المؤلفون: Géraldine Bart, Benoit Le Goff, Laurie Charret, Grégoire Cormier, David Boutoille, Emmanuelle Dernis, Christelle Darrieutort-Laffite, Emmanuel Hoppe

المصدر: Journal of Antimicrobial Chemotherapy. 76:3029-3032

مصطلحات موضوعية: Male, 0301 basic medicine, Microbiology (medical), medicine.medical_specialty, Bursitis, medicine.drug_class, Olecranon, 030106 microbiology, Antibiotics, medicine.disease_cause, Septic bursitis, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Antibiotic therapy, Elbow Joint, medicine, Humans, Pharmacology (medical), Olecranon Process, Pharmacology, 030222 orthopedics, Streptococcus, business.industry, Bacterial Infections, Middle Aged, medicine.disease, Comorbidity, Anti-Bacterial Agents, Infectious Diseases, medicine.anatomical_structure, Cellulitis, Female, business

الوصف: Background No current guidelines are available for managing septic bursitis (SB). Objectives To describe the clinical characteristics and management of olecranon and prepatellar SB in five French tertiary care centres. Methods This is a retrospective observational multicentre study. SB was diagnosed on the basis of positive cultures of bursal aspirate. In the absence of positive bursal fluid, the diagnosis came from typical clinical presentation, exclusion of other causes of bursitis and favourable response to antibiotic therapy. Results We included 272 patients (median age of 53 years, 85.3% male and 22.8% with at least one comorbidity). A microorganism was identified in 184 patients (67.6%), from bursal fluids in all but 4. We identified staphylococci in 135 samples (73.4%), streptococci in 35 (19%) and 10 (5.5%) were polymicrobial, while 43/223 bursal samples remained sterile (19.3%). Forty-nine patients (18%) were managed without bursal fluid analysis. Antibiotic treatment was initially administered IV in 41% and this route was preferred in case of fever (P = 0.003) or extensive cellulitis (P = 0.002). Seventy-one (26%) patients were treated surgically. A low failure rate was observed (n = 16/272, 5.9%) and failures were more frequent when the antibiotic therapy lasted Conclusions Despite variable treatments, SB resolved in the majority of cases even when the treatment was exclusively medical. The success rate was equivalent in the non-surgical and the surgical management groups. However, a treatment duration of

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::dafaeae5cf13b4a9e6db087760bf84c9Test
https://doi.org/10.1093/jac/dkab265Test

المؤلفون: Jean-Marie Berthelot, Christelle Darrieutort-Laffite, Benoît Le Goff

المصدر: Joint bone spine. 89(6)

مصطلحات موضوعية: Arthritis, Rheumatoid, Rheumatology, Humans, Dysbiosis, CTLA-4 Antigen, Genetic Predisposition to Disease, Protein Tyrosine Phosphatase, Non-Receptor Type 22, HLA-DRB1 Chains

الوصف: This narrative review gathers current evidence for a contribution of rheumatoid arthritis (RA) HLA-DRB1, PTPN22 and CTLA4 polymorphisms to the gut dysbiosis observed in RA, especially at its onset (transient excess of Prevotella). The gut microbiome contains elements which are 30% heritable, including genera like Bacteroides and Veillonella, and to a lesser extent Prevotella. The first months/year seems a critical period for the selection of a core of microbiota, that should be considered as a second self by the immune system, and tolerized by regulatory T and B cells. Imperfect tolerization may increase the risk of RA following further repeated silent translocations of various gut microorganisms, including Prevotella copri, from gut to joints (fostered by a concurrent loss in gut mucosa of protective bacteria like Faecalibacterium prausnitzii). Genetics studies confirmed that Prevotella copri was partly heritable, and strong associations were observed between the overall microbial composition of stools and the HLA-DRB1 RA risk allele, either in a US cohort (P=0.00001), or the Twins UK cohort (P=0.033). This finding also stands for persons still free from RA, and was replicated in the Swiss SCREEN-RA cohort. Gene variants of PTPN22 also modify intestinal microbiota composition, compromise granulocyte-mediated antibacterial defence in gut, and reduce the suppressive effect of gut regulatory B cells. CTLA4 variants may similarly contribute to RA dysbiosis, since immunotherapy by CTLA-4 blockade depends on microbiota, and CTLA4 activates T follicular regulatory cells to reduce immune responses to segmented filamentous bacteria. Suggestions for future works are made.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::01c4af7fbf15f516368cd8f205f95370Test
https://pubmed.ncbi.nlm.nih.gov/35940545Test

