Mascarinas Angelie L, Newman Joel S, Warner Jon J P, Jain Nitin B
From the Department of Physical Medicine and Rehabilitation, Harvard Medical School/Spaulding Rehabilitation Hospital, Charlestown (ALM); Department of Radiology, New England Baptist Hospital, Boston (JSN); Department of Orthopaedics, Massachusetts General Hospital, Boston (JJPW); and Department of Physical Medicine and Rehabilitation, Vanderbilt University Medical Center, Nashville, Tennessee (NBJ).
Am J Phys Med Rehabil. 2014 Dec;93(12):e9-e14. doi: 10.1097/PHM.0000000000000197.
Only a few reports exist in the literature for sonographic assessment of the pectoralis major muscle. Presented is a case of pectoralis major muscle atrophy as a cause of persistent internal rotation weakness diagnosed via ultrasound in a patient with multiple previous surgeries and contraindication to magnetic resonance imaging because of a shoulder implant. This patient's physical examination suggested an abnormal contour of the pectoralis major muscle on contraction, so he was referred for diagnostic ultrasound. The ultrasound was key to guiding the management of this patient because surgical repair of a torn pectoralis major muscle was planned if this was found. No pectoralis major tear or rupture was seen on ultrasound, but there was evidence of pectoralis major muscle atrophy. Accordingly, surgery was avoided and the patient was able to continue with his physical therapy program.
文献中仅有少数关于超声评估胸大肌的报道。本文介绍了一例胸大肌萎缩导致持续性内旋无力的病例，该病例通过超声诊断，患者此前接受过多次手术，因肩部植入物而存在磁共振成像禁忌证。该患者的体格检查提示收缩时胸大肌轮廓异常，因此他被转诊进行诊断性超声检查。超声对于指导该患者的治疗至关重要，因为如果发现胸大肌撕裂，计划进行手术修复。超声检查未发现胸大肌撕裂或断裂，但有胸大肌萎缩的证据。因此，避免了手术，患者能够继续进行物理治疗方案。
