THE SHOULDER - HAND SYNDROME The eady diagnosis, treatment and rehabilitation

Sindrom rame-šaka je patološki sindrom gornjeg ekstremiteta koji je karakteriziran regionalnim neurovegetativnim poremećajem, afekcijom tkiva oko zgloba, jakim bolom ti slabošću a:fiiciranog ekstremiteta, pseudoinflamatornim fenomenom, trofičkim smetnjama, wemenski og.ran:ičenim tokom i ozdravljenjem, a katkad s posljedicama. Neobično je važno da se sindrom rame-šaka prepozna u ranoj fazi kako bi se liječenje li rehabiLitacija proveli što uspješnlije, a samim time i brže uspostavila funkcionalna sposobnost zahvaćenog ekstremiteta. U ranoj dijagnootici koriste se slijedeće pretrage: mjerenje oscilometrijskog indeksa, ultrazvučna dtijagnostlik. a na principu Dopplera, venska okluzivna pletismog.rafija, periungvalna kapilaroskopija, termografija i scintigrafija. U l.liječenju sindroma rame-šaka primjenjuje se medikamentozna i fizikal-na terapija. Medikamentozno liječenje uključuje primjenu analgetika i nesteraidnih antiflogistLka, kortikosteroida, vazodilatatornih preparata (blokatori alfa adlrenergičnih vlakana),, griseofulvina, kaicitonina, blokatora beta adrenergičnih vlakana, ganglioplegika dtd. Od fizikalne terapije u ranoj fazi primjenjuje se krlioterapija i elektroanalgezija. Kineziterapija se u početku sastoji od aktivno potpomognutih, a kasnije s popuštanjem bolova i aktivnih vježbi.The shoulder-hand syndrome is a pathologic syndrome of the upper extremities\u27 which is characterized by ·regional neurrovegetative disturbance, the tissue around sur.rounding the joint is affected, there is strong pain and weakness of the affected extremity, pseudoinflammatory phenomenon, and trophic dtisturbances. The course of the disease and recovery are limited in duration and sometimes the disease leaves consequences. lt is very important to recognize early the shoulder-hand syndrome in order tlo administer treatment and rehabilitation as successfully as possible and thus to restore the function to the affected extremity. The following examinations are used in the early diagnostics: measurement of the oscillometric index, Doppler ultrasound, venous occlusive plethysmography, periungual capillaroscopy, thermography and scinttigraphy. The treatmant of the shoulder-hand syndrome incluges: medicamentose and physical therapy. Drug therapy consists in administration of analgesics and non-steroid antiphlogistics, corticosteroids, vassodilatating preparations (alpha adrenergic fibers blockators), griseophulv.ines, calcitonines, beta adrenergic fibers blockators, gangliopleglcs ette. As to the physical therapy, in the early stages cryotherapy and electroanalgesia a!l"e used. Kinesitherapy consists, in the beginning, fuoom actively supported exe.rcises and later, on, when the pain diminishes, the active exercises are introduce