肩甲骨脊椎間距離の臨床的意義
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概要
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It is thought that the difference between affected and un-affected side of scapula-spine distance (SSD) is the evidence to have a shoulders injury in inspection. However, it is not cleared which disorder appears for the difference of SSD. The purpose of this study was to investigate the characteristic of the differences of SSD for each disorder and made an index of differential diagnosis by inspection. We examined 215 cases that had shoulder complaints. We measured SSD of both sides at the upper distances between the medial border of spine of scapula and spinous process of the same height and at the lower distances between inferior angle of scapula and that. We diagnosed from the findings of XP and MRI and clinical examinations. The differences of SSD of each disorder: the upper, the lower. Small size (under 1cm) of rotator cuff tear were 30cases: +2.5mm, +3.0mm. Medium size (1-3cm) of it were 48cases: +4.0mm, +3.3mm. Large size (over 3cm) of it were 40cases: +7.1mm, +9.9mm. Throwing shoulder were 32cases: +7.3mm, +6.7mm. Thoracic outlet syndrome were 15cases: +10.6mm, +7.1mm. Calcific tendonitis of rotator cuff were 17cases: +1.4mm, +1.6mm. Recurrent dislocation of the shoulder were 7cases: -1.7mm, +0.9mm. Frozen shoulder were 26cases: -0.7mm, +1.1mm. The differences of SSD in large size of RCT and throwing shoulder and thoracic outlet syndrome were more than +7mm. As tear sizes were increased, We found that scapulas position of affected side became to abduction and upper rotation. The differences of SSD in calcific tendonitis of rotator cuff and recurrent dislocation and frozen shoulder were less than ±2mm. The differences of SSD becomes an important index of differential diagnosis by inspection.
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