RADIOLOGICAL ASSESSMENT OF DISTURBED MOBILITY OF THE UPPER THORACIC APERTURE IN THORACIC OUTLET SYNDROME
Karl-August J. Lindgren*, Hannu Rytkonen (Dept. of Rehabilitation* and Radiology, Kuopio University Hospital, Kuopio, Finland)
Thoracic outlet syndrome (TOS) is a complex disorder caused by neurovascular irritation in the region of the thoracic outlet. Recent studies indicate that a functional cause may explain the symptoms of thoracic outlet syndrome better than do anomalous structures. The purpose of this study was to radiologically assess a possible disturbed mobility of the upper thoracic aperture in TOS patients.
We examined the bony thoracic outlet of 15 TOS patients (11 women and 4 men) by computerized axial spiral tomography (CT) with multiplanar reconstruction (MPR) and three-dimensional reconstruction (3 DR). The mean age of the patients was 40 years (range 16 to 58 years). The area around the first ribs, including the first costotransverse and costovertebral joints, was scanned by spiral CT in maximal expiration and inspiration positions. Possible malfunction of the first ribs was assessed clinically using the cervical rotation lateral flexion (CRLF) test.
3D-CT images showed a dislocation of the first rib at the costotransverse joint on the symptomatic side and a port mobility in 11 patients out of 13 with a positive CRLF test. Two patients with a negative CRLF test had no pathology on their 3D-CT images.
Our study showed that it is possible to assess the kinesiology of the bony thoracic outlet by spiral CT. This suggests that disturbed mobility, possibly of functional origin, of structures in the upper aperture, may be the cause of the symptoms of TOS patients.
COMBINED TREATMENT FOR SCAPULOHUMERAL PERIARTHRITIS WITH NINTY-ONE CASES REPORT
Cui, Hai-yan (Qindao 2nd People's Hospital, Qindao, China)
PURPOSE: To get rid of the reson of periomethritis, have the symptom disappeared, increasing the curative rate.
METHOD: We used the combining therapy-tradition chinese medicine ion therapy, ZhouLin irradiation therapy, and motor therapy to cure 91 cases. One time a day, 12 times is a course.
RESULT: 71 cases were cured, 12 cases felt good, 7 cases felt better than before. Follow-time is 12-15 months. No cases were recurrence.
CONCLUSION: We think the combining therapy can improve cure rate highly. It's a ideal therapy method for periomethritis.