大转子疼痛综合征的超声病理解剖。

IF 1.3 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Journal of Ultrasound Pub Date : 2024-09-01 Epub Date: 2023-12-12 DOI:10.1007/s40477-023-00836-x
Leire Atilano, Nerea Martin, Gotzon Iglesias, Jose Ignacio Martin, Josu Mendiola, Ayoola Aiyegbusi, Paola Bully, Manuel Rodriguez-Palomo, Isabel Andia
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引用次数: 0

摘要

目的:在大转子痛综合征(GTPS)临床诊断中,确定并强调可作为成像生物标记描述不同患者表型的相关 US 特征:通过超声检查,我们对 88 名临床诊断为 GTPS 的患者进行了评估,以了解臀中肌(上后方和外侧)和臀小肌的肌腱基质变化和钙沉积情况。转子周围检查包括筋膜、转子滑囊、皮质不规则和内生骨赘。使用多变量回归模型评估了病理变化与疼痛和功能的关系:在 88 位患者中,86 位(97.7%)检查出臀中肌肌腱病变,54 位(61.4%)检查出臀小肌肌腱病变。97.7%的患者存在钙沉积,与压痛有关(p = 0.009),最常位于臀中肌而不是臀小肌(p = 0.014);钙化与肌腱厚度(p = 0.042)、低瘀血性(p = 0.005)和部分撕裂(p = 0.030)有关。36名患者(40.9%)出现滑囊肿胀;多变量回归模型预测,滑囊肿胀的患者疼痛较轻(p = 0.008),臀肌萎缩(p = 0.001)和臀中肌纤维模式丧失(p = 0.002)的患者功能障碍较轻:GTPS包括退行性钙化性臀肌腱病和与身体功能和疼痛相关的转子周围间隙改变。GTPS的严重程度可通过超声成像生物标志物进行评估。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Sonographic pathoanatomy of greater trochanteric pain syndrome.

Aims: To identify and highlight pertinent US features that could serve as imaging biomarkers to describe different patient phenotypes, within Great Trochanteric Pain Syndrome (GTPS) clinical diagnosis.

Materials and methods: Using ultrasound we evaluated eighty-eight clinically diagnosed patients with GTPS, for tendon matrix changes and calcium deposits in the gluteus medius (superoposterior and lateral aspects) and in the gluteus minimus. Peritrochanteric examination included fascia lata, trochanteric bursa, cortical irregularities and the presence of enthesophytes. The association of pathological changes with pain and functionality was evaluated using multivariate regression models.

Results: Out of the 88 patients, 86 examinations (97.7%) detected gluteus medius tendinopathy, and 54 patients (61.4%) had gluteus minimus tendinopathy in addition. Calcium deposits were present in 97.7% of patients, associated with tenderness (p = 0.009), and most often located in the gluteus medius rather than in the gluteus minimus (p = 0.014); calcifications were associated with tendon thickness (p = 0.042), hypoechogenicity (p = 0.005) and the presence of partial tears (p = 0.030). Bursa swelling occurred in 36 patients (40.9%); multivariate regression models predicted less pain in patients with bursa distension (p = 0.008) and dysfunction in patients with gluteal muscle atrophy (p = 0.001) and loss of fibrillar pattern in the gluteus medius (p = 0.002).

Conclusion: GTPS involves both degenerative calcifying gluteal tendinopathy and alterations in the peritrochanteric space associated with physical function and pain. The severity of GTPS can be assessed using ultrasound imaging biomarkers.

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来源期刊
Journal of Ultrasound
Journal of Ultrasound RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
CiteScore
4.10
自引率
15.00%
发文量
133
期刊介绍: The Journal of Ultrasound is the official journal of the Italian Society for Ultrasound in Medicine and Biology (SIUMB). The journal publishes original contributions (research and review articles, case reports, technical reports and letters to the editor) on significant advances in clinical diagnostic, interventional and therapeutic applications, clinical techniques, the physics, engineering and technology of ultrasound in medicine and biology, and in cross-sectional diagnostic imaging. The official language of Journal of Ultrasound is English.
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