診斷用超音波與理學檢查

Diagnostic Ultrasonographic Examination and Physical Examination

吳爵宏(Chueh-Hung Wu) ； 王亭貴(Tyng-Guey Wang)

《物理治療》 35卷3期 (2010/09) Pp. 188-193

摘要

高解像力超音波近年來廣泛被使用於骨骼肌肉系統病變的診斷和治療。它的非侵入性、好的移動性，容易取得等特色使得它的應用越來越廣，甚至成為骨骼肌肉門診不可或缺的工具。這樣普遍的使用超音波檢查是否會使得專業醫療人員過於依賴超音波檢查而忽略了傳統之理學檢查，進而影響臨床診斷的品質，值得探討。我們認為超音波檢查及理學檢查在診斷骨骼肌肉病變各有其擅長之處，若能各取其長而避其短，將可有效地提升我們診斷骨骼肌肉病變的能力。在本文中，僅就作者的觀點將超音波檢查及理學檢查分成五個方面探討，分別為：（一）超音波檢查如何協助理學檢查更深入的分辨病因；（二）理學檢查如何協助超音波檢查釐清影像的臨床意義；（三）超音波檢查如何取代部分的理學檢查；（四）超音波檢查如何結合理學檢查產生新的意義；（五）超音波檢查如何協助檢驗理學檢查的適用性。

關鍵字

超音波 ； 理學檢查 ； 骨骼肌肉病變

並列摘要

High-resolution ultrasonography has become more and more popular in the diagnosis and treatment of musculoskeletal disorders recently. It is widely used in many fields and becomes an essential tool in the musculoskeletal clinic because of its non-invasiveness, portability and accessibility. It warrants a discussion about whether considerable uses of ultrasonographic examinations will make the medical staff rely on ultrasonography and neglect conventional physical examinations, thus affecting the quality of clinical diagnosis. In our opinion, ultrasono-graphic examinations and physical examinations have their own unique advantages. By taking the strength and avoiding the weakness of both examinationss, we can promote our ability in diagnosis of musculoskeletal disorders. In this article, we will discuss about the relationship of ultrasonographic examinations and physical examinations in five aspects from the viewpoint of authors. First, ultrasonographic examinations can assist physical examinations in differential diagnosis of musculoskeletal disorder. Second, physical examinations can assist ultrasonographic examinations in clarifying the clinical significance of imaging abnormality. Third, ultrasonographic examinations can replace physical examinations in some circumstance. Fourth, ultrasonographic examinations can combine with physical examinations to provide valuable and objective evidence for clinical diagnosis. Fifth, ultrasonographic examinations can be used to verify the applicability of physical examinations.

並列關鍵字

Ultrasonography ； Physical examination ； Musculoskeletal disorder