Acromioclavicular arthropathy – the painful shoulder syndrom
Marek Łyp, Wojciech Maciak, Anna Cabak, Adam Ogonowski
Marek Łyp, Wojciech Maciak, Anna Cabak, Adam Ogonowski – Acromioclavicular arthropathy – the painful shoulder syndrom. Fizjoterapia Polska 2006; 6(1); 51-57
Background, The painful shoulder syndrom is very difficult and makes problems even to experiences clinicians. Based on our knowledge of the structure and topography of the acromioclavicular joint two tests to assess the joint were used. These were the passive forced flexion of the upper extremity in the horizontal plain and forced elevation by adduction. Material and methods. The homogenous group of twenty probands with acromioclavicular arthropathy was separated based on the criterion that no other reason of the painful shoulder was observed. The first step of the therapy was an advice to the patients to reduce the movement in the joint and simultaneously the series of treatment with 2,5% ketoprofen was applied. Patients who were not fully recovery were given one or two injection in the joint with 1 ml triamcinolone acetonite and 1 ml 1%-lignocaine. For the subjective assessment we use four steps verbal pain scale. For the objective assessment authors use the special tests for the acromioclavicular arthropathy in physical examination. Results. After ten phonophoresis treatments a full recovery of six patients was observed. Next in 14 patients who was not observed full recovery we use one or two injection with 1 ml triamcinolone acetonite and 1 ml 1%-lignocaine. After the first injection ten of fourteen patients reported no pain in the shoulder region. The four patients who still claimed the pain in the shoulder were given the second injection after a week. The full recovery was observed in two of the cases. The two patients reported an improvement. Conclusion. The correct diagnosis builds the basement of the successful therapy. Phonophoresis with 2,5% ketoprofenem with additional local injection of anaestheticum with glucocorticosteroid (1 ml triamcinolone acetonite and 1 ml 1%-lignocaine) is an effective method of therapy the acromioclavicular arthropathy. The study should be continued with larger groups of patients to present objective results.
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