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Review Question - QID 8754

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QID 8754 (Type "8754" in App Search)
Figures 26a through 26c show the MRI scans of a 47-year-old man who underwent arthroscopic shoulder surgery 6 months ago and continues to have pain despite a prolonged course of rehabilitation. Management should now consist of
  • A
  • B
  • C

rotator cuff repair.

30%

127/430

revision acromioplasty.

24%

105/430

fragment excision.

17%

74/430

open reduction and internal fixation.

23%

101/430

continued rehabilitation.

5%

22/430

  • A
  • B
  • C

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The MRI scans show an os acromiale of the mesoacromion type. This represents an unfused acromial apophysis. Pain is thought to be caused by either motion at the site or downward displacement of the anterior aspect of the acromion onto the rotator cuff, causing impingement. Most patients can be treated nonsurgically as they are usually asymptomatic. In those patients with persistent symptoms of pain and tenderness over the acromion, surgery consisting of rigid internal fixation and bone grafting has yielded satisfactory results. Excision may be a viable treatment option for the preacromion type.

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