[Value of diagnostic measures in soft tissue diseases and soft tissue lesions of the shoulder joint].
Calcifying tendinitis, acute tendinitis, frozen shoulder, rotator cuff rupture, subluxation of the gleno-humeral joint and injury of the biceps tendon are commonly classed under the blanket term "peri-arthropathy of the shoulder". It is now possible to make a precise diagnosis of these shoulder disorders by means of a clinical examination supported by X-ray examination, ultrasonography, arthrography, computed tomography (CT), magnetic resonance imaging (MRI) and arthroscopy. Calcifying tendinitis is diagnosed by consideration of the patient's history, followed by clinical examination and X-ray examination. Acute tendinitis is a clinical diagnosis, as is frozen shoulder. Ruptures of the rotator cuff can be detected by ultrasonography, which is a screening method; such ruptures can also be detected by arthrography. The localization and extent of the defect are best estimated by arthroscopy. Shoulder instability is another clinical diagnosis. Bony defects of the humeral head (Hill-Sachs lesion) or the glenoid rim are revealed by computed tomography (CT). CT arthrography reveals the presence of any Broca-Hartman lesion in the anterior inferior part of the anterior capsular mechanism. Rupture, subluxation or luxation of the biceps tendon are diagnosed either by clinical examination or by arthroscopy. Knowledge of the sensitivity, specificity and accuracy of the diagnostic procedures makes it possible to carry them out in a standardized, logical sequence. Arthroscopy allows a decidedly more accurate diagnosis than any of the other methods, but as it is an invasive procedure it should be kept until last when diagnosis of disorders of the gleno-humeral joint is required.
Orthopädische Klinik im Annastift, Medizinischen Hochschule Hannover.
C J
CJ
Wirth
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D
Kohn
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Melzer
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Markl
D001182:Arthroscopy; D003952:Diagnostic Imaging; D006801:Humans; D007592:Joint Diseases / Q000175:diagnosis*; D008487:Medical History Taking; D010808:Physical Examination; D000070599:Shoulder Injuries; D013708:Tendon Injuries / Q000175:diagnosis
Wertigkeit diagnostischer Massnahmen bei Weichteilerkrankungen und Weichteilschäden des Schultergelenks.