DOI QR코드

DOI QR Code

Physical Examination of Shoulder Instability

견관절 불안정성에 대한 이학적 검사

  • Kim, Jae-Hwa (Department of Orthopedic Surgery, Bundang CHA Hospital, College of Medicine, Pochon CHA University)
  • 김재화 (포천중문 의과대학교 분당 차병원 정형외과학교실)
  • Published : 2008.06.15

Abstract

Shoulder instability is generally diagnosed from a detailed history, physical examination and various radiological studies. Although, a physical examination is essential for making a diagnosis, it is quite difficult. For a precise physical examination, a thorough anatomical knowledge and a great deal of experience is needed. In addition, normal translation and pathologic laxity should be differentiated. An anatomical and biomechanical understanding of a stable and unstable shoulder joint and a precise physical examination are needed to determine the direction and extent of the instability as well as to diagnose the associated lesions and improve the surgical results.

견관절 불안정성에 대한 진단은 상세한 병력 청취, 이학적 검사, 이에 따른 각종 방사선학적 검사를 통해 이루어진다. 그러나 이학적 검사는 진단에 결정적인 역할을 하고 있음에도 불구하고 어려움을 느끼는 경우가 많다. 정확한 이학적 검사를 위해서는 충분한 해부학적 지식과 많은 경험을 필요로 하며, 또한 정상적인 전이와 병적인 이완의 정도는 매우 구별하기가 용이하지 않은 경우가 많기 때문이다. 견관절의 정상적인 안정성에 대한 해부학적, 생역학적 이해와 정확한 이학적 검사를 통해 불안정성의 방향과 정도뿐만 아니라 동반 병소까지 정확히 진단되어야 성공적인 수술의 전제 조건이 될 것이다.

Keywords

References

  1. Bigliani LU, Keller EL, Flatow RG, et al.: Glenohumeral stability-biomechanical properties of passive and active stabilizers. Clin Orthop Relat Res, 330:13-30, 1996. https://doi.org/10.1097/00003086-199609000-00003
  2. Burkhart SS, Morgan CD, Kibler WB: Shoulder injuries in overhead athletes: The dead arm revisited. Clin Sports Med, 19: 125-157, 2000. https://doi.org/10.1016/S0278-5919(05)70300-8
  3. David JM: Orthopedic physical assessment. 4th ed. Philadelphia: 245-261, 2002.
  4. Frederick AM, Caroline MC, Steven BL: Principle for the evaluation and management of shoulder instability. AAOS Instructional Course Lectures, 56: 23-34, 2007.
  5. Gerber C, Nyffeler RW: Classification of glenohumeral joint instability. Clin Orthop Relat Res, 400:65-76, 2002. https://doi.org/10.1097/00003086-200207000-00009
  6. Joseph PI, Gerald RW: Biomechanics and pathologic lesions in the overhead athlete. In: Disorders of the shoulder. Lippincott Williams & Wilkins, Philadelphia, 233-248, 1999.
  7. Joseph PI, Gerald RW: Disorders of the shoulder: diagnosis and management. Philadelphia, 251-333,1999.
  8. Lee YG: The shoulder: diagnosis and treatment. 1st ed. Seoul: 28-31, 2004.
  9. Nobuhara K, Ikeda H: Rotator interval lesion: Clin Orthop Relat Res, 223:44-50, 1987.
  10. Rhee KJ, Ko SH, Kim SJ, et al.: The shoulder & elbow. 1st ed. Seoul: 86-88, 2007.
  11. Kim SH, Park JS , Jeong WK, Shin SK: The Kim test: A novel test for posteroinferior labral lesion of the shoulder- A comparison to the jerk test. Am J Sports Med, 33: 1188-1192, 2005. https://doi.org/10.1177/0363546504272687
  12. Von Eisenhart-Rothe RM, Jager A, Englmeier KH, Vogl TJ, Graichen H: Relevance of arm position and muscle activity on three-dimensional glenohumeral translation in patients with traumatic and atraumatic shoulder instability. Am J Sports Med, 30: 514-522, 2002. https://doi.org/10.1177/03635465020300041101