肩胛下肌炎伴关节内伸展的罕见病例。

Sundarajan Silvampatti, Shivam Shah, Terence D Souza, Ramakanth Rajgopalakrishan, Shanmuganath Rajsekaran
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引用次数: 0

摘要

简介:许多肩部病变表现为疼痛和僵硬;这种情况的主要诊断包括钙化性肌腱炎或肩袖撕裂。其中,骨化性肌炎是非常罕见的。病例报告:一名22岁女性,因肩部疼痛6个月向我们提出投诉。临床检查,外旋和内旋受限。经评估,x线片正常,而磁共振成像和计算机断层扫描显示肩胛下肌1.5 cm × 1 cm病变延伸至肩关节。首先进行超声引导活检,随后进行开放切除活检,发现骨化性肌炎。术后15天,患者实现了全活动,术后无大变化。肩功能评分Constant-Murley评分(0-100)从术前到术后分别从66分提高到95分,University of California评分(0-35)从17分提高到34分。讨论:肌炎通常是一种创伤后良性异位骨化病,累及四肢大肌肉,如大腿、肘部等。到目前为止,只有3例报告牵涉到肩袖肌腱,但没有一例牵涉到关节内伸展。这种情况的治疗通常是保守的;然而,对于那些关节功能受损、症状持续或神经血管问题的患者,应考虑手术治疗。因此,由于患者的日常活动受损,我们成功地对其进行了手术治疗。结论:肩关节周围的骨化性肌炎是罕见的,但当出现时,与其他常见的异位骨化相比,它在外观和位置上表现出差异。其处理应根据症状的程度和患者的具体主诉。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Rare Case of Subscapularis Myositis Ossificans with Intra-articular Extension.

Introduction: Many of the shoulder pathologies present with pain and stiffness; the principal diagnosis of this condition includes calcific tendonitis or rotator cuff tears. Among these, myositis ossificans is very rare.

Case report: A 22-year-old female presented to us with a complaint of pain in the shoulder for 6 months. On clinical examination, external rotation and internal rotation were restricted. On evaluation, X-ray was normal, while magnetic resonance imaging and computed tomography scan showed 1.5 cm × 1 cm lesion in the subscapularis extending in the shoulder joint. First an ultrasound-guided biopsy was performed, which was followed by open excision biopsy revealing myositis ossificans. Post-operative period was uneventful with the patient achieving full range of motion after 15 days of surgery. Shoulder functional score Constant-Murley score (0-100) increased from 66 to 95, and University of California score (0-35) improved from 17 to 34 from pre-operative to post-operative period, respectively.

Discussion: Myositis is usually a post-traumatic benign heterotopic ossificans that involves large muscles of extremities like the thigh, elbow, etc. So far, only 3 cases have been reported with involvement of rotator cuff tendons, but none with an intra-articular extension. Treatment of this condition is usually conservative; however, surgical treatment is indicated should be considered for those with impaired joint function, continued symptoms, or neurovascular problems. Thus, our case was successfully treated operatively because of impairment in her day-to-day activities.

Conclusion: Myositis ossificans is rare around the shoulder, but when present, it demonstrates differences with respect to appearance and location as compared to other commonly reported heterotopic ossification. Its management should be according to the degree of symptoms and patient-specific complaints.

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