Department of Physical Medicine and Rehabilitation, Turkish Armed Forces Rehabilitation Center, Gülhane Military Medical Academy, Ankara, Turkey.
J Rehabil Med. 2012 Feb;44(2):181-3. doi: 10.2340/16501977-0914.
We report here a case of neoplastic brachial plexopathy detected by musculoskeletal ultrasonography in a patient with chronic cervicobrachialgia.
METHODS/RESULTS: A 71-year-old man presented at Gülhane Military Medical Academy, Turkish Armed Forces Rehabilitation Center, Ankara, Turkey with a one-year history of cervicobrachial pain radiating to the left arm and numbness in the medial aspect of the left arm and hand. He could not tolerate magnetic resonance imaging because his pain was exacerbated by cervical extension. Radiographs of his chest and cervical spine were normal. Ultrasound examination of the left brachial plexus revealed segmental fusiform swelling, suggestive for a compressing lesion. Magnetic resonance imaging of the brachial plexus performed under general anaesthesia revealed a left apical lung tumour (Pancoast) infiltrating the brachial plexus.
Clinicians should consider neoplastic brachial plexopathy, which is an uncommon diagnosis, when evaluating patients with unrelenting and severe cervicobrachialgia. Musculoskeletal ultrasonography can be beneficial for examining brachial plexus lesions.
我们在此报告一例因慢性颈臂痛而行肌肉骨骼超声检查发现的肿瘤性臂丛神经病。
方法/结果:一名 71 岁男性因颈臂痛一年,向左臂放射,左手臂和手内侧麻木而就诊于土耳其武装部队康复中心安卡拉的古尔哈尼军事医学院。因颈椎伸展时疼痛加剧,他无法耐受磁共振成像检查。他的胸部和颈椎 X 线片正常。左侧臂丛超声检查显示节段性梭形肿胀,提示受压病变。在全身麻醉下进行的臂丛磁共振成像显示左侧肺尖部肿瘤(潘科斯特瘤)侵犯臂丛。
当评估持续且严重的颈臂痛患者时,临床医生应考虑不常见的诊断——肿瘤性臂丛神经病。肌肉骨骼超声检查有助于检查臂丛病变。