 四边孔综合征（quadrilateral space syndrome）是旋肱后动脉和腋神经在四边孔处受压后所引起的一系列临床症候群，主要表现是腋神经支配的肩臂外侧的感觉障碍和三角肌功能受限，继发于肩部外伤或继发于上肢过度运动后。四边孔综合征主要发生在优势肢体，也可以发生于双侧肢体，外伤是常见原因。 Clinical presentation Patients present with posterior shoulder pain and paresthesia over the lateral arm due to an axillary nerve neuropathy. Shoulder pain may also be vague and be associated with local tenderness. 由于腋神经病变，患者出现肩后疼痛和侧臂感觉异常。肩部疼痛也可能是模糊的，并与局部压痛有关。 Pathology Quadrangular space syndrome is a neurovascular compression syndrome of the posterior humeral circumflex artery (PHCA) and/or the axillary nerve or one of its major branches in the quadrangular space. 四边形间隙综合征是旋肱后动脉（PHCA）和/或腋神经或其四边形间隙主要分支之一的神经血管压迫综合征。 Quadrangular space syndrome most commonly occurs when the neurovascular bundle is compressed by fibrotic bands within the narrow quadrangular space and/or by hypertrophy of the muscle boundaries. Fibrotic bands form as the result of trauma, with resultant scarring and adhesions. Cases reported in throwing athletes, tennis players, and in the dominant arm of volleyball players support the fibrosis and hypertrophy based hypotheses. 四边形空间综合征最常见于神经血管束被狭窄四边形空间内的纤维化带和/或肌肉边界肥大压迫时。创伤后形成纤维带，导致瘢痕和粘连。在投掷运动员、网球运动员和排球运动员的优势臂中报告的病例支持基于纤维化和肥大的假设。   Variation in axillary nerve division and a genetically smaller quadrangular space have been hypothesized to predispose to quadrangular space syndrome. This may account for the limited number of reported cases. 腋神经分裂的变异和遗传上较小的四边形空间被认为易患四边形空间综合征。这可能是报告病例数量有限的原因。 MRI MRI is the investigation of choice but is often normal. MRI may demonstrate atrophy of the teres minor and/or deltoid muscles with or without fatty infiltration. A literature review has shown varying proportions of deltoid and teres minor involvement. Fibrous bands are usually not visible on MRI. In the presence of a mass, the neurovascular bundle may be displaced. MRI是首选的检查方法，但通常是正常的。MRI可能显示小圆肌和/或三角肌萎缩，有或没有脂肪浸润。文献综述显示，三角肌和小圆肌受累的比例各不相同。MRI上通常看不到纤维带。在有肿块的情况下，神经血管束可能会移位。 Angiography (DSA) Before the advent of MRI, conventional angiography was the primary diagnostic modality. Angiography would show occlusion or compression of the posterior circumflex artery in the quadrangular space region, more pronounced when the arm is abducted. The neurovascular bundle may also be displaced. 在MRI出现之前，常规血管造影是主要的诊断方式。血管造影显示旋后动脉在四边形间隙区域闭塞或受压，当手臂外展时更为明显。神经血管束也可能移位。  
|
|
|
