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帕森斯-特纳综合征模拟肌肉骨骼性肩部疼痛:SARS-CoV-2 大流行时期的 1 例病例报告。

Parsonage-Turner Syndrome mimicking musculoskeletal shoulder pain: A case report during the SARS-CoV-2 pandemic era.

机构信息

Department of Clinical Sciences and Translational Medicine, 60259University of Roma "Tor Vergata" c/o Medicine and Surgery School, Rome, Italy.

Department of Medicine and Health Science "Vincenzo Tiberio", 60238University of Molise C/da Tappino c/o Cardarelli Hospital, Campobasso, Italy.

出版信息

J Telemed Telecare. 2023 Feb;29(2):133-146. doi: 10.1177/1357633X221100059. Epub 2022 Jun 9.

Abstract

Parsonage-Turner Syndrome or neuralgic amyotrophy is a peripheral neuropathy typically characterized by an abrupt onset of pain, followed by progressive neurological deficits (e.g. weakness, atrophy, occasionally sensory abnormalities) that involve the upper limb, mainly the shoulder, encompassing an extensive spectrum of clinical manifestations, somehow difficult to recognize. This case report describes the proper management of a 35-year-old, bank employee and sports amateur who reported subtle and progressive upper limb disorder with previous history of neck pain. SARS-CoV-2 pandemic era made patient's access to the healthcare system more complicated. Nevertheless, proper management of knowledge, relevant aspects of telerehabilitation-based consultation for musculoskeletal pain, advanced skills, tools and technologies led the physiotherapist to suspect an atypical presentation of Parsonage-Turner Syndrome. Further, neurologist consultation and electromyography suggested signs of denervation in the serratus anterior and supraspinatus muscle. Therefore, an appropriate physiotherapist's screening for referral is conducted to correct diagnosis and thorough treatment.

摘要

帕森特纳特纳综合征或神经痛性肌萎缩症是一种周围神经病,通常以突然出现疼痛为特征,随后出现进行性神经功能缺损(如无力、萎缩,偶尔伴有感觉异常),主要累及上肢,主要是肩部,涉及广泛的临床表现,有点难以识别。本病例报告描述了对一名 35 岁银行职员和业余运动员的恰当管理,该患者曾有颈部疼痛史,出现轻微和进行性上肢障碍。SARS-CoV-2 大流行时期使患者更难以获得医疗保健系统。然而,对基于远程康复咨询的肌肉骨骼疼痛相关知识、适当方面的管理,先进的技能、工具和技术使物理治疗师怀疑帕森特纳特纳综合征的非典型表现。此外,神经科医生会诊和肌电图检查提示前锯肌和冈上肌失神经支配的迹象。因此,进行了适当的物理治疗师转诊筛查,以进行正确诊断和彻底治疗。

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