DOI QR코드

DOI QR Code

상완 이두건의 병소에 대한 초음파 검사의 유용성

Efficacy of Ultrasonogram for the Diagnosis of Biceps Tendon Pathology

  • 서중배 (단국대학교 의과대학 정형외과학교실) ;
  • 이지영 (단국대학교 의과대학 영상의학과교실) ;
  • 방승철 (단국대학교 의과대학 정형외과학교실)
  • Seo, Joong-Bae (Department of Orthopaedic Surgery, Dankook University College of Medicine) ;
  • Lee, Jee-Young (Department of Radiology, Dankook University College of Medicine) ;
  • Bahng, Seung-Chul (Department of Orthopaedic Surgery, Dankook University College of Medicine)
  • 발행 : 2008.12.15

초록

목적: 회전근 개 질환 환자에서 상완 이두건의 병소에 대한 수술 전 초음파 검사의 정확성을 알아보기 위하여 본 연구를 시행하였다. 대상 및 방법: 2006년 1월부터 2007년 3월까지 회전근 개 질환으로 수술적 치료를 받은 환자 중 수술 전 초음파 검사를 시행 한 67명의 환자를 대상으로 후향적 조사를 하였다. 환자들의 연령은 평균 58세였으며, 남자 41예, 여자 26예였다. 상완 이두건의 관절경 및 초음파 소견은 '정상', '탈구', '아탈구', '건증', '부분 또는 완전 파열'등으로 기술하였으며, 관절경과 초음파 소견 간의 일치 여부를 조사하였다. 결과: 초음파 검사 67예 중 37예가 '정상'이었으며, 30예가 '비정상'이었다. '정상' 37예 중 5예는 관절경 검사상 '부분 파열'이 있었으며, '비정상' 30예 중 8예는 관절경 검사상 '정상'이었다. 초음파 검사상 3예의 '탈구' 및 4예의 '완전 파열'은 관절경 검사 결과와 일치하였다. 초음파 검사에서 '건증'이 기술된 20예는 관절경 검사에서 '부분 파열' 15예, '정상' 5예로 관찰되었다. 결론: 상완 이두건의 병소에 대한 초음파 검사는 상완 이두건의 탈구 또는 완전 파열 시에는 진단이 일치하였으나, 부분 파열에 대해서는 정확한 진단이 어려웠다.

Purpose: We wanted to assess the accuracy of ultrasound for detecting abnormality of the long head of the biceps tendon in patients with rotator cuff disorders. Materials and Methods: Between January 2006 and March 2007, we reviewed the arthroscopic findings of biceps tendons in 67 patients with rotator cuff disorder and who underwent ultrasonography pre-operatively. The patients' average age was 58 years and there were 41 males and 26 females. The statuses of the biceps tendons were described as 'normal', 'dislocation', 'subluxation', 'partial or complete tears', and 'tendinopathy'. We investigated the correspondence between the arthroscopic and ultrasonographic findings. Results: On ultrasonography, the biceps tendons were 'normal' in 37 patients and 'abnormal' in 30 patients. On arthroscopy, 5 biceps tendons turned out to have partial tears, which were 'normal' on ultrasonography. On the other hand, 8 biceps tendons were 'normal' which were 'abnormal' on ultrasonography. Three dislocations and 4 complete tears of biceps tendons were identified on arthroscopy, and all of them were detected by ultrasonography. Of the 20 cases of 'tendinopathy' seen on ultrasonography, 15 patients had partial tears and the remaining 5 patients were normal on arthroscopy. Conclusion: Ultrasonography is accurate for detecting some biceps pathologies, such as dislocation or complete tear, but it is not accurate for the detection of partial tear.

키워드

참고문헌

  1. Armstrong A, Teefey SA, Wu T: The efficacy of ultrasound in the diagnosis of long head of the biceps tendon pathology. J Shoulder Elbow Surg, 15: 7-11, 2006. https://doi.org/10.1016/j.jse.2005.04.008
  2. Beall DP, Williamson EE, Ly JQ, et al: Association of biceps tendon tears with rotator cuff abnormalities: degree of correlation with tears of the anterior and superior portions of the rotator cuff. AJR Am J Roentgenol, 18: 633-639, 2003.
  3. Beggs I: Ultrasound of the shoulder and Elbow. Orthop Clin North Am, 37: 277-285, 2006. https://doi.org/10.1016/j.ocl.2006.03.004
  4. Bryant L, Shnier R, Bryant C, Murrell GA: A comparison of clinical estimation, ultrasonography, magnetic resonance imaging, and arthroscopy in determining the size of rotator cuff tears. J Shoulder Elbow Surg, 11: 219-224, 2002. https://doi.org/10.1067/mse.2002.121923
  5. Churchill RS, Fehringer EV, Dubinsky TJ, Matsen FA 3rd: Rotator cuff ultrasonography: diagnostic capabilities. J Am Acad Orthop Surg, 12: 6-11, 2004.
  6. Hodler J, Fretz CJ, Terrier F, Gerber C: Rotator cuff tears: Correlation of sonographic and surgical findings. Radiology, 169: 791-794, 1988. https://doi.org/10.1148/radiology.169.3.3055040
  7. Kumar VP, Satku K, Balasubramaniam P: The role of the long head of biceps brachii in the stabilization of the head of the humerus. Clin Orthop Relat Res, 244: 172-175, 1989.
  8. Mack LA, Gannon MK, Kilcoyne RF, Matsen FA 3rd: Sonographic evaluation of the rotator cuff: Accuracy in patients without prior surgery. Clin Orthop Relat Res, 234: 21-27, 1988.
  9. Martin-Hervas C, Romero J, Navas-Acien A, Reboiras JJ, Munuera L: Ultrasonographic and magnetic resonance images of rotator cuff lesions compared with arthroscopy or open surgery findings. J Shoulder Elbow Surg, 10: 410-415, 2001. https://doi.org/10.1067/mse.2001.116515
  10. Paavolainen P, Ahovuo J: Ultrasonography and arthrography in the diagnosis of tears of the rotator cuff. J Bone Joint Surg Am, 76: 335-340, 1994.
  11. Read JW, Perko M: Shoulder ultrasound: diagnostic accuracy for impingement syndrome, rotator cuff tear and biceps tendon pathology. J Shoulder Elbow Surg, 7: 264-271, 1998. https://doi.org/10.1016/S1058-2746(98)90055-6
  12. Roberts CS, Walker JA 2nd, Seligson D: Diagnostic capabilities of shoulder ultrasonography in the detection of complete and partial rotator cuff tears. Am J Orthop, 30: 159-162, 2001.
  13. Teefey SA, Hasan SA, Middleton WD, Patel M, Wright RW, Yamaguchi K: Ultrasonography of the rotator cuff. A comparison of ultrasonographic and arthroscopic findings in one hundred consecutive cases. J Bone Joint Surg Am, 82: 498-504, 2000.
  14. Zanetti M, Hodler J: Imaging of degenerative and posttraumatic disease in the shoulder joint with ultrasound. Eur J Radiol, 35: 119-125, 2000. https://doi.org/10.1016/S0720-048X(00)00227-8