医学专题—肩袖损伤.ppt

肩袖损伤(sǔnshāng)肩袖损伤(sǔnshāng)的流行病学当我们在临床上遇到疑似病人，只有X片而无MRI检查时，
1我们能从X片中得到(dédào)什么信息？
2我们印象中的可疑诊断有哪些？
3针对性的体查有哪些？

GazzolaS,BleakneyRR.Currentimagingoftherotatorcuff[J].SportsMedArthrosc,
2011,19(3):300-9.TypeIcalcificationwithafluffy,fleecyappearancewithpoorlydefinedborders,withacutesymptomsandtermedtheresorptivephase.
TypeIIcalcification,morediscreetandofhomogenousdensity,withwell-circumscribedborders,andintheformativephase.2可疑(kěyí)诊断3针对肩袖损伤(sǔnshāng)的体查2fullcantest

1)90degreesinthehorizontalplane
2)rotated45degreesexternally
3)withthethumbpointingupwardpainfularctest
60°-120°

1)shoulderinexternalrotation
2)palmfacingup
4resistedisometricabduction

1)thearminneutralrotation
2)abductsthearmto90degrees
1externalrotationstrengthtest=Patte’stest

1)thepatient’selbowin90degrees
2)intheplaneofthescapula
2externalrotationlagsign

1)elbowpassivelyflexedto90degrees
2)maximalexternalrotation
3dropsign

1)almostfullexternalrotation
2)elbowflexedat90degrees4weaknesswithexternalrotation

1)elbowsflexedto90degrees
2)thethumbsup
3)shouldersrotatedinternally20degrees3肩胛(jiānjiǎ)下肌肩内旋、后伸功能2internalrotationlagsign
3bellypress
4bearhugtest
4针对(zhēnduì)肩峰下撞击综合症的体查Hawkins-Kennedytest关于(guānyú)MRI解剖(jiěpōu)足印（footprint）关于(guānyú)MRI正常(zhèngcháng)肩袖的MRI斜矢状面正常(zhèngcháng)肩袖的MRI横断面损伤(sǔnshāng)肩袖的MRI魔法(mófǎ)角magicanglephenomenon
thefibersareat55degreestothemainmagneticfieldonT1
EricksonSJ,ProstRW,TiminsME.The“magicangle”effect:backgroundphysicsandclinicalrelevance.Radiology.1993;188:23-25.我们(wǒmen)在MRI上应得到的信息肩袖走行及连续性脂肪(zhīfáng)渗透（fattyinfiltration）肌肉(jīròu)萎缩（muscleatrophy）肩袖损伤(sǔnshāng)的分类肩袖损伤(sǔnshāng)的分类肩袖损伤(sǔnshāng)的治疗肩袖损伤(sǔnshāng)的治疗开放手术(shǒushù)骨质端的固定肩袖损伤(sǔnshāng)的治疗不可修复肩袖损伤(sǔnshāng)的判定and2)fattyinfiltrationoftherotatorcuffmusclesatstagethreeorgreater.不可修复肩袖损伤(sǔnshāng)的治疗
latissimusdorsitransfers

一篇关于背阔肌修复巨大撕裂肩袖损伤(sǔnshāng)的系统评价结果显示：在45.5个月的随访期内，Constantscore,activeforwardelevation和activeexternalrotation术后明显优于术前。谢谢(xièxie)！内容(nèiróng)总结