非手术切除肩部巨大钙化灶。

Nonsurgical removal of a massive calcification of the shoulder.

作者信息

Calvi Marco, Malnati Silvia, Clivio Veronica, Vincenzo Zakaria, Callegari Leonardo, Genovese Eugenio Annibale

机构信息

ASST-Settelaghi, Ospedale di Circolo e Fondazione Macchi, Varese 21100, Italy.

Università degli Studi dell'Insubria, Varese 21100, Italy.

出版信息

Radiol Case Rep. 2024 Aug 24;19(11):5226-5230. doi: 10.1016/j.radcr.2024.07.194. eCollection 2024 Nov.

Abstract

Calcific tendinopathy of the shoulder is a prevalent and painful condition marked by calcific deposits in the rotator cuff tendons or subacromial bursa, with an incidence of 2.7% to 20%, predominantly affecting individuals aged 30 to 50. Women are 1.5 times more likely to be affected than men. Deposits are frequently bilateral in 10%-20% of cases and most commonly found in the supraspinatus tendon. The pathogenesis remains unclear, with theories suggesting repetitive strain or ischemic degeneration leading to calcium deposition. The disease progresses through precalcific, calcific, and postcalcific phases, with symptoms ranging from mild pain to severe, disabling pain resistant to medication. Diagnosis primarily involves radiographs or CT scans, with ultrasound aiding in deposit staging. Conservative treatments include medication, physiotherapy, and subacromial corticosteroid injections. Novel nonsurgical treatments like ultrasound-guided needling (UGN) and extracorporeal shock wave therapy (ESWT) have shown promise. When conservative measures fail, surgical options achieve significant improvement. This case report details a 53-year-old woman with a 12 cm calcification treated successfully with UGN, demonstrating the efficacy of this minimally invasive technique for large deposits.

摘要

肩部钙化性肌腱炎是一种常见且疼痛的病症,其特征为在肩袖肌腱或肩峰下滑囊中出现钙化沉积物,发病率为2.7%至20%,主要影响30至50岁的人群。女性受影响的可能性是男性的1.5倍。在10%-20%的病例中,沉积物常为双侧性,最常见于冈上肌腱。其发病机制尚不清楚,有理论认为反复劳损或缺血性退变会导致钙沉积。该病会经历钙化前期、钙化期和钙化后期阶段,症状从轻微疼痛到严重的、药物难以缓解的致残性疼痛不等。诊断主要依靠X光片或CT扫描,超声有助于确定沉积物的分期。保守治疗包括药物治疗、物理治疗和肩峰下皮质类固醇注射。新型非手术治疗方法,如超声引导下针刺(UGN)和体外冲击波疗法(ESWT)已显示出前景。当保守措施失败时,手术选择可取得显著改善。本病例报告详细介绍了一名53岁女性,其12厘米的钙化灶通过UGN成功治疗,证明了这种微创技术对大沉积物的有效性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/047c/11387548/533d5fa2621e/gr1.jpg

相似文献

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索