[图文]肌骨超声诊断指南肩部-.doc

? ? ? ? 6 supraspinatus tendon: positioning(2 Place the dorsum of the hand over the opposite back pocket (forced internal rotation, stress manoeuvre. There should not be any space gap between the elbow and the lateral chest wall. Using this position, the supraspinatus becomes a more anterior structure and the transducer should be oriented almost vertically to be in axis with it. Consider that the tendon fibers are more stretched than in the position described at point -5. This may be possible cause of overestimation of tear size. Due to an excessive internal rotation, the long head of the biceps tendon may be difficult to be visualized in this position. 6 冈上肌肌腱：定位（2） 将手背放在后兜位置（被动内旋，加压手法），肘部应该 紧贴和侧胸壁。采用这个体位，冈上肌就会前移，探头要 垂直放置以与其处于同一轴线上。我们认为该肌腱纤维比 第5点中描述的那个位置更加伸展。这样就有可能夸大撕 裂的范围。由于过度内旋，这个体位时二头肌长头肌腱可 能很难显示。 ? 7 subacromial impingenment test Dynamic assessment of subacromial (anterosuperior impingement can be attempted by placing the probe in the coronal plane with its medial margin at the lateral margin of the acromion. The patient abducts his arm while in internal rotation. With this manoeuvre, the supraspinatus and the bursa can be seen passing deep to the coracoacromial arch. 7 肩峰下冲击试验 将探头的内侧缘置于肩峰的外侧缘取冠状切面能 够动态观察肩峰下的（前上）冲击，病人手臂内 旋的同时外展，通过此种手法，能够显示冈上肌 及其滑囊从深部走向肩峰弓。