Walsworth Matthew K, Mills James T, Michener Lori A
Walter Reed Army Medical Center, Washington, DC, USA.
Phys Ther. 2004 Apr;84(4):359-72.
Suprascapular neuropathy, resulting in shoulder pain and weakness, is frequently misdiagnosed. The consequences of misdiagnosis can include inappropriate physical rehabilitation or surgical procedures. The purpose of this case report is to describe the differential diagnosis of suprascapular neuropathy.
Five patients were initially diagnosed with subacromial impingement syndrome and referred for physical therapy. Physical therapist examination findings were consistent with subacromial impingement syndrome and suprascapular neuropathy. Subsequent electrophysiologic testing confirmed the diagnosis of suprascapular neuropathy in all 5 patients.
The differential diagnosis of patients with suprascapular neuropathy includes subacromial impingement syndrome, rotator cuff pathology, C5-6 radiculopathy, and upper trunk brachial plexopathy. The diagnostic process and a table with key findings based on evidence and clinical experience is presented for differential diagnosis.
肩胛上神经病变可导致肩部疼痛和无力,常被误诊。误诊的后果可能包括不适当的物理康复或外科手术。本病例报告的目的是描述肩胛上神经病变的鉴别诊断。
5例患者最初被诊断为肩峰下撞击综合征并接受物理治疗转诊。物理治疗师的检查结果与肩峰下撞击综合征和肩胛上神经病变相符。随后的电生理测试证实所有5例患者均为肩胛上神经病变。
肩胛上神经病变患者的鉴别诊断包括肩峰下撞击综合征、肩袖病变、C5-6神经根病和臂丛上干病变。本文给出了基于证据和临床经验的诊断过程及关键发现的表格,用于鉴别诊断。