Medicine and Health Sciences Commons^™

Expert Consensus On The Diagnosis And Management Of Digoxin Toxicity, Jason B Hack, Sue Wingate, Ron Zolty, Michael W Rich, Paul J Hauptman

2020-Current year OA Pubs

While there has been a decline in the use of digoxin in patients with heart failure and atrial fibrillation, acute and chronic digoxin toxicity remains a significant clinical problem. Digoxin's narrow therapeutic window and nonspecific signs and symptoms of toxicity create clinical challenges and uncertainty around the diagnostic criteria of toxicity and responsive treatment choices for the bedside clinician. A systematic review of published literature on digoxin toxicity (34,587 publications over 6 decades, with 114 meeting inclusion criteria) was performed to develop 33 consensus statements on diagnostic and therapeutic approaches which were then evaluated through a modified Delphi process involving …

Nutcracker Syndrome (A Delphi Consensus), Floor Heilijgers, Suresh Vedantham, Et Al.

2020-Current year OA Pubs

BACKGROUND: Nutcracker syndrome (NCS) describes the symptomatic compression of the left renal vein between the aorta and superior mesenteric artery. Whereas asymptomatic compression is a common radiological finding, patients with NCS can report a range of symptoms. There are no specific diagnostic criteria and interventions include a range of open surgical and endovascular procedures. Therefore, we wished to develop an international consensus document covering aspects of diagnosis, management, and follow-up for patients with NCS.

METHODS: A three-stage modified Delphi consensus was performed. A steering committee developed 37 statements covering 3 categories for patients with NCS: diagnosis, management, and follow-up. These …

Acquired Ductopenia: An Insight Into Imaging Findings, Rachita Khot, Nathan R Shelman, Daniel R Ludwig, Rashmi T Nair, Mark A Anderson, Sudhakar K Venkatesh, Raj Mohan Paspulati, Rex A Parker, Christine O Menias

2020-Current year OA Pubs

Hepatic ductopenia is a pathologic diagnosis characterized by a decrease in the number of intrahepatic bile ducts as a consequence of various underlying etiologies. Some etiologies, such as primary sclerosing cholangitis, primary biliary cholangitis, and ischemic cholangitis, often have distinctive imaging findings. In contrast, other causes such as chronic rejection following liver transplantation, drug-induced biliary injury, infection, malignancy such as lymphoma, and graft-versus-host disease may only have ancillary or non-specific imaging findings. Thus, diagnosing ductopenia in conditions with nonspecific imaging findings requires a multidimensional approach, including clinical evaluation, serological testing, imaging, and liver histology to identify the underlying cause. These …

Caregiver Worry About Covid-19 As A Predictor Of Social Mitigation Behaviours And Sars-Cov-2 Infection In A 12-City U.S. Surveillance Study Of Households With Children, Steven M Brunwasser, Katherine Rivera-Spoljaric, Et Al.

2020-Current year OA Pubs

OBJECTIVE: Understanding compliance with COVID-19 mitigation recommendations is critical for informing efforts to contain future infectious disease outbreaks. This study tested the hypothesis that higher levels of worry about COVID-19 illness among household caregivers would predict lower (a) levels of overall and discretionary social exposure activities and (b) rates of household SARS-CoV-2 infections.

METHODS: Data were drawn from a surveillance study of households with children (

RESULTS: Caregivers with high enrollment levels of worry about COVID-19 illness were more likely to reduce direct social contact outside the household, particularly during the U.S.'s most deadly pandemic wave. Households of caregivers with …

Delayed Tooth Eruption As An Early Clinical Indicator Of Genetical Tooth Agenesis: A Family-Based Study Of Cases With Whole-Exome Sequencing, Yu-Chen Jeng, I-Ting Chen, Hui-Ching Cheng, Hsin-Yu Huang, Chao-Kai Hsu, Yu-Fen Yen

Journal of Dental Sciences

Delayed tooth eruption is frequently considered a benign developmental variation but may represent an early sign of genetically driven tooth agenesis. We evaluated a 22-month-old female presenting with markedly delayed eruption (only eight primary teeth) and a positive family history of ectodermal features. Given the inconclusive early radiographic findings, whole-exome sequencing (WES) was utilized. WES revealed the proband carried a heterozygous EDARADD variant (NM_080738:c.328G>T; p.Asp110Tyr). Subsequent familial segregation analysis identified an additional heterozygous WNT10A variant (NM_025216:c.637G>A; p.Gly213Ser) within the broader family. The EDARADD variant alone was associated with varying presentations from normal dentition to delayed eruption. Furthermore, the …

