Aguililla Liñan Jose Miguel, Miguel Pérez María Isabel, Palau González Jordi, Möller Parera Ingrid, Martinoli Carlo
Gimbernat i Tomàs Cerdà School of Physiotherapy, Universitat Autònoma de Barcelona, Avinguda de la Generalitat 202, 204, Sant Cugat del Vallès, 08174, Barcelona, Spain.
Department of Pathology and Experimental Therapeutics, Human Anatomy and Embryology Unit, Faculty of Medicine and Health Sciences, University of Barcelona, C/ Feixa Llarga s/n, 08907, Hospitalet de Llobregat, Barcelona, Spain.
Curr Rev Musculoskelet Med. 2020 Aug;13(4):385-390. doi: 10.1007/s12178-020-09636-w.
Radiohumeral synovial plicae (RHSP) have been studied by different authors in different ways; in spite of this, the evidence is poor and the results are controversial and inconclusive even when it comes to referring to this elbow structure. The aim of this article is to review the embryologic development, anatomy and histology, pathophysiologic features, clinical manifestations, physical examination, imaging findings, and treatment of radiohumeral synovial plicae, for their correct clinical interpretation in patients with intractable lateral epicondylitis.
Radiohumeral synovial plicae syndrome (RHSPS) can cause intractable lateral epicondylitis and can be easily confused with other clinical conditions affecting the elbow. Many clinicians are not familiar with radiohumeral synovial plica syndrome since there are not many studies about it and previous reports do not seem to reach a consensus. Although its role in elbow injuries and epicondylitis is accepted and its surgical treatment is effective, there is no clear consensus about clinically relevant aspects. RHSP are remnants of normal embryo development of the articular synovial membrane with different anatomical locations, size and shape. Traumatism or overuse can turn RHSP into symptomatic structures at any age and can be compressed between the radial and humeral heads during movement. This compression can cause pain and other symptoms such as snapping, catching, mobility restriction, pitching, clicking, locking, blockage, popping and swelling. Radiohumeral synovial plica syndrome (RHSPS) may be an isolated condition or it can be associated with other elbow abnormalities. The findings on physical examination and imaging diagnosis are multiple and variable. Nowadays, RHSPS are quite unknown and previous reports do not seem to agree, leading to misdiagnoses as epicondylitis and making this structure the main cause of some cases of "intractable lateral epicondylitis". The outcomes of surgical treatments are quite promising although more, higher quality research is needed. Taking this into account, this review is meant to be a starting point for new anatomical and clinical studies.
不同作者以不同方式对桡肱滑膜皱襞（RHSP）进行了研究；尽管如此，相关证据不足，即便在提及这种肘部结构时，结果也存在争议且尚无定论。本文旨在综述桡肱滑膜皱襞的胚胎发育、解剖学与组织学、病理生理特征、临床表现、体格检查、影像学表现及治疗方法，以便在难治性外侧肱骨髁炎患者中对其进行正确的临床解读。
桡肱滑膜皱襞综合征（RHSPS）可导致难治性外侧肱骨髁炎，且易与影响肘部的其他临床病症相混淆。由于关于桡肱滑膜皱襞综合征的研究不多，且既往报告似乎未达成共识，许多临床医生对其并不熟悉。尽管其在肘部损伤和肱骨髁炎中的作用已得到认可，且手术治疗有效，但在临床相关方面尚无明确共识。桡肱滑膜皱襞是关节滑膜正常胚胎发育的残留物，具有不同的解剖位置、大小和形状。创伤或过度使用可使桡肱滑膜皱襞在任何年龄转变为有症状的结构，并且在运动过程中可被夹在桡骨头和肱骨头之间。这种挤压可导致疼痛和其他症状，如弹响、卡顿、活动受限、投球感、咔嗒声、锁定、阻塞、爆裂声和肿胀。桡肱滑膜皱襞综合征（RHSPS）可能是一种孤立病症，也可能与其他肘部异常相关。体格检查和影像学诊断结果多样且各异。如今，桡肱滑膜皱襞综合征鲜为人知，既往报告似乎也未达成一致，导致误诊为肱骨髁炎，并使这种结构成为某些“难治性外侧肱骨髁炎”病例的主要病因。手术治疗的效果颇具前景，不过仍需要更多高质量的研究。考虑到这一点，本综述旨在成为新的解剖学和临床研究的起点。
