关节炎性肩关节的超声及手术评估
Ultrasound and operative evaluation of arthritic shoulder joints.
作者信息
Alasaarela E, Leppilahti J, Hakala M
机构信息
Department of Internal Medicine, University of Oulu, Finland.
出版信息
Ann Rheum Dis. 1998 Jun;57(6):357-60. doi: 10.1136/ard.57.6.357.
OBJECTIVE
To assess the diagnostic value of ultrasonography (US) in the evaluation of arthritic shoulder joints.
METHODS
Twenty shoulders of 20 inpatients with arthritis were evaluated by US one day before the shoulder operation. Changes in the subacromial-subdeltoid bursa, biceps tendon and tendon sheath, rotatof cuff, and glenohumeral joint were recorded and compared with findings at operation.
RESULTS
In the detection of effusion/hypertrophy in the subacromial-subdeltoid bursa, US had a sensitivity of 93% and a specificity of 83%. For a biceps tendon rupture US had a sensitivity of 70% and a specificity of 100%. US missed three intraarticular biceps tendon ruptures. For effusion/hypertrophy in the biceps tendon sheath US had a sensitivity of 100% and a specificity of 83%. For a rotator cuff tear US had a sensitivity of 83% and a specificity of 57%. US missed two small longitudinal rotator cuff tears. Three thin membranous, but intact, rotator cuff tendons were classified as full thickness tears by US. Synovial effusion/hypertrophy was detected by US and at operation in all of the 12 glenohumeral joints that were evaluable at surgery.
CONCLUSION
US is a reliable method in experienced hands for the evaluation of inflammatory changes of an arthritic shoulder. In advanced stages of rheumatoid shoulder joints, however, US is not useful, because destructive bone changes and tendon ruptures change the normal anatomy and restrict shoulder motions, limiting the visibility of US.
目的
评估超声检查（US）在评估关节炎性肩关节中的诊断价值。
方法
对20例关节炎住院患者的20个肩部在肩部手术前一天进行超声检查。记录肩峰下 - 三角肌下滑囊、肱二头肌肌腱及腱鞘、肩袖和盂肱关节的变化，并与手术所见进行比较。
结果
在检测肩峰下 - 三角肌下滑囊积液/肥厚方面，超声的敏感性为93%，特异性为83%。对于肱二头肌肌腱断裂，超声的敏感性为70%，特异性为100%。超声漏诊了3例关节内肱二头肌肌腱断裂。对于肱二头肌肌腱鞘积液/肥厚，超声的敏感性为100%，特异性为83%。对于肩袖撕裂，超声的敏感性为83%，特异性为57%。超声漏诊了2例小的纵向肩袖撕裂。3条薄的、但完整的肩袖肌腱被超声分类为全层撕裂。在手术中可评估的所有12个盂肱关节中，超声和手术均检测到滑膜积液/肥厚。
结论
对于经验丰富的医生，超声是评估关节炎性肩部炎症变化的可靠方法。然而，在类风湿性肩关节的晚期，超声无用，因为破坏性骨改变和肌腱断裂改变了正常解剖结构并限制了肩部运动，限制了超声的可视性。
Zotero 插件