Bursae: the Body’S Throw Pillows the Other Day, My Niece Asked Me Why Our Bones Don’T Rub Together When We Move Them
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Shoulder Impingement
3 Shoulder Impingement Catherine E. Tagg, FRCR1 Alastair S. Campbell, FRCR2 Eugene G. McNally, FRCR3 1 Nevill Hall Hospital, Aneurin Bevan Health Board, Abergavenny, Address for correspondence Eugene G. McNally, FRCR, Nuffield United Kingdom Orthopaedic Centre, Oxford University Hospitals NHS Trust, Old Road, 2 Craigavon Area Hospital, Southern Health and Social Care Trust, Oxford, OX3 7LD, UK (e-mail: [email protected]). Portadown, United Kingdom 3 Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Trust, Oxford, United Kingdom Semin Musculoskelet Radiol 2013;17:3–11. Abstract This update examines recent articles and evidence for the role of ultrasound in the diagnosis and management of shoulder impingement syndromes and emphasizes its principal application in evaluation for external impingement. Shoulder ultrasound is Keywords commonly used as the initial investigation for patients with shoulder pain and suspected ► shoulder impingement. This is due to the high resolution of current ultrasound machines, wide ► ultrasound availability, good patient tolerance, cost effectiveness, and, most importantly, its ► impingement dynamic and interventional role. Impingement is a clinical scenario of painful functional limita- (AC) joint. The morphology of the acromion has been catego- tion of the shoulder,1 thought to be secondary to compression rized into three types (type I flat, type II concave, and type III or altered dynamics that irritate and ultimately damage the hooked). It has been suggested that the hooked type III tissues around the shoulder joint. Shoulder impingement is configuration may predispose to external impingement.9 currently subdivided into external (subacromial) and internal However, it is more likely that (unless the anatomical changes impingement. External impingement is further subdivided into are gross) acromial changes are secondary rather than pri- primary and secondary, and internal impingement into poster- mary. -
Coding, Documentation, Reimbursement & Compliance Issues for Physician Practices & Ascs
Orthopaedic Coding Seminar CA Orthopaedic Assoc. Coding, Documentation, Reimbursement & Compliance Issues for Physician Practices & ASCs Speaker Stephanie Ellis, R.N., CPC 256 Seaboard Lane, Suite C-103 Franklin, TN • (615) 371-1506 [email protected] www.ellismedical.com 2012 ICD-9 AND SUMMARY OF UPCOMING CHANGE TO ICD-10 In January of 2009, CMS decided they wanted to change the diagnosis and hospital procedural coding system from ICD-9 to the ICD-10 system, which was related to the provisions of the Health Insurance Portability and Accountability Act (HIPAA) passed by Congress in 1996 to standardize health care information. While the original effective date for the change to the ICD-10 system for providers was originally supposed to be October 1, 2013, CMS has put a hold on that date and has not yet stated what the new implementation date will be. The following provides a comparison between the ICD-9 and ICD-10 coding systems out of the Federal Register 49802 from 2008. Comparison of ICD-9 to ICD-10 Systems ICD-9-CM ICD-10-CM Diagnosis codes 3-5 digits Diagnosis codes 3-7 characters Approximately 14,000+ codes Approximately 69,000+ codes 1st character can be Alpha or Numeric 1st character is Alpha; characters 2 & 3 Followed by 2-5 Numeric characters are Numeric; characters 4-7 can be Alpha or Numeric Limited space for addition of new codes Flexible for addition of new codes Coding system lacks detail Coding system is very specific Coding system lacks laterality Coding system includes laterality Coding system is difficult to analyze data Specificity improves coding accuracy due to non-specificity of codes and ability to collect data Coding system is non-specific - codes do Detail of coding improves accuracy of not provide detail of diagnoses necessary data useful for research for medical research Coding system not used in countries outside Coding system allows exchange of data of the U.S. -
Dynamic Ultrasonography of the Shoulder
Dynamic ultrasonography of the shoulder Jina Park, Jee Won Chai, Dong Hyun Kim, Seung Woo Cha Department of Radiology, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea REVIEW ARTICLE Ultrasonography (US) is a useful diagnostic method that can be easily applied to identify the https://doi.org/10.14366/usg.17055 cause of shoulder pain. Its low cost, excellent diagnostic accuracy, and capability for dynamic pISSN: 2288-5919 • eISSN: 2288-5943 Ultrasonography 2018;37:190-199 evaluation are also advantages. To assess all possible causes of shoulder pain, it is better to follow a standardized protocol and to perform a comprehensive evaluation of the shoulder than to conduct a focused examination. Moreover, a proper dynamic study can enhance the diagnostic quality of US, especially when the pathology is not revealed by a static evaluation. The purpose of this article is to review the common indications for dynamic US of the shoulder, and to present Received: August 1, 2017 the basic techniques and characteristic US findings. Revised: August 26, 2017 Accepted: August 26, 2017 Keywords: Shoulder; Ultrasonography; Movement Correspondence to: Jee Won Chai, MD, PhD, Department of Radiology, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, 20 Boramae-ro 5-gil, Dongjak-gu, Seoul 07061, Korea Introduction Tel. +82-2-870-2549 Fax. +82-2-870-3539 Ultrasonography (US) is a commonly performed examination for shoulder pain, recommended by E-mail: [email protected] experts as the first-choice technique to evaluate various rotator cuff diseases and nonrotator cuff diseases [1-4]. When US is performed by an experienced radiologist, its diagnostic sensitivity and specificity for detecting rotator cuff tears are comparable to those of magnetic resonance imaging (MRI) [5]. -
Giant Cell Tumor of the Pes Anserine Bursa (Extra-Articular Pigmented Villonodular Bursitis): a Case Report and Review of the Literature
Hindawi Publishing Corporation Case Reports in Medicine Volume 2011, Article ID 491470, 6 pages doi:10.1155/2011/491470 Case Report Giant Cell Tumor of the Pes Anserine Bursa (Extra-Articular Pigmented Villonodular Bursitis): A Case Report and Review of the Literature Haitao Zhao,1 Aditya V. Maheshwari,2, 3 Dhruv Kumar,4 and Martin M. Malawer2, 5 1 Department of Orthopedic Oncology, Beijing JiShui Tan Hospital, Peking University, 31 Xinjiekou East Street, Xicheng District, Beijing 100035, China 2 Department of Orthopedic Oncology, Washington Hospital Center, 110 Irving Street North West, Washington, DC 20010, USA 3 Department of Orthopedic Surgery, SUNY Downstate Medical Center, 450 Clarkson Avenue, P.O. Box 30, Brooklyn, NY 11203, USA 4 Department of Pathology, Washington Hospital Center, 110 Irving Street North West, Washington, DC 20010, USA 5 Department of Orthopedic Oncology, The George Washington University Hospital, 900 23rd Street North West, Washington, DC 20037, USA Correspondence should be addressed to Haitao Zhao, [email protected] Received 14 February 2011; Accepted 7 April 2011 Academic Editor: Edward V. Craig Copyright © 2011 Haitao Zhao et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Pigmented villonodular synovitis (PVNS) is a rare, benign, proliferating disease affecting the synovium of joints, bursae, and tendon sheaths. Involvement of bursa (PVNB, pigmented villonodular bursitis) is the least common, and only few cases of exclusively extra-articular PVNB of the pes anserinus bursa have been reported so far. We report a case of extra-articular pes anserine PVNB along with a review of the literature.