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SETIAWAN.H 发表于 2024-6-27 15:59
我觉得你书没有看明白。现在的共识是这个疾病不应该叫网球肘，而是叫外上髁炎。然后这确实是一种无菌性炎 ...
谁都知道这玩意的正式名称叫“肱骨外上髁炎”（可能以后换名字叫“伸肌总腱肌腱病”也说不定）
我说网球肘只是为了方便大家理解
但是，确实他不是一种无菌性炎症性疾病，可能在某个阶段有一些炎症细胞，但是缺乏证据。
我来引用文献的原话：
ical Features
The lateral epicondyle of the humerus, located just above the capitellum, is the origin of the extensor-supinator muscles.126,130
by tendinopathy from other sources of symptoms such as muscle, joint, or nerve pathology.
The most common site of pathology in LET is the
juncture of the common extensor muscle origin of the lateral epicondyle.99
The enthesis or insertion of the common extensor tendon is characterized by a load sharing mechanism where fibers of the ECRB tendon fuses with the lateral collateral ligament of the elbow and joint capsule and subsequently with the annular ligament of the proximal radial ulnar joint.125
There has been a shift in understanding of tendon pathology over the past 20 years. Tendinopathy refers to a nonrupture injury in the tendon or peritendon (paratenon and epitenon) that is aggravated by mechanical loading.62
The term tendiniStress is dissipated throughout the entire enthesis
organ and may explain the somewhat diffuse distribution of pain at the lateral elbow with LET.12
The common extensor tendon of the wrist and fingers at the elbow may be injured not only by repetitive tensile loading but also by shearing forces against the capitellum with forearm rotation.23
The ECRB tendon has a unique anatomic location that makes its undersurface vulnerable to contact and abrasion against the lateral edge of the capitellum during forearm pronation and supination.275
Relative hypovascularity of the ECRB tendon may further contribute to the susceptibility of the tendon to injury and may negatively impact healing.8,161
The extensor carpi radialis longus and extensor
digitorum tendons may also be involved. This may explain why repetitive loading of the elbow, forearm, wrist, and/or digits during work or athletic activities increases the risk of LET.48,171
However, similar biomechanical loading can potentially injure adjacent structures; therefore, a thorough examination is required to differentiate lateral elbow pain caused
tis characterizes an acute condition with a cell-mediated inflammatory response. Tendinosis is a term that has been used to describe chronic degenerative tendon pathology, characterized by an abundance of fibroblasts, vascular hyperplasia, and unstructured collagen. Over time, clinical terminology has changed from tendinitis or tendinosis to tendinopathy, which represents the pain and impaired muscle function related to a broad spectrum of potential intratendinous changes in structure, histology, and chemical mediators of pain and/ or inflammation.58
In those with LET, as with other forms of
tendinopathy, individuals present somewhere in the continuum between acute and chronic conditions that may fluctuate over an episode of care. Therefore, it is possible that low-grade inflammation may be intermittent and may occur for short periods after intense tendon loading in chronic situations characterizing an acute-on-chronic condition in some cases.
It has been postulated that LET is acquired by irritation of the hypovascular zone of the common extensor tendon at its attachment on the lateral epicondyle, which leads to subsequent neovascularization45
that has been described as “angiofibroblastic tendinosis.”99 Chronic LET is characterized by cpg8 | december 2022 | volume 52 | number 12 | journal of orthopaedic & sports physical therapy Journal of Orthopaedic & Sports Physical Therapy |
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发表于 2024-6-17 15:19:42
