tailieunhanh - Chẩn đoán bệnh Viêm xương khớp

Các doanh (AC) acromioclavicular May Be bị ảnh hưởng bởi một số các quá trình bệnh lý, MOST viêm xương khớp thường, viêm khớp posttraumatic, xương đòn và osteolysis xa. Việc chẩn đoán thích hợp của một vấn đề thường có thể được rút ra từ một lịch sử kỹ lưỡng, kiểm tra thể chất, | Painful Conditions of the Acromioclavicular Joint Benjamin S. Shaffer MD Abstract The acromioclavicular AC joint may be affected by a number of pathologic processes most commonly osteoarthritis posttraumatic arthritis and distal clavicle osteolysis. The correct diagnosis of a problem can usually be deduced from a thorough history physical examination and radiologic evaluation. Asymptomatic AC joint degeneration is frequent and does not always correlate with the presence of symptoms. Selective lidocaine injection enhances diagnostic accuracy and may correlate with surgical outcome. Nonoperative treatment is helpful for most patients although those with osteolysis may have to modify their activities. In appropriately selected patients open or arthroscopic distal clavicle resection is necessary to relieve symptoms. Recent biomechanical and clinical data emphasize the importance of capsular preservation and minimization of bone resection however the optimal amount of distal clavicle resection remains elusive. Patients with AC joint instability have poor results after distal clavicle resection. J Am Acad Orthop Surg 1999 7 176-188 The acromioclavicular AC joint is a relatively frequent source of clinical symptoms most often due to primary osteoarthritis posttrau-matic arthritis or distal clavicle osteolysis. These processes disrupt the normal anatomy and functional biomechanics of the AC joint. This article will focus on the specific techniques of evaluation necessary to differentiate symptoms referable to the AC joint from those related to pathologic changes in other areas of the shoulder girdle as well as specific treatment strategies for management of conditions involving the AC joint. Functional Anatomy and Biomechanics The AC joint is a diarthrodial joint which supports the shoulder girdle through the clavicular It connects the oval convex distal clavicle with the somewhat incongruous concave acromial facet. Between the hyaline-cartilage articular surfaces

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