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编辑评论:在评估肩袖旋转肌钙化性肌腱病患者时,磁共振成像(MRI)检查是否始终适用?

Editorial Commentary: Is Magnetic Resonance Imaging of the Shoulder Ever Appropriate in Evaluating Patients With Calcific Tendinopathy of the Rotator Cuff?

机构信息

Houston, Texas.

出版信息

Arthroscopy. 2020 Apr;36(4):991-992. doi: 10.1016/j.arthro.2020.01.014.

DOI:10.1016/j.arthro.2020.01.014
PMID:32247429
Abstract

Calcific tendinopathy of the rotator cuff is a common pathology that often presents with clinical symptoms simulating a rotator cuff tear. The reported incidence of rotator cuff tear in the setting of calcific tendinopathy varies widely; however, the reported incidence of full-thickness rotator cuff tear on imaging in calcific tendinopathy is consistently low (<5%). In patients with symptomatic calcific tendinopathy, initial conservative management followed by minimally invasive treatments should be employed prior to performing shoulder magnetic resonance imaging to assess for a rotator cuff tear. A shoulder magnetic resonance imaging may be performed for preoperative planning prior to surgical removal of calcium deposits, but even in this patient population, the incidence of full-thickness rotator cuff tear is low.

摘要

肩袖钙化性肌腱病是一种常见的疾病,常表现为类似于肩袖撕裂的临床症状。钙化性肌腱病合并肩袖撕裂的报告发生率差异很大;然而,钙化性肌腱病在影像学上全层肩袖撕裂的报告发生率一直较低(<5%)。对于有症状的钙化性肌腱病患者,在进行肩关节磁共振成像(MRI)以评估肩袖撕裂之前,应先采用初始的保守治疗和微创治疗。在进行手术切除钙沉积物之前,可能会进行肩关节 MRI 以进行术前规划,但即使在这种患者人群中,全层肩袖撕裂的发生率也较低。

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引用本文的文献

1
Zero echo time MRI in shoulder MRI protocols for the diagnosis of rotator cuff calcific tendinopathy improves identification of calcific deposits compared to conventional MR sequences but remains sub-optimal compared to radiographs.磁共振肩袖协议中应用零回波时间 MRI 技术诊断肩袖钙化性肌腱炎,与常规 MRI 序列相比,能更好地显示钙化沉积,但与 X 线相比仍不够理想。
Eur Radiol. 2023 Sep;33(9):6381-6391. doi: 10.1007/s00330-023-09602-3. Epub 2023 Apr 4.
2
Reliable diagnosis of posterosuperior rotator cuff tears requires a combination of clinical tests.可靠的后上肩袖撕裂的诊断需要结合临床检查。
Knee Surg Sports Traumatol Arthrosc. 2021 Jul;29(7):2118-2133. doi: 10.1007/s00167-020-06136-9. Epub 2020 Jul 28.