Bayam Levent, Ahmad Mudussar A, Naqui Syed Z, Chouhan Aroonkumar, Funk Lennard
Wrightingon Hospital, Wigan, England.
Am J Orthop (Belle Mead NJ). 2011 Jul;40(7):353-8.
We conducted a study to ascertain specific patterns of pain in patients with common shoulder disorders and to describe a comprehensive shoulder pain map. We prospectively studied 94 cases involving an upper limb pain map and correlated the maps with the final diagnoses made by 2 clinicians who were blinded to the pain map findings. Pattern, severity, and type of pain were specific to each common shoulder disorder. In subacromial impingement, pain was predominantly sharp, occurred around the anterior aspect of the shoulder, radiated down the arm, and was associated with dull, aching pain radiating to the hand. A similar pain pattern was found in rotator cuff tears. In acromioclavicular joint pathology, pain was sharp, stabbing, and well localized to the anterosuperior shoulder area. Glenohumeral joint arthritis was marked by the most severe pain, which occurred in a mixed pattern and affected the entire arm. Whereas the pain of instability was a mixture of sharp and dull pain, the pain of calcific tendonitis was severe and sharp. Both pains were limited to the upper arm and shoulder. Pain mapping revealed definitive patterns for shoulder pathologies. We advocate using pain maps as useful diagnostic guides and research tools.
我们开展了一项研究，以确定常见肩部疾病患者的特定疼痛模式，并描绘出一份全面的肩部疼痛图谱。我们前瞻性地研究了94例涉及上肢疼痛图谱的病例，并将这些图谱与2名对疼痛图谱结果不知情的临床医生做出的最终诊断进行关联。疼痛的模式、严重程度和类型因每种常见肩部疾病而异。在肩峰下撞击症中，疼痛主要为锐痛，发生在肩部前方周围，沿手臂向下放射，并伴有向手部放射的钝痛和隐痛。在肩袖撕裂中也发现了类似的疼痛模式。在肩锁关节病变中，疼痛为锐痛、刺痛，且局限于肩上前部区域。盂肱关节关节炎的特点是疼痛最为严重，呈混合模式，影响整个手臂。不稳定的疼痛是锐痛和钝痛的混合，钙化性肌腱炎的疼痛则严重且尖锐。这两种疼痛都局限于上臂和肩部。疼痛图谱揭示了肩部病变的明确模式。我们主张将疼痛图谱用作有用的诊断指南和研究工具。
