PERIARTRITA SCAPULOMUMERALA

Asist. Univ. dr. Luana Macovei

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 DEFINITIE:

sindrom clinic caracterizat prin durere,

redoare articulara si impotenta functionala
determinat de procese patologice localizate la
nivelul umarului si care afecteaza structurile
periarticulare: ligamente, capsula articulara,
tendoane, bursa si muschi.

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 CLASIFICARE:

1. Umar simplu dureros

2. Umar dureros acut
3. Umar mixt
4. Umar blocat
5. Umar pseudoparalitic

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 CAUZE:

1. INTRINSECI: 2. EXTRINSECI

- Artrite reumatismale -Neuropatii C5-C6

- Artrite infectioase -Sindroame fibromialgice
- Artrite posttraumatice -Sdr Pancoast-Tobias
- Artropatii degenerative -Sdr Parsonage-Turner
- Neurogene
- Neoplazice
- Afectiuni periarticulare

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 CAZ CLINIC

ANAMNEZA:
1. Istoric:
- Boli reumatismale (inflamatorii/degenerative)
- Comorbiditati nereumatismale
- Traumatisme, CVM

2. Simptome:
- Durerea (caracter, localizare)
- Redoarea (prezenta/absenta)

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 EXAMEN CLINIC
ANATOMIE FUNCTIONALA
ARTICULATII SINOVIALE:
1.Glenohumerala
2.Acromioclaviculara
3.Sternoclaviculara

ARTICULATII “FUNCTIONALE”:
1.Scapulotoracica
2.Subacromiodeltoidiana (suprahumerala)

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 EXAMEN CLINIC

1. INPECTIE

2. PALPARE

3. MOBILITATE

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 INSPECTIA

Anterior Posterior Lateral

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 INSPECTIA

- simetria reperelor osoase

- simetria contururilor musculare

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 PALPAREA

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 PALPAREA

ARTICULATII:
-sternoclaviculara
-acromioclaviculara

INSERTII CAPSULOLOIGAMENTARE
-supraspinos
- biceps
- deltoid
-varful coracoidei

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 PALPAREA
HIPOTROFIA/TUMEFACTIA/CONTRACTURA MUSCULARA

-Trapez

-Angular

-Deltoid

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 MOBILITATEA
-Flexia (antepulsia)

- Extensia (retropulsia)

-Abductia

-Adductia

-Rotatia interna

-Rotatia externa

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 MOBILITATEA

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 RADIOGRAFIA

• Tumefactia partilor moi

• Osteocondensarea rebordului glenoidian/
culisei bicipitale
• Deformarea, descentrarea capului humeral
• Pensarea spatiului artic. acromioclaviculare
• Chisturi subcondrale
• Osteofite

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 ECOGRAFIA
- insertiile, structura tendoanelor

-procese inflamatorii la nivelul burselor (bursite)

- ruptura coifului rotatorilor

-Capsula (ingrosata/retractata)

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 DIAGNOSTIC
- tendinite : supraspinos, infraspinos, biceps,

-Bursite

-sindrom de impingement

-sdr de ruptura a coifului rotatorilor

-capsulita retractila

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 TRATAMENT
• MEDICAMENTOS
- Atialgic po, topic
- AINS po, topic
- Infilratii CS

• FIZICAL
-fizioterapie antalgica, antiinflamatorie, decontracturanta,

• KINETIC
• TRATAMNTUL ETIOLOGIC
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