Santos-Zaldívar K P, López-Muñoz R, Aguiñaga-Malanco S E, Méndez-Domínguez N
Escuela de Medicina. Universidad Marista de Mérida. Mérida, Yucatán, México.
Escuela de Fisioterapia y Rehabilitación. Universidad Marista de Mérida. Mérida, Yucatán, México.
Acta Ortop Mex. 2020 Jul-Aug;34(4):242-248.
The painful shoulder is an entity that generates much of the orthopedic consultations worldwide, although it can affect at any stage of life, its prevalence is higher as age increases. Rotator cuff condition is often the most relevant cause of pain and dysfunction. Two common consequences of rotator cuff condition are pseudoparesis and pseudoparalysis, and even though they share similar etiology and symptomatology, their clinical differentiation is critical for optimal management and timely resolution.
To review the theoretical and clinical bases for the differentiation and management of pseudoparesis and pseudoparalysis due to rotator cuff pathology.
Descriptive review of the concepts of pseudoparesis and pseudoparalysis from the orthopedic, physiotherapy and rehabilitation perspective.
Once the differences in rotator cuff injury mechanisms and how they translate into painful shoulder semiology are understood, it is possible to integrate a differential diagnosis between pseudoparesia and pseudoparalysis. Diagnosis should integrate specific evaluations and exercises to identify both conditions and, once distinguished and identified, allow optimal guidance of therapeutic approach.
The differentiation between pseudoparalysis and pseudoparesis allows us to understand the mechanisms of injury and, finally, to provide the optimal treatment for patients with painful shoulder due to rotator cuff pathology.
肩部疼痛是一个在全球范围内引发大量骨科会诊的问题,尽管它可在生命的任何阶段出现,但随着年龄增长其患病率会更高。肩袖损伤通常是疼痛和功能障碍的最主要原因。肩袖损伤的两个常见后果是假性轻瘫和假性麻痹,尽管它们具有相似的病因和症状,但它们的临床鉴别对于优化治疗和及时解决问题至关重要。
回顾因肩袖病变导致的假性轻瘫和假性麻痹的鉴别与管理的理论和临床依据。
从骨科、物理治疗和康复角度对假性轻瘫和假性麻痹的概念进行描述性综述。
一旦理解了肩袖损伤机制的差异以及它们如何转化为肩部疼痛症状学,就有可能对假性轻瘫和假性麻痹进行鉴别诊断。诊断应结合特定评估和练习来识别这两种情况,一旦区分并确定,就能为治疗方法提供最佳指导。
假性麻痹和假性轻瘫之间的鉴别使我们能够理解损伤机制,并最终为因肩袖病变导致肩部疼痛的患者提供最佳治疗。