Winters J C, Sobel J S
Rijksuniversiteit, disciplinegroep Huisartsgeneeskunde, Groningen.
Ned Tijdschr Geneeskd. 1998 May 30;142(22):1241-4.
In two patients with shoulder complaints, a man aged 56 years and a woman aged 43, the function of the shoulder girdle (structures of the cervical spine, the upper thoracic spine and the upper ribs) played an important role. A simple classification of shoulder complaints is presented in which the influence of the shoulder girdle is recognized: (a) synovial disorder: complaints originating from the structures of the glenohumeral joint, the subacromial space, the acromioclavicular joint or combinations of these, (b) shoulder girdle disorder: the complaints are caused by functional problems in the structures of the shoulder girdle, (c) combination disorder: both a synovial disorder and a functional disorder of the structures of the shoulder girdle are causing the complaints, making it impossible to determine which structure is the primary cause. Considering the limited therapeutic choices (at first nonsteroidal antiinflammatory drugs, followed in case of persistent complaints by injections of analgesics and corticosteroids for synovial complaints, or manipulative therapy for shoulder girdle complaints), a more detailed classification is not needed to determine a successful therapeutic strategy.
在两名有肩部问题的患者中，一名56岁男性和一名43岁女性，肩带（颈椎、上胸椎和上肋骨的结构）的功能起到了重要作用。本文提出了一种简单的肩部问题分类方法，其中认识到了肩带的影响：(a) 滑膜紊乱：源于盂肱关节、肩峰下间隙、肩锁关节或这些结构组合的问题，(b) 肩带紊乱：问题由肩带结构的功能问题引起，(c) 联合紊乱：肩带结构的滑膜紊乱和功能紊乱共同导致问题，使得无法确定哪个结构是主要原因。考虑到有限的治疗选择（起初使用非甾体抗炎药，对于持续性问题，如果是滑膜问题则注射镇痛药和皮质类固醇，或者对于肩带问题进行手法治疗），不需要更详细的分类来确定成功的治疗策略。
