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Jo A Hannafin - One of the best experts on this subject based on the ideXlab platform.
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The effect of myofibroblasts and corticosteroid injections in adhesive Capsulitis.
Journal of Shoulder and Elbow Surgery, 2016Co-Authors: Carolyn M. Hettrich, Edward F. Dicarlo, Deborah A. Faryniarz, Katherine B. Vadasdi, Riley J. Williams, Jo A HannafinAbstract:Hypothesis Adhesive Capsulitis is a condition that results in restricted glenohumeral motion. Fibroblasts have been implicated in the disease process; however, their role as a contractile element in the development of fibrosis and capsular contracture is not well understood. We hypothesized (1) that myofibroblast prevalence in capsular biopsy specimens from patients with adhesive Capsulitis would be increased compared with controls and (2) that patients treated with an intra-articular injection of corticosteroid would have fewer myofibroblasts. Methods The study prospectively enrolled 20 consecutive patients with adhesive Capsulitis scheduled for capsular release and matched controls. Tissue samples were collected from the posterior and anterior capsule for histomorphologic and immunohistologic analyses. Identical sectioning and preparation was performed in 14 additional adhesive Capsulitis specimens from patients who had not received corticosteroid injections. Results Patients with adhesive Capsulitis not treated with preoperative corticosteroid demonstrated more histologic evidence of fibromatosis, synovial hyperplasia, and an increase in positive staining for α-smooth muscle actin than patients who had received intra-articular injections of steroid. No specimens obtained from control patients demonstrated positive staining for α-smooth muscle actin. Discussion There was a higher prevalence of myofibroblast staining in patients with adhesive Capsulitis, implicating activation of the myofibroblast in the pathophysiology of capsular contracture. Intra-articular steroid injection decreases the presence and amount of fibromatosis, vascular hyperplasia, fibrosis, and the presence of fibroblasts staining for α-smooth muscle actin. This supports the use of steroid injections to alter the disease process by decreasing the pathologic changes found in the capsular tissue.
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magnetic resonance imaging of adhesive Capsulitis correlation with clinical staging
HSS Journal, 2008Co-Authors: Carolyn M Sofka, Gina A Ciavarra, Jo A Hannafin, Frank A Cordasco, Hollis G PotterAbstract:The purpose of this study was to evaluate non-contrast magnetic resonance imaging (MRI) findings of adhesive Capsulitis and correlate them with clinical stages of adhesive Capsulitis. This will hopefully define a role for shoulder MR imaging in the diagnosis of adhesive Capsulitis as well as in potentially directing appropriate treatment. Forty-seven consecutive non-contrast magnetic resonance imaging examinations of 46 patients with a clinical diagnosis of adhesive Capsulitis were retrospectively reviewed and correlated with clinical staging. Specific MRI criteria correlated with the clinical stage of adhesive Capsulitis, including the thickness and signal intensity of the joint capsule and synovium as well as the presence and severity of scarring in the rotator interval. Routine MRI of the shoulder without intraarticular administration of gadolinium can be used to diagnose all stages of adhesive Capsulitis, including stage 1, where findings may be subtle on clinical examination. We believe that future studies assessing the role of MRI in guiding the initiation of appropriate treatment should be undertaken.
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intra articular corticosteroid injection for the treatment of idiopathic adhesive Capsulitis of the shoulder
HSS Journal, 2007Co-Authors: Robert G Marx, Thomas L Wickiewicz, Robert W Malizia, Keith Kenter, Jo A HannafinAbstract:Treatment for idiopathic adhesive Capsulitis or frozen shoulder of the shoulder is controversial. The hypothesis of the study is that intra-articular corticosteroid injection in the early stages of idiopathic adhesive Capsulitis will lead to a razpid resolution of stiffness and symptoms. This is a retrospective cohort study of only patients with stage 1 or stage 2 adhesive Capsulitis. The diagnosis was made by history and physical examination and only when other causes of pain and motion loss were eliminated. Stage 1 adhesive Capsulitis was defined as significant improvement in pain and normalization of motion following intra-articular injection. Stage 2 included patients who had significant improvement in pain and partial improvement in motion following injection. Seven patients with stage 1 and 53 patients with stage 2 comprised the baseline cohort. The mean age was 52 years (range: 30 to 78); 46 patients were female and nine patients had diabetes mellitus. Patients completed a physical examination as well as a shoulder rating questionnaire for symptoms and disability. Criteria for resolution were defined as forward flexion and external rotation to within 15° of the contralateral side and internal rotation to within three spinal levels of the contralateral side. Forty-four of the patients out of 60 met the criteria for recovery at a mean of 6.7 months. The mode and median time to recovery was 3 months. The mean score at final follow-up for 41 patients using the shoulder-rating questionnaire of L’Insalata was 90 (range 52–100). The mean time to recovery for the stage 1 patients was 6 weeks (range: 2 weeks to 3 months), and it was 7 months for stage 2 patients (range: 2 weeks to 2 years). Glenohumeral corticosteroid injection for early adhesive Capsulitis may have allowed patients to recover motion at a median time of 3 months. In many cases, the patients had improvement prior to the 3-month mark; however, that was the routine time for follow-up. Patients with stage 1 disease tended to resolve more rapidly than stage 2 patients. Prompt recognition of stage 1 and stage 2 idiopathic adhesive Capsulitis and early injection of corticosteroid with local anesthesia may be both diagnostic and therapeutic.
