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中华肩肘外科电子杂志 ›› 2024, Vol. 12 ›› Issue (02) : 168 -171. doi: 10.3877/cma.j.issn.2095-5790.2024.02.012

病例报告

肱二头肌远端肌腱损伤一例
刘小慧1, 李冰1, 范文婷1, 朱家安1,()   
  1. 1. 100044 北京大学人民医院超声医学科
  • 收稿日期:2024-03-02 出版日期:2024-05-05
  • 通信作者: 朱家安
  • 基金资助:
    国家自然科学基金面上项目(82071930); 北京大学人民医院研究与发展基金基础培育项目(RDJP2022-50)
  • Received:2024-03-02 Published:2024-05-05
引用本文:

刘小慧, 李冰, 范文婷, 朱家安. 肱二头肌远端肌腱损伤一例[J]. 中华肩肘外科电子杂志, 2024, 12(02): 168-171.

肱二头肌远端肌腱损伤在临床较少见,发生率低[1],常见的损伤机制为肘关节负重由屈曲位向伸直位活动,肱二头肌突然受力所致[2]。准确及时的诊断是治疗的关键。随着肌骨超声应用的广泛深入,其对肱二头肌远端肌腱的检查及诊断也得到了进一步应用。本文报道1例肱二头肌远端肌腱部分撕裂,查阅并回顾以往的相关文献,进一步讨论和复习该疾病的诊断及治疗,尤其是对其超声诊断在该病中的临床意义进行探讨。

图1 初诊时患者左肘呈被动屈曲,肘关节及腕关节轻度内旋
图2 左侧肱二头肌远端肌腱灰阶声像图,肱二头肌远端肌腱局部纤维结构紊乱,连续性差
图3 左侧肱二头肌远端肌腱超微血流显像(cSMI)声像图注:浅红色部分即肌腱内及其周围组织的异常血流信号,提示局部存在创伤性炎症
图4 患者肘部核磁共振图像显示肱二头肌远端肌腱内异常信号,提示存在部分撕裂、积液等
图5 5个月后门诊随访,肘关节外展恢复,内旋及外旋约80°,外旋活动基本恢复,过度内旋及过度外旋时轻微疼痛
图6 Hook实验检查肱二头肌远端肌腱示意图
图7 超声检查肱二头肌远端肌腱位置及探头示意图
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