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Scalenus syndrome misdiagnosis _47168

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					?Cervical spondylosis, cases, checking, bevel, tenderness




?Scalenus syndrome misdiagnosis

?

Scalenus syndrome is the human neck and chest between the surrounding
tissue lesions induced by a group of syndrome, its clinical
manifestations and Cervical Radiculopathy and similar. Therefore
often be misdiagnosed as the treatment of cervical spondylosis. Our
hospital has 2001 ~ 2007 to follow-up treatment of cervical
spondylosis poor a multi-party conference and found that some
patients for the scalenus syndrome, with a marked improvement in
symptoms after treatment or recovery. The cases are summarized as
follows:

Materials and methods: Shenyang City Hospital of Orthopaedics Li
River

1. case source and included in the standard:

January 2001-December 2006 to attend after outpatient treatment for
patients with the following standards are incorporated into the
analysis of data; a:: apparent: a limb pain numbness .b: cervical
massage therapy 2 courses are not obvious. C: imaging diagnostic
support treatment of cervical spondylosis but ineffective.

General information: 2, 65 cases meet these criteria, including men,
women, 35 cases of 30 cases. Average age of 34., 45 patients to
attend before the courts to cervical spondylosis Diagnostics line
conservative treatment for 2 courses for about a month or more, the
effect is not visible or is invalid.

65 patients Institute expert consultation reassessed for diagnosis
and for cervical CT scan, including 61 cases were again diagnosed as
scalenus syndrome.

Diagnostic criteria: 1, limb pain or numbness of the affected limb
ulnar radial to the little finger, chenzhonggan. 2, ulnar nerve skin
feeling. 3, check:. ardison experiment-positive: patient sitting
position, the hands are placed knee. First record of the radial
artery pulse strength, compare, and then let the patient after the
inspiratory breath-holding, if suffering from side-to-pulse weakened
or lost shall be positive.

4, cervical spine CT show side scalenus soft shadow less obvious
hypertrophy detected.

Results

65 patients in 61 cases meet the diagnostic criteria were diagnosed
as: scalenus syndrome, 94% of patients. One of the 38 cases of all
meet the diagnostic criteria for 23 cases meet the diagnostic
criteria for 1-3 items.

61 patients improved treatment for one or two courses of treatment,
the symptoms disappear with no more than six months.

Typical case analysis

King XX, male, 39 years old. Agency staff. The left side of the neck
and the left arm pain, numbness of the little finger for half a year,
once the courts as the "vertebra", traction, massage therapy is not
valid. In July 2003 to cure my hospital. Enquiries: C5, C6 left
paraspinal unbearable tenderness, sour, supraclavicular full, the
pressure of sour, radiation to the little finger of ulnar and upper
limbs, ardison test positive. Cervical space CT scan see clearly left
soft tissue mast. Consultation: scalenus syndrome. Improvement of
massage, focusing on the affected side scalenus parts and the
affected arm row press, kneading, bombs, etc. The basic symptoms
after a course of treatment, after two courses of treatment without
abnormal sensations. Back to work, follow-up of one year without
recurrence.

Discussion

Scalenus syndrome clinical manifestations in many ways and cervical
spondylosis and similar, so often misdiagnosed conditions. But it is
essentially the pathogenesis aspects and, therefore, a clear
difference between troubleshooting guide to treatment with extremely
important.

Misdiagnosis scalenus syndrome due to more complex, all mainly has
following several aspects: 1. the specialist division of restrictions
such as massage practitioners often because the check-in cannot be
too small or professional level low to misdiagnosis. Group 61
patients in 45 cases without hospital system diagnosis and treatment,
massage massaging people diagnosed with cervical spondylosis, massage
therapy better our cure. 2. More time to clinical experience of
doctors than young lower rates misdiagnosed, this group of 15
patients Institute for young doctors initial diagnosis to treatment
of cervical spondylosis manipulation on treatment outcome, senior
expert consultation was diagnosed as: scalenus syndrome, syndrome
therapy achieved remarkable results. So that detailed interrogation
check is to avoid critical misdiagnosis. 3, part of the scalenus
syndrome patients possibly and and cervical spondylosis, which often
result in excessive emphasis on 1905 doctor cervical disease
diagnosis and treatment, tend to ignore the scalenus syndrome exist
to treat.

For a diagnosis of cervical spondylotic myelopathy in patients with
repeated treatments should be further detailed article: cervical
spine CT visible on both sides of the scalenus soft shadow the
asymmetry, affected a mast, so do the cervical spine CT helps
scalenus syndrome diagnosis.

In addition scalenus muscle testing (Adson.test) positive also
prompts the scalenus syndrome diagnosis.

Some of the scalenus syndrome is due to cervical ribs to the x-ray
lateral cervical is looking on in order to improve diagnostic
accuracy.

In General, to conservative treatment and massage. Massage therapy
effect is not evident available local anaesthetic injection directly
into the scalenus muscle symptoms immediately relieved, and sometimes
can get a permanent cure. If conservative treatment is not valid, and
symptoms are unbearable when surgical treatment should be taken, its
operation and approach you can reference the neck rib surgery,
surgery of carefully sniffing the brachial plexus and subclavian
artery compression and parts, the scalenus cut, separation and ease
the pressure on nerves and blood vessels.

Shenyang municipal hospital (110003) Li River



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?Cervical spondylosis, cases, checking, bevel, tenderness

				
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posted:11/6/2010
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