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adhesive Capsulitis a treatment approach
Clinical Orthopaedics and Related Research, 2000Co-Authors: Jo A Hannafin, Theresa ChiaiaAbstract:Adhesive Capsulitis of the shoulder is a condition of unknown etiology that results in the development of restriction of active and passive glenohumeral motion. The authors will review what currently is known about the etiology of idiopathic adhesive Capsulitis, will raise unanswered questions regar
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immunolocalization of cytokines and their receptors in adhesive Capsulitis of the shoulder
Journal of Orthopaedic Research, 1997Co-Authors: Scott A Rodeo, Jo A Hannafin, Russell F Warren, Thomas L WickiewiczAbstract:: The purpose of this study was to test the hypothesis that specific cytokines are involved in the initiation and evolution of the fibrotic process in adhesive Capsulitis of the shoulder. After approval from the Institutional Review Board, biopsies of shoulder capsule and synovium were collected during shoulder arthroscopy from 19 patients with adhesive Capsulitis, 14 patients with nonspecific synovitis and no fibrosis or clinical evidence of adhesive Capsulitis, and seven patients undergoing surgery for another pathology who had a normal capsule and synovium. Immunohistochemical localization with monoclonal antibodies to transforming growth factor-beta and its receptor, platelet-derived growth factor and its receptor, basic fibroblast growth factor, interleukin-1 beta, tumor necrosis factor-alpha, and hepatocyte growth factor was performed using standard immunoperoxidase techniques. The frequency of cytokine staining was correlated with the clinical diagnosis. Synovial cells, fibroblasts, T-cells, and B-cells were identified with specific antibodies, and newly synthesized matrix was examined for type-I and type-III collagen by immunohistochemical staining. The predominant cell types present were synovial cells and fibroblasts. Staining for type-III collagen in adhesive Capsulitis tissues indicated new deposition of collagen in the capsule. There was staining for transforming growth factor-beta and its receptor, platelet-derived growth factor and its receptor, interleukin-1 beta, and tumor necrosis factor-alpha in adhesive Capsulitis and nonspecific synovitis tissues, compared with minimal staining in normal capsule. Staining was more frequent in synovial cells than in capsular cells. The frequency of cell and matrix staining for transforming growth factor-beta, platelet-derived growth factor, and hepatocyte growth factor was greater in adhesive Capsulitis tissues than in those from patients with nonspecific synovitis. No difference in the frequency of staining between primary (idiopathic) and secondary adhesive Capsulitis was found. The results of this study indicate that adhesive Capsulitis involves both synovial hyperplasia and capsular fibrosis. Cytokines such as transforming growth factor-beta and platelet-derived growth factor may be involved in the inflammatory and fibrotic processes in adhesive Capsulitis. Matrix-bound transforming growth factor-beta may act as a persistent stimulus, resulting in capsular fibrosis. Understanding the basic pathophysiology of adhesive Capsulitis is an important step in the development of clinically useful antifibrotic agents that may serve as novel treatments for patients with this conditions.
Daping Wang - One of the best experts on this subject based on the ideXlab platform.
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rna sequence analysis of samples from patients with idiopathic adhesive Capsulitis
Molecular Medicine Reports, 2017Co-Authors: Tongda Zhang, Jianyi Xiong, Wei Lu, Li Duan, Daping WangAbstract:: The present study aimed to investigate idiopathic adhesive Capsulitis (frozen shoulder), to gain insights on its pathogenesis, diagnosis and therapeutic targets. Using RNA‑sequencing (seq), the present study investigated differentially expressed genes (DEGs) in five samples from five idiopathic adhesive Capsulitis patients and two samples from two acromioclavicular dislocation patients, without idiopathic adhesive Capsulitis. The DEGs were analyzed using the following tools: Gene Ontology enrichment analysis, Kyoto Encyclopedia of Genes and Genomes pathways analysis and protein‑protein interaction analysis. A total of 188 DEGs were identified and it was observed that 150 of these were upregulated and 38 were downregulated. It was hypothesized that various nutrient associated proteins may be associated with idiopathic adhesive Capsulitis. The Matrix metalloproteinase family of proteins (MMPs), may exhibit a key role in the formation of abnormal collagen cross‑links. Overall, the comprehensive and detailed information collected in the present study, regarding idiopathic adhesive Capsulitis, may provide a foundation on which in‑depth follow‑up experiments may be based, aimed at identifying novel strategies for treatment of this disease.
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RNA‑sequence analysis of samples from patients with idiopathic adhesive Capsulitis.
