; Young Adult

OBJECTIVETo evaluate therapy effect of radiofrequency in the treatment of painful heel syndrome under arthroscopy.

METHODSFrom January 2006 to December 2011, 13 patients with painful heel syndrome being admitted into our hospital were studied. There were 5 males and 8 femals, ranging in age from 35 to 68 years. All these surgeries were performed under local anesthesia. After constructing a man-made lacouna in the subcutaneous tissue above plantar fascia, a medial and a lateral portal were established on both sides of plantar fascia and at the anterior edge of calcaneal tuberosity. Hyperplasia and torn fiber tissue of plantar fascia, and plantar calcaneal bursa were removed with radiofrequency probe under arthroscopy. Then penetration of the plantar fascia was carried out in a reticulation-shaped pattern with a special radiofrequency probe TOPAZ. Each patient was assessed with VAS pain evaluation criteria and AOFAS ankle-hindfoot score system (AOFAS-AH) before and after operation. All the patients were followed up, and the duration ranged from 6 to 12 months.

RESULTSAll the 13 patients got excellent recovery with their heel pain relieved significantly. VAS score was 8.71 +/- 1.64 before operation, 6.27 +/- 2.53 at the 1st month after operation, and 2.30 +/- 2.69 at the 6th month after operation. AOFAS-AH score was 56.43 +/- 3.72 preoperation, 68.15 +/- 7.38 at 1st month post operation, and 84.51 +/- 2.93 at 6th month after operation. There were no perioperative and postoperative complications related to the procedure, such as blood vessel and nerve injury, and infection.

CONCLUSIONPlantar fasciitis and plantar calcaneal bursitis are main factors of painful heel syndrome. Due to advantages of being easy to operate, having definite effect and no use to do spur removal or plantar fasciotomy. Endoscopy assisted plantar calcaneal bursa removal and plantar fascia penetration by radiofrequency technique can be a satisfactory treatment method for painful heel syndrome.

Adult ; Aged ; Arthroscopy ; methods ; Bursa, Synovial ; pathology ; surgery ; Bursitis ; pathology ; surgery ; Female ; Foot Diseases ; surgery ; Heel ; pathology ; surgery ; Humans ; Male ; Metatarsalgia ; pathology ; surgery ; Middle Aged ; Radio Waves

OBJECTIVETo study the surgical techniques and results of arthroscopic treatment of bursal-side partial-thickness rotator cuff tears.

METHODSFrom June 2002 to December 2007, 57 patients with bursal-side partial-thickness rotator cuff tears underwent arthroscopic treatment. There were 34 male and 15 female patients, the average age was 49.7 years (25 - 71 years). Fifteen left shoulder and 34 right ones were involved. Seven cases were classified as degree I, 6 as II and 36 as III according to Ellman classification. The anterior-posterior and the supraspinatus outlet projection of the X-rays were obtained before surgery. Twenty-nine patients had been received by sonography and 36 patients had undergone MRI examinations. All the patients underwent subacromial bursectomy and acromioplasty, 13 cases underwent cuff debridement, 36 cases underwent cuff repair. Among them, 3 cases were treated by side to side suture of rotator cuff, 26 cases were treated by suture anchor, 7 cases were treated by side to side suture combined with suture anchor. UCLA scoring system was adopted before operation and at the final evaluation.

RESULTSForty-nine patients had been reviewed at least 2 years after the operation with an average of 48 months (2 to 7 years). The average score was 32.1 ± 3.8 postoperatively, and the mean pain score was 2.9 ± 1.0 vs 8.4 ± 1.7 (P = 0.000) for pre- vs. post-operation, the function score was 5.4 ± 1.2 vs. 9.1 ± 1.4 (P = 0.000), the mean forward flexion score was 4.3 ± 1.1 vs. 4.9 ± 0.2 (P = 0.000), the mean forward flexion strength was 4.0 ± 0.4 vs. 4.8 ± 0.4 (P = 0.000), the results were 16 excellent, 31 good and 2 bad. Forty-seven patients were satisfied with the operation.

CONCLUSIONSArthroscopy is an effective method for the treatment of bursal-side partial-thickness rotator cuff tears. The key to the operation lies in bleeding control, proper acromioplasty and correct suturing method. This surgery has many advantages such as mini-invasion and rapid recovery.

Adult ; Aged ; Arthroscopy ; methods ; Bursa, Synovial ; injuries ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Rotator Cuff ; surgery ; Rotator Cuff Injuries ; Treatment Outcome

Rice body formation in a joint or bursa is a rare condition, and is usually associated with rheumatoid arthritis or tuberculous arthritis. Here we describe a case of multiple rice body formation in a shoulder joint and in adjacent bursae, which was confirmed to be due to septic arthritis by Candida species. To the best of our knowledge, rice body formation in Candida septic arthritis in an immune-competent patient has not been previously reported.
Aged ; Arthritis, Infectious/*microbiology/radiography ; Bursa, Synovial/*microbiology/radiography ; Candida/isolation & purification ; Candidiasis/*microbiology/radiography ; Foreign Bodies/*etiology ; Humans ; Male ; Shoulder Joint/*microbiology/radiography