Diagnóstico diferencial de una paresia dolorosa de la mano: Presentación de una nueva entidad clínica: el síndrome hombro-mano

Abstract

Background A painful paresis of the hand is a symptom frequently encountered in clinical practice. Based on a consistent coincidence of typical clinical symptoms of the hand with certain tissue alterations of the shoulder musculature, a new clinical syndrome –the Shoulder-Hand- Syndrome (SHS)– is introduced. Appropriate differential diagnosis regarding clinically similar, but pathophysiologically different, syndromes –like, for instance, the Carpal Tunnel Syndrome (CTS)– is of crucial importance. Aim Introducing and establishing a new clinical syndrome – the Shoulder-Hand-Syndrome (SHS). Methods Analysis of about 150 clinical cases observed over the course of five years, applying criteria of trigger point medicine. Results A certain, clinically-pathophysiologically consistent and uniform kind of painful hand paresis may be subsumed under the term “Shoulder-Hand-Syndrome” (SHS). Discussion Definition of diagnostic criteria and therapeutic strategies pertaining to SHS. Conclusion The distinct co-emergence of soft tissue alterations of the shoulder and typical symptoms of the hand, as well as the response to a clearly defined therapy calls for a separate classification of this clinical complex as “Shoulder-Hand-Syndrome”. This syndrome can efficiently be treated with a combination of therapeutic local anaesthesia, acupuncture, and additional medication.