Thomas T, Gazielly D, Bruyère G, Alexandre C
Department of Rheumatology, Bellevue Hospital, France.
Rev Rhum Engl Ed. 1995 Apr;62(4):249-54.
Frozen shoulder is a well-defined nosologic entity characterized by retraction of the anterior portion of the glenohumeral joint capsule. When clinical findings are inconclusive, arthrography can differentiate a frozen shoulder from a stiff and painful shoulder. We report three cases of stiffness of the shoulder that we believe was due to a unique pathological process. Flexion was restricted to 120 degrees and a sensation suggestive of mechanical blockage was felt upon passive flexion. Medical rotation was restricted and painful, whereas lateral rotation with the elbow held against the torso was normal. Findings upon arthrography or magnetic resonance imaging were normal, with no evidence of capsulitis or chronic rotator cuff lesions. Our pathogenic hypotheses include a lesion of the proximal portion of the long head of the biceps brachii or a focal ligamentous lesion. Treatment should consist of specific physical therapy and, in refractory forms, gentle mobilization under general anesthesia.
肩周炎是一种明确的疾病实体，其特征为盂肱关节囊前部挛缩。当临床表现不明确时，关节造影可区分肩周炎与僵硬疼痛的肩部。我们报告了三例肩部僵硬病例，我们认为这是由一种独特的病理过程所致。屈曲受限至120度，被动屈曲时可感觉到一种类似机械性阻挡的感觉。内旋受限且疼痛，而肘部紧贴躯干时的外旋正常。关节造影或磁共振成像检查结果正常，无囊炎或慢性肩袖损伤的证据。我们的致病假说包括肱二头肌长头近端病变或局灶性韧带病变。治疗应包括特定的物理治疗，对于难治性病例，可在全身麻醉下进行轻柔的活动。