Characterization Of The Biofilm-Forming Ability And Certain Virulence Characters Ofaeromonas Spp. Isolates From Rainbow Trout, Türker Çelebi̇, Ertan Emek Onuk, Esra Demi̇rbaş, Gökçen Di̇nç

Turkish Journal of Veterinary & Animal Sciences

Aeromonas spp., commonly found in the aquatic environment, cause infections in both fish and humans. Their pathogenicitydepends on various virulence factors and ability to form biofilm. The current study aimed to determine the biofilm-forming capabilitiesand certain virulence characteristics of 25 Aeromonas spp. isolates obtained from rainbow trout in Türkiye. The biofilm-forming abilitiesof isolates were investigated comparatively using Congo red agar (CRA), the tube method (TM), and tissue culture plates (TCPs).Potential virulence factors, including hemolytic activity, gelatinase production, serine protease activity, DNase activity, and motility,were evaluated using phenotypic tests. Additionally, the distribution of four known virulence genes, namely aerA, exu, fla, …

Effects Of A Diet Supplemented With A Blend Of Protected Organic Acids And Essential Oilson Growth Performance And Cecal Microbiota Composition In Broilers, Mehmet Akan, Kadi̇r Serdar Di̇ker, Serdar Özlü, Murat Çelebi̇, Seyyi̇de Sariçam İnce, Barişhan Doğan, Okan Eli̇bol

Turkish Journal of Veterinary & Animal Sciences

Organic acids (OAs) and essential oils (EOs) have several positive effects on the gut microbiota of broilers. In this study, weaimed to determine the efficacy of a blend of protected OAs and EOs [P(OA+EO)] on the growth performance and cecal microbiota ofbroiler chickens. A total of 160 Ross 308 broiler chickens, including 80 male and 80 female birds, all 1 day old, were randomly distributedbetween the control group (basal diet) and the treatment group [basal diet + 300 g/t P(OA+EO)] according to an 8-pen arrangementwith 4 replicates of 20 birds. Body weight (BW), body weight gain (BWG), feed consumption (FC), …

The Nohs 2024 Code Of Ethics Update, Kevin C. Snow, Christian Williams, Ed Neukrug, Kristin Barker, Kristin Ballard, Braxton A. Morrison, Leslie C.M. Mcclane, Meghan N. Morgan, Stephanie Collins

Counseling & Human Services Faculty Publications

The NOHS Ethics committee engaged in a revision of the Ethical Standards for Human Services Professionals (2024). This update focused on significant changes in the field of human services as they relate to a broad group of human services professionals. The article explores interviews with key members of the revision committee sharing their thoughts on the necessity for the current revision and the ever-present importance for human service professionals to understand and engage with the NOHS ethics code as an essential living document for the benefit of client well-being, to promote the integrity of the human services profession, and to …

Organizational Accounting In Value-Based Care: How Are You Really Doing?, Stephanie Fischer Mba, Jennifer Stephens Do

Administration & Leadership

No abstract provided.

Improving Outcomes Of Single-Sided Deaf Cochlear Implant Users By Reducing Interaural Frequency And Loudness Mismatches Through Device Programming, Laura K Holden, Rosalie M Uchanski, Noël Y Dwyer, Ruth M Reeder, Timothy A Holden, Jill B Firszt

2020-Current year OA Pubs

The study aimed to improve outcomes in Nucleus cochlear implant (CI) recipients with single-sided deafness (SSD) by reducing interaural frequency and loudness mismatches through device programming. In Experiment 1a, a modified frequency allocation table (FAT) was created to better match the tonotopicity of the contralateral ear and reduce interaural frequency mismatch. Twenty experienced SSD-CI users completed localization and speech recognition tests with their everyday FAT. Tests were repeated after 6 weeks' use of the modified FAT. Participants compared both FATs for 2 weeks before being tested again with each. For 10 newly implanted SSD-CI recipients (Experiment 1b), Group A was …

Surgeon Interpretation Of Patient-Reported Outcome Measures In Upper Extremity Osteoarthritis, Rick S. Looman, Koen Oude Nijhuis, Sina Ramtin, David Ring, Daniel A. London, Ryan Calfee, Niels Brinkman, Science Of Variation Group

2020-Current year OA Pubs

PURPOSE: Measures that quantify levels of pain intensity, incapability, symptoms of distress, and unhelpful thinking were designed as research tools. We studied how surgeons interpret and act on these scores in the care of individual patients.

