Easily Missed Patellar Lesions in Emergency Department: A Report of Four Cases

急診室易漏診的髕骨創傷：四病例報告

賴俊達(Chun-Da Lai) ； 張志偉(Chih-Wei Chang) ； 許以霖(I-Lin Hsu) ； 林啟禎(Chii-Jeng Lin) ； 楊俊佑(Chyun-Yu Yang) ； 賴國安(Kuo-An Lai)

《Journal of Emergency Medicine, Taiwan》 12卷4期 (2010/12) Pp. 119-122

摘要

膝關節因位置表淺和有限軟組織覆蓋常容易受到各種傷害。其中，體骨創傷是常見的一種。在繁忙的急診室，工作超荷、缺乏經驗與了解適當影像評估，常導致診斷失誤和延遲治療。我們提出四例被漏診的體骨創傷。後來確診是依病患的長時不適與合適的影像所獲。除完整病史與身體檢查外，我們建議將軸向投影納入對急性膝外傷的例行影像評估，以提醒臨床醫師減少對這些陷阱發生漏診的可能。

關鍵字

漏診 ； 髕骨 ； 急診 ； 診斷失誤 ； 急性膝外傷 ； 陷阱

並列摘要

The superficial location and limited soft tissue coverage make the knee vulnerable to various injuries; and consequently, patellar trauma is commonly encountered. In the busy emergency department, frequent overloads, relative inexperience, and unawareness of proper radiographic assessment commonly lead to diagnostic errors and delay in treatment. Herein we presented 4 neglected patellar lesions from acute knee injuries, whose diagnosis was made later with persistent discomfort and definite radiographic validation. In addition to the complete history and physical examination, we suggest integration of axial projection into the routine radiographic protocol for acute knee trauma to arouse clinical suspicion and avoid associated orthopedic pitfalls.

並列關鍵字

missed ； patellar ； emergency department ； diagnostic error ； acute knee ； pitfalls