Visited the National Gallery recently and enjoyed admiring these Picassos that featured the elbow prominently
Why Architecture is the Perfect Theme for our. National Shoulder and Elbow Week event in Buffalo. You could argue that architecture is what happens when art and engineering collide. You might be able to say the same thing for shoulder and elbow surgery. As shoulder and elbow surgeons we “reconstruct” joints, “restore” anatomy and use … Read more
Most people know that smoking is bad for your heart and lungs. Few people know that it’s bad for your bones and joints.
There’s a host of reasons why smoking leads to poor bone health. And I’m not sure how interested you are in the nitty gritty bichemical details of why this is. So I will cut to the chase and highlight two specific scenarios in which smoking can be bad for your bones.
Most people think that you need an MRI to “see” everything that is going on in your shoulder. But it’s simply not true. And there are a few ways that you can be fooled by this line of reasoning.
1. You fail to put findings in context
I can show you MRI reports of normal shoulders that will scare the daylights out of you. These are full page documents that describe in great detail, essentially normal findings in medical lingo. Unfortunately as a layperson and even many medical professionals who are unfamiliar with the problem, most of this language will sound scary and can be misinterpreted.
Heuristics are “rules of thumb” that people use to make decisions in situations that involve uncertainty. Taleb writes about them in depth and I enjoy his writing. The daily practice of medicine requires making frequent high stakes decision with incomplete knowledge. Where “evidence based medicine” leaves off, heuristics often take over.
I think both doctors and patients use them, but in different ways.
I saw a patient in the office recently whose x-rays were a testament to two important points about shoulder arthritis:
A study from the recent American Arthroscopy Association of North America outlines risk factors for poor outcomes after surgery in patients who have had dislocations. Background: Steve Burkhart popularized the concept of the inverted pear-shaped socket. He found that if more than 1/4 of the bone was missing from the socket after a dislocation and a strictly soft tissue arthroscopic repair was performed to fix it, then these patients would be at high risk for
Below is a typical case of severe arthritis in the ball and socket portion of the shoulder joint.
Arthritis is actually relatively uncommon in this joint. But when it occurs it tends to show a distinct pattern. The hallmark of arthritis at the ball and socket shoulder joint is joint space narrowing bone spurs at the bottom of the ball portion of the joint.