肩盂唇下副神经节囊肿伴盂唇撕裂——一种罕见的肩部疼痛病因。
Inferior paralabral ganglion cyst of the shoulder with labral tear -- a rare cause of shoulder pain.
机构信息
Department of Orthopedic Surgery, Daejeon St. Mary's Hospital, The Catholic University of Korea, 520-2, Deahung-Dong, Joong-Gu, Daejeon 302-803, Republic of Korea, Korea.
出版信息
Orthop Traumatol Surg Res. 2012 Apr;98(2):193-8. doi: 10.1016/j.otsr.2011.09.020. Epub 2012 Mar 3.
INTRODUCTION
Paralabral ganglion cysts of the shoulder are rare, and their pathogenesis is similar to that of meniscal cysts. The paralabral cysts are most frequently reported along the posterior, superior, and anterior aspects of the glenohumeral joint and are uncommon inferiorly to the joint. These cysts rarely become evident clinically, unless they cause compression of surrounding structures, i.e. nerve.
PATIENTS AND METHODS
We report a retrospective series of five patients with inferior paralabral ganglion cysts of the shoulder without compression of the surrounding nerve which were treated during the period from March 2007 to December 2009. All these patients presented with only chronic shoulder pain as their chief complaint, and preoperative MRI showed the cyst over the inferior aspect of a torn glenoid labrum. All patients were treated by arthroscopic cystic decompression with labrum repair. All patients were re-evaluated with MRI performed at an average of 15 months postoperatively. The clinical outcome, including the Constant score, was assessed for all patients at a median of 16 months postoperatively.
RESULTS
All the five patients had remission of pain and were satisfied with the shoulder function. The postoperative MRI in all patients showed no labral cyst recurrence. The median Constant score improved from a preoperative level of 81.5 points to 98.0 points at last follow-up.
CONCLUSION
This study demonstrates that, in the absence of any nerve compression symptoms around the shoulder joint, inferior paralabral cysts with labral tear also be considered in the differential diagnosis of chronic shoulder pain. Arthroscopic repair of the cyst with repair of the labrum can lead to the disappearance of symptoms. Knowledge of this clinical condition and its imaging features is critical for a correct diagnosis of this uncommon cause of chronic shoulder pain.
LEVEL OF EVIDENCE
Level IV. Retrospective therapeutic study.
简介
肩部的盂唇旁神经节囊肿较为罕见，其发病机制与半月板囊肿相似。盂唇旁囊肿最常报道于盂肱关节的后上和前侧，关节下方较少见。这些囊肿很少在临床上出现，除非它们压迫周围结构，如神经。
患者与方法
我们报告了一组 5 例肩部下盂唇旁神经节囊肿的回顾性病例，这些患者没有周围神经受压的情况，他们在 2007 年 3 月至 2009 年 12 月期间接受了治疗。所有这些患者均仅表现为慢性肩部疼痛，术前 MRI 显示囊肿位于撕裂的盂唇下。所有患者均通过关节镜下囊肿减压和盂唇修复进行治疗。所有患者均在术后平均 15 个月时行 MRI 复查。所有患者在术后中位数为 16 个月时进行了包括 Constant 评分在内的临床结果评估。
结果
所有 5 例患者的疼痛均得到缓解，对肩部功能满意。所有患者术后 MRI 均未见盂唇囊肿复发。术后中位数 Constant 评分从术前的 81.5 分提高到末次随访时的 98.0 分。
结论
本研究表明，在肩关节周围无任何神经压迫症状的情况下，伴有盂唇撕裂的下盂唇旁囊肿也应考虑作为慢性肩部疼痛的鉴别诊断。关节镜下囊肿切除和盂唇修复可使症状消失。了解这种临床情况及其影像学特征对于正确诊断这种不常见的慢性肩部疼痛原因至关重要。
证据等级
IV 级，回顾性治疗研究。
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