肌骨超声检查对不同临床分期冻结肩的诊断价值  

Diagnostic value of muscle bone ultrasound in frozen shoulder with different clinical stages

作　　者：钱约男 胡安鑫 钟润鸣 王朋会 董伊隆 QIAN Yuenan;HU Anxin;ZHONG Runmin;WANG Penghui;DONG Yilong(Department of Ultrasonography,the Third Affiliated Hospital of Wenzhou Medical College,Rui'an 325200,China)

机构地区：[1]温州医科大学附属第三医院超声科,325200 [2]温州医科大学附属第三医院骨科,325200

出　　处：《浙江医学》2023年第3期284-287,292,共5页Zhejiang Medical Journal

基　　金：温州市医药卫生科研项目(2021022)。

摘　　要：目的分析不同临床分期冻结肩的腋下关节囊厚度和肩袖间隙血流信号情况,探讨应用肌骨超声检查对不同临床分期冻结肩的诊断价值。方法收集2018年6月至2021年12月温州医科大学附属第三医院就诊的患者,其中冻结肩患者87例(冻结肩组)和非冻结肩患者30例(非冻结肩组),冻结肩组患者参照临床表现进一步分为冻结肩Ⅰ期组35例、冻结肩Ⅱ期组29例和冻结肩Ⅲ期组23例。检查各组患者肩关节的肌骨超声表现,比较各组患者腋下关节囊厚度和肩袖血流阳性率。结果冻结肩患者患侧腋下关节囊厚度为(3.46±1.04)mm,明显高于非冻结肩组的(1.89±0.36)mm,差异有统计学意义(P<0.05)。腋下关节囊厚度冻结肩Ⅰ期组为(2.87±0.95)mm,冻结肩Ⅱ期组为(4.44±0.72)mm,冻结肩Ⅲ期组为(3.08±0.46)mm,3组间比较差异有统计学意义(P<0.05),且冻结肩Ⅱ期组患者肩关节囊厚度最厚,分别与Ⅰ期、Ⅲ期组患者比较差异均有统计学意义(均P<0.05);冻结肩组肩袖间隙血流阳性率高于非冻结肩组,差异有统计学意义(P<0.05)。进一步分析发现,肩袖间隙血流阳性冻结肩Ⅰ期组35例、Ⅱ期组3例、Ⅲ期组1例、非冻结肩组2例,4组间比较差异有统计学意义(P<0.05)。冻结肩Ⅰ期组肩袖间隙血流阳性率远高于其他组(P<0.05)。相关性分析显示,冻结肩患者腋下关节囊厚度与疾病病程之间无相关性(r=-0.037,P>0.05)。结论应用超声检查检测腋下关节囊厚度和肩袖间隙血流情况有助于临床早期诊断冻结肩及早期治疗,缩短患者病程,具有重要的临床应用价值。Objective To explore the diagnostic value of ultrasound in frozen shoulder with different stages.Methods Eighty seven patients with frozen shoulder(frozen shoulder group)and 30 patients without frozen shoulder(control group)who underwent shoulder ultrasound examination the Third Affiliated Hospital of Wenzhou Medical University from June 2018 to December 2021 were enrolled.According to clinical manifestations the patients with frozen shoulder were further divided into frozen shoulder stage I group(35 cases),stage II group(29 cases)and stage III group(23 cases).The thickness of axillary joint capsule and the positive rate of rotator cuff blood flow on ultrasonography were compared between study group and control group and among frozen shoulder patients with different stages.Results The thickness of axillary joint capsule in frozen shoulder group was(3.46±1.04)mm,which was significantly higher than that in control group(1.89±0.36)mm(P<0.05).The thickness of frozen shoulder axillary joint capsule in stage I,II and III was(2.87±0.95)mm,(4.44±0.72)mm and(3.08±0.46)mm,respectively(P<0.05).The positive rate of blood flow in rotator cuff space in frozen shoulder group was significantly higher than that in control group(P<0.05).The positive rate of blood flow in the rotator cuff space of the frozen shoulder stage I group(35/35)was significantly higher than that of stage II(3/29),stage III(1/23)and control(2/30)groups(P<0.05).The thickness of axillary joint capsule was not correlated with the course of disease in patients with frozen shoulder(r=-0.037,P>0.05).Conclusion The ultrasound detection of the thickness of axillary joint capsule and the blood flow in rotator cuff space is conducive to the diagnosis and staging of frozen shoulder.

关 键 词：肌骨超声 肩关节 疼痛 关节囊 厚度 

分 类 号：R686[医药卫生—骨科学]