title: The painful arc syndrome. Clinical classification as a guide to management.
abstract: Ninety-seven patients suffering from painful arc syndrome of the shoulder were studied. Local anaesthetic and radiographic contrast investigations were carried out. One-third of the patients had lesions in the posterior part of the rotator cuff which resolved after injections of local anaesthetic and steroid. One-third had anterior lesions in the subscapularis tendon: almost all resolved under the same regime but two required division of the coraco-acromial ligament. The remaining third had lesions of the supraspinatus tendon, usually associated with degeneration of the acromio-clavicular joint: most of these failed to gain relief from the local anaesthetic and steroid. Twenty-two operations were performed either by a transcromial or by a deltoid splitting approach. Excision of the outer end of the clavicle and division of the coraco-acromial ligament abolished the pain in most cases.
mesh_terms: D000173:Acromioclavicular Joint / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D006801:Humans; D007592:Joint Diseases / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*; D008012:Lidocaine; D008023:Ligaments, Articular / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000175:diagnosis; D011859:Radiography; D012785:Shoulder Joint / Q000601:surgery; D013256:Steroids / Q000627:therapeutic use; D013577:Syndrome; D013710:Tendons / Q000601:surgery
chemical_list: D013256:Steroids; D008012:Lidocaine