原文链接http://radiopaedia.org/articles/parsonage-turner-syndrome-2
Parsonage-Turner syndrome is an acute idiopathic brachial neuritis.
神经痛性肌萎缩（Parsonage-Turner syndrome）是一种急性特发性臂丛神经炎。
There is male predominance (M:F 2:1 to 11.5:1) . Patients from 3 months to 85 years old have been reported, but the majority are between 3rd to 7th decade of life.
流行病学
男性好发（男:女=2：1-11.5：1），发病年龄从3个月至85岁均见报道，但多数患者是30岁-70岁。
The presentation is typically quite sudden, with an onset of a painful shoulder girdle and progressive weakness. Symptoms are however non-specific, and can mimic numerous other much more common conditions such as cervical spondylosis, labral tear with paralabral cyst and other suprascapular notch masses, rotator cuff deficiency,shoulder impingement, calcific tendonitis and adhesive capsulitis .The findings are unilateral in two-thirds of cases.
A combination of history, EMG (which demonstrates denervation changes, especially of the suprascapular nerve) and imaging make the diagnosis.
临床表现
通常是急性发病，表现为肩胛带疼痛和进行性无力。但症状无特异性，同以下其他常见疾病表现相仿，如：颈椎病，盂唇撕裂伴囊肿和其他肩胛上切迹肿块，肩袖撕裂，肩关节撞击综合征，钙化性肌腱炎和粘连性关节囊炎。这种临床表现见于三分之二的病例。
结合病史、肌电图（表现为失神经改变，尤其是肩胛上神经）和影像学表现作出诊断。
The aetiology is uncertain, although localised infectious (viral) or immunological process is suspected. In almost all cases (97%) the suprascapular nerve is involved and is the only nerve involved in 50% of cases. The axillary nerve and subscapular nerveare also sometimes involved, either in combination or alone.
As a result the most frequently involved muscles are supraspinatus and infraspinatus (innervated by suprascapular nerve) followed by deltoid (innervated by axillary nerve).
Bilateral involvement is reported.
病理
发病机制尚不清，可以与局部感染（病毒）或免疫反应相关。几乎所有的病例（97％）肩胛上神经都会受累且50%病例是唯一的受累神经；腋神经和肩胛下神经有时也被受累，单独或联合受累。
最常累及的肌肉是冈上肌和冈下肌（由肩胛上神经支配），其次是三角肌（由腋神经支配）。
有报道双侧受累。
The most striking features on MRI are denervation changes in muscles. Initially, the muscle appears normal. Over the next few weeks high T2 signal develops. Gradually, especially in patients with a protracted course, atrophy and fatty infiltration will develop with the increase in T1 signal and decreased muscle bulk.
影像学表现：
MRI
MRI上最显着特征性的表现是失神经肌肉萎缩改变。最初，肌肉无异常信号改变；几周内发展为T2WI像呈高信号。渐渐地，尤其是在病程较长的患者中，肌肉萎缩和脂肪浸润将导致T1WI像信号增高和肌肉体积减少。
The condition is typically self-limiting with supportive therapy only being required. Weakness may persist for many years although 90% of patients will have noted an excellent recovery by three years.
治疗及预后
该病通常是自限性的，只需对症治疗。尽管90％的患者会在3年内得到很好的恢复，但疲软可能持续多年。
This syndrome was first described in 1943 by Spillane, but popularised with a larger series in 1948 by Parsonage and Turner.
历史与词源
这种综合征最早是由Spillane在1943年报道，但是真正认识此病是由Parsonage 和 Turner在1948年通过大宗病例报道。
Differential diagnosis on MR findings includes:
disuse atrophy of shoulder girdle muscles
quadrilateral space syndrome
other entrapment syndromes around the shoulder
mass in the suprascapular notch (e.g. ganglion)
trauma
MR表现的鉴别诊断包括：
肩带肌废用性萎缩
四边孔综合征
其它肩关节周围神经压迫综合征
肩胛上切迹的肿块（例如：腱鞘囊肿）
外伤
病例图片：
图片来源：http://radiopaedia.org/articles/parsonage-turner-syndrome-2
联系客服