METHODS: In an online experiment, 67 upper limb specialists from the Science of Variation Group reviewed 10 fictious patient scenarios of trapeziometacarpal, wrist and elbow osteoarthritis (OA) and randomized elements of radiographic severity, levels of discomfort and incapability, deprivation index score (social health), and levels of distress and unhelpful thinking (mental health). Multilevel mixed-effects linear regression identified patient factors associated with surgeon concern, enthusiasm …

The Ethics Of Patient And Public Involvement Across The Research Process: Towards Partnership With People With Aphasia, Deborah Hersh, Mark Israel, Ciara Shiggins

Research outputs 2014 to 2021

Background: Conducting Patient and Public Involvement (PPI) in health research is a way of building knowledge that incorporates the experience of service users, adds research impact, and helps avoid wasting resources on findings that have little relevance to people or cannot be implemented. We argue that there is a need to extend ethical considerations currently focused on research participants with aphasia to encompass and guide expectations of involvement in partnerships with people with aphasia across the research lifecycle.

Method: We use the 2018 revision of the Australian National Statement on Ethical Conduct in Human Research as the framework for this …

Increased Nitrate Intake From Beetroot Juice Over 4 Weeks Changes The Composition Of The Oral, But Not The Intestinal Microbiome, Rebeka Fejes, Joana Séneca, Petra Pjevac, Martin Lutnik, Stefan Weisshaar, Nina Pilat, Romy Steiner, Karl Heinz Wagner, Richard J. Woodman, Catherine P. Bondonno, Jonathan M. Hodgson, David Berry, Michael Wolzt, Oliver Neubauer

Research outputs 2022 to 2026

Inorganic dietary nitrate, metabolized through an endogenous pathway involving nitrate reducing bacteria, improves cardiovascular health, but its effects on the oral and intestinal microbiomes of older adults with treated hypertension are unknown. Our study investigated the effects of nitrate from beetroot juice on the oral and intestinal microbiomes of this population. A randomized, double-blind, placebo-controlled crossover trial was conducted with 15 participants (age range: 56–71 years), who consumed nitrate-rich or nitrate-depleted (placebo) beetroot juice for 4 weeks. The oral microbiome analysis revealed an increase in Neisseria and a decrease in Veillonella relative abundance (for both, PERMANOVA p < 0.001), with no significant changes in the intestinal microbiome composition. Our findings suggest that an increased dietary nitrate intake from a vegetable source may selectively modulate the oral microbiome and promote an increased abundance of nitrate-reducing species, which was previously associated with improved cardiovascular health outcomes.

The Impact Of Opening A Private Hospital Emergency Department On The Hospital And Patient Characteristics, Christiana Mustac, John Maxwell, Paola Chivers, Gordon Laing, Terry Bayliss

Research outputs 2022 to 2026

Introduction Australian public hospital emergency departments (EDs) are under increasing pressure with higher patient volumes, failure to meet triage target times and increased ambulance wait times. Further, there is limited literature exploring how the opening of an ED affects Australian hospitals. This study focuses on Hollywood Private Hospital (HPH), a large private hospital in Western Australian which opened their ED in November 2021. The research aimed to examine how the introduction of the ED influenced the hospital’s service demands and resourcing. Method This study investigated hospital inpatient characteristics including admissions, clinical deterioration episodes, deaths, aft er-hours theatre activity and companion …

Barriers And Motivators To Attending Group Exercise Classes In Women With Anxiety, Depression And Post-Traumatic Stress Disorder, Sarah Ford

Theses: Doctorates and Masters

Research has demonstrated the positive effect of exercise on mental health disorders such as anxiety disorder, depression and post-traumatic stress disorder. Studies have also investigated the barriers and motivators that women in particular experience when contemplating the ways in which to engage in physical activity. However, a literature gap exists regarding women who experience anxiety disorder, depression and post-traumatic stress disorder, and the barriers and motivators that they specifically navigate when looking to attend group exercise classes. In this body of research for the award of Master of Medical and Health Science by Research, a scoping review was first conducted …

