Drooping shoulders

Introduction The drooping shoulder is one of the symptoms of forest encephalitis. Forest encephalitis is an acute infectious disease of the central nervous system caused by forest encephalitis virus. The pathogen of this disease belongs to the fourth subgroup of the genus Rhabdovirus. It is icosahedral symmetrical and has a diameter of 30nm. It is surrounded by a reticular lipoprotein membrane, so it is linear. It has a core surrounded by a protein shell and is a single-stranded RNA. Pathogens can be isolated from the brain tissue of patients within 7 days of onset, and can also be detected in other organs and body fluids such as spleen, liver, blood, cerebrospinal fluid, urine, etc., but the positive rate is low. The virus can be stored in brain tissue for 70 days, preserved in 50% glycerol for more than 3 months (4 ° C), and can be stored for a longer period of time at low temperatures. About 10% of patients have neutralizing antibodies in the serum 15 days after the disease, which can exist for a long time. Complement-binding antibodies appeared at 1 month after infection and decreased significantly after half a year. Hemagglutination-inhibiting antibodies appear earlier and are present in serum for a longer period of time.

Cause

Pay attention to the season and region of the disease, whether there is a history of field work within one month before the disease, whether there is a history of bite, and whether there is a history of vaccination against forest encephalitis.

an examination

Related inspection

Bone and joint MRI

The incubation period of this disease is 8-14 days. When you get sick, you have fever, headache, nausea, vomiting, confusion, and neck stiffness. Subsequently, the muscles of the neck, shoulders and upper limbs were reproduced, which showed that the head was unable to lift, the shoulders were drooping, and both hands were unable to swing. If the symptoms improve, the body temperature will drop to normal after one week, and the symptoms will disappear. The recovery period is longer and can be left with sequelae.

Differential diagnosis

Differential diagnosis of the sagging shoulder:

Dislocation after the shoulder joint: posterior dislocation of the shoulder joint is less common. One of the reasons is that there is strong muscle group protection behind the shoulder joint, which is difficult to dislodge backwards. Even after dislocation, it is easy to return due to the tensile stress of the posterior muscle group. Therefore, it is rare in clinical practice.

The incubation period of this disease is 8-14 days. When you get sick, you have fever, headache, nausea, vomiting, confusion, and neck stiffness. Subsequently, the muscles of the neck, shoulders and upper limbs were reproduced, which showed that the head was unable to lift, the shoulders were drooping, and both hands were unable to swing. If the symptoms improve, the body temperature will drop to normal after one week, and the symptoms will disappear. The recovery period is longer and can be left with sequelae.

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