肩痛原因としての腋窩神経絞扼性神経炎

抄録

16 cases of entrapment neuropathy of the axillary nerve in the quadrilateral space were reported. Etiology, symptomatology, differential diagnosis and therapy of this disorder were discussed. The complaints of the patients were pain on the dorsal and lateral aspect of the shoulder, especially in abduction, external rotation and horizontal abduction of the shoulder.
Objective findings were sensory disturbance in the autonomo u s zone of the axillary nerve, muscle atrophy of the deltoid and the terses minor muscle and tenderness on the quadrilateral space. But in mild cases muscle atrophy was not observed. In two cases partial muscle spasmus of the deltoid and the teres minor muscle and tenderness on them were observed. In one case with muscle atrophy the electromyographic investigation showed neurogenic changes of the deltoid and the teres minor muscle: motor unit action potential were long in duration, high in amplitude and polyphasic. This case was operated on and satisfactory result followed neurolysis. In other cases there was a good response to local infiltration of steroid and procaine hydrochloride. Our cases suggest that this neuropathy might also be considered in the differential diagnosis of a patient presenting with shoulder pain. Useless diagnostic procedures and treatment can be avoided if the physician is aware of this condition.