Gobind Rai Garg Pathology Pdf 13
LDG was involved in patient management and taking consent from the patient. PG and SB were involved in the writing of the case report and follow-up of the patient. RB was involved in the histopathology of the tumor. All authors read and approved the final manuscript.
gobind rai garg pathology pdf 13
LAA was measured from an oblique coronal MRI slice just posterior to the acromioclavicular joint. The angle was determined by the intersection of a line parallel to the acromion undersurface and a second line parallel to the glenoid fossa (as shown in Figure 2). The critical shoulder angle (CSA) is measured between a line through the inferior lateral edge of the glenoid to the inferior lateral edge of the acromion and a line parallel to the glenoid (as shown in Figure 3) and the AI. The AI (A/B) is calculated by dividing the distance between the osseous glenoid plane to the lateral border of the acromion (A) by the distance between the osseous glenoid plane and the most lateral part of the proximal humerus, from 68 patients with partial or full-thickness supraspinatus tendon tears and 30 controls without subacromial pathology (as shown in Table 1 of the descriptive statistics). Later we evaluated these parameters and their relationship with RCT. All MRI images of our study were performed by using a 1.5-Tesla unit system (Siemens). A dedicated shoulder array coil was used. When imaging the shoulder with MRI, patients were placed in a supine position with their arms at the sides of their body in partial external rotation with the shoulder coil. Initially, localiser images were obtained, followed by coronal oblique, sagittal oblique, and axial images. The coronal oblique plane was selected parallel to the course of the supraspinatus tendon itself for optimal visualisation of the tendon.
Many studies, which reported no difference in the acromial index of patients who had calcifying tendinitis, partial-thickness rotator cuff tears, or full-thickness rotator cuff tears, called into question the biomechanical theory proposed by Nyffeler et al. regarding the association between large acromial index and rotator cuff disease as well as between small acromial index and osteoarthritis [9,13,14]. In contrast, our study supported Nyffeler et al. because a high AI index was seen in RCT patients, especially for full thickness tears [9]. Torrens et al. also reported similar findings in a study in Spain, in which patients with rotator cuff tears had a significantly larger acromial index of 0.72 compared with 0.68 in patients without cuff pathology, and there were differences between the sexes [15]. It was observed that high AI can be one of the associated factors for progression of severity of rotator cuff tears.
In our study CSA was found to be 34.6, corroborating with several other authors, such as Gerber et al., Spiegl et al., Moor et al., and Bouaicha et al., who also found similar results [16-19]. Gerber et al. demonstrated a biomechanical study that a high CSA may induce overload of the supraspinatus tendon, particularly at low degrees of active abduction [16]. Garcia et al., in a retrospective study, made a postoperative ultrasound examination after arthroscopic repair of RCTs and found that higher CSA significantly increased the risk of a full thickness rotator cuff re-tear after arthroscopic repair [20]. Although for Kirsch et al. CSA is a strong radiographic predictor of rotator cuff pathology, it did not have a predictive effect on outcomes after arthroscopic repair of atraumatic full-thickness tears [21].
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