Division of Physical Medicine and Rehabilitation, Stanford University School of Medicine, Palo Alto, California, USA.
Pain Pract. 2011 Jul-Aug;11(4):392-6. doi: 10.1111/j.1533-2500.2010.00424.x. Epub 2010 Nov 28.
The management of bicipital tendonitis can be challenging to the clinician. Traditionally, blind injections near the bicipital groove have been performed by clinicians with risk of bicipital tendon rupture or atrophy. Because of the inaccuracy and risk associated with blind bicipital tendon steroid injections, we sought to ascertain whether a fluoroscopically guided steroid injection into the region of the origin of the long head of the bicipital tendon (supraglenoid tubercle) was efficacious.
A retrospective chart review of 6 consecutive patients with a diagnosis of bicipital tendonitis was performed. All patients underwent a fluoroscopically guided steroid/anesthetic injection into the supraglenoid tubercle of the shoulder. The main outcome measure was post-procedure change in visual analog pain scale; the secondary outcome was the physical examination (presence of a Speed's test).
Ten cases were identified, but only 6 had complete data and were included in the analysis. Five of the 6 patients experienced a reduction in pain by 50% at follow-up.
A fluoroscopically guided block injected into the supraglenoid tubercle may be effective in the management of bicipital tendonitis.
二头肌肌腱炎的治疗对临床医生来说具有挑战性。传统上,临床医生在二头肌沟附近进行盲目注射,但存在二头肌肌腱断裂或萎缩的风险。由于盲目进行二头肌肌腱类固醇注射存在不准确性和风险,我们试图确定是否可以通过在长头二头肌肌腱(肩盂上结节)起点区域进行荧光引导类固醇注射来有效治疗。
对 6 例连续诊断为二头肌肌腱炎的患者进行了回顾性图表审查。所有患者均接受了荧光引导下的肩盂上结节类固醇/麻醉注射。主要观察指标为术后视觉模拟疼痛量表的变化;次要观察指标为体格检查(是否存在 Speed 试验阳性)。
共确定了 10 例,但只有 6 例有完整的数据并纳入分析。6 例患者中有 5 例在随访时疼痛减轻了 50%。
荧光引导下注射至肩盂上结节的阻滞可能对二头肌肌腱炎的治疗有效。