著者

板寺 英一 市川 徳和 山川 晴吾 橋詰 博行 井上 一

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.24, no.3, pp.383-385, 2000-09-30 (Released:2012-11-20)

参考文献数

8

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We studied the MRI findings of a frozen shoulder in three different phases. Forty-one frozen shoulders were available for this study. The mean age of the patients was 58 years (range,43 to 77 years). The mean range of elevation of the shoulders was 118 degrees (range,80 to 140 degrees). There were 10 shoulders in the acute phase (less than 2 months),16 in the subacute plase (2 to 3 months),15 in the chronic phase (4 to 12 months). Oblique coronal, oblique sagittal, and axial sequences were made with the fast spin-echo technique using a 0.5-tesla MR Vectra unit. On T2-weighted images, high signal intensities (HIS) in the glenohumeral joint (GHJ), the subacromial bursa (SAB) and the bicipital groove (BG) were analyzed, and then the contraction of the axillary pouch was evaluated.HIS at the GHJ was moderate in 40%, slight in 20% and none in 40% of the shoulders in the acute phase; in 0%, in 63% and in 37%, respectively, in the subacute phase; and in 7%, in 40% and in 53%, respectively, in the chronic phase. HIS at the SAB was moderate in 0%, slight in 30% and none in 70% of the shoulders in the acute phase; in 0%, in 25% and in 75%, respectively, in the subacute phase; and in 0%, in 27% and in 73%, respectively, in the chronic phase. HIS at the BG was moderate in 30%, slight in 60% and none in 10% of the shoulders in the acute phase; in 25%, in 19% and in 56%, respectively, in the subacute phase; and in 13%, in 40% and in 47%, respectively, in the chronic phase. Contraction of the axillary pouch was observed in 20% of the shoulders in the acute phase,69%in the subacute phase, and 73% in the chronic phase.In conclusion, there were increased amounts of fluid at the GHJ and BG in the acu, t eb upt haosnely a small amount at the SAB. Shoulder stiffness may be caused by contraction of the GHJ capsule which develops as the intraarticular synovitis resolves.

著者

市川 徳和 板寺 英一 山川 晴吾 橋詰 博行 井上 一

出版者

中部日本整形外科災害外科学会

雑誌

中部日本整形外科災害外科学会雑誌 (ISSN:00089443)

巻号頁・発行日

vol.42, no.1, pp.1-6, 1999

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現在まで五十肩(凍結肩)における病理学的報告は少ない。今回五十肩の病態を明らかにするために,関節鏡を使用して関節内の変化を検索し生検により滑膜の病理所見を検討した。対象は14例15肩で,年齢は平均56歳であった。罹病期間は平均5.6カ月,日整会肩関節疾患治療成績判定基準(以下JOA score)は平均51点であった。関節鏡視所見として五十肩では前方関節唇は軽度の摩耗までで関節構成体の変化は少なかった。滑膜は発赤し易出血性であり,上関節腔や肩甲下筋腱嚢付近で増殖していた。五十肩ではほとんどの症例で関節腔が狭く鏡視が困難であった。関節内滑膜の病理所見として血管増生は強く炎症細胞浸潤は軽度であった。また血管の拡張を伴いその中に血液のうっ滞が認められた。以上より五十肩は関節腔の狭小を伴い,関節腔内ではうっ血を特徴とする循環不全の存否が確認できた。