المؤلفون: Robert Touitou, Géraldine Bart, Marion Couderc, E. Veillard, Pascal Guggenbuhl, P. Coquerelle, Sophie Godot, Christian Lormeau, Denis Mulleman, Guillaume Coiffier, Carine Salliot, Marion Baldeyrou, Beate Hyem, Jean-Marc Ziza, Thomas W. Bauer, René-Marc Flipo, Christelle Darrieutort-Laffite, Raphaèle Seror, Bernard Fouquet, Louis Bernard

المساهمون: Imagerie Moléculaire et Stratégies Théranostiques (IMoST), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne (UCA), CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand

المصدر: Joint Bone Spine
Joint Bone Spine, 2020, 87 (6), pp.538-547. ⟨10.1016/j.jbspin.2020.07.012⟩
Joint Bone Spine, Elsevier Masson, 2020, 87 (6), pp.538-547. ⟨10.1016/j.jbspin.2020.07.012⟩

مصطلحات موضوعية: Adult, Staphylococcus aureus, medicine.medical_specialty, medicine.drug_class, [SDV]Life Sciences [q-bio], Antibiotics, 03 medical and health sciences, 0302 clinical medicine, Rheumatology, Internal medicine, Humans, Medicine, Streptococcus gallolyticus, 030212 general & internal medicine, Medical diagnosis, Intensive care medicine, ComputingMilieux_MISCELLANEOUS, Language, 030203 arthritis & rheumatology, Arthritis, Infectious, business.industry, Staphylococcal Infections, medicine.disease, Anti-Bacterial Agents, 3. Good health, Joint aspiration, Infective endocarditis, Septic arthritis, business, Trauma surgery

الوصف: Septic arthritis (SA) in an adult native joint is a rare condition but a diagnostic emergency due to the morbidity and mortality and the functional risk related to structural damage. Current management varies and the recommendations available are dated. The French Rheumatology Society (SFR) Bone and Joint Infection Working Group, together with the French Language Infectious Diseases Society (SPILF) and the French Orthopaedic and Trauma Surgery Society (SOFCOT) have worked according to the HAS methodology to devise clinical practice recommendations to diagnose and treat SA in an adult native joint. One new focus is on the importance of microbiological documentation (blood cultures and joint aspiration) before starting antibiotic treatment, looking for differential diagnoses (microcrystal detection), the relevance of a joint ultrasound to guide aspiration, and the indication to perform a reference X-ray. A cardiac ultrasound is indicated only in cases of SA involving Staphylococcus aureus, oral streptococci, Streptococcus gallolyticus or Enterococcus faecalis, or when infective endocarditis is clinically suspected. Regarding treatment, we stress the importance of medical and surgical collaboration. Antibiotic therapies (drugs and durations) are presented in the form of didactic tables according to the main bacteria in question (staphylococci, streptococci and gram-negative rods). Probabilistic antibiotic therapy should only be used for patients with serious symptoms. Lastly, non-drug treatments such as joint drainage and early physical therapy are the subject of specific recommendations.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::e9308e225fae67b0cbfb68fa506305f5Test
https://doi.org/10.1016/j.jbspin.2020.07.012Test

المؤلفون: Claire Bernier, Hélène Aubert, Jean-Marie Berthelot, Antoine Néel, Christian Agard, Sébastien Barbarot, Benoit Le Goff, Mohamed Hamidou, Agathe Masseau, Françoise Kraeber-Bodéré, Christelle Darrieutort-Laffite, Catherine Ansquer

المصدر: Arthritis Research & Therapy, Vol 22, Iss 1, Pp 1-10 (2020)
Arthritis Research & Therapy

