冈上肌肌腱炎课件

肩关节冈上肌腱炎武汉，，，，，、、、、、11111111武汉肩关节肩关节钙化性冈上肌腱炎

（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）定义：肩关节囊及其周围韧带、肌腱和滑囊的慢性特异性炎症，又称“凝肩综合征”、“粘连性肩关节炎”、“五十肩”等;好发年龄及人群：50岁左右，女性多于男性；文献报道：右侧发病高于左侧；注意：肩周炎并非某一点的独立疾病，而是与肩关节周围病变（如滑囊炎，肌腱炎、钙化、撕裂的等）有密切联系，继而引起肩周软组织广泛粘连，肩关节活动障碍;病理肩关节囊与滑膜隐窝的无菌炎症：充血、水肿、炎细胞浸润；

肩部周围肌肉、韧带、深筋膜的慢性劳损（可伴出血）；ClassificationofShoulderPortionDisorders

引起慢性肩痛与活动受限的肩周疾病

(Shoulderdisorderswithchronicshoulderpainandshoulderjointactivitylimits)

1.肱二头肌长头肌腱鞘炎(myotenositisoflongheadofbicepsbrachii)

2.CST；3.

肩峰撞击综合征:肩峰下滑囊炎/肩袖撕裂

(SubacromialImpingementSyndrome:subacromialbursitis/rotatorcufftear)

4.盂唇-韧带复合体损伤(glenoidallabrum-Ligamentcomplexinjury)5.冻结肩(粘连性关节囊炎)：FrozenShoulder(adhesivecapsulitis)

Normalandtendinitisofthelongheadofthebiccps21A:normal21B:MRimageshowstheenlargementofthetendon(arrow)andabnormalinternalhighsignalintensityfulltear

Dislocationofthelongheadofthebiceps.Delamination-typetearofthesubscapularis肩关节撞击综合征(ImpingementSyndromeoftheShoulder)定义(Definition)

喙肩弓与肱骨头之间的空间绝对或相对减小，使肩部在上举外展过程中，喙肩弓与肱骨头反复卡压其间的软组织结构〖主要为肩峰下滑囊(Subacromialbursa)、冈上肌腱(supraspinatustendon)和部分冈下肌腱(lower-scapulartendon)、肱二头肌长头腱(longheadofbiceptendon)〗引起症状，称为肩峰下撞击综合征。Subdeltoid–subacromialbursitisSubdeltoid–subacromialbursitis.

AcromialmorphologyFullthicknesstearofthesupraspinatusretractionofthetendonFullthicknesstearofthesubscapularispartialthicknesstearofthesubscapularislabraltearClassicalBankeartLesion

上方盂唇前后撕裂（SLAP）completelyseparatedfromthe