Hemiplegic Shoulder Pain: A Narrative Review, Yeh-Kai Liao, Chueh-Hung Wu, Levent Özçakar

Rehabilitation Practice and Science

Hemiplegic shoulder pain is a common post-stroke complication that negatively affects functional recovery. It is caused by both mechanical and neurological factors. Prevention focuses on proper positioning, patient education, and maintenance of motion. Treatment remains largely conservative; with increasing research surrounding injection therapies, including intra-articular corticosteroid injection, subacromial hyaluronic acid injection, suprascapular nerve blocks, and botulinum toxin injection, all of which have demonstrated improved pain control. Functional electrical stimulation appears to be beneficial, and adjunct therapies such as supportive devices and robotic training may further enhance conventional treatment. Herewith, evidence regarding medications and acupuncture remains limited. Emerging treatments including high-intensity …

Current Injection Treatment For Adhesive Capsulitis, A Narrative Review, Laurence Roy-Bélanger, Tian Yue Ding, Édouard Marcoux, Mathieu Boudier-Revéret

Rehabilitation Practice and Science

This narrative review outlines the current practices related to ultrasound-guided (USG) injection treatments for adhesive capsulitis (AC), including injection sites, approaches, medications, and doses.

USG procedures are increasingly accessible for AC, offering diverse injection approaches and medication dosing. Given the methodological variations in existing studies, a summary of current practices is essential. We conducted a narrative review of recent literature retrieved from computerized databases.

Glenohumeral (GH) and coracohumeral ligament (CHL) injections may improve outcomes for AC, with some evidence suggesting potential benefits of targeting the CHL. Subacromial bursa injections alone appear to be less effective. Multi-site injection techniques show promising …

Unveiling The Role Of The Suprascapular Nerve In Painful Shoulder: A Narrative Review With A Focus On Ultrasound-Guided Diagnosis And Intervention, Hong Hong, Wei-Ting Wu, Ke-Vin Chang

Rehabilitation Practice and Science

Suprascapular nerve disorders are a significant yet often underdiagnosed cause of shoulder pain and dysfunction, stemming from the nerve's critical role in shoulder stability and mobility through its innervation of the supraspinatus and infraspinatus muscles. This review explores the anatomy and clinical relevance of the suprascapular nerve, highlighting the need for accurate diagnosis in cases of pain, weakness, or functional impairment that mimic other shoulder conditions. Among diagnostic modalities, ultrasound has become a vital tool, providing real-time imaging to precisely assess nerve compression or damage. Its utility extends to therapy, with recent advancements in ultrasound-guided interventions—such as nerve blocks, corticosteroid …

Axillary Web Syndrome Following Breast Cancer Surgery: A Review Of Current Literature, Christina Soong, Tyng-Guey Wang, Shaw-Gang Shyu

Rehabilitation Practice and Science

Axillary web syndrome (AWS), a complication primarily following breast cancer surgeries involving axillary lymph node dissection (ALND), presents as painful cords extending from the axilla, impairing shoulder mobility and potentially delaying cancer treatment. This review consolidates existing knowledge on AWS, covering its clinical presentation, risk factors, pathophysiology, and management strategies. AWS typically arises within weeks post-surgery but may develop later, manifesting as fibrous cords that hinder arm movement. Diagnosis relies primarily on clinical examination, and the reported incidence varies significantly across different populations and study designs. Risk factors include ALND, younger age, low body mass index, and adjuvant therapies. The …

Multidisciplinary Approach To Managing Hypotonia And Developmental Delays Due To A Novel Gtpbp3 Mutation, Fan Mei, Ru-Lan Hsieh

Rehabilitation Practice and Science

Introduction: Hypotonia in early life is often challenging to diagnose due to its diverse etiologies, with genetic disorders accounting for about one-third of cases. A precise diagnosis using a comprehensive, multidisciplinary approach is crucial for determining prognosis, guiding treatment, and providing genetic counseling.

