岡上肌肌腱炎課件

肩關(guān)節(jié)岡上肌腱炎武漢，，，，，、、、、、11111111武漢肩關(guān)節(jié)肩關(guān)節(jié)鈣化性岡上肌腱炎

（CalcifiedSupraspinatusTendonitis）1.CSTisakindofsofttissuelesions(belongsto

scapulohumeralperiarthritis

)2.Etiology：Therepeateduseofshoulderjoint、Subacromialimpingement、Tendondegeneration、calciumdeposition.strianor

trauma

degeneration

calciumdeposition3.Symptom：swellandpain

image

manifestationsinearlystage

X-RAY:softtissuemassingreater

tuberosit

inhomogeneous

density

MRI:lowsignal

intensity

on

T1WIandhighsignalintensityonT2WI(bonedestruction)

maybe

misdiagnosed

as

osteoblastoma

Image

manifestationsinlatestage

X-Ray:Calcification

in

different

shapes

fluffytype:rough/alongthelongaxissupraspinatus

tendon

longstrip:

edges

tidy/alongthelongaxissupraspinatus

tendon

sphere:edges

tidy/aroundthelongaxissupraspinatus

tendon

CSTthecalciumdepositashypointensesignalwithinthesupraspinatustendon(arrow)肩周炎（PeriarthriteScapulohumerale）定義：肩關(guān)節(jié)囊及其周圍韌帶、肌腱和滑囊的慢性特異性炎癥，又稱“凝肩綜合征”、“粘連性肩關(guān)節(jié)炎”、“五十肩”等;好發(fā)年齡及人群：50歲左右，女性多于男性；文獻報道：右側(cè)發(fā)病高于左側(cè)；注意：肩周炎并非某一點的獨立疾病，而是與肩關(guān)節(jié)周圍病變（如滑囊炎，肌腱炎、鈣化、撕裂的等）有密切聯(lián)系，繼而引起肩周軟組織廣泛粘連，肩關(guān)節(jié)活動障礙;病理肩關(guān)節(jié)囊與滑膜隱窩的無菌炎癥：充血、水腫、炎細胞浸潤；

肩部周圍肌肉、韌帶、深筋膜的慢性勞損（可伴出血）；ClassificationofShoulderPortionDisorders

引起慢性肩痛與活動受限的肩周疾病

(Shoulderdisorderswithchronicshoulderpainandshoulderjointactivitylimits)

1.肱二頭肌長頭肌腱鞘炎(myotenositisoflongheadofbicepsbrachii)

2.CST；3.

肩峰撞擊綜合征:肩峰下滑囊炎/肩袖撕裂

(SubacromialImpingementSyndrome:subacromialbursitis/rotatorcufftear)

4.盂唇-韌帶復合體損傷(glenoidallabrum-Ligamentcomplexinjury)5.凍結(jié)肩(粘連性關(guān)節(jié)囊炎)：FrozenShoulder(adhesivecapsulitis)

Normalandtendinitisofthelongheadofthebiccps21A:normal21B:MRimageshowstheenlargementofthetendon(arrow)andabnormalinternalhighsignalintensityfulltear

Dislocationofthelongheadofthebiceps.Delamination-typetearofthesubscapularis肩關(guān)節(jié)撞擊綜合征(ImpingementSyndromeoftheShoulder)定義(Definition)

喙肩弓與肱骨頭之間的空間絕對或相對減小，使肩部在上舉外展過程中，喙肩弓與肱骨頭反復卡壓其間的軟組織結(jié)構(gòu)〖主要為肩峰下滑囊(Subacromialbursa)、岡上肌腱(supraspinatustendon)和部分岡下肌腱(lower-scapulartendon)、肱二頭肌長頭腱(longheadofbiceptendon)〗引起癥狀，稱為肩峰下撞擊綜合征。Subdeltoid–subacromialbursitisSubdeltoid–subacromialbursitis.

AcromialmorphologyFullthicknesstearofthesupraspinatusretractionofthetendonFullthicknesstearofthesubscapularispartialthicknesstearofthesubscapularislabraltearClassicalBankeartLesion

上方盂唇前后撕裂（SLAP）completelyseparatedfromthe