Hong Choon Chiet, Thambiah Matthew Dhanaraj, Manohara Ruben
Department of Orthopaedic Surgery, University Orthopaedic, Hand and Reconstructive Microsurgery Cluster, National University Hospital, Singapore.
J Orthop Surg (Hong Kong). 2019 May-Aug;27(2):2309499019847145. doi: 10.1177/2309499019847145.
The quadrilateral space is bounded by the teres minor superiorly, the teres major inferiorly, the long head of the triceps medially and the shaft of the humerus laterally. The axillary nerve and posterior circumflex humeral artery pass through this space to enter the posterior compartment of the upper arm. Quadrilateral space syndrome (QSS) is caused by entrapment of the axillary nerve or its main branches and/or the posterior circumflex humeral artery in the quadrilateral space by internal or external compression. QSS can often be difficult to diagnose, given that patients may present with non-specific symptoms. As such, patients may be misdiagnosed with more common disorders of the shoulder. We report a case of QSS masquerading initially as rotator cuff pathology with positive impingement signs.
四边形间隙上界为小圆肌，下界为大圆肌，内侧为肱三头肌长头，外侧为肱骨干。腋神经和旋肱后动脉穿过此间隙进入上臂后骨筋膜鞘。四边形间隙综合征（QSS）是由于腋神经或其主要分支和/或旋肱后动脉在四边形间隙内因内外侧压迫而被卡压所致。鉴于患者可能表现为非特异性症状，QSS常常难以诊断。因此，患者可能被误诊为更常见的肩部疾病。我们报告一例最初表现为肩袖病变且撞击征阳性的伪装成QSS的病例。
