肩关节半脱位误诊1例及文献复习  

Misdiagnosis of shoulder subluxation in 1 case and literature review

作　　者：陈文科 周宪华 Chen Wenke;Zhou Xianhua(Department of Trauma Surgery, Yanzhou District Peopled Hospital of Jining City ( Affiliated Hospital of Jining Medical College)272100)

机构地区：[1]济宁市兖州区人民医院一济宁医学院附属医院兖州院区创伤外科,山东济宁272100

出　　处：《中国伤残医学》2019年第10期33-34,共2页Chinese Journal of Trauma and Disability Medicine

摘　　要：患者因左肩部外伤后疼痛、活动受限5天就诊,左肩关节X线:左肩关节脱位,左肱骨大结节骨折?给与肩关节脱位手法整复复位失败,建议行手术切开复位治疗,以“左肩关节脱位,左肱骨大结节骨折?”收入院。患者拒绝手术切开复位。因查体关节囊未及明显空虚感,尚不能排除无肩关节脱位可能,完善三维CT检查:肱骨大结节外上方高密度影,考虑:韧带骨化。肩关节MRI检查:左肩关节冈上、冈下肌腱慢性损伤,肱骨大结节旁软组织钙化;左肩关节退行性变。予以消炎止痛药物及功能锻炼,治疗10天后患者症状明显缓解出院。出院诊断:左肩关节退行性变;左肩袖钙化性肌腱炎;左冈上肌腱钙化。肩袖钙化性肌腱炎,是一种常见的引起肩痛和残疾的肩袖疾病,导致肩关节半脱位少见。The patient was diagnosed with pain and activity limitation after left shoulder trauma for 5 days. Left shoulder joint X - ray: left shoulder joint dislocation, left humeral large tuberosity fracture? For the failure of the shoulder joint dislocation to complete the reset failure, it is recommended to perform surgical open reduction treatment to " left shoulder joint dislocation, left humerus large tuberosity fracture?" The patient refused surgery to open the reduction. Because of the lack of obvious emptiness of the joint capsule, it is still impossible to rule out the possibility of dislocation of the shoulder joint. Perfect 3D CT examination: high density shadow on the outer part of the greater tibia. Consider: ligament ossification. MRI examination of the shoulder joint: chronic injury of the left shoulder joint, the infraorbital tendon, soft tissue calcification beside the greater tibial tuberosity;degenerative changes of the left shoulder joint. The anti 一 inflammatory and analgesic drugs and functional exercise were given. After 10 days of treatment, the symptoms of the patients were obviously relieved and discharged. Discharge diagnosis: degenerative changes of the left shoulder joint;calcified tendinitis of the left shoulder sleeve;calcification of the left superior tendon. Cadastal calcific tendinitis is a common rotator cuff disease that causes shoulder pain and disability, resulting in a subluxation of the shoulder joint.

关 键 词：肩关节半脱位 肩袖钙化性肌腱炎 误诊 文献复习 

分 类 号：R684.7[医药卫生—骨科学]