冈上肌出口位.ppt

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1、Supraspinatusoutletviewandsupraspinatustendontear早读片胡娟2011-02-24肩关节解剖冈上肌腱出口冈上肌出口位TypeofacromionTypeIhasaflatundersurfaceandnorelationshiptoimpingement(4.6%).TypeIIacromionischaracterizedbyacurvedundersurface(81.3%).typeIIIacromionhasananteriorhook(hookedac

2、romion)(14.1%).AfourthtypeofacromionshapewasaddedthathasaconvexundersurfaceVähäkariMetal.ActaRadiol.2010,51(2):202-206Biglianietal.(1986)foundatypeIIIacromionin70%ofcadaverswithrotatorcufftears,whereasonly3%oftypeIacromionwereassociatedwithatear.Bursal-sid

3、epartialtearsorfull-thicknesstearsoftherotatorcuffarealwaysassociatedwithseveredegenerativechangesintheacromion,butdegenerativechangesintheundersurfaceoftheacromioncanbepresentwhentherotatorcuffisnormalSupraspinatustendontearClinicalfindingsApproximately40

4、%ofasymptomaticpatientsover50yearsoldhavefullthicknessrotatorcufftearsTheprevalenceofpartial-andfull-thicknesstearsinsymptomaticpatientsover60yearsoldisgreaterthan60%Chroniccausessuchasrepetitivemicrotrauma,subacromialimpingement,tendondegeneration,andhypo

5、vascularityarethoughttoberesponsibleformosttearsandaccountforthisage-dependentprevalence.AcutemacrotraumaislessfrequentlyresponsiblefortearsClinicalexaminationasawholehasasensitivity90%andaspecificityof54%inthedetectionoffull-thicknessrotatorcufftears.supr

6、aspinatusweaknessweaknessofexternalrotationimpingementMoosikasuwanetal.RadioGraphics2005;25:1591–1607Thesupraspinatusmuscleaidsnotonlyinstabilizationoftheshoulderjointbutalsoinabductionofthearm.Clinicalimpingementsyndromeischaracterizedbypainduringuseofthe

7、shoulderthatisrelievedbylocalsubacromialanestheticinjection.TotestforweaknessofexternalrotationbyevaluatingtheinfraspinatusandtearsminormusclesSupraspinatustendonteardeJesusetal.AJR2009;192:1701–1707DifferentialdiagnosisSupraspinatustendinosiscalcifictendi

8、nitissubacromialsubdeltoidbursitisgreatertuberosityfractureadhesivecapsulitiscalcifictendinitisThanks!