Bland J H, Merrit J A, Boushey D R
Semin Arthritis Rheum. 1977 Aug;7(1):21-47. doi: 10.1016/s0049-0172(77)80003-6.
The shoulder, a very common site of pain syndromes in medical practice, lends itself well to precise clinical analysis and identification of the pain-sensitive structure or structures. Once identified, rational and effective management can be applied, associated with predictably good prognosis. Early identification of the emerging specific syndrome is important in decreasing the duration of the clinical disorder and in achieving optimum return of shoulder function. Laboratory and X-ray studies are not commonly required in diagnosis and management. There are a confusing variety of names attached to the many shoulder pain syndromes; however, there are two most common categories. One is associated with severe pain but little or no limitation of shoulder movement (at least passive movement), in which the pain-sensitive structure is tendon or tendon sheath; the other is associated with both pain and limitation of active and passive motion, in which the pain-sensitive structures are capsule, bursa, and synovium as well as muscle and multiple tendons.
肩部是医学实践中疼痛综合征非常常见的部位，很适合进行精确的临床分析以及对疼痛敏感结构的识别。一旦识别出来，就可以采用合理有效的治疗方法，并伴有可预见的良好预后。早期识别新出现的特定综合征对于缩短临床疾病的持续时间以及实现肩部功能的最佳恢复很重要。在诊断和治疗中通常不需要实验室检查和X线检查。许多肩部疼痛综合征有各种各样令人困惑的名称；然而，有两大类最为常见。一类与严重疼痛相关，但肩部活动（至少被动活动）很少受限或不受限，其中疼痛敏感结构是肌腱或腱鞘；另一类与主动和被动活动的疼痛及受限都相关，其中疼痛敏感结构是关节囊、滑囊、滑膜以及肌肉和多条肌腱。
