#16
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#17
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а можно ссылку на эти исследования? Делая УЗИ при болезни Де Кервена, наблюдал теносиновит в 100% случаях.
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С уважением, Дмитрий Владимирович |
#18
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Про гистологические находки при болезни Де Кервена - британцы в 1998 писали, что нет признаков воспаления, а скорее дегенеративный процесс:
The condition was not characterized by inflammation, but by thickening of the tendon sheath and most notably by the accumulation of mucopolysaccharide, an indicator of myxoid degeneration. These changes are pathognomonic of the condition and are not seen in control tendon sheaths. The term 'stenosing tenovaginitis' is a misnomer and we believe that de Quervain's disease is a result of intrinsic, degenerative mechanisms rather than extrinsic, inflammatory ones. --- J Hand Surg Br. 1998 Dec;23(6):732-4. The histopathology of de Quervain's disease. Clarke MT и соавт. позже в 2015, специалисты из Тайваня, таки находят воспалительные изменения: Previous studies consistently reported that the pathological change of this condition is thought to be primarily an extensor retinaculum thickened by fibrosis and angiogenesis instead of inflammation... Neutrophil elastase and cyclooxygenase occur in the de Quervain disease retinaculum and increased with the grade of collagen structure. After angiogenesis, macrophage infiltration occurs in the grade II matrix worse than grade III matrix. Inflammation is present in de Quervain disease. This study provides direct evidence for inflammatory cell and infiltration factors and offer valuable clues for specific pharmacological therapies for de Quervain disease. --- Ann Plast Surg. 2015 May;74 Suppl 2:S146-51. Inflammation is present in de Quervain Disease--correlation study between biochemical and histopathological evaluation. Kuo YL, и соавт.
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Искренне, Вадим Валерьевич. |
#19
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В 2016 году вышла статья/обзор, где на основании пред. публикаций находят существенную разницу в анатомических особенностях у пациентов с этой болезнью:
Patients with De Quervain disease were more likely to have a septum dividing the compartment and a single slip of abductor pollicis longus. These variations are clinically relevant in the pathophysiology and treatment of De Quervain's tenosynovitis. --- J Plast Reconstr Aesthet Surg. 2017 Jan;70(1):127-131. Epub 2016 Sep 9. Surgical anatomy of the first extensor compartment: A systematic review and comparison of normal cadavers vs. De Quervain syndrome patients. [Ссылки доступны только зарегистрированным пользователям ]
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Искренне, Вадим Валерьевич. |
#20
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