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肩部卡压性神经病。

Entrapment Neuropathies of the Shoulder.

机构信息

Musculoskeletal Division, Department of Radiology, NYU Langone Health, New York, New York.

WellSpan Orthopedic Group, Chambersburg, Pennsylvania.

出版信息

Semin Musculoskelet Radiol. 2022 Apr;26(2):114-122. doi: 10.1055/s-0042-1742752. Epub 2022 May 24.

Abstract

Entrapment neuropathies of the shoulder most commonly involve the suprascapular or axillary nerves, and they primarily affect the younger, athletic patient population. The extremes of shoulder mobility required for competitive overhead athletes, particularly in the position of abduction and external rotation, place this cohort at particular risk. Anatomically, the suprascapular nerve is most prone to entrapment at the level of the suprascapular or spinoglenoid notch; the axillary nerve is most prone to entrapment as it traverses the confines of the quadrilateral space.Radiographs should be ordered as a primary imaging study to evaluate for obvious pathology occurring along the course of the nerves or for pathology predisposing the patient to nerve injury. Magnetic resonance imaging plays a role in not only identifying any mass-compressing lesion along the course of the nerve, but also in identifying muscle signal changes typical for denervation and/or fatty atrophy in the distribution of the involved nerve.

摘要

肩部嵌压性神经病最常累及肩胛上神经或腋神经,主要影响年轻的、运动活跃的患者群体。竞技性过顶运动员需要肩部达到极端的活动度,尤其是在外展和外旋的位置,使这群人处于特别高的风险中。解剖学上,肩胛上神经在肩胛上或肩胛冈下切迹处最容易受到嵌压;腋神经在穿过四边形间隙时最容易受到嵌压。应将 X 线片作为主要影像学检查来评估神经走行沿途是否存在明显的病变,或是否存在使患者易发生神经损伤的病变。磁共振成像不仅可以识别神经走行沿途任何压迫性肿块病变,还可以识别受累神经分布区的失神经和/或脂肪萎缩的典型肌肉信号变化。

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