新西兰的Masters S医生和 Burley S医生在2007年7月的Aust Fam Physician（澳大利亚家庭医生）杂志上撰文，分析了肩关节疼痛的诊断和治疗。 文中称，在全科医师的门诊中，经常可以遇到肩关节疼痛的患者。肩关节疼痛常可由急性疼痛转变为慢性肩关节疼痛。肩关节疼痛患者的临床表现常包括：疼痛、无力或僵硬，有的患者也是以上两到三种症状同时出现。该文总结了一条诊断和治疗肩关节疼痛及肩关节周围组织结构疼痛的流程。全面采集病史（包括患者的社会、心理情况）和熟练的肩关节体格检查技能非常重要。其他专门的检查对全科医师诊断肩关节疼痛时的影像不大。肩关节急性疼痛可能转变为慢性疼痛的趋势（生物方面和心理方面都是这个转变的危险因素）意味着医生在从多种治疗方法中选择合适的治疗方法时要采用个体化、以病人为中心的方法。 参考链接： 1、全文链接： http://www.racgp.org.au/afp/200706/200706masters.pdf 2、Pubmed链接： http://www.ncbi.nlm.nih.gov/pubmed/17565397 Aust Fam Physician . 2007 Jun;36(6):414-6, 418-20. Shoulder pain. Masters S , Burley S . Source University of Otago, New Zealand. Abstract BACKGROUND: Shoulder pain is common in general practice and is a condition that frequently becomes chronic. Presentation includes either pain, weakness and stiffness, or a combination of these symptoms. OBJECTIVE: This article presents a systematic approach to diagnosing and managing disorders of the shoulder joint and surrounding structures. DISCUSSION: Thorough history taking (including psychosocial aspects) and skilled examination are essential; special investigations rarely affect the general practitioner's management of shoulder pain. The tendency toward chronicity of shoulder pain (increased by certain biological and psychosocial risks) means that the clinician should adopt a patient centred approach in choosing from a wide range of treatment modalities. 江苏省徐州医学院附属医院骨科 关节镜、 膝关节外科、 骨科运动医学 方向 高绪仁 编译 高绪仁：每天以解决膝、肩关节问题为乐：） 每天努力提高自己的技术和服务水平 不仅仅是解决其膝、肩关节问题，更是给其带来希望、未来和新生！
印度芒格洛尔 的影像学医师Priyank S Chatra在2012年1月份的Indian J Radiol Imaging（印度放射影像学）杂志上撰文，归纳总结了膝关节周围常见的滑囊及其核磁共振MRI影像学表现。 滑囊是一种充满液体的囊性组织结构。滑囊多位于皮肤和肌腱之间或肌腱和骨骼之间。滑囊主要的功能是减少附近相邻可运动性结构之间的摩擦。膝关节周围的滑囊可分为髌骨周围滑囊和其它位置的滑囊。 该文中，作者描述了最常见的各种膝关节周围滑囊病变及其核磁共振MRI影像学表现。 参考链接： 1、全文链接： http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3354353/?tool=pubmed 2、Pubmed链接： http://www.ncbi.nlm.nih.gov/pubmed/22623812 Indian J Radiol Imaging. 2012 Jan;22(1):27-30. Bursae around the knee joints . Chatra PS . Source Department of Radiology, Yenepoya Medical College, Mangalore, Karnataka, India. Abstract A bursa is a fluid-filled structure that is present between the skin and tendon or tendon and bone. The main function of a bursa is to reduce friction between adjacent moving structures. Bursae around the knee can be classified as those around the patella and those that occur elsewhere. In this pictorial essay we describe the most commonly encountered lesions and their MRI appearance. 江苏省徐州医学院附属医院骨科 关节镜、 膝关节外科、 骨科运动医学 方向 高绪仁 编译 高绪仁：每天以解决膝、肩关节问题为乐：） 每天努力提高自己的技术和服务水平 不仅仅是解决其膝、肩关节问题，更是给其带来希望、未来和新生！
