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Article
April 1941

RELATION OF THE SCALENUS ANTICUS MUSCLE TO PAIN IN THE SHOULDERDIAGNOSTIC AND THERAPEUTIC VALUE OF PROCAINE INFILTRATION

Author Affiliations

Associate in Surgery, University of Pennsylvania; Associate in Surgery, the Mount Sinai Hospital PHILADELPHIA
From the Surgical Outpatient Department of the Hospital of the University of Pennsylvania and from the Surgical Service of Dr. B. Lipshutz, the Mount Sinai Hospital.

Arch Surg. 1941;42(4):739-757. doi:10.1001/archsurg.1941.01210100099010
Abstract

Pain in the region of the shoulder and arm is a frequent diagnostic and therapeutic problem. Such pain has often been attributed to some form of subacromial bursitis, of traumatic origin, of the chronic type with adhesions or of the acute or chronic type due to calcified deposits in the supraspinatus tendon, although the evidence in favor of the diagnosis was in many instances unconvincing. It was always difficult to understand the radiation of pain to the neck and down the arm as due to a bursal lesion, but Codman's observations so exactly fit the clinical picture that I was inclined to accept his explanation of a "pseudoneuritis." Codman,1 in writing on calcified deposits in the supraspinatus tendon, said: "If there has been a long, painful stage all the adjoining nerves become sensitized and the phenomena we call 'neuritis' supervene."... "The pain or hyperesthesia, originally mainly felt in the

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