整形37

【臨床症状】40代 肘痛

【問題】画像所見と診断名は?

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※ T2WI、T1WI、脂肪抑制の順に冠状断、横断像で表示

    ▶答えはこちら
    • 脂肪抑制画像にて、短橈側手根伸筋の近位側に高信号を認める
    • 腱の不連続は認めない
    • 外側上顆炎(テニス肘)に一致する所見
    • 他には関節水腫などの異常所見なし

    【外側上顆炎】

    ・外側上顆炎とは、総伸筋腱起始部の変性や断裂の総称

    ・同部位には長橈側手根伸筋、短橈側手根伸筋、総指伸筋などが付着している

    ・40~50代に多く発症する

    ・テニス肘とも呼ばれ、テニス選手の半数近くに発生する事が知られているが、スポーツに関係無く発症することも多い

    ・臨床症状は、肘外側の慢性的な痛みで手首の伸展によって痛みが増強するのが特徴

    ・診断方法にThimsenテスト、Chairテスト、中指伸展テストなどがあり、これらのテストで肘外側から前腕にかけての痛みが出た場合に外側上顆炎(テニス肘)と診断される

    ・治療法は基本的に保存療法で、症状や重症度により外科的手術も選択される

    骨軟部疾患の画像診断 第2版 より引用改変