Esposito S, Ragozzino A, Russo R, Minelli S, Tuccillo M
II Servizio di Radiologia, Ospedale Cardarelli, USL 40, Napoli.
Radiol Med. 1993 May;85(5):583-7.
The painful shoulder--i.e., adhesive capsulitis--present two basic symptoms: painful and impaired motion. Clinics allow the diagnosis to be made, but treatment is difficult. In our opinion, shoulder arthrography is very useful to distinguish idiopathic from secondary capsulitis involving bones and joints: moreover, in the patients with adhesive capsulitis, arthrography is useful when removing adhesions by repeated forceful distensions of the joint capsule. January 1990 through December 1991, forty-five patients with adhesive capsulitis were studied with shoulder arthrography; 19 patients with primary adhesive capsulitis underwent forceful distension with lidocain and contrast medium and the intraarticular injection of 40 mg of triamcinolone enantate to eliminate local adhesions. Arthrographic brisement yielded good results: improved motion was observed in all patients, lasting 2 to 7 months. Forceful joint capsule distension is easy to perform and complication-free and yields valuable results; all of the above make the procedure advisable as a good alternative to surgery in primary adhesive capsulitis patients.
疼痛性肩部——即粘连性关节囊炎——有两个基本症状：疼痛和活动受限。临床可以做出诊断，但治疗困难。我们认为，肩关节造影对于区分特发性与累及骨骼和关节的继发性关节囊炎非常有用；此外，对于粘连性关节囊炎患者，在通过反复强力扩张关节囊去除粘连时，关节造影是有用的。1990年1月至1991年12月，对45例粘连性关节囊炎患者进行了肩关节造影研究；19例原发性粘连性关节囊炎患者用利多卡因和造影剂进行强力扩张，并关节内注射40毫克曲安奈德以消除局部粘连。关节造影下手法松解取得了良好效果：所有患者的活动均有改善，持续2至7个月。强力扩张关节囊操作简便、无并发症且效果显著；上述所有优点使得该方法成为原发性粘连性关节囊炎患者手术的良好替代方案。