مصطلحات موضوعية: Male, medicine.medical_specialty, lcsh:Diseases of the musculoskeletal system, Interleukin 1 receptor antagonist, Single Center, Cohort Studies, 030207 dermatology & venereal diseases, 03 medical and health sciences, 0302 clinical medicine, Schnitzler syndrome, Musculoskeletal Pain, Internal medicine, medicine, Humans, Bone pain, Retrospective Studies, business.industry, Waldenstrom macroglobulinemia, Retrospective cohort study, Bone scan, medicine.disease, Rash, Rheumatology, Bone lesions, Cohort, Female, medicine.symptom, lcsh:RC925-935, business, 030215 immunology, Research Article, Follow-Up Studies

الوصف: Objective To report on the characteristics and long-term course of rheumatic manifestations in Schnitzler syndrome (SchS). Methods A retrospective cohort study of patients with SchS followed between 2000 and 2020. Inclusion criteria included a diagnosis of SchS (Strasbourg criteria). All available bone scans were reviewed and scored according to the intensity and number of pathological sites. The scintigraphic score was compared with the clinical activity score, CRP level, and treatments. Results Twenty-five patients were included. Median age at diagnosis was 68 years. Eighty patients (72%) had SchS-related rheumatic pain. Most patients had a long-standing isolated rash before constitutional and/or rheumatic symptoms appeared. The monoclonal component level was usually very low (IgMκ in 22/25). Rheumatic pain predominated around the knees. Bone scans revealed abnormal tracer uptake in 15/18 (85%). The scintigraphic score correlated with clinical activity (r = 0.4, p r = 0.47, p p Conclusions Rheumatic manifestations are very prevalent in SchS. However, bone pain can be misleading and contribute to misdiagnosis. Bone scan abnormalities are very prevalent and correlate with disease activity and treatments. IL1-Ra has a dramatic and durable efficacy but may not be required in every patient early on.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::52bd4540be4dcd843b01445f9f1276c5Test
http://link.springer.com/article/10.1186/s13075-020-02318-5Test

المؤلفون: Stéphane Ploteau, Benoit Le Goff, Jean-Marie Berthelot, Christelle Darrieutort-Laffite, Frédéric Douane

المصدر: Joint bone spine. 89(2)

مصطلحات موضوعية: business.industry, Spinal stenosis, Hyperemia, Anatomy, medicine.disease, Thrombosis, Venous stasis, medicine.anatomical_structure, Rheumatology, Pregnancy, Tissue Plasminogen Activator, Vasa nervorum, medicine, Humans, Female, Arachnoiditis, Radiculopathies, business, Varices, Vein, Radiculopathy, Spinal Nerve Roots, Intervertebral Disc Displacement

الوصف: Compression of roots/nerves can disrupt some of their functions, but does not necessarily cause pain. This is illustrated by the frequency of nearly asymptomatic spinal stenosis or disc herniations. In fact, pain of radiculopathies (and nerve entrapments) may mostly be the consequence of intraneural oedema induced by microscopical venous stasis around roots/spinal ganglia (or nerves) not or poorly shown by imaging. This narrative review first lists arguments for a role of congestion of vasa-nervorum in the pathophysiology of radiculopathies, including those induced by disc herniation and spinal stenosis, but also other sources of overpressures in spinal venous plexuses (pregnancy, vena cava atresia and thrombosis, portal hypertension, epidural varices, arterio-venous fistula, vertebral hemangioma or hemangioblastoma). It also details sources of venous congestion around nerves outside the spine, from pelvis (May-Thurner syndrome, Nut-cracker syndrome) to buttocks (superior and inferior gluteal veins), and even thighs and legs. A better recognition of a preeminent role of venous congestion in radiculopathies, plexopathies, and nerve entrapments, should have major consequences: (i) discard the dogma that compression is mandatory to induce root/nerve suffering, since root/nerve adherences in two locations can impair blood flow in vasa-nervorum through root/nerve stretching; (ii) implementation of sensitive techniques to visualise impingement of blood flow around or within roots and nerves; (iii) better prevention of roots/nerves adherence, or arachnoiditis induced by extravascular fibrin deposition secondary to venous stasis.; (iv) optimizing treatments dampening clot formation and/or extravascular fibrin leakage in the intradural/peridural spaces, or around roots/nerves, like guided injection of tissue plasminogen activator.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::882023f8cc3172e7a7bb0c801c413ab5Test
https://pubmed.ncbi.nlm.nih.gov/34653602Test

