PURPOSE: These case reports have been prepared to highlight the uncommon occurrence of anterior shoulder dislocation after an epileptic seizure, the recognition of which is important as this type of injury is associated with bony lesions and a high incidence of recurrence. MATERIALS AND METHODS: We report two cases of recurrent anterior dislocation of the shoulder due to grand mal epilepsy. These cases were treated as usual anterior dislocations of the shoulder, and were regularly followed to detect any recurrence of shoulder instability. RESULTS: Outcome of the surgery in the two cases was different because of the differences in seizure control. In the patient in whom seizures were well-controlled, there was no recurrence of instability, while the patient with poorly controlled seizures developed a recurrence of the dislocation following shoulder repair. CONCLUSION: The authors emphasize the need to control seizures in order to prevent injury recurrence in this subset of patients.
Dislocations ; Epilepsy ; Epilepsy, Tonic-Clonic ; Humans ; Incidence ; Recurrence ; Seizures ; Shoulder ; Shoulder Dislocation

PURPOSE: We report here on a solution for the case of a 71 year old lady with cartilage destruction in the left shoulder and the loss of the rotator cuff secondary to post-septic arthritic sequelae. MATERIALS AND METHODS: After thorough laboratory, clinical and radiological investigation of the patient to rule out any foci of active infection, we contemplated performing reverse total shoulder arthroplasty as a primary procedure. RESULTS: At 22 months follow up, the patient had an excellent result according to the UCLA and ASES scales. CONCLUSION: Reverse total shoulder arthroplasty seems to be an efficient procedure to improve pain and function in the post-septic shoulder accompanying severe rotator cuff injury.
Arthritis, Infectious ; Arthroplasty ; Cartilage ; Follow-Up Studies ; Humans ; Rotator Cuff ; Shoulder

BACKGROUND: Although flourine-18-flourodeoxyglucose (FDG) positron emission tomography (PET) has a limitation for localizing anatomical structures, combining it with computed tomography (CT) has made it more efficient for overcoming such limitations. This study aims to evaluate the efficacy of PET/CT for evaluating diseases of the shoulder. METHODS: Retrospective examination was performed on 25 patients who underwent FDG-PET/CT scanning. All the patients were over 60 years of age, and they were evaluated both clinically and radiologically for shoulder pain. The study period was from May, 2006 to May, 2008. One of the patients had metastatic lesion in a shoulder and this patient was excluded from the study, so the total number of subjects in the study was finally 24 patients. RESULTS: PET/CT showed 67% sensitivity, 73% specificity, a positive predictive value of 60%, a negative predictive value of 79%, 27% false positivity and 33% false negativity concerning shoulder pain. PET/CT showed negative finding in 4 cases that were successfully treated by operative treatment (rotator cuff tear [RCT], 3 cases; impingement syndrome, 1 case). Negative findings were also noted in 6 cases in which the pain subsided after conservative treatment (RCT, 1 case; suspected RCT, 2 cases; impingement syndrome, 3 cases). All the patients with osteoarthritis and rheumatoid arthritis had positive findings on PET/CT scanning. CONCLUSIONS: PET/CT is a useful adjunct to the existing imaging modalities to assess functional and pathophysiologic processes and at a very early stage, and so PET/CT can help physicians make better preoperative and postoperative decisions on treatment.
Aged ; Bursitis/radiography/radionuclide imaging ; Female ; Fluorodeoxyglucose F18/*diagnostic use ; Humans ; Joint Diseases/*radiography/*radionuclide imaging ; Male ; Middle Aged ; *Positron-Emission Tomography ; Predictive Value of Tests ; Radiopharmaceuticals/*diagnostic use ; Rotator Cuff/injuries/radiography/radionuclide imaging ; Sensitivity and Specificity ; Shoulder Joint/*radiography/*radionuclide imaging ; *Tomography, X-Ray Computed