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rnal rotation,第十三頁,共四十四頁。,3 drop sign 1) almost full external rotation 2) elbow flexed at 90 degrees,第十四頁,共四十四頁。,4 weakness with external rotation 1) elbows flexed to 90 degrees 2) the thumbs up 3) shoulders rotated internally 20 degrees,第十五頁,共四十四頁。,3 肩胛(jiānjiǎ)下肌 肩內(nèi)旋、后伸功能,1 lift off test asking the patient to internally rotate the arm to lift the hand posteriorly off of the back,第十六頁,共四十四頁。,2 internal rotation lag sign,第十七頁,共四十四頁。,3 belly press,第十八頁,共四十四頁。,4 bear hug test,第十九頁,共四十四頁。,4 針對(duì)(zhēndu236。)肩峰下撞擊綜合癥的體查,第二十頁,共四十四頁。,HawkinsKennedy test,第二十一頁,共四十四頁。,關(guān)于(guāny)MRI,肩袖解剖(jiěpōu),第二十二頁,共四十四頁。,解剖(jiěpōu)足?。╢ootprint),第二十三頁,共四十四頁。,關(guān)于(guāny)MRI,正常(zh232。ngch225。ng)肩袖的MRI 斜冠狀面,第二十四頁,共四十四頁。,正常(zh232。ngch225。ng)肩袖的MRI 斜矢狀面,第二十五頁,共四十四頁。,正常(zh232。ngch225。ng)肩袖的MRI 橫斷面,第二十六頁,共四十四頁。,損傷(sǔnshāng)肩袖的MRI,第二十七頁,共四十四頁。,魔法(m243。 fǎ)角 magic angle phenomenon the fibers are at 55 degrees to the main magnetic field on T1 Erickson SJ, Prost RW, Timins ME. The “magic angle” effect: background physics and clinical relevance. Radiology. 1993。188:2325.,第二十八頁,共四十四頁。,我們(wǒ men)在MRI上應(yīng)得到的信息,1 肩袖走行及連續(xù)性 2 高信號(hào)(x236。nh224。o) 3 脂肪變性 4 肌肉萎縮 5 肌肉回縮 6 三角肌下、肩峰下囊滑液相連,第二十九頁,共四十四頁。,肩袖走行及連續(xù)性,第三十頁,共四十四頁。,脂肪(zhīf225。ng)滲透(fatty infiltration),Fuchs B, Weishaupt D, Zanetti M, Hodler J, Gerber C. Fatty degeneration of the muscles of the rotator cuff: assessment by computed tomography versus magnetic resonance imaging. J Shoulder Elbow Surg 1999。8:599605.,第三十一頁,共四十四頁。,肌肉(jīr242。u)萎縮(muscle atrophy),1 切線(qiēxi224。n)征[1] (tangent sign) 2 肩胛比(scapular ratio)Scapular ratio uses the ratio of the supraspinatus muscle in cross section on the sagittal oblique image compared with