المؤلفون: Caroline Trang, Jean-Marie Berthelot, Yves Maugars, Christelle Darrieutort-Laffite, Benoit Le Goff

المصدر: Joint bone spine. 88(6)

مصطلحات موضوعية: Mycobiota, Innate immune system, biology, business.industry, Microbiota, Fungi, Chromosomal translocation, biology.organism_classification, medicine.disease, Fungal antigen, Microbiology, Gastrointestinal Microbiome, Pathogenesis, CARD Signaling Adaptor Proteins, Mice, Rheumatology, Antigen, Spondylarthritis, Medicine, Animals, Dysbiosis, Humans, business, Bacteria

الوصف: This review lists current evidences for a contribution of gut mycobiota to the pathogenesis of SpA and related conditions. Gut mycobiota has a small size as compared to bacterial microbiota, but an even greater inter- and intra-individual variability. Although most fungi (brought by food or air) are only transitory present, a core mycobiota of gut resident fungi exists, and interplays with bacteria in a complex manner. A dysbiosis of this gut mycobiota has been observed in Crohn's disease and sclerosing cholangitis, with decreased proportion of Saccharomyces cerevisiae and outgrowth of more pathogenic gut fungi. Fungal-induced lower number of commensal gut bacteria can promote translocation of some bacterial/fungal antigens through mucosae, and live fungi can also cross the epithelial border in Crohn's disease. This dysbiosis also lower the ability of bacteria to metabolize tryptophan into regulatory metabolites, consequently enhancing tryptophan metabolism within human cells, which might contribute to fatigue. Translocation of mycobiotal antigens like curdlan (beta-glucan), which plays a major role in the pathogenesis of SpA in the SGK mice, has been observed in humans. This translocation of fungal antigens in human SpA might account for the anti-Saccharomyces antibodies found in this setting. Contribution of fungal antigens to psoriasis and hidradenitis suppurativa would fit with the preferential homing of fungi in the skin area most involved in those conditions. Fungal antigens also possess autoimmune uveitis-promoting function. As genes associated with SpA (CARD9 and IL23R) strongly regulate the innate immune response against fungi, further studies on fungi contribution to SpA are needed.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::eb9c2609c7db856b5156dfbf9e51520cTest
https://pubmed.ncbi.nlm.nih.gov/34166798Test

المؤلفون: Benoit Le Goff, Jean-David Albert, Nicolas Dumoulin, Guillaume Coiffier, Grégoire Cormier, Stéphane Varin, Christelle Darrieutort-Laffite

المصدر: The American journal of sports medicine. 49(4)

مصطلحات موضوعية: medicine.medical_specialty, Percutaneous, Physical Therapy, Sports Therapy and Rehabilitation, law.invention, 03 medical and health sciences, Rotator Cuff, 0302 clinical medicine, Randomized controlled trial, law, Shoulder Pain, Post-hoc analysis, medicine, Effective treatment, Humans, Orthopedics and Sports Medicine, Rotator cuff, Calcific tendinopathy, Therapeutic Irrigation, Ultrasonography, Interventional, 030203 arthritis & rheumatology, 030222 orthopedics, business.industry, Calcific tendinitis, medicine.disease, Ultrasound guided, Surgery, medicine.anatomical_structure, Treatment Outcome, Case-Control Studies, Tendinopathy, business

