主动前伸和后缩对胸锁关节疼痛的诊断价值。
Diagnostic value of active protraction and retraction for sternoclavicular joint pain.
作者信息
Van Tongel Alexander, Karelse Anne, Berghs Bart, Van Isacker Tom, De Wilde Lieven
机构信息
Department of Orthopaedic Surgery and Traumatology, Ghent University Hospital, De Pintelaan 185, B-9000 Gent, Belgium.
出版信息
BMC Musculoskelet Disord. 2014 Dec 11;15:421. doi: 10.1186/1471-2474-15-421.
BACKGROUND
Sternoclavicular joint (SCJ) arthropathy is an uncommon cause of mechanical pain. The aim of this study is to evaluate the diagnostic value of two active clinical tests for localizing the sternoclavicular joint as the source of mechanical pain.
METHODS
All patients between June 2011 and October 2013 that visited the orthopedic departments of three hospitals with atraumatic pain in the area of the SC joint were evaluated. Local swelling, pain at palpation, pain during arm elevation and two newly described tests (pain during active scapular protraction and retraction) were evaluated. CT images were evaluated. The patients were then divided into two groups according to whether they had a ≥50% decrease in pain following the SCJ injection. Sensitivity and specificity for local swelling, the four clinical tests and CT-scan were measured.
RESULTS
Forty eight patients were included in this study and SC joint pain was confirmed in 44. The tests with highest sensitivity were pain on palpation, (93% sensitivity) and pain during active scapular protraction (86%). CT-scan showed a sensitivity of 84%. Local swelling showed a high specificity (100%).
CONCLUSION
Pain at the SCJ during active scapular protraction is a good clinical diagnostic tool for SC arthropathy.
背景
胸锁关节（SCJ）关节炎是机械性疼痛的罕见病因。本研究旨在评估两种主动临床检查对于将胸锁关节定位为机械性疼痛来源的诊断价值。
方法
对2011年6月至2013年10月期间到三家医院骨科就诊的所有在胸锁关节区域有非创伤性疼痛的患者进行评估。评估局部肿胀、触诊疼痛、手臂抬高时疼痛以及两种新描述的检查（主动肩胛骨前伸和后缩时疼痛）。对CT图像进行评估。然后根据胸锁关节注射后疼痛是否减轻≥50%将患者分为两组。测量局部肿胀、四项临床检查和CT扫描的敏感性和特异性。
结果
本研究纳入48例患者，44例确诊为胸锁关节疼痛。敏感性最高的检查是触诊疼痛（敏感性93%）和主动肩胛骨前伸时疼痛（86%）。CT扫描敏感性为84%。局部肿胀显示出高特异性（100%）。
结论
主动肩胛骨前伸时胸锁关节疼痛是胸锁关节炎的良好临床诊断工具。
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