冰凍肩的超音波檢查

　　　　　冰凍肩是引起慢性肩痛及失能的常見原因，其診斷有賴於詳細的病史與理學檢查 ，並佐以影像學檢查。軟組織超音波不具侵入性，方便簡單又可做動態檢查，加上近年來其 解像力不斷提高，適合於做冰凍肩之篩檢。 本研究利用 10MHz 高解像力之超音波，檢查了 51 名患者共 56 個肩膀。 檢查內容包括患者的肱二頭肌、脊上肌、脊下肌、滑液囊及肱骨 頭之活動，參考 Mack 等人及 Crass 等人的檢查步驟。 結果顯示有 43% (24 個 ) 之患者 有滑液囊發炎、腫脹現象，16% ( 9個) 患者有肱二頭肌長頭肌腱炎，43% (24個) 患者有脊 上肌肌腱斷裂，57% (32 個 ) 患者有夾入現象。 由本研究得知，冰凍肩患者常合併有滑液 囊之發炎腫脹、脊上肌肌腱斷裂、及肱二頭肌生長頭肌腱炎。除了常規之關節運動外，若能 針對其病理變化加以治療，療效就更易顯現。所以，我們認為高解像力之超音波可作為冰凍 肩診斷及治療之輔助工具，它方便簡單，適當的使用將有助於決定此類患者之治療方式。
　　　　　Improvements in equipment design and examination technique have led to an increasing role for ultrasound iin detecting soft tissue lesions. Ultrasound examination is noninvasive, widely available, less expensive, and allows dynamic study. Using ultrasound, we investigated the related soft tissue pathologies in individuals diagnosed as having frozen shoulder. Using a 10 MHz linear transducer probe (Diasonic VST master series), we examined 56 shoulders in 51 patients. The images consisted of transverse and longitudinal views of the biceps, supraspinatus, infraspinatus and subacromio-subdeltoid bursa, and dynamic motion of the humeral head. Sonography demostrated either subacromio-subdeltoid bursitis or bursa dilatation in 43% of patients, biceps tendinitis in 16%, and partial rupture of the supraspinatus in 43%. Moreover impingement was found in 57% of patients. We conclude that individuals with frozen shoulder have various surrounding soft tissue disorders. Ultrasound is a reliable and useful diagnostic tool to detect these pathologies. Based on the different pathologies detected by ultrasound, more specific and effective therapeutic policy can be instituted.