Stallenberg Bernard, Destate Nathalie, Feipel Véronique, Gevenois Pierre Alain
Department of Radiology, Université Libre de Bruxelles and Erasme Hospital, Route de Lennik 808, Brussels 1170, Belgium.
AJR Am J Roentgenol. 2006 Oct;187(4):894-900. doi: 10.2214/AJR.05.0351.
The purpose of our study was to verify that increased widening of the anterior portion of the subacromial-subdeltoid bursa is associated with anteromedial shoulder pain.
Bursography, sonography, and CT were performed in six cadaver shoulders and compared with anatomic sections in neutral position and while the humerus was extended and internally rotated. For the clinical study, the width of the anterior portion of the bursa was measured in both positions in both shoulders of 27 patients referred because of shoulder pain and in eight asymptomatic volunteers. Pain was coded as absent, experienced in the anteromedial portion of the shoulder, or experienced elsewhere but not anteromedially, and we compared the pain scores between shoulder positions.
In all cadaver shoulders, when compared with CT scans and anatomic sections, sonography showed the morphology of the bursa, its relationships with surrounding structures, and morphologic changes associated with position. In volunteers, the mean width of the bursa was 0.74 +/- 0.05 and 0.93 +/- 0.09 mm (p = 0.013), respectively, in neutral and stress position. In patients, the same values were 0.70 +/- 0.07 and 0.81 +/- 0.14 mm (p = 0.286) in the asymptomatic side and 1.20 +/- 0.11 and 1.75 +/- 0.23 mm (p < 0.001) in the symptomatic side, respectively. The bursa was wider in patients experiencing pain anteromedially than in those who experienced pain elsewhere and volunteers (p = 0.002 and < 0.001, respectively), and the bursa was wider in symptomatic shoulders than in asymptomatic shoulders (p < 0.001).
Widening of the anterior portion of the subacromial-subdeltoid bursa is associated with anteromedial shoulder pain and the clinical syndrome of coracoid impingement.
本研究的目的是验证肩峰下 - 三角肌下滑囊前部增宽与肩部前内侧疼痛相关。
对6具尸体肩部进行囊造影、超声检查和CT检查，并与中立位以及肱骨伸展和内旋时的解剖切片进行比较。对于临床研究，测量了27例因肩部疼痛前来就诊的患者以及8名无症状志愿者双肩在两种体位下的滑囊前部宽度。疼痛分为无疼痛、肩部前内侧疼痛或其他部位疼痛但非前内侧疼痛，并比较了不同肩部体位下的疼痛评分。
在所有尸体肩部中，与CT扫描和解剖切片相比，超声检查显示了滑囊的形态、其与周围结构的关系以及与体位相关的形态变化。在志愿者中，中立位和应力位下滑囊的平均宽度分别为0.74±0.05和0.93±0.09毫米（p = 0.013）。在患者中，无症状侧相同数值分别为0.70±0.07和0.81±0.14毫米（p = 0.286），有症状侧分别为1.20±0.11和1.75±0.23毫米（p < 0.001）。肩部前内侧疼痛的患者滑囊比其他部位疼痛的患者和志愿者更宽（分别为p = 0.002和< 0.001），有症状的肩部滑囊比无症状的肩部更宽（p < 0.001）。
肩峰下 - 三角肌下滑囊前部增宽与肩部前内侧疼痛及喙突撞击临床综合征相关。
