肌骨超声技术指南肌骨超声技术指南----肩部肩部((欧洲肌欧洲肌骨放射学骨放射学))Althoughpatient’spositioningforshoulderUSvariAlthoughpatient’spositioningforshoulderUSvarieswidelyacrossdifferentCountriesandInstitutionseswidelyacrossdifferentCountriesandInstitutionsreflectingmultifacetedopinionsandexperiencesofreflectingmultifacetedopinionsandexperiencesofdifferentexaminers,westronglyrecommendtoexadifferentexaminers,westronglyrecommendtoexaminethepatientwhileseatedonarevolvingstool.Tminethepatientwhileseatedonarevolvingstool.Thispositionallowstheexaminertoreachtheanteriohispositionallowstheexaminertoreachtheanterior,lateralandposterioraspectsoftheshoulderwithtr,lateralandposterioraspectsoftheshoulderwiththeprobebysimplyaskingthepatienttorotateontheprobebysimplyaskingthepatienttorotateonthechair.hechair.不同的国家和机构给病人进行肩部超声检查时所采取的体不同的国家和机构给病人进行肩部超声检查时所采取的体位各不相同，体现了不同诊查者不同的观点和经验，但是，位各不相同，体现了不同诊查者不同的观点和经验，但是，我们强烈推荐让病人坐在转凳上进行检查。这个体位能够我们强烈推荐让病人坐在转凳上进行检查。这个体位能够让诊查者只要让病人转动一下凳子就能够使用探头扫查到让诊查者只要让病人转动一下凳子就能够使用探头扫查到肩的前面、侧面和后面。肩的前面、侧面和后面。longheadofthebicepstendonlongheadofthebicepstendon二头肌腱长头二头肌腱长头Placethearminslightinternalrotation(directPlacethearminslightinternalrotation(directedtowardsthecontralateralknee)withtheelbedtowardsthecontralateralknee)withtheelbowflexed90°,palmup.Startbyfindingtheloowflexed90°,palmup.Startbyfindingthelongbicepstendoninbetweenthegreaterandlngbicepstendoninbetweenthegreaterandlessertuberosities–Useshortandlong(morelessertuberosities–Useshortandlong(morelimitedutility)axisplanestoexaminethebicepimitedutility)axisplanestoexaminethebiceps.s.肘部屈曲肘部屈曲90°90°，手臂轻度内旋（指向对侧膝部），，手臂轻度内旋（指向对侧膝部），掌心向上。先在大、小结节之间找到肱二头肌长头掌心向上。先在大、小结节之间找到肱二头肌长头腱，采用短轴和长轴（作用有限）切面检查二头肌。腱，采用短轴和长轴（作用有限）切面检查二头肌。ShifttheprobeuptoexaminethebicepsiniShifttheprobeuptoexaminethebicepsinitsintraarticularcourseanddowntoreachthetsintraarticularcourseanddowntoreachthemyotendinousjunction(levelofthepectoralismyotendinousjunction(levelofthepectoralismajortendon).majortendon).向上移动探头检查二头肌关节内的走行，向下移动向上移动探头检查二头肌关节内的走行，向下移动探头探测肌探头探测肌--腱连接部（胸大肌肌腱水平）。腱连接部（胸大肌肌腱水平）。LegendLegend:SubS,subscapularistendon;Su:SubS,subscapularistendon;SupraS,supraspinatustendon;Arrow,lonpraS,supraspinatustendon;Arrow,longheadofthebicepstendon;LT,lessergheadofthebicepstendon;LT,lessertuberosity;GT,greatertuberosity;SH,stuberosity;GT,greatertuberosity;SH,shortheadofthebiceps;LH,longheadhortheadofthebiceps;LH,longheadofthebiceps;H,humeralshaft;Arrowhofthebiceps;H,humeralshaft;Arrowheads,pectoralismajortendoneads,pectoralismajortendon图例：图例：SubSSubS肩胛下肌肌腱；肩胛下肌肌腱；SupraSSupraS冈上肌肌腱；箭号，肱二头肌长头；冈上肌肌腱；箭号，肱二头肌长头；LTLT小结节；小结节；GTGT大结节；大结节；SHSH二头肌短头；二头肌短头；LHLH二头肌长头；二头肌长头；HH肱骨干；箭头，胸大肱骨干；箭头，胸大肌肌腱肌肌腱3subscapularistendon3subscapularistendonRotatethearmexternallyfixingtheelbowonRotatethea...
