Herrera Joseph E, Stubblefield Michael D
New York-Presbyterian Hospital and Hospitals of Columbia and Cornell, New York, USA.
Arch Phys Med Rehabil. 2004 Dec;85(12):1939-42. doi: 10.1016/j.apmr.2004.06.065.
To report rotator cuff tendonitis as a complication of lymphedema and to discuss the possible etiology and treatment options.
Retrospective review of 8 cases.
University hospital outpatient clinic.
A total of 8 breast cancer patients with a history of lymphedema and ipsilateral shoulder pain.
Patients with lymphedema and ipsilateral shoulder pain were diagnosed with rotator cuff tendonitis if all of the following 3 tests were positive: supraspinatus test, Neers impingement test, and Hawkins impingement test. Patients diagnosed with rotator cuff tendonitis were prescribed a nonsteroidal anti-inflammatory drug (NSAID) and physical therapy (PT).
Improvement in symptoms of shoulder pain at a 4- to 6-week follow-up, as measured by visual analog scale (VAS).
Seven of 8 patients reported a subjective decrease in their symptoms of shoulder pain at a 4- to 6-week follow-up. The average improvement in shoulder pain as measured by VAS was a 4.5-point decrease from the original pain score given. One of 8 patients had a full-thickness supraspinatus tendon tear and required additional decongestive therapy and PT to obtain relief of symptoms.
Rotator cuff tendonitis is a complication of lymphedema caused by internal derangement of tendon fibers, which may be subject to impingement, functional overload, and intrinsic tendinopathy. Conservative treatment with NSAIDs and PT is a safe and effective treatment.
报告肩袖肌腱炎作为淋巴水肿的一种并发症，并探讨其可能的病因及治疗选择。
对8例病例进行回顾性分析。
大学医院门诊。
共有8例有淋巴水肿病史且同侧肩部疼痛的乳腺癌患者。
淋巴水肿且同侧肩部疼痛的患者，如果以下3项检查均为阳性，则诊断为肩袖肌腱炎：冈上肌试验、Neer撞击试验和Hawkins撞击试验。诊断为肩袖肌腱炎的患者给予非甾体类抗炎药（NSAID）和物理治疗（PT）。
在4至6周的随访中，通过视觉模拟量表（VAS）测量肩部疼痛症状的改善情况。
8例患者中有7例在4至6周的随访中报告肩部疼痛症状主观减轻。通过VAS测量，肩部疼痛的平均改善程度是较初始疼痛评分降低4.5分。8例患者中有1例冈上肌腱全层撕裂，需要额外的消肿治疗和PT以缓解症状。
肩袖肌腱炎是由肌腱纤维内部紊乱引起的淋巴水肿并发症，可能受到撞击、功能过载和原发性肌腱病的影响。使用NSAIDs和PT进行保守治疗是一种安全有效的治疗方法。
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