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股二头肌撕裂导致的假性坐骨神经痛

Pseudo-Sciatica Pain Due to a Biceps Femoris Muscle Tear.

作者信息

Correia Rodrigo, Correia Guilherme, Meixedo Sofia, de Castro Correia Miguel, Carvalho José Luís

机构信息

Physical Medicine and Rehabilitation, Centro de Reabilitação do Norte, Unidade Local de Saúde (ULS) Gaia/Espinho, Vila Nova de Gaia, PRT.

Orthopedics and Traumatology, Unidade Local de Saúde (ULS) Braga, Braga, PRT.

出版信息

Cureus. 2024 Nov 23;16(11):e74286. doi: 10.7759/cureus.74286. eCollection 2024 Nov.

DOI:10.7759/cureus.74286
PMID:39717292
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11664441/
Abstract

Hamstring injuries (HSIs) are common among athletes, particularly in high-speed sports, and are frequently associated with prolonged recovery periods and a high recurrence rate. This study presents a 36-year-old male with sciatica-like symptoms following an acute hamstring tear during an amateur football match. The patient experienced this pain two weeks after the injury, suggesting potential sciatic nerve involvement. Ultrasonographic imaging revealed a partial myotendinous rupture of the biceps femoris long head, adjacent to the sciatic nerve. The patient underwent a structured five-week rehabilitation program, resulting in significant improvement, including reduced pain, enhanced muscle strength, and improved flexibility. This case highlights the role of early intervention and targeted rehabilitation in preventing complications, such as hamstring syndrome (HSS), and emphasizes the importance of using ultrasonography for diagnosis. This study also addresses the limitations in diagnostic imaging and provides insights into the link between muscle injury and sciatic nerve irritation, contributing valuable knowledge to the limited literature on this subject.

摘要

腘绳肌损伤(HSIs)在运动员中很常见,尤其是在高速运动项目中,并且常常与恢复时间延长和高复发率相关。本研究报告了一名36岁男性,在一场业余足球比赛中急性腘绳肌撕裂后出现类似坐骨神经痛的症状。患者在受伤两周后出现这种疼痛,提示可能累及坐骨神经。超声成像显示股二头肌长头部分肌腱肌肉连接处破裂,靠近坐骨神经。患者接受了为期五周的结构化康复计划,结果有显著改善,包括疼痛减轻、肌肉力量增强和灵活性提高。该病例突出了早期干预和针对性康复在预防诸如腘绳肌综合征(HSS)等并发症方面的作用,并强调了使用超声进行诊断的重要性。本研究还探讨了诊断成像中的局限性,并深入分析了肌肉损伤与坐骨神经刺激之间的联系,为该主题的有限文献提供了有价值的知识。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a8e/11664441/0419ef60d0d6/cureus-0016-00000074286-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a8e/11664441/0419ef60d0d6/cureus-0016-00000074286-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a8e/11664441/0419ef60d0d6/cureus-0016-00000074286-i01.jpg

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本文引用的文献

1
Sciatic Nerve Compression after a Chronic Proximal Hamstring Tear: A Report of Two Cases and a Narrative Review of the Literature.慢性腘绳肌近端撕裂后坐骨神经受压:两例报告及文献综述
Life (Basel). 2023 Aug 17;13(8):1762. doi: 10.3390/life13081762.
2
Hamstring muscle injury in the athlete: state of the art.运动员的腿后肌群损伤:最新技术。
J ISAKOS. 2021 May;6(3):170-181. doi: 10.1136/jisakos-2017-000145. Epub 2020 Nov 12.
3
ECCENTRIC HAMSTRING STRENGTH IS ASSOCIATED WITH AGE AND DURATION OF PREVIOUS SEASON HAMSTRING INJURY IN MALE SOCCER PLAYERS.
在男性足球运动员中,股后肌群离心力量与年龄及上赛季股后肌群损伤的持续时间相关。
Int J Sports Phys Ther. 2020 Apr;15(2):246-253.
4
Risk factors for hamstring injuries in Australian male professional cricket players.澳大利亚男性职业板球运动员腘绳肌损伤的风险因素。
J Sport Health Sci. 2017 Sep;6(3):271-274. doi: 10.1016/j.jshs.2017.05.004. Epub 2017 May 12.
5
Time to get our four priorities right: an 8-year prospective investigation of 1326 player-seasons to identify the frequency, nature, and burden of time-loss injuries in elite Gaelic football.是时候明确我们的四个优先事项了:一项对1326个运动员赛季进行的为期8年的前瞻性调查,以确定精英盖尔式足球中失时伤病的频率、性质和负担。
PeerJ. 2018 Jul 20;6:e4895. doi: 10.7717/peerj.4895. eCollection 2018.
6
Accuracy of 3 Clinical Tests to Diagnose Proximal Hamstrings Tears With and Without Sciatic Nerve Involvement in Patients With Posterior Hip Pain.3 种临床检测诊断伴有和不伴有坐骨神经受累的髋关节后侧疼痛患者腘绳肌近端撕裂的准确性。
Arthroscopy. 2018 Jan;34(1):114-121. doi: 10.1016/j.arthro.2017.06.048. Epub 2017 Dec 6.
7
Outcomes After Operative and Nonoperative Treatment of Proximal Hamstring Avulsions: A Systematic Review and Meta-analysis.手术与非手术治疗近端腘绳肌腱撕裂的结局:系统评价与荟萃分析。
Am J Sports Med. 2018 Sep;46(11):2798-2808. doi: 10.1177/0363546517732526. Epub 2017 Oct 10.
8
A three-year epidemiological prospective cohort study of rugby league match injuries from the European Super League.一项来自欧洲超级联赛的三年橄榄球联盟比赛伤害的前瞻性队列研究。
J Sci Med Sport. 2018 Feb;21(2):160-165. doi: 10.1016/j.jsams.2017.08.012. Epub 2017 Aug 24.
9
Hamstring injuries have increased by 4% annually in men's professional football, since 2001: a 13-year longitudinal analysis of the UEFA Elite Club injury study.自 2001 年以来,男子职业足球中腘绳肌损伤的年增长率为 4%:UEFA 精英俱乐部损伤研究的 13 年纵向分析。
Br J Sports Med. 2016 Jun;50(12):731-7. doi: 10.1136/bjsports-2015-095359. Epub 2016 Jan 8.
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Am J Sports Med. 2015 Nov;43(11):2841-51. doi: 10.1177/0363546514555327. Epub 2014 Nov 10.