1. 1) shoulder in external rotation 2. 2) palm facing up
1. 4 resisted isometric abduction
1. 1) the arm in neutral rotation 2. 2) abducts the arm to 90
1. 1) elbow passively flexed to 90 degrees 2) maximal external rotation
1. 3 drop sign
1. 1) almost full external rotation 2) elbow flexed at 90 degrees
DePalma AF, Kruper JS. Long-term study of shoulder joints affliated with and treated for calcific tendinitis[J]. Clin Orthop.1961;20:61-72.
2 可疑诊断
1 关于肩周炎 肩周炎=冻结肩（《实用骨科学》第3版），是由于肩关 节周围软组织病变而引起肩关节疼痛和活动功能障碍。
degrees
2 冈下肌和小圆肌 肩外旋功能
1. 1 external rotation strength test=Patte’s test
1.
2. 2) in the plane of the scapula
1. 2 external rotation lag sign
1. 4 weakness with external rotation
1. 1) elbows flexed to 90 degrees 2. 2) the thumbs up 3. 3) shoulders rotated internally
20 degrees
3 肩胛下肌 肩内旋、后伸功能
calcific tendinopathy
Type I calcification with a fluffy, fleecy appearance with poorly defined borders, with acute symptoms and termed the resorptive phase. Type II calcification, more discreet and of homogenous density, with wellcircumscribed borders, and in the formative phase.
normal subacromial joint space (≥7mm) (arrow) 1 superior subluxation of the humeral head (arrow) 2 notched humeral neck (arrowhead)
Gazzola S, Bleakney RR.Current imaging of the rotator cuff[J].Sports Med Arthrosc, 2011,19(3):300-9.
1 Hand C, Clipsham K, Rees JL, et al. Long-term outcome of frozen shoulder. J Shoulder Elbow Surg 2008;17:231-6. 2 Reeves B. The natural history of the frozen shoulder syndrome. Scand J Rheumatol 1975;4:193-6.
国外报道 Frozen shoulder 40-60 years of age, incidence 2-5%[1]. 3 phases[2] 1) freezing phase 2-9 months, pain and loss of motion of the glenohumeral
joint in all direction，usually worst at night and when lying on the affected side 2) 2) frozen phase 4-12 months, stiffness reaches its maximum 3) thawing phase 5-12 months, range of motion returns to normal 4) 2 肩峰下撞击综合症 疼痛，主诉为三角肌下疼痛，并经常向下放射 至前方的肱二头肌，夜间疼痛可影响睡眠
肩袖损伤
当我们在临床上遇到疑似病人，只有X片而无MRI检 查时， 1 我们能从X片中得到什么信息？ 2 我们印象中的可疑诊断有哪些？ 3 针对性的体查有哪些？
1 读X片 cystic change of the greater tuberosity
Gazzola S, Bleakney RR.Current imaging of the rotator cuff[J].Sports Med Arthrosc,2011,19(3):300-9.
2 full can test
1. 1) 90 degrees in the horizontal plane
2. 2) rotated 45degrees externally 3) with the thumb pointing upward
3 painful arc test 4 60°-120°
3 针对肩袖损伤的体查 1 冈上肌 肩外展功能
1 empty can test
1) 90 degrees abduction 2) 30 degrees horizontal abduction (in the plane of the scapula) 3) thumbs pointing downward
1 lift off test