• 3 subscapularis tendon Rotate the arm externally fixing the elbow on the iliac crest to show the subscapularis tendon and its insertion on the lesser tuberosity (slight supination of the hand may be helpful to neutralize the tendency to lift and abduct the elbow from the lateral chest wall). 3 肩胛下肌肌腱 将肘部固定于髂嵴处，上肢外旋可显示肩胛下肌 肌腱及其小结节附着部。（手掌轻度后旋可有助 于抵抗肘部上抬和外展离开侧胸壁的力量）
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• Legend: SubS, subscapularis tendon; SupraS, supraspinatus tendon; Arrow, long head of the biceps tendon; LT, lesser tuberosity; GT, greater tuberosity; SH, short head of the biceps; LH, long head of the biceps; H, humeral shaft; Arrowheads, pectoralis major tendon • 图例： SubS 肩胛下肌肌腱； SupraS 冈上肌肌腱； 箭号，肱二头肌长头； LT 小结节；GT 大结节；SH 二头肌短头；LH 二头肌长头；H 肱骨干；箭头， 胸大肌肌腱
• 不同的国家和机构给病人进行肩部超声检查时所采取的体 位各不相同，体现了不同诊查者不同的观点和经验，但是， 我们强烈推荐让病人坐在转凳上进行检查。这个体位能够 让诊查者只要让病人转动一下凳子就能够使用探头扫查到 肩的前面、侧面和后面。
• long head of the biceps tendon 二头肌腱长头 Place the arm in slight internal rotation (directed towards the contralateral knee) with the elbow flexed 90°, palm up. Start by finding the long biceps tendon in between the greater and lesser tuberosities – Use short and long (more limited utility) axis planes to examine the biceps. 肘部屈曲90°，手臂轻度内旋（指向对侧膝部），掌心向 上。先在大、小结节之间找到肱二头肌长头腱，采用短 轴和长轴（作用有限）切面检查二头肌。 Shift the probe up to examine the biceps in its intraarticular course and down to reach the myotendinous junction (level of the pectoralis major tendon). • 向上移动探头检查二头肌关节内的走行，向下移动探头 探测肌-腱连接部（胸大肌肌腱水平）。
• Legend: Arrow, long head of the biceps tendon; dashed line, insertion of the subscapularis tendon; Co, coracoid; Del, deltoid muscle; LT, lesser tuberosity; SubS, subscapularis tendon; void arrowheads, tendon fascicles of the subscapularis; white arrowheads, muscle tissue interposed between tendon fascicles •
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肌骨超声技术指南--肩部
主讲：XX XX
凡大医治病，必当安神
定志，无欲无求，先发大慈恻 隐之心，誓愿普救含灵之苦。
- - 孙思邈
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• Although patient’s positioning for shoulder US varies widely across different Countries and Institutions reflecting multifaceted opinions and experiences of different examiners, we strongly recommend to examine the patient while seated on a revolving stool. This position allows the examiner to reach the anterior, lateral and posterior aspects of the shoulder with the probe by simply asking the patient to rotate on the chair.
• This tendon should be evaluated along its long(transverse planes) and short- (sagittal planes) axis during passive external and internal rotation with hanging arm. Sweep the transducer up and down over the subscapularis until its full width is demonstrated. 评价该肌腱应该在手臂上举状态下被动外旋和内 旋时沿其长轴切面（横切面）和短轴切面（矢状 切面）进行扫查。在肩胛下肌表面上下扫查，直 至整块肌肉都能全部显示。