超声波后侧旋转应力测试对于无创性后侧旋转不稳定性诊断的有效性
Nattakorn Mahasupachai1, Arnakorn Premsiri1, Cholawish Chanlalit1
1HRH Princess Maha Chakri Sirindhorn Medical Center, Faculty of Medicine, Srinakharinwirot University, Nakhon Nayok, Thailand.
Journal of shoulder and elbow surgery
|October 9, 2025
概括
一个新的超声波测试准确地诊断出无创性后侧旋转不稳定性 (PLRI),这是持续性网球手肘的常见原因. 这种非侵入性方法通过可靠地识别隐藏的肘部不稳定性,有助于手术决策.
科学领域:
- 整形外科 整形外科 整形外科
- 诊断成像 诊断成像 诊断成像
- 肌肉骨系统疾病 肌肉骨系统疾病
背景情况:
- 球员肘部 (延伸器 carpi radialis brevis enthesopathy) 经常需要手术治疗潜在的疾病.
- 创伤后侧旋转不稳定性 (PLRI) 是一个具有挑战性的诊断,由于微妙的不稳定性和有限的诊断测试灵敏度.
- 准确诊断PLRI对于有效管理反抗性网球手肘至关重要.
研究的目的:
- 为了评估超声波后侧旋转应力测试的诊断准确性.
- 为了比较超声波测试与关节镜检查的性能,这是诊断PLRI的黄金标准.
- 评估超声波后侧旋转应力测试的可靠性.
主要方法:
- 一项前性诊断准确性研究,涉及42名接受肘部关节镜检查的患者.
- 作为黄金标准,采用了关节镜腰腔 (UH) 间隙开口标志.
- 进行了动态超声波与超声波后侧旋转应力测试,使用相同的机动.
主要成果:
- 超声波测试达到了90.48%的准确性,超过了MRI (54.76%) 和体检 (高达78.57%).
- 显示高特异性 (100%) 和负预测值 (87.88%),灵敏度为69.23%.
- 显示出出色的内部观察者 (ICC: 0.87-0.94) 和观察者间 (ICC: 0.78-0.94) 可靠性.
结论:
- 超声波后侧旋转应力测试是一种非常准确的,非侵入性的工具,用于诊断非创伤性PLRI.
- 它的高特异性和对冲性比较能力使其在手术前评估中具有价值.
- 推用于临床实践,以改善固的网球手肘病例的手术决策.
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