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颈椎病的肌肉骨骼模拟病症。

Musculoskeletal mimics of cervical radiculopathy.

机构信息

H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas, USA.

Harris Health System, Electrodiagnostic Laboratory, Smith Clinic/Ben Taub Hospital, Houston, Texas, USA.

出版信息

Muscle Nerve. 2022 Jul;66(1):6-14. doi: 10.1002/mus.27553. Epub 2022 Apr 24.

Abstract

Musculoskeletal mimics of cervical radiculopathy will be explored in this AANEM monograph. A review of the literature and textbooks was conducted. Musculoskeletal cervical radiculopathy mimics include: (1) head/neck pain, such as neck tension, cervicogenic headache, and temporomandibular disorder; (2) referred pain from shoulder pathology, such as rotator cuff tears/impingement; (3) elbow region abnormalities, including medial/lateral epicondylitis; (4) wrist/hand conditions, such as DeQuervain's tenosynovitis and intersection syndrome; (5) muscle connective tissue disorders, including myofascial trigger points; (6) conditions that have decreased range of motion, including frozen shoulder and rounded shoulders with tight pectoral/scalene muscles; (7) conditions with joint hyperlaxity and instability, as seen in post-stroke shoulder subluxation; (8) vascular conditions, such as thoracic outlet syndrome; and (9) autonomic controlled soft tissue changes associated with complex regional pain syndrome. Formulating a differential diagnosis and recognizing mimics of cervical radiculopathy can decrease the time between symptom onset and diagnosis/treatment plan.

摘要

本 AANEM 专论将探讨颈椎神经根病的肌肉骨骼模拟病症。我们对文献和教科书进行了回顾。肌肉骨骼性颈椎神经根病模拟病症包括:(1)头/颈部疼痛,如颈部紧张、颈源性头痛和颞下颌关节紊乱;(2)肩部病变引起的牵涉痛,如肩袖撕裂/撞击;(3)肘部区域异常,包括内/外侧上髁炎;(4)手腕/手部疾病,如 DeQuervain 腱鞘炎和交叉综合征;(5)肌肉结缔组织疾病,包括肌筋膜触发点;(6)运动范围减小的病症,包括冻结肩和胸大肌/斜方肌紧张导致的圆肩;(7)关节过度活动和不稳定的病症,如中风后肩关节半脱位;(8)血管疾病,如胸廓出口综合征;(9)与复杂性区域疼痛综合征相关的自主控制软组织变化。制定鉴别诊断并识别颈椎神经根病的模拟病症可以减少症状出现到诊断/治疗计划之间的时间。

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