澳大利亚昆士兰运动医学专家Shane Brun于2012年4月份的Australian Family Physician（澳大利亚家庭医生杂志）上撰文，提出了肩关节损伤的初步病情评估流程。 在澳大利亚的初级保健医疗机构（社区医院），肩关节损伤的患者很多。然而对于开业的全科医生而言，在诊断肩关节疼痛时知识往往不够，故常显得不够自信。本文总结了一个对肩关节损伤的患者进行初步病情评估时的框架流程图。深刻理解肩关节的解剖和肩关节的独特特点对于准确把握肩关节各种损伤非常重要。全面准确把握患者的病史对于探究损伤的机制、功能障碍的类型和疼痛的根源是非常必要的。 在进行肩关节的体格检查时，要特别注意：1、双肩是否不对称？2、肩关节压痛的位置在哪里？3、肩关节的活动范围如何？ 参考链接： 1、全文链接： http://www.racgp.org.au/afp/201204/201204brun1.pdf 2、Pubmed链接： http://www.ncbi.nlm.nih.gov/pubmed/22472683 Aust Fam Physician. 2012 Apr;41(4):217-20. Initial assessment of the injured shoulder . Brun S . Source Musculoskeletal Sports Medicine, Clinical Skills Unit, School of Medicine and Dentistry, James Cook University, Queensland. Abstract BACKGROUND: Shoulder injuries are common in the primary care setting, yet general practitioners may feel unequipped to confidently assess the patient presenting with shoulder pain. OBJECTIVE: This article provides a framework for the initial assessment of a patient presenting with an injured shoulder . DISCUSSION: A solid understanding of the anatomy and unique features of the shoulder is important to adequately assess any injury. A focused history needs to particularly explore the mechanism of injury, the type of dysfunction and the nature of the pain. On examination, particular attention should be paid to loss of symmetry, localisation of tenderness and the range of movement. 江苏省徐州医学院附属医院骨科 关节镜、 膝关节外科、 骨科运动医学 方向 高绪仁 编译 高绪仁：每天以解决膝、肩关节问题为乐：） 每天努力提高自己的技术和服务水平 不仅仅是解决其膝、肩关节问题，更是给其带来希望、未来和新生！
法国儿童骨科医师Bouju Y在2011年11月份的Orthopaedics Traumatology: Surgery Research（骨科和创伤学：手术与研究杂志）撰文，分析儿童膝关节半月板创伤性损伤核磁共振MRI检查结果和关节镜检查结果的一致性。 儿童出现创伤性膝关节半月板损伤时必须尽快、优先诊断明确。因为这有助于对膝关节半月板的保护并有助于保护整个膝关节的未来。儿童膝关节半月板损伤常常单独存在、难于在临床上诊断明确。在儿童膝关节半月板损伤的诊断上，常规多积极借助于关节镜进行明确诊断，但现在放射科医师越来越多地借助于核磁共振MRI来诊断儿童膝关节半月板的损伤。本文主要研究在儿童半月板损伤时核磁共振MRI检查和关节镜检查的检查结果的是否具有一致性。作者进行了一个回顾性研究。1995年到2008年，9到16岁的儿童，共计69个膝关节进行了核磁共振MRI检查，也随后进行了关节镜探查。 本组研究将盘状半月板排除在外。一名临床医师总结所有的相关病历。一名专攻儿童病理的放射科医师总结了所有的相关核磁共振MRI影像。骨骺闭合的病例被排除在外。所有的相关病历都是可供分析的。关节镜下检查的检查作为参照物，评估半月板损伤的表现、半月板损伤的位置和半月板损伤的类型。第一次进行核磁共振MRI检查结果读片和第二次进行核磁共振MRI检查结果读片和关节镜的检查结果总的一致性分别是78%和82% 。第一次进行核磁共振MRI检查结果读片和第二次进行核磁共振MRI检查结果读片和关节镜的检查结果对内侧 半月板来说一致性分别是：77% 和 80% 。第一次进行核磁共振MRI检查结果读片和第二次进行核磁共振MRI检查结果读片和关节镜的检查结果对外侧半月板来说一致性分别是：78% 和 84%。 在第一次读片时，内测半月板有13个假阳性损伤、外侧半月板有5个假阳性损伤。在第二次读片时，内测半月板有9个假阳性损伤、外侧半月板有0个假阳性损伤。在第一次读片时，总的敏感性是70% 。在第二次读片时，总的敏感性是64% 。在第一次读片时，总的特异性是81% 。在第二次读片时，总的特异性是90% 。 本研究的结果，和既往文献相符合，鼓舞人心，证明了核磁共振对诊断膝关节半月板损伤的有效性。但是在分析内侧半月板和外侧半月板时也隐藏着很多不一致的东西：如核磁共振可能过高地评估了内侧半月板的损伤、过低地评估了外侧半月板的损伤。 该文的结论是：膝关节核磁共振MRI检查只是提供半月板损伤的的一个辅助诊断方法，而不能完全准确地反映出半月板损伤的情况。对膝关节核磁共振影像学结果的解读要结合临床体格检查和儿童骨科专家的临床经验。 参考链接： http://www.ncbi.nlm.nih.gov/pubmed?term=The%20concordance%20of%20MRI%20and%20arthroscopy%20in%20traumatic%20meniscal%20lesions%20in%20children Orthop Traumatol Surg Res. 2011 Nov;97(7):712-8. Epub 2011 Oct 13. The concordance of MRI and arthroscopy in traumatic meniscal lesions in children . Bouju Y , Carpentier E , Bergerault F , De Courtivron B , Bonnard C , Garaud P . Source Pediatric Orthopedics Department, Clocheville Hospital, Tours University Hospital Center, 37044 Tours cedex, France. Abstract INTRODUCTION: Traumatic meniscal lesions in children must be diagnosed quickly and efficiently as a priority in order to