Video Experimental Relacionado
Updated: Jun 26, 2026
07:52
Evaluating Postural Control and Lower-extremity Muscle Activation in Individuals with Chronic Ankle Instability
Published on: September 18, 2020
¿Tiene este paciente una inestabilidad del hombro o una lesión en el labrum?
Jolanda J Luime1, Arianne P Verhagen, Harald S Miedema
1The Netherlands Expert Centre for Work-related Musculoskeletal Disorders, Erasmus, University Medical Center Rotterdam, Rotterdam, The Netherlands. b.koes@erasmusmc.nl
JAMA
|October 28, 2004
Resumen
El diagnóstico preciso de la inestabilidad del hombro puede ser ayudado por pruebas clínicas específicas como la reubicación y la liberación anterior. Sin embargo, el diagnóstico de la patología intraarticular (PIA) requiere una investigación adicional, con pruebas de carga I y II de bíceps que muestran promesa.
Área de la Ciencia:
- La ortopedia es la ortopedia.
- Precisión en el diagnóstico.
- Biomecánica del hombro Biomecánica del hombro
Sus antecedentes:
- El diagnóstico del dolor de hombro generalmente se basa en la toma de la historia clínica y las pruebas clínicas.
- La precisión diagnóstica de estos métodos para la inestabilidad del hombro o la patología intraarticular (IAP) sigue sin estar clara.
Objetivo del estudio:
- Analizar sistemáticamente la precisión diagnóstica de las pruebas clínicas y la historia clínica del paciente para identificar la inestabilidad del hombro y el PAI.
Principales métodos:
- Se realizó una búsqueda exhaustiva de la literatura en múltiples bases de datos (PubMed, EMBASE, CINAHL).
- Los estudios elegibles compararon los elementos de la historia clínica o las pruebas de examen físico con un estándar de referencia.
- La calidad metodológica se evaluó utilizando la lista de verificación de evaluación de la calidad de los estudios de precisión diagnóstica (QUADAS).
Principales resultados:
- Las pruebas de reubicación y de liberación anterior demostraron su utilidad en el diagnóstico de la inestabilidad del hombro (LR de entre 6,5 y 8,3).
- La carga bíceps I y II, la provocación del dolor de Mimori y las pruebas de resistencia a la rotación interna mostraron ser prometedoras para el diagnóstico de lesiones labrales (LRs que van desde 7.2 hasta 29).
- Se encontró que varias otras pruebas comunes eran menos útiles; no se identificaron estudios de precisión para la toma de antecedentes o pruebas clínicas de atención primaria.
Conclusiones:
- Las pruebas de reubicación y liberación anterior están respaldadas por la mejor evidencia para diagnosticar la inestabilidad del hombro.
- La precisión diagnóstica para la patología intraarticular (IAP), específicamente las lágrimas labrales, es menos clara, pero las pruebas de fuerza de carga de bíceps I y II, provocación de dolor de Mimori y resistencia a la rotación interna son las más prometedoras.
Videos de Conceptos Relacionados
01:29Blood and Nerve Supply to the Bones
Bones are dynamic organs that require a rich supply of oxygen and nutrients. Around 5% to 10% of the cardiac output supplies blood to the bones. A typical long bone has three main sources: the nutrient artery, the metaphyseal and epiphyseal arteries, and the periosteal arteries.
Nutrient Artery
The nutrient artery is the main blood vessel that enters the diaphysis via the nutrient foramen. While most long bones have only one nutrient foramen, large bones, such as the femur, may have two. This...
Nutrient Artery
The nutrient artery is the main blood vessel that enters the diaphysis via the nutrient foramen. While most long bones have only one nutrient foramen, large bones, such as the femur, may have two. This...
01:27Fractures: Bone Repair
Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the procedure...
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the procedure...
01:29Bone Disorders
Aging and its effect on bone remodeling is the most common cause of bone disorders. In young and healthy people, bone deposition and resorption happen at an equal rate to maintain optimal bone health.
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
01:24Flail Chest-I
Overview of Flail Chest
Flail chest is a severe and potentially life-threatening condition characterized by the fracture of three or more adjacent ribs in multiple places. It is most commonly caused by direct impacts and trauma, such as motor vehicle accidents or injuries from a steering wheel impact. It can also occur due to falls in elderly individuals with osteoporosis, or assaults involving sharp objects.
Pathophysiology
The pathophysiology of flail chest is complex, involving fractures of...
Flail chest is a severe and potentially life-threatening condition characterized by the fracture of three or more adjacent ribs in multiple places. It is most commonly caused by direct impacts and trauma, such as motor vehicle accidents or injuries from a steering wheel impact. It can also occur due to falls in elderly individuals with osteoporosis, or assaults involving sharp objects.
Pathophysiology
The pathophysiology of flail chest is complex, involving fractures of...
01:26Flail Chest-II
Managing flail chest, a condition characterized by a segment of the chest wall moving independently from the rest of the thoracic cage, requires a comprehensive approach. It includes a thorough assessment of the patient's condition, a diagnostic evaluation to determine the extent of the injury, and the implementation of appropriate medical interventions tailored to the individual's needs.
Assessment:
1. Clinical Evaluation:
History:
Assessment:
1. Clinical Evaluation:
History: