Navegando por Palavras-chave "repetitive strain injuries"
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- ItemAcesso aberto (Open Access)Equívocos diagnósticos envolvendo as tendinites: impacto médico, social, jurídico e econômico(Sociedade Brasileira de Reumatologia, 2009-12-01) Siena, Cesar; Helfenstein Junior, Milton [UNIFESP]; Justiça Federal da 3ª região; Universidade Federal de São Paulo (UNIFESP)Evidence of the clinical, social, and economic impact of mistaken diagnoses of tendonitis and other chronic painful disorders are analyzed. The objective of this review is to call attention to the possible diagnostic hyper valuation of tendonitis, especially those supposedly multiple or refractory, based on evidence. A review of the literature on chronic painful disorders, such as fibromyalgia, in the context of mistaken diagnosis of tendonitis, as well a review of false positive and ultrasonographic (US) scan diagnostic parameters, is presented. Evidence of therapeutic mistakes were found in 41% and diagnostic mistakes in 70 to 85% of the cases, with proven unpreparedness regarding those disorders in up to 93.7% of the physicians. The diverse repercussions of this epidemic of mistakes are discussed.
- ItemSomente MetadadadosAn evaluation of the association between fibromyalgia and repetitive strain injuries in metalworkers of an industry in Guarulhos, Brazil(Elsevier B.V., 2001-02-01) Gallinaro, A. L.; Pollak, Daniel Feldman [UNIFESP]; Natour, J.; Universidade Federal de São Paulo (UNIFESP)Repetitive strain injuries are a common diagnostic label far musculoskeletal pain occurring at the workplace. Although many individuals present with diffuse pain, the diagnosis of fibromyalgia in this setting is rare. Our objective was to establish the paint prevalence of the fibromyalgia syndrome in a population of assembly line workers in São Paulo, Brazil. Methods. Thirty-four workers with repetitive strain injury diagnoses were studied and compared with 49 workers, paired by age, sex, and labor function. All individuals were studied by a comprehensive clinical protocol, Diagnosis of fibromyalgia syndrome was established when the 1990 American College of Rheumatology criteria far this syndrome were met. Results, Among the 34 workers with the diagnosis of repetitive strain injuries, 58.8% fulfilled the American College of Rheumatology criteria for fibromyalgia syndrome, while only 10.4% of the controls met the same criteria. Conclusions. Fibromyalgia syndrome was largely involved in the symptoms of patients with repetitive strain injuries, as opposed to coworkers with non-repetitive strain injuries, So, instead of the repetitive strain injuries label, many of these cases should be called fibromyalgic patients. (C) 2001 Editions scientifiques et medicates Elsevier SAS.
- ItemAcesso aberto (Open Access)Fibromialgia, LER, entre outras confusões diagnósticas(Sociedade Brasileira de Reumatologia, 2006-02-01) Helfenstein Junior, Milton [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)This is a typical case, extremely common on daily practice, occuring in several areas of our country, involving a young female patient, active professionally, deviated from her job for several years, arguing total lack of efficacy on her treatment, conversely to scientific evidence. She complains of diffuse pain, erroneously interpreted as consequence of her job, with multiple specific diagnosis of musculoskeletal lesions, which has becoming worse, despite of withdrawal of the incriminated biomechanical overloading. The case was interpreted as a disease, lato sensu, which is not recognized in the medical literature. The possibility of fibromyalgia, psicogenic rheumatism and simulation, involving litigation, is brought foward.
- ItemAcesso aberto (Open Access)O ombro em uma linha de produção: estudo clínico e ultrassonográfico(Sociedade Brasileira de Reumatologia, 2009-08-01) Maeda, Ernesto Youiti [UNIFESP]; Helfenstein Junior, Milton [UNIFESP]; Ascencio, João Eduardo Barile; Pollak, Daniel Feldman [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)INTRODUCTION: The correlation among shoulder pain, abnormal physical examination and ultrasonography is controversial in the occupational scenario. OBJECTIVE: Establish the association between pain, physical examination and ultrasounds in workers of a pharmaceutical industry. PATIENTS AND METHODS: One hundred workers were invited to take part in the study and submitted to the inclusion and exclusion criteria, and 93 were included. All enrolled patients gave written informed consent, and had a physical examination performed by one of the authors. Ultrasound examination was performed, at the latest one month of the physical examination, by an experienced operator who was blind to the clinical setting. RESULTS: There was statistical correlation between pain and clinical maneuvers in 57 shoulders for supraspinatus tendon (SE) (P = 0,000) and no correlation with biceps tendon maneuvers (P > 0,05). In the comparison between clinical findings and ultrasonography, the maneuvers of Neer, Hawkins and Jobe had statistical association (P < 0,05). The association between pain and altered ultrasonography was statistically significant (16 among 57 individuals with pain, with P < 0,05), but there was significant false-positive ultrasound findings in asymptomatic shoulders (7 individuals). CONCLUSION: The precise diagnosis is a complex process, which requires the association of clinical and occupational anamnesis, accurate physical examination and ultrasonography performed by an experienced operator.