الوصف: Background: Calcific tendinitis of the rotator cuff is a frequent cause of shoulder pain. Ultrasound-guided percutaneous lavage (UGPL) is an effective treatment, but factors associated with good clinical and radiological outcomes still need to be identified. Purpose: To study the clinical, procedural, and radiological characteristics associated with improved shoulder function and the disappearance of calcification on radiograph after UGPL. Study Design: Case-control study; Level of evidence, 3. Methods: This is a post hoc analysis of the CALCECHO trial, a double-blinded randomized controlled trial conducted on 132 patients. The trial assessed the effect of corticosteroid injections after UGPL, and patients were randomly assigned to receive either corticosteroid or saline solution in the subacromial bursa. We analyzed all patients included in the randomized controlled trial as 1 cohort. We collected the patients’ clinical, procedural, and radiological characteristics at baseline and during follow-up (3, 6, and 12 months). Univariable analysis, followed by multivariable stepwise regression through forward elimination, was performed to identify the factors associated with clinical success (Disabilities of the Arm, Shoulder and Hand [DASH] score Results: Good clinical outcomes at 3 months were associated with steroid injections after the procedure (odd ratio [OR], 3.143; 95% CI, 1.105-8.94). At 6 months, good clinical evolution was associated with a lower DASH score at 3 months (OR, 0.92; 95% CI, 0.890-0.956) and calcium extraction (OR, 10.7; 95% CI, 1.791-63.927). A lower DASH at 6 months was also associated with a long-term favorable outcome at 12 months (OR, 0.939; 95% CI, 0.912-0.966). Disappearance of calcification at 3 and 12 months occurred more frequently in patients in whom communication was created between the calcification and the subacromial bursa during the procedure (OR, 2.728 [95% CI, 1.194-6.234] at 3 months; OR, 9.835 [95% CI, 1.977-48.931] at 12 months). Importantly, an association between calcification resorption and good clinical outcome was found at each time point. Conclusion: Assessing patients at 3 months seems to be an essential part of their management strategy. Calcium extraction and creating a communication between the calcific deposits and subacromial bursa are procedural characteristics associated with good clinical and radiological evolution.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::e855bca0fe1586773a1e4c6ad4a64346Test
https://pubmed.ncbi.nlm.nih.gov/33719606Test

المؤلفون: Stéphane Varin, Grégoire Cormier, Lucie Planche, Benoit Le Goff, Guillaume Coiffier, Jean-David Albert, Christelle Darrieutort-Laffite, Yves Maugars

المصدر: Annals of the Rheumatic Diseases. 78:837-843

مصطلحات موضوعية: Adult, Male, Visual analogue scale, medicine.medical_treatment, Immunology, Equivalence Trials as Topic, Punctures, Methylprednisolone, General Biochemistry, Genetics and Molecular Biology, Injections, Intra-Articular, Rotator Cuff, 03 medical and health sciences, 0302 clinical medicine, Double-Blind Method, Rheumatology, Tendinitis, Shoulder Pain, Humans, Immunology and Allergy, Medicine, Therapeutic Irrigation, Glucocorticoids, Saline, Ultrasonography, Interventional, Pain Measurement, 030203 arthritis & rheumatology, Pain, Postoperative, 030222 orthopedics, Dry needling, business.industry, Calcinosis, Calcific tendinitis, Middle Aged, medicine.disease, Acute Pain, Treatment Outcome, Anesthesia, Tendinopathy, Female, Saline Solution, Subacromial bursa, business, Follow-Up Studies, medicine.drug, Calcification

الوصف: ObjectiveSteroid injections are common after an ultrasound-guided puncture and lavage (UGPL) of calcific tendonitis of the rotator cuff. However, steroids may prevent calcification resorption and negatively affect tendon healing. Our study was designed to determine whether saline solution was non-inferior to steroids in the prevention of acute pain reactions in the week following UGPL.MethodsThis was a randomised, double-blinded, controlled non-inferiority trial with 12-month follow-up. We included 132 patients (66 in each group) with symptomatic calcification measuring more than 5 mm. Patients received 1 mL of saline or steroid (methylprednisolone 40 mg) in the subacromial bursa at the end of UGPL. Primary outcome was the maximal pain during the week following the procedure with a prespecified non-inferiority margin of 10 mm (0–100 visual analogue scale). Secondary outcomes included pain at rest and during activity, function (disabilities of the arm, shoulder and hand score) and radiological evolution of the calcification over the 12-month follow-up.ResultsThe estimated mean difference in the first week’s maximal pain between these two groups was 11.76 (95% CI 3.78 to 19.75). Steroids significantly improved VAS pain at rest and during activities, as well as function at 7 days and 6 weeks. They did not change the rate of calcification resorption, which occurred in 83% and 74% of patients at 12 months in the saline and steroid groups.ConclusionNon-inferiority of saline when compared with steroids could not be established. However, steroid injection improved pain in the 6 weeks following the procedure, and function in the 3 months after, with no significant effect on calcification resorption.Trial registration numberNTC02403856.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::dcece3babe2a404951bc62970e939b9fTest
https://doi.org/10.1136/annrheumdis-2018-214971Test