Molecular Medicine Reports, 2017Co-Authors: Tongda Zhang, Jianyi Xiong, Wei Lu, Li Duan, Daping WangAbstract:: The present study aimed to investigate idiopathic adhesive Capsulitis (frozen shoulder), to gain insights on its pathogenesis, diagnosis and therapeutic targets. Using RNA‑sequencing (seq), the present study investigated differentially expressed genes (DEGs) in five samples from five idiopathic adhesive Capsulitis patients and two samples from two acromioclavicular dislocation patients, without idiopathic adhesive Capsulitis. The DEGs were analyzed using the following tools: Gene Ontology enrichment analysis, Kyoto Encyclopedia of Genes and Genomes pathways analysis and protein‑protein interaction analysis. A total of 188 DEGs were identified and it was observed that 150 of these were upregulated and 38 were downregulated. It was hypothesized that various nutrient associated proteins may be associated with idiopathic adhesive Capsulitis. The Matrix metalloproteinase family of proteins (MMPs), may exhibit a key role in the formation of abnormal collagen cross‑links. Overall, the comprehensive and detailed information collected in the present study, regarding idiopathic adhesive Capsulitis, may provide a foundation on which in‑depth follow‑up experiments may be based, aimed at identifying novel strategies for treatment of this disease.
Hyun Dae Shin - One of the best experts on this subject based on the ideXlab platform.
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adhesive Capsulitis of the shoulder dimensions of the rotator interval measured with magnetic resonance arthrography
Journal of Shoulder and Elbow Surgery, 2009Co-Authors: Kwang Jin Rhee, Hyun Dae ShinAbstract:Background This study was performed to define the dimensions of the rotator interval (RI) in adhesive Capsulitis using magnetic resonance (MR) arthrography preoperatively to clarify and evaluate pathology. Methods We performed a retrospective review of a series of 73 shoulders that underwent MR arthrography. The shoulders were grouped according to their diagnosis: group I comprised 47 shoulders without adhesive Capsulitis; group II comprised 26 shoulders with adhesive Capsulitis. Using MR arthrography, we estimated the height, base, RI area, width, RI index, and RI ratio. Results The group II shoulders differed significantly in height, base, RI area, RI index, and RI ratio from the group I shoulders. There were statistically significant differences in RI dimensions between patients with and without adhesive Capsulitis of the shoulder. Conclusions Estimating the dimensions of the RI in adhesive Capsulitis using MR arthrography may prove to be valuable for assessing patients preoperatively. Level of evidence Basic science study.
Hollis G Potter - One of the best experts on this subject based on the ideXlab platform.
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magnetic resonance imaging of adhesive Capsulitis correlation with clinical staging
HSS Journal, 2008Co-Authors: Carolyn M Sofka, Gina A Ciavarra, Jo A Hannafin, Frank A Cordasco, Hollis G PotterAbstract:The purpose of this study was to evaluate non-contrast magnetic resonance imaging (MRI) findings of adhesive Capsulitis and correlate them with clinical stages of adhesive Capsulitis. This will hopefully define a role for shoulder MR imaging in the diagnosis of adhesive Capsulitis as well as in potentially directing appropriate treatment. Forty-seven consecutive non-contrast magnetic resonance imaging examinations of 46 patients with a clinical diagnosis of adhesive Capsulitis were retrospectively reviewed and correlated with clinical staging. Specific MRI criteria correlated with the clinical stage of adhesive Capsulitis, including the thickness and signal intensity of the joint capsule and synovium as well as the presence and severity of scarring in the rotator interval. Routine MRI of the shoulder without intraarticular administration of gadolinium can be used to diagnose all stages of adhesive Capsulitis, including stage 1, where findings may be subtle on clinical examination. We believe that future studies assessing the role of MRI in guiding the initiation of appropriate treatment should be undertaken.
Luca Maria Sconfienza - One of the best experts on this subject based on the ideXlab platform.
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multi modal imaging of adhesive Capsulitis of the shoulder
Insights Into Imaging, 2016Co-Authors: Marcello Zappia, Francesco Di Pietto, Alberto Aliprandi, Simona Pozza, Paola De Petro, Alessandro Muda, Luca Maria SconfienzaAbstract:Adhesive Capsulitis of the shoulder is a clinical condition characterized by progressive limitation of active and passive mobility of the glenohumeral joint, generally associated with high levels of pain. Although the diagnosis of adhesive Capsulitis is based mainly on clinical examination, different imaging modalities including arthrography, ultrasound, magnetic resonance, and magnetic resonance arthrography may help to confirm the diagnosis, detecting a number of findings such as capsular and coracohumeral ligament thickening, poor capsular distension, extracapsular contrast leakage, and synovial hypertrophy and scar tissue formation at the rotator interval. Ultrasound can also be used to guide intra- and periarticular procedures for treating patients with adhesive Capsulitis. • Diagnosis of adhesive Capsulitis is mainly based on clinical findings. • Imaging may be used to exclude articular or rotator cuff pathology. • Thickening of coracohumeral and inferior glenohumeral ligaments are common findings. • Rotator interval fat pad obliteration has 100 % specificity for adhesive Capsulitis. • Ultrasound can be used to guide intra- and periarticular treatments.