最后审阅: 18 五月 2021
最后更新: 27 十月 2020

小结

定义

病史和体格检查

关键诊断因素

  • 重复性工作或涉及空中兴趣爱好/活动史
  • 上肢及其相邻部位疼痛
  • 手臂、手和/或手指感觉异常
  • 上肢循环改变
  • 上肢疲乏

其他诊断因素

  • 锁骨骨折史
  • 心血管或胸部手术史
  • 颈肋触诊
  • 肩周皮下静脉侧支形成(Urschel 征)
  • 运动无力
  • 多汗
  • 鱼际肌萎缩
  • 劳累性疼痛 / 跛行
  • 锁骨上心脏收缩期杂音
  • 四肢血压差异
  • Adson 氏试验(斜角肌)阳性
  • 肋锁试验阳性
  • 过度外展试验阳性
  • Roos 试验阳性
  • 拉伸试验阳性
  • 上肢张力试验阳性
  • Wright 式试验阳性
  • 上肢血肿 / 水肿

危险因素

  • 颈肋和颈椎骨异常
  • 创伤
  • 姿势不良
  • 重复性高强度的活动
  • 机动车撞击
  • 乳房大或植入物
  • 肥胖
  • 年龄(10 几岁至 60 岁)
  • 女性
  • 脊髓灰质炎病史
  • 妊娠
  • 正中胸骨切开术

诊断性检查

首要检查

  • 颈椎棘突 X 光
  • 胸部 X 线检查 (CXR)
  • 肌电图/神经传导速度
  • CT 血管造影术
  • 多普勒超声检查

需考虑的检查

  • 颈 / 锁骨 / 肩部 MRI
  • 肌肉阻滞检查
  • 传统动脉造影术
  • 磁共振血管成像 (MRA)
  • 静脉对比造影术
  • 磁共振静脉造影术 (MRV)
  • 全血细胞计数和凝血功能检查

治疗流程

撰稿人

Sports Medicine Fellow

Christiana Care Health Services

Department of Family and Community Medicine

Wilmington

DE

利益声明

CS is the author of a reference cited in this topic.

Associate Professor

Department of Family and Community Medicine

Jefferson Medical College

Thomas Jefferson University

Philadelphia

PA

利益声明

MIH is the author of a reference cited in this topic.

Dr Chaney Stewman and Dr Marc I. Harwood would like to gratefully acknowledge Dr Pedro K. Beredjiklian, Dr Peter C. Vitanzo, Dr Harold C. Urschel Jr, Rachel Montano, and Brenda Knee, previous contributors to this topic. PKB has stock ownership in Wright Medical Inc. PCV is the author of a reference cited in this topic. HCU is an author of several references cited in this topic. RM and BK declare that they have no competing interests.

同行评议者展开全部内容

Professor of Vascular Surgery

St. George's NHS Healthcare Trust

London

UK

利益声明

IL declares that he has no competing interests.

Assistant Professor

University of Colorado School of Medicine

Aurora

CO

利益声明

SRL is the author of a reference cited in this topic.

Chief

Cardiothoracic Surgery

University of Virginia School of Medicine

Charlottesville

VA

利益声明

JAK declares that he has no competing interests.

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