腱板断裂に伴い肩関節血症を反復した 1 例

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We report a case of repeated hemarthrosis of the shoulder joint with rotator cuff tear. <BR>A 68-year-old man felt sudden severe right shoulder pain and swelling, and had emergency puncture of hemorrhage five times. He had untreated hypertension and diabetes mellitus. MRI showed a massive chronic tear of the supraspinatus, infraspinatus, and subscapularis tendon. Since he feared the attacks of severe pain, we performed arthroscopic synovectomy of the glenohumeral joint(GHJ) and the subacromial bursa(SAB). Synovium was extremely multiplied at both GHJ and SAB, but we cannot detect the bleeding point. Pathological diagnosis of the specimens showed no malignancy. After surgery, no recurrence of the hemarthrosis was observed. The JOA score improved from 58 points to 76 points one year postoperatively. His pain alleviated after the surgery, so he was satisfied with the clinical result.<BR>We suggest that in this case hypertension and diabetes mellitus caused easy-to-bleeding status, whereas massive rotator cuff tear caused instability and impingement at the shoulder joint, which made reactive synovitis. Arthroscopic synovectomy provided satisfactory clinical outcomes.
日本肩関節学会の論文