小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 肩部疼痛
- 肩部无力
- 主动关节活动度丧失
- 外旋试验可诱发疼痛和无力
- 空杯试验出现疼痛无力
其他诊断因素
- 三角肌疼痛
- 夜间痛
- 抬离试验出现疼痛无力
- 压腹试验诱发疼痛和无力
- Neer撞击试验诱发疼痛
- Hawkins撞击试验诱发疼痛
- 粘连性关节囊炎
危险因素
- 年龄 60 岁以上
- 反复过顶运动史
- 上方盂唇撕裂史
- 肩关节损伤
诊断性检查
首要检查
- X 线检查
需考虑的检查
- 诊断性注射
- 核磁共振成像 (MRI)
- 超声
- MRI关节造影术
- CT关节造影术
- CT 扫描
治疗流程
急性小型肩袖撕裂
急性中等/大型/巨大可修复性肩袖撕裂
急性不可修复性撕裂
慢性有症状的肩袖撕裂
撰稿人
作者
John D. Kelly IV, MD
Professor of Clinical Orthopaedic Surgery
Director of Sports Shoulder Service
Orthopaedic Surgery
University of Pennsylvania
Philadelphia
PA
利益声明
JDK declares that he has no competing interests.
鸣谢
Dr John D. Kelly would like to gratefully acknowledge Dr Robert J. Gionfriddo, Dr Jason Jacob, Dr Daniel J. Solomon, and Dr Michael G. Clarke, previous contributors to this topic.
利益声明
DJS serves as a speaker/course instructor for Arthrex Inc. and Pacific Medical Inc. and has received honoraria from both companies. RJG, JJ, and MGC declare that they have no competing interests.
同行评议者
Matthew T. Provencher, MD
Assistant Director
Orthopaedic Shoulder and Sports Surgery
Naval Medical Center San Diego
San Diego
CA
利益声明
MTP declares that he has no competing interests.
Radhakant Pandey, FRCS, McH(orth)
Consultant in Trauma and Orthopaedics
Department of Trauma and Orthopaedics
Leicester Royal Infirmary
Leicester
UK
利益声明
RP declares that he has no competing interests.
内容使用需遵循免责声明