Chen C K, Yeh L, Chen C T, Pan H B, Yang C F, Resnick D
Department of Radiology, Kaohsiung Veterans General Hospital, Taiwan.
AJR Am J Roentgenol. 1998 Feb;170(2):449-53. doi: 10.2214/ajr.170.2.9456962.
A retrospective review of the MR images and radiographs of 26 shoulders in 17 patients suffering from contracture of the deltoid muscle was used to establish the characteristic imaging findings.
Deltoid muscle contractures in 26 shoulders in 17 patients encountered over a 4-year period are reported. The history of intramuscular injection and clinical symptoms and signs are detailed. Imaging studies including routine radiographs (24 shoulders), MR images (25 shoulders), and computed arthrotomograms (two shoulders) were reviewed. On MR images, the winging angle of the scapula (angle between the axis of the scapular body and the coronal plane of the chest) and the diameter of the lesion were measured and compared with data derived from 24 age-matched control subjects.
Diagnostic MR features of deltoid muscle contracture include fibrotic cord in the deltoid muscle, especially its middle portion, extending from the superior acromial surface to the deltoid tuberosity, and winging of the scapula (increased winging angle of the scapula). Characteristic radiographic features include abduction contracture, winging of the scapula, lateral down-sloping of the acromial process, and a superior acromial enthesophyte.
MR images are sensitive and accurate in the diagnosis of contracture of the deltoid muscles. Characteristic features also allow accurate routine diagnosis on radiographs.
回顾性分析17例三角肌挛缩患者26个肩部的磁共振成像（MR）图像和X线片，以确定其特征性影像学表现。
报告了4年间收治的17例患者26个肩部的三角肌挛缩情况。详细记录了肌肉注射史及临床症状和体征。回顾了包括常规X线片（24个肩部）、MR图像（25个肩部）和计算机关节造影（2个肩部）在内的影像学检查。在MR图像上，测量肩胛骨的翼状角（肩胛体轴线与胸部冠状面之间的角度）和病变直径，并与24名年龄匹配的对照者的数据进行比较。
三角肌挛缩的诊断性MR特征包括三角肌内，尤其是其中部，有纤维化条索，从肩峰上缘延伸至三角肌粗隆，以及肩胛骨翼状畸形（肩胛骨翼状角增大）。特征性X线表现包括外展挛缩、肩胛骨翼状畸形、肩峰外侧向下倾斜以及肩峰上缘骨赘形成。
MR图像对三角肌挛缩的诊断敏感且准确。其特征性表现也有助于在X线片上进行准确的常规诊断。
