pain arc sign
Introduction
Introduction The pain arc sign is a chronic shoulder pain syndrome caused by repeated friction and impact between the structure of the subacromial space and the shoulder arch during shoulder abduction. It is a common disease in middle-aged and above. The disease includes acromion bursitis, supraspinatus tendonitis, calcification of the supraspinatus tendon, rotator cuff rupture, and biceps tendon tenosynovitis. The common clinical feature is that there is a pain arc in the active abduction of the shoulder joint, and the passive activity pain is significantly reduced or even completely painless.
Cause
Cause
A variety of shoulder diseases can be caused. Such as supraspinatus rupture, supraspinatus tendonitis, supraspinatus calcification, acromion sac bursitis, humeral large nodular fractures can be caused.
Examine
an examination
Related inspection
Blood test angiography
More common in middle-aged people, its typical feature is that when the shoulder joint actively abducts, there is a pain arc.
1. Symptoms: The main symptom of this disease is shoulder pain, mainly around the shoulder peak, sometimes involving the entire deltoid muscle. The pain is caused by nighttime. The patient is afraid of the lateral position. In severe cases, it is necessary to take painkillers for a long time. Secondly, the affected limb is abducted and the activity is limited. When the upper arm is abducted to 60°80°, there is obvious pain. Sometimes the shoulder joint is felt to be stuck by the object and cannot continue to lift.
2. Signs: 1 There is tenderness in the area from the shoulder to the big tibial tuberosity; 2 When the shoulder joint is passive, it can smell the sputum; 3 The pain sign is positive, that is, the pain only occurs in 60°~120°. Within the scope. If the shoulder joint is passively abducted, the pain arc sign is not typical. 4 The long-term movement of the shoulder joint is limited, mainly due to limited abduction, external rotation and extension of the joint. 5 shoulder impact test is positive.
an examination
1. X-ray examination: Most patients have normal X-ray examination. A few patients with severe X-ray examination showed hardening of the humerus, nodules, cystic changes or osteophytes, hardening of the acromion of the shoulder, formation of spurs on the lower surface of the shoulder. The upper tendon is partially calcified at the attachment point of the large nodule, the acromioclavicular joint traumatic arthritis, and the humeral head moving up, narrowing the subacromial space.
2. Shoulder arthrography: shoulder arthrography is not used as a routine examination method for this disease, mainly used to identify whether the rotator cuff is partially torn or completely torn. The indications for shoulder arthrography are: 1 chronic pain in the shoulders over 40 years of age, no symptoms of conservative treatment for 3 months, positive impact test; 2 trauma caused by sudden severe weakness and limited mobility; 3 Unstable scapular joint dislocation or shoulder joint dislocation with shoulder symptoms, aged 40 years and older. If the scapular joint and the scapular sac are found to communicate with each other during angiography, it is the basis for the complete tearing of the rotator cuff.
Diagnosis
Differential diagnosis
Pain in the shoulder: due to visceral disease, causing shoulder pain, or hyperalgesia, known as suffering. Symptoms appear to be slow, dull, or uncomfortable. They do not completely conform to the nerve direction, the area is blurred, and the pain is blurred.
Limited shoulder movement: limited shoulder activity, more common with periarthritis and shoulder dislocation.
Persistent severe shoulder pain: persistent severe shoulder pain, often caused by dislocation of the shoulder joint. There is a clear history of trauma.
More common in middle-aged people, its typical feature is that when the shoulder joint actively abducts, there is a pain arc.