Case Presentation: We report the first case in Taiwan involving compound heterozygous mutations in the GTPBP3 gene. A 13-month-old girl presented with developmental delays and hypotonia despite normal prenatal screenings and a year of rehabilitation therapy. Next-generation sequencing revealed two novel mutations: c.785A>C (p.Gln262Pro), a missense mutation in Exon 5, and c.1175_1181dup (p.Ser395GlufsTer4) …

Ambulation Challenges Post High-Voltage Electrical Burn Involving Three Extremities, Complicated With Osteomyelitis: A Case Report, Chiang-Hui Huang, Katie Pei-Hsuan Wu

Rehabilitation Practice and Science

High-voltage electrical burns in occupational settings can leave detrimental injuries with immediate impact and long-term sequel. Despite extensive literature on the injury mechanism, comprehensive long-term rehabilitation descriptions for such devastating cases remain scarce. This report presents a significant traumatized high-voltage electrical injury involved three out of four extremities. A late complication with extensive tibial osteomyelitis affecting two-thirds of the bone severely compromised the patient’s ambulation potential, emphasizing the importance of segmental rehabilitation with progressive tolerance in ambulatory weight-bearing. We evaluated the patient’s physical, mental, and social component using Barthel Index, Veterans RAND 12-Item Health Survey (VR-12), and Patient-Reported Outcomes Measurement …

Clinical Application Of Intraoperative Neurophysiological Monitoring During Detethering Surgery Of A Newborn: A Case Report, Mu-Yun Lin, Hsin-Hung Chen, Tsui-Fen Yang

Rehabilitation Practice and Science

Background:

Tethered cord syndrome (TCS) is a rare congenital condition that causes abnormal tension on the spinal cord and often requires early surgical intervention to prevent progressive neurological and orthopedic deficits. However, performing detethering surgery in neonates presents unique challenges due to their immature neural pathways, which complicate intraoperative neuromonitoring (IONM).

Case Description:

We report the case of a 13-day-old neonate with TCS who underwent successful detethering surgery under advanced IONM. Double-train stimulation with a linked quadripolar montage was employed to elicit motor evoked potentials (MEPs), overcoming the challenge of monitoring immature corticospinal tracts. Additionally, subdural strip electrodes were used …

Late-Onset Sciatic Nerve Compression Due To Distal Femoral Osteochondroma, I-Fan Hsieh, Tian-Shin Yeh

Rehabilitation Practice and Science

Osteochondroma is one of the most common benign bone tumors, typically asymptomatic, and rarely causes nerve compression. Previous case reports documented nerve compression by osteochondroma arising from the proximal fibula, pelvic bone, and spine. We report a rare case of osteochondroma at the distal femur causing sciatic nerve compression with symptom onset at 42 years old. This case highlights that osteochondroma can develop at any skeletal location, and even though these lesions typically cease to grow after skeletal maturity. Individuals with a history of osteochondroma should consider it as a differential diagnosis for new symptoms even in older age to …

Dysphagia In Becker Muscular Dystrophy: A Case Report And Literature Review, Chien-Ping Chen, Hung-Jui Chuang, Yi-Chi Li, Ming-Yen Hsiao, Tyng-Guey Wang

Rehabilitation Practice and Science

Dysphagia is a recognized complication in patients with muscular dystrophies, but its characteristics in Becker muscular dystrophy (BMD) remain underexplored. This case report describes a man with BMD who developed dysphagia, initially presenting with mild symptoms but later experiencing aspiration pneumonia with respiratory failure. He regained safe oral intake after swallowing training. Three years later, he suffered worsening dysphagia following a severe coronavirus disease-2019 (COVID-19) infection, ultimately losing the ability to resume oral feeding despite months of rehabilitation. Literature on swallowing disorder in BMD reported poor mastication, reduced laryngeal elevation, and increased pharyngeal residue; however, silent aspiration, as observed in …

Effectiveness Of Fu's Subcutaneous Needling In Pain Management And Rehabilitation: A Narrative Review, Po-En Chiu, Chun-Chang Wu, De-Jian Lu, Zhonghua Fu, Li-Wei Chou

Rehabilitation Practice and Science

Fu’s Subcutaneous Needling (FSN) is a modern needling technique distinct from traditional acupuncture, primarily used for musculoskeletal pain, neuropathic conditions, and emerging applications in rehabilitation. FSN is also designated as a kind of dry needling focusing on deactivating myofascial trigger points. This review categorizes FSN-related studies into case reports, clinical trials, and animal studies, evaluating its therapeutic efficacy, safety, and mechanisms. Case reports suggest that FSN provides rapid pain relief and functional improvement, while clinical trials, including randomized controlled trials (RCTs), support its role in reducing pain and enhancing neuromuscular function despite limitations in sample size and protocol consistency. Animal …

Immersive Computer-Assisted And Traditional Balance Training Methods On Balance Performance In Young Athletes: A Randomized Comparative Study, Hsien-I Lai, Yun-Hsin Huang, Chen-Yu Chien, Chung-Lan Kao

Rehabilitation Practice and Science

Introduction: Balance is essential for athletic performance. This study compared immersive computer-assisted balance training using the Bertec Balance Advantage CDP/IVR system with traditional soft mat training in young athletes.