المؤلفون: Catherine Chevalier, Julien Herman, Frédéric Blanchard, Julien De Lima, Christelle Darrieutort-Laffite, Benoit Le Goff, Régis Brion

المصدر: Arthritis Research & Therapy, Vol 23, Iss 1, Pp 1-11 (2021)
Arthritis Research & Therapy

مصطلحات موضوعية: 0301 basic medicine, Rotator cuff tendons, Pathology, medicine.medical_specialty, Myeloid, Inflammasomes, Interleukin-1beta, Inflammation, Diseases of the musculoskeletal system, Inflammasome, 03 medical and health sciences, 0302 clinical medicine, In vivo, Apatites, NLR Family, Pyrin Domain-Containing 3 Protein, medicine, Humans, Apatite, 030203 arthritis & rheumatology, Chemistry, Caspase 1, Air pouch model, Interleukin, medicine.disease, In vitro, 030104 developmental biology, medicine.anatomical_structure, RC925-935, Tendinopathy, Tumor necrosis factor alpha, medicine.symptom, Research Article, Interleukin-1, medicine.drug, Calcification

الوصف: Background Calcific tendonitis of the rotator cuff is due to carbonated apatite deposits in the shoulder tendons. During the evolution of the disease, an acute inflammatory episode may occur leading to the disappearance of the calcification. Although hydroxyapatite crystal-induced inflammation has been previously studied with synthetic crystals, no data are available with calcifications extracted from patients suffering from calcific tendinopathy. The objective of the study was to explore the inflammatory properties of human calcifications and the pathways involved. Methods Human calcifications and synthetic hydroxyapatite were used in vitro to stimulate human monocytes and macrophages, the human myeloid cell line THP-1, and human tenocytes. The release of IL-1β, IL-6, and IL-8 by cells was quantified by ELISA. The gene expression of pro- and anti-inflammatory cytokines was evaluated by quantitative PCR. NF-kB activation and NLRP3 involvement were assessed in THP-1 cells using a NF-kB inhibitor and a caspase-1 inhibitor. The inflammatory properties were then assessed in vivo using a mouse air pouch model. Results Human calcifications were able to induce a significant release of IL-1β when incubated with monocytes, macrophages, and THP-1 only if they were first primed with LPS (monocytes and macrophages) or PMA (THP-1). Stimulation of THP-1 by human calcifications led to similar levels of IL-1β when compared to synthetic hydroxyapatite although these levels were significantly inferior in monocytes and macrophages. The patient’s crystals enhanced mRNA expression of pro-IL-1β, as well as IL-18, NF-kB, and TGFβ when IL-6 and TNFα expression were not. IL-1β production was reduced by the inhibition of caspase-1 indicating the role of NLRP3 inflammasome. In vivo, injection of human calcifications or synthetic hydroxyapatite in the air pouch led to a significant increase in membrane thickness although significant overexpression of IL-1β was only observed for synthetic hydroxyapatite. Conclusions As synthetic hydroxyapatite, human calcifications were able to induce an inflammatory response resulting in the production of IL-1β after NF-kB activation and through NLRP3 inflammasome. In some experiments, IL-1β induction was lower with human calcifications compared to synthetic apatite. Differences in size, shape, and protein content may explain this observation.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::a18bc9d94eb8b9d074ab6b6da7d601edTest
https://doi.org/10.21203/rs.3.rs-156807/v1Test

المؤلفون: Charles Sougué, Christelle Darrieutort-Laffite, Yves Maugars, Benoit Le Goff

المصدر: Joint bone spine. 88(2)

مصطلحات موضوعية: medicine.medical_specialty, business.industry, Ultrasound, medicine.disease, Rotator Cuff Injuries, Rotator Cuff, medicine.anatomical_structure, Rheumatology, Tendon Injuries, medicine, Humans, Rotator cuff, Radiology, business, Calcification, Ultrasonography

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::37a71e1231090a7c78b90d3784e62903Test
https://pubmed.ncbi.nlm.nih.gov/33186733Test