Baring Toby, Emery Roger, Reilly Peter
Imperial College, St Mary's Hospital, London W2 1NY, UK.
Best Pract Res Clin Rheumatol. 2007 Apr;21(2):279-94. doi: 10.1016/j.berh.2006.12.001.
Disease of the rotator cuff is common. It is responsible for a high proportion of patients with shoulder pain presenting to general practice, causing work absenteeism and claims for sickness benefits. Rotator cuff disease (RCD) can often be managed in primary health care services, although some cases may require secondary referral. Both extrinsic and intrinsic factors to the cuff tendon are thought to be involved in the pathogenesis leading on to a spectrum of conditions ranging from sub-acromial bursitis to mechanical failure of the cuff tendon itself. Careful history and examination followed by pertinent investigation are essential to establish the correct diagnosis. The main aim of treatment is to improve symptoms and restore function of the affected shoulder. The majority of patients suffering from RCD can be managed by conservative means, but a shift in attitude has led to a significant number benefiting from invasive procedures ranging from decompression of the sub-acromial space to large, open procedures reconstructing the tendon itself.
肩袖疾病很常见。在因肩部疼痛前往全科诊所就诊的患者中，肩袖疾病占比很高，会导致旷工和疾病津贴索赔。肩袖疾病（RCD）通常可在初级卫生保健服务中得到处理，不过有些病例可能需要转诊至二级医疗机构。肩袖肌腱的外在因素和内在因素均被认为参与了发病机制，进而导致一系列病症，从肩峰下滑囊炎到肩袖肌腱本身的机械性失效。详细的病史采集、体格检查以及相关检查对于确立正确诊断至关重要。治疗的主要目标是改善症状并恢复患肩功能。大多数患有RCD的患者可通过保守方法进行处理，但观念的转变使得大量患者受益于从肩峰下间隙减压到大型开放性肌腱重建手术等侵入性手术。