conserve the meniscus and safeguard the future of the knee. They are often isolated and difficult to identify clinically. In the diagnostic work up stage, an excessive resort to diagnostic arthroscopy has given way to increasing use of MRI by radiologists without pediatric specialization. The present study examined the agreement between MRI aspect and arthroscopic exploration in traumatic meniscal lesions in children . PATIENTS AND METHODS: Sixty-nine knees in children aged 9 to 16 years having undergone MRI followed by arthroscopy for knee trauma between 1995 and 2008 were included in a retrospective design. Discoid meniscus was excluded. Files were reviewed by a single clinician and MRI scans by a radiologist specialized in pediatric pathology. Cases of epiphyseal fusion were excluded. All files were analyzable. Agreement with arthroscopic findings as reference was assessed for presence, location and type of meniscal lesion. RESULTS: Overall agreement with arthroscopy was respectively 78% and 82% on first and second MRI readings: 77% and 80% for the medial, and 78% and 84% for the lateral meniscus. On the first reading, there were 13 false positives for the medial and 5 for the lateral meniscus, versus 9 and 0 respectively on second reading. Overall sensitivity was 70% on first reading and 64% on second, and overall specificity 81% and 90%, respectively. DISCUSSION: The present results, in line with the literature, may appear encouraging, but hide considerable disparity between analysis of the medial and of the lateral meniscus: MRI overestimated medial and underestimated lateral meniscus lesions . CONCLUSION: MRI serves only as a support and does not provide sure diagnosis of meniscus lesion. Interpretation should take account of the clinical examination and the pediatric orthopedic specialist's experience. 江苏省徐州医学院附属医院骨科 关节镜、 膝关节外科、 骨科运动医学 方向 高绪仁 编译 高绪仁：每天以解决膝、肩关节问题为乐：） 每天努力提高自己的技术和服务水平 不仅仅是解决其膝、肩关节问题，更是给其带来希望、未来和新生！
以色列的一家关节镜与运动医学中心Haviv B医生于2012年3月的Harefuah（以色列医学会医学杂志）上撰文，对具有症状的肩关节肩袖损伤进行了归纳总结。 文中称，肩关节肩袖损伤在中老年患者中非常常见。肩关节肩袖损伤会导致肩关节慢性疼痛。五十几岁、六十几岁、七十几岁和八十几岁人群中肩关节肩袖损伤的发生率分别为12.8%, 25.6%, 45.8% 和50%。 肩袖损伤的病因机理可分为两类。即：1、内源性原因（如：反复的微创伤）；2、外源性原因（如：肩峰下撞击）。对于有症状的肩袖损伤患者来说，肩峰下滑囊可能是致痛来源。因为无症状的肩袖损伤很多，所以现在还不能确定是不是肩袖损伤本身就能够引起疼痛。肩关节疼痛和无力的症状是逐渐增加的，然而，受到一个创伤后，肩关节疼痛和无力的症状会突然急性发作。肩袖损伤常出现上肢上举过头困难，并常出现夜间疼痛。对肩关节肌肉肌力的评估可以初步诊断出来是不是肩袖损伤撕裂。普通的肩关节X线片对排除肩关节其它诊断是很重要的。超声检查和核磁共振MRI检查能够进一步确诊肩袖的撕裂，然而，当对指导治疗有必要时再进行超声检查和核磁共振检查。外科手术治疗的常见适应症是：相对年轻和活动多的患者的急性肩袖撕裂；或者是当对慢性撕裂治疗采用其它治疗方法无效的时候。 现在，大部分的肩袖损伤都是在全关节镜下完成的。肩关节镜治疗肩袖损伤具有创伤小、康复快、疼痛轻的特点。 参考链接： http://www.ncbi.nlm.nih.gov/pubmed/22741212 Harefuah. 