课件：肌腱滑囊及关节囊的慢性损伤性炎症.ppt

谢谢大家! Thank you very much for your attention! 后面内容直接删除就行 资料可以编辑修改使用 资料可以编辑修改使用 资料仅供参考，实际情况实际分析 * * Diagnosis The most sensitive test was the wrist flexion test, whereas nerve percussion was the most specific and the least sensitive. They also found that with the wrist in neutral position, the mean pressure within the carpal tunnel in patients with carpal tunnel syndrome was 32 mm Hg. This pressure increased to 99 mm Hg with 90 degrees of wrist flexion and to 110 mm Hg with the wrist at 90 degrees of extension. The pressures in the control subjects with the wrist in neutral position were 25 mm Hg, 31 mm Hg with the wrist in flexion, and 30 mm Hg with the wrist in extension. Sensibility testing in peripheral nerve compression syndromes was investigated, found that threshold tests of sensibility correlated accurately with symptoms of nerve compression and electrodiagnostic studies. Electrodiagnostic studies are reliable confirmatory tests. Ultrasonography has been used to show the movement of the flexor tendons within the carpal tunnel Early reports of MRI in carpal tunnel syndrome are promising. A major advantage of MRI is its high soft tissue contrast, which gives detailed images of both bones and soft tissues. Care should be taken not to confuse this syndrome with nerve compression caused by a cervical disc herniation, thoracic outlet structures, and median nerve compression proximally in the forearm and at the elbow Treatment If mild symptoms have been present and there is no thenar muscle atrophy, the injection of hydrocortisone into the carpal tunnel may afford relief. Great care should be taken not to inject directly into the nerve. Injection also can be used as a diagnostic tool in patients without bony or tumorous blocking of the canal; 65% of these cases probably are caused by a nonspecific synovial edema, and these seem to respond more favorably to injection. Injection also helps to eliminate the possibility of other syndromes, especially cervical