小结
定义
病史和体格检查
关键诊断因素
- 滑囊部位疼痛
- 滑囊部位触痛
- 关节主动活动范围减小
其他诊断因素
- 存在的危险因素
- 低热（化脓性滑囊炎
- 肿胀
- 红斑（化脓性滑囊炎
- 皮肤表面温度升高（化脓性滑囊炎
- 肩关节外展时的疼痛弧（肩峰下
- 髋关节外侧疼痛（大转子
- 髋关节旋转、外展或内收到极限时疼痛（大转子
- 髋外展肌抗阻力收缩时疼痛（大转子
- 假性神经根痛：疼痛向下放射至大腿外侧（大转子）
- 无法触及髌骨（髌前
- 足跟后触及包块（跟骨后
危险因素
- 导致滑囊机械应力增加的职业
- 类风湿关节炎
- 痛风或假性痛风
- 穿通伤
- 髋关节骨性关节炎
- 邻近关节感染
- 下肢不等长
- 髂胫束挛缩
- 腰椎退变性关节炎
- 膝外翻畸形
- 低帮鞋
- 喙肩弓下的解剖性或功能性撞击
诊断性检查
首要检查
- 临床诊断
需考虑的检查
- 抽吸液革兰染色及细菌培养
- 晶体分析
- 受累区域的X线检查
- 核磁共振成像 (MRI)
治疗流程
非化脓性滑囊炎
化脓性滑囊炎
撰稿人
作者
Nicola Maffulli, MD, MS, PhD, FRCS(Orth)
Centre Lead and Professor of Sports and Exercise Medicine
Consultant Trauma and Orthopaedic Surgeon
Queen Mary University of London
Barts and The London School of Medicine and Dentistry
William Harvey Research Institute
Centre for Sports and Exercise Medicine
Mile End Hospital
London
UK
利益声明
NM is an author of a number of references cited in this topic.
Umile Giuseppe Longo, MD, MSc
Specialist in Orthopaedic and Trauma Surgery
Department of Orthopaedic and Trauma Surgery
Campus Bio-Medico University
Trigoria
Rome
Italy
利益声明
UGL is an author of a number of references cited in this topic.
Vincenzo Denaro, MD
Professor and Head of Orthopaedic and Trauma Surgery
Dean of the Faculty of Medicine
Campus Bio-Medico University
Trigoria
Rome
Italy
利益声明
VD declares that he has no competing interests.
同行评议者
Kelton Burbank, MD
Orthopedic Surgeon
University of Massachusetts Medical School
Leominster
MA
利益声明
KB declares that he has no competing interests.
Franceso Oliva, MD, PhD
Specialist in Orthopedics and Trauma
Studi di Roma "Tor Vergata
Grottaferrata
Rome
Italy
利益声明
FO declares that he has no competing interests.
鉴别诊断
- 内侧半月板病变
- 内侧间室骨性关节炎
- 贝克囊肿
更多 鉴别诊断指南
- 临床知识总结：鹰嘴滑囊炎
- 临床知识总结：髌前滑囊炎
更多 指南
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