2012 Feb;151(2):102-6, 126. . Haviv B , Bronak S , Thein R . Source Arthroscopy and Sports Injuries Unit, Hasharon Hospital, Rabin Medical Center, Petach Tikva, Israel. Abstract Rotator cuff tears of the shoulder are common in the middle age and elderly population and can cause chronic pain. The prevalence of rotator cuff tears in people in their 50s, 60s, 70s, and 80s is 12.8%, 25.6%, 45.8% and 50% respectively. Etiological theories for tear evolvement are divided into intrinsic (e.g. recurrent microtrauma) and extrinsic (e.g. subacromial impingement). The subacromial bursa is probably the source of pain in symptomatic patients with rotator cuff tear. It is uncertain whether the tear itself can produce pain because of the high prevalence of asymptomatic tears. The symptoms are of gradual increase in shoulder pain and weakness, however, it can happen acutely due to an injury. Difficulties in overhead activities and night pain are common. Evaluation of shoulder muscle strength can imply on cuff tear. Shoulder radiograph is essential specifically to rule out other diagnosis. Imaging such as ultrasound and magnetic resonance can further define the tear, however they should be used only if they will affect the management of the condition. Common indications for surgical repair are acute tear in a relatively young and active patient or when the treatment of symptomatic patient with chronic tear had failed. Most repairs are currently performed in an all arthroscopic technique which is minimally invasive with easier rehabilitation and less pain. 江苏省徐州医学院附属医院骨科 关节镜、 膝关节外科、 骨科运动医学 方向 高绪仁 编译 高绪仁：每天以解决膝、肩关节问题为乐：） 每天努力提高自己的技术和服务水平 不仅仅是解决其膝、肩关节问题，更是给其带来希望、未来和新生！
美国俄亥俄州立大学骨科的Bellisari Greg等在2011年3月份的Sports medicine and arthroscopy review（运动医学和关节镜评论）杂志上撰文，总结了儿童膝关节半月板损伤撕裂的情况。 随着骨科未发育成熟儿童、青少年参加体育活动的机会增加，随着医生对半月板损伤认识的加深，儿童、青少年发生半月板损伤检出率在增加。因为在年轻的患者，半月板损伤会产生长期的后续不良后果，所以加强对半月板损伤的认识和提高半月板损伤的治疗效果是非常重要的。 本文中作者总结了膝关节半月板的解剖、膝关节半月板的发育，回顾了半月板撕裂损伤的分类和诊断方法，讨论了膝关节半月板损伤各种治疗方法的选择及各种治疗方法的治疗效果情况，并重点讨论了儿童膝关节外侧盘状半月板和半月板囊肿。 参考链接：1、杂志链接 http://journals.lww.com/sportsmedarthro/toc/2011/03000 2、Pubmed链接 http://www.ncbi.nlm.nih.gov/pubmed/21293238 Sports Med Arthrosc. 2011 Mar;19(1):50-5. Meniscus tears in children. Bellisari G , Samora W , Klingele K . Source Department of Orthopaedics, The Ohio State University, Columbus, OH, USA. Abstract Increased athletic participation by the skeletally immature athlete and a heightened suspicion by physicians have contributed to an increase in the incidence of meniscal injuries in children and adolescents. In young patient, meniscal injury could have long-term consequences, so an understanding of recognition and treatment is essential. We review the anatomy and development of the menisci, review classification and diagnosis of meniscal tears, discuss management options and outcomes of treatment, and focus on discoid lateral meniscus and meniscal cysts . 江苏省徐州医学院附属医院骨科 关节镜、 膝关节外科、 骨科运动医学 方向 高绪仁 编译 高绪仁：每天以解决膝、肩关节问题为乐：） 每天努力提高自己的技术和服务水平 不仅仅是解决其膝、肩关节问题，更是给其带来希望、未来和新生！