Methods: Twenty-two young athletes were randomly assigned to a soft mat group (n = 10) or a Bertec group (n = 12). Both groups completed four training sessions over two weeks. Balance was assessed pre- and post-training using the Sensory Organization Test (SOT), Limits of Stability (LOS) test, and Dynamic Visual Acuity (DVA) test. Two-way mixed ANOVA and Bonferroni-corrected post-hoc analyses were performed.

Results: Both groups improved in postural stability and …

Ultrasound-Guided Injection In Meralgia Paresthetica: A Narrative Review, Jia-Chi Ko, Tyng-Guey Wang, Shaw-Gang Shyu

Rehabilitation Practice and Science

Meralgia paresthetica (MP) is a neuropathic pain syndrome resulting from compression or irritation of the lateral femoral cutaneous nerve (LFCN). Traditional diagnostic approaches rely on clinical assessments and electrodiagnostic testing. Ultrasound has emerged as a non-invasive, cost-effective modality for detailed visualization of the LFCN and guiding treatment interventions.

This review explores the anatomical considerations of the LFCN, its common etiological factors, clinical presentation, current management strategies, and ultrasound-guided injection techniques. While LFCN exhibits notable anatomical variability, and it is susceptible to external compression near the inguinal ligament. Some potential causes reveal as obesity, diabetes mellitus, or surgical interventions. Patients typically …

Ultrasound-Guided Percutaneous Needle Barbotage And Ultrasonic Tenotomy For Rotator Cuff Calcific Tendinopathy, Toru Omodani

Rehabilitation Practice and Science

Rotator cuff calcific tendinopathy (RCCT) is a common source of shoulder pain caused by calcium deposits within the rotator cuff tendons. Ultrasound-guided interventions have emerged as effective, minimally invasive alternatives to surgery for symptomatic cases unresponsive to conservative treatments. This review summarizes two primary techniques: percutaneous needle barbotage and percutaneous ultrasonic tenotomy. In needle barbotage, one or two needles are inserted under ultrasound guidance to inject and aspirate saline, thereby fragmenting and removing the calcific deposit. This method yields rapid pain relief and improved shoulder function, with follow-up imaging often demonstrating near-complete deposit resolution. For particularly hard or recalcitrant deposits, …

Safety In Dry Needling: The Role And Contributions Of The International Dry Needling Education & Training Advisory Group (Idnetag), W Mahmoud, J. Dommerholt

Rehabilitation Practice and Science

Dry needling is an intervention that physical therapists use to address various neuromusculoskeletal pain syndromes, primarily through targeting myofascial trigger points (TrPs) in muscle tissue. This technique involves inserting thin filiform needles into specific areas to relieve pain and improve movement. Despite its therapeutic potential, concerns regarding adverse events (AEs) necessitate stringent safety protocols and guidelines. In response, the International Dry Needling Education & Training Advisory Group (IDNETAG) was established in 2023 with members from diverse professions across eight countries. IDNETAG's mission is to enhance global standards of practice, focusing on safety, education, and consistency in treatment protocols. Research indicates …

A Rare Case Of Bilateral Supraspinatus Tendon Tears With Unilateral Musculotendinous Junction Involvement In An Elderly Patient, Kanyamas Poompreecha, Patsaree Pattanasuwanna, Ya-Chu Hsu

Rehabilitation Practice and Science

Rotator cuff (RC) tears are a common cause of shoulder pain in the elderly, though tears at the musculotendinous junction (MTJ) are uncommonly observed. We present a rare case of bilateral supraspinatus tendon tears in a 68-year-old male, with unilateral involvement of the MTJ. Symptoms developed three months after resuming resistance training following left acromioclavicular dislocation surgery. Ultrasound revealed a full-thickness insertional tear on the left and a partial MTJ tear on the right. Conservative treatment led to symptom resolution without surgery. This case highlights the diagnostic value of dynamic ultrasound for subtle rotator cuff and MTJ lesions in elderly …