| Objective:To study the shoulder ultrasonographic images and values of healthy adults, and compare them to scapulohumeral periarthritis patients, in order to explore the ultrasonographic diadynamic methods and criteria for scapulohumeral periarthritis. Methods:1. Measure 83 healthy adult shoulders with high-frequency ultrasound for the normal values and images of rotator cuff, muscular fasciae, shoulder bursa mucosa, joint capsule and other structures.2. Measure the same indexes of 40 scapulohumeral periarthritis patients shoulders with high-frequency ultrasound, and compare them to healthy adult shoulders.3. Observe the muscle tendon, rotator cuff and other structures of shoulder through the anatomy on 6 essays of shoulder joint. Measure double shoulders of 5 antisepticised adult corpses with high-frequency ultrasound to study their values and images. Results:The structures of rotator cuff, muscle tendon and bursa mucosa were clear, and the muscular fasciae were thin on the healthy adult shoulder ultrasonographic images. The normal values of rotator cuff were:The thicknesses of left tendon of subscapularis muscle equal to and attached to coracoid process were 4.42±0.57mm and 2.28±0.40mm, while the thicknesses of right tendon were 4.31±0.61mm and 2.24±0.53mm; the thicknesses of left tendon of infraspinatus muscle equal to and attached to anatomical neck were 4.62±0.54 mm and 2.22±0.33mm, while the thicknesses of right tendon were 4.74±0.53mm and 2.24±0.50mm; the thicknesses of left tendon of teres minor muscle equal to and attached toanatomical neck were 2.97±0.34mm and 1.86±0.25mm, while the thicknesses of right tendon were 3.03±0.34mm and 1.89±0.28mm; the thicknesses of left tendon of supraspinatus muscle equal to and attached toanatomical neck were 4.90±0.73mm and 2.31±0.37mm, while the thicknesses of right tendon were 5.12±0.83mm and 2.36±0.35mm; the thicknesses of left infraspinatus muscle was 0.60±0.09mm, while the thicknesses of right infraspinatus muscle was 0.64±0.10 mm; the thicknesses of bursa synovialis sub triangular muscle was 0.59±0.17mm; the thicknesses of joint capsule under the shoulder was 2.21±0.37mm. The abnormal changes of ultrasonographic image in scapulohumeral periarthritis patient shoulders consisted of thickness of joint capsule under the shoulder (adhesive synovitis), peritendinitis of caput longum musculi bicipitis brachii, myotenositis of caput longum musculi bicipitis brachii, maladie of muscle tendon, bursitis around shoulder, myofascitis, calcify of muscle tendon and arthrositis, whose values on ultrasonographic image were obviously bigger compare to normal controls:the group of thickness of joint capsule under the shoulder was 3.14±1.11mm, while the normal control was 2.21±0.37mm, P<0.05; the group of fluidify of caput longum musculi bicipitis brachii was 9.28±2.05 mm, while the normal control was 3.91±1.19 mm, P<0.05; the tendon thickness of infraspinatus muscle in the muscle tendon maladie group was 5.41±1.00 mm, while the normal control was 4.62±0.54 mm, P<0.05; the group of fluidify around shoulder mucous bursa was 1.35±0.97 mm, while the normal control was 0.59±0.17mm, P<0.05; the group of myofascitis was 0.88±0.13 mm, while the normal control was 0.64±0.10mm, P<0.05. All the values above between scapulohumeral periarthritis patients and healthy adults have statistical differences, which hints that rotator cuff, muscular fasciae, shoulder bursa mucosa, joint capsule and other structures around shoulder may be affected in scapulohumeral periarthritis patients. We should pay attention to the images and values of rotator cuff, muscular fasciae, shoulder bursa mucosa, joint capsule and other structures in shoulder ultrasonic inspection. Conclusion:High-frequency ultrasound can display the soft tissues around the shoulder clearly. The quantization of values of rotator cuff, muscular fasciae, shoulder bursa mucosa, joint capsule and other structures around shoulder can be a good method for the diagnosis of scapulohumeral periarthritis. |
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