美国加利福尼亚大学骨科Drew A. Lansdown医师和Brian T. Feeley医师在2012年5月份的The Physician and Sportsmedicine（医师与运动医学）杂志上撰文，回顾了肩关节肩袖损伤的诊断和治疗方法。 在美国，肩关节肩袖损伤是非常常见的。肩关节肩袖损伤是患者来到初级保健医师处就诊的常见原因。现在看，肩关节肩袖损伤更易发生在老年人身上。肩袖的组成肌肉能够使上臂完成举过头顶的动作，并且能够控制肩关节活动。全面的体格检查能够得出肩袖损伤的诊断。影像学检查能够让我们更深刻地理解肩关节肩袖损伤的内部病理改变。核磁共振MRI检查能够让我们清晰地看到肩袖。很多肩袖撕裂，特别是部分撕裂，在保守治疗后症状能够有所缓解。对于保守治疗效果欠佳的肩关节肩袖损伤患者来说，外科手术治疗可能能够减轻患者的肩关节疼痛、提高肩关节的功能活动范围。对于肩袖不能修补的患者，可以采用反置式人工全肩关节置换术进行治疗。 新的科技发展促使研究人员考虑在肩袖损伤治疗中采用生物学增强的办法，但这一方法还处在研究之中。 参考链接：1、杂志链接 https://www.physsportsmed.org/doi/10.3810/psm.2012.05.1967 2、Pubmed链接 http://www.ncbi.nlm.nih.gov/pubmed/22759608 Phys Sportsmed. 2012 May;40(2):73-86. Evaluation and treatment of rotator cuff tears. Lansdown DA , Feeley BT . Source Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, CA 94158, USA. Abstract Rotator cuff injuries are common problems and a frequent reason for patients to present to primary care physicians. These injuries are seen more frequently now with the aging population. These muscles allow for movement of the arm in overhead activities and controlled movements through space. A thorough physical examination can lead to the diagnosis of rotator cuff pathology. Radiographic imaging may offer some insight into the underlying pathology, and magnetic resonance imaging provides for excellent visualization of the rotator cuff. Many rotator cuff tears, especially partial tears, will symptomatically improve with conservative management. Surgical treatment may offer improved pain relief and function in those patients for whom nonoperative care is insufficient. In cases in which rotator cuff repair is not possible, the reverse total shoulder arthroplasty is a possibility. New technologies are also under investigation that allow for biological augmentation of rotator cuff tears. 江苏省徐州医学院附属医院骨科 关节镜、 膝关节外科、 骨科运动医学 方向 高绪仁 编译 高绪仁：每天以解决膝、肩关节问题为乐：） 每天努力提高自己的技术和服务水平 不仅仅是解决其膝、肩关节问题，更是给其带来希望、未来和新生！
下面我翻译一篇比较好的文章，这篇文章来自弗吉尼亚联邦大学医学院物理治疗科，这篇文章告诉大家怎样才能确诊肩峰撞击综合征，怎样排除SAIS。 标题：Reliability and diagnostic accuracy of 5 physical examination tests and combination of tests for subacromial impingement. 标题：肩峰撞击综合征5种特殊检查及其联合检查的可靠性和诊断的准确性 Michener LA, Walsworth MK, Doukas WC, Murphy KP. Department of Physical Therapy, Virginia Commonwealth University, Medical College of Virginia, PO Box 980224, Richmond, VA 23298, USA. lamichen@vcu.edu Abstract 摘要 OBJECTIVE: To investigate the reliability and diagnostic accuracy of individual tests and combination of tests for subacromial impingement syndrome (SAIS). 目的：评估肩峰撞击综合征每个特殊试验及其联合试验的信度和诊断的准确性 DESIGN: A prospective, blinded study design. 方案：预期，双盲试验 PARTICIPANTS: Patients with shoulder pain (n=55, mean age=40.6y). 受试者：肩痛患者（n=50，平均年龄=40.6岁） INTERVENTIONS: Patients were evaluated with 5 physical examination tests for SAIS: Neer, Hawkins-Kennedy, painful arc, empty can (Jobe), and external rotation resistance tests. Surgical diagnosis was the reference standard. 介入方法：患者依次被做检查5种肩峰撞击综合征特殊试验：Neer 试验, Hawkins-Kennedy 试验, 疼痛弧试验,空罐头试验(Jobe), 和外旋抵抗试验。 