肩鎖關節擾亂症

Acromioclavicular Derangement

鍾進燈(Chinn-Dong Chung) ； 周崇頌(Chrong-Song Chuo) ； 徐道昌(Tao-Chang Hsu)

《中華民國復健醫學會雜誌》 15期 (1987/12) Pp. 35-37

https://doi.org/10.6315/JRMA.198712.0035

摘要

為探討肩銷關節因素，引發肩痛，肩關節活動限制。本研究將臨床上臆斷為肩銷關節病變患者，以治療斷法，確定病灶位置，再以殊X光照相法，清楚顯示關節情形，排除骨折，脫位，骨性，風濕性，結核性關節炎和腫瘤。臨床上理學檢查合乎下列三點，稱臆斷為肩鎖關節病變。1.主訴肩痛，肩鎖關節處局部壓痛。2.疼痛弧在150°至180°之間。3.水平內縮活動減少，終末端活動引疼痛。此類患經肩鎖關節內注射，理學檢查症候消失，X光檢查正常，本文為肩鎖關擾亂症，此病人臨床常見，但是常被疏忽。本科自75年9月起至76年3月止半年期間臆斷為肩鎖關節病變者共30位，經治療診斷，Ｘ光檢查後，診斷為肩鎖關節擾亂症共有15位，一但診斷確定，治療重點必須針對此關節，進行熱敷，超音波，關節活動操作，才能夠得到良好效果。

關鍵字

肩銷關節擾亂症 ； 疼痛弧 ； 終末端活動 ； 治療性診斷 ； 關節活動操作

並列摘要

The purpose of this study were to evaluate the acromicolavicular joint factor eliciting the shoulder pain and limitation of movement. We collected 30cases with suspected the A-C joint lesion disclosed by physical examination from O.P.D of the Rehabilation Dept. V.G.H.-T.C sine Sept. '86 to March. '87. The physical findings were (1) local tenderness at the A-C joint area, (2) painful arc at 150 to 180 degree, (3) limited R. O.M. during horizontal adduction and elicited pain at the end range. The patient recieved intra-articular injection at the A-C joint with kenacort 0.5cc +2% xylocaine 0.5cc for therapeutic diagnosis. The patients whose symptoms subsided within three minutes after injection recieved the special view of the shoulder joint in order to demostrate A-C joint clearly to rule out dislocation, subluxation, R.A,.O.A. TB. and tumors.
After disapearance of the physical findings and negative finding of the special X-ray examination was documented we called it A-C joint derangement.
The results were (1) in 21out of 30cases symptoms were free after injection (2) in 15 out of 21cases negative finding of X-ray examination was noted. That is, 15 cases were labeled as the A-C joint derangement. The mangement should be focused on the A-C joint and achiefed by hot pad, ultrasound, stretching and mobilization.

並列關鍵字

Acromioclavicular joint derangement ； Painful Arc ； End-range ； Therapeutic Diagnosis ； Mobilization