MAIN OUTCOME MEASURES: Diagnostic accuracy calculated with a receiver operating characteristic (ROC) curve and sensitivity, specificity, positive likelihood ratio (+LR), and negative likelihood ratio (-LR). A forward stepwise binary logistic regression analysis was used to determine the best test combination for SAIS. An ROC curve analysis was also used to determine the cut point of the number of tests discriminating between the presence and absence of SAIS. Kappa coefficients and percent agreement assessed interrater reliability. 主要测试方法：诊断的准确性由ROC曲线测量、以及敏感性、特殊性、阳性率和阴性率。多因素二元logistic回归分析用来确定肩峰撞击综合征最佳的特殊试验。ROC曲线分析用来确定肩峰撞击综合征的真阳性率和假阳性率，Kappa系数作为一致性检验。 RESULTS: The ROC analyses revealed a significant area under the curve (AUC) (AUC=.67-.72, P.05) for all tests, except for the Hawkins-Kennedy. The tests with a +LR greater than or equal to 2.0 were the painful arc (+LR=2.25; 95% CI, 1.33-3.81), empty can (+LR=3.90; 95% CI, 1.5-10.12), and the external rotation resistance tests (+LR=4.39; 95% CI, 1.74-11.07). Tests with -LR less than or equal to 0.50 were the painful arc (-LR=.38; 95% CI, .16-.90), external rotation resistance (-LR=.50; 95% CI, .28-.89), and Neer tests (-LR=.35; 95% CI, .12-.97). The regression analysis had no specific test combinations for confirming or ruling out SAIS. The ROC analysis was significant (AUC=.79, P=.001), with a cut point of 3 positive tests out of 5 tests. Reliability was moderate to substantial agreement (kappa=.45-.67) for the painful arc, empty can, and external rotation resistance tests and fair strength of agreement (kappa=.39-.40) for the Neer and Hawkins-Kennedy tests. 结果：ROC曲线说明了除了Hawkins-Kennedy试验外，所有试验的曲线下面积有显著意义(AUC=.67-.72, P.05)。阳性率大于等于2.0的试验是疼痛弧试验(+LR=2.25; 95% CI, 1.33-3.81)，空罐头试验(+LR=3.90; 95% CI, 1.5-10.12)和外旋抵抗试验(+LR=4.39; 95% CI, 1.74-11.07)。阴性率小于等于0.50的试验是疼痛弧试验(-LR=.38; 95% CI, .16-.90), 外旋抵抗试验(-LR=.50; 95% CI, .28-.89), 和Neer 试验(-LR=.35; 95% CI, .12-.97)。回归分析显示没有特殊试验组合确定或排除SAIS。ROC曲线分析3/5试验阳性具有显著意义(AUC=.79, P=.001)，疼痛弧试验、空罐头试验和外旋抵抗试验具有良好相关性(kappa=.45-.67)，Neer试验和 Hawkins-Kennedy 试验具有中等的相关性(kappa=.39-.40)。 CONCLUSIONS: The single tests of painful arc, external rotation resistance, and Neer are useful screening tests to rule out SAIS. The single tests of painful arc, external rotation resistance, and empty can are helpful to confirm SAIS. The reliability of all tests was acceptable for clinical use. Based on reliability and diagnostic accuracy, the single tests of the painful arc, external rotation resistance, and empty can have the best overall clinical utility. The cut point of 3 or more positive of 5 tests can confirm the diagnosis of SAIS, while less than 3 positive of 5 rules out SAIS. 结论：疼痛弧试验、外旋抵抗试验和Neer试验对筛选排除SAIS较有用。疼痛弧试验、外旋抵抗试验和空罐头试验对确诊SAIS较有用。这五种试验的信度在临床上都可以被接受。基于信度与诊断的准确性，疼痛弧试验、外旋抵抗试验和空罐头试验临床的使用价值最大。这5种试验中的3种试验阳性便可以确诊SAIS，然而5个试验中少于3种试验阳性便可以排除SAIS。 表1五种肩峰撞击征特殊试验的可靠性系数Kappa值 表2. 肩峰撞击征试验诊断的准确性 表3.联合试验诊断的准确性 表4. 每个特殊试验及联合试验队肩峰撞击征确诊的概率和排除的概率 文章PubMed链接： http://www.ncbi.nlm.nih.gov/pubmed/19887215
标签: 肩关节
