- 期刊
常用理學檢查與診斷用超音波於肩關節病變之應用及限制
Physical Examination and Ultrasonography of the Shoulder: Application and Limitation
摘要
背景與目的：肩關節病變是肌肉骨骼病變常發生的部位，在臨床上有許多方法可以協助我們診斷肩關節病變。其中，超音波和理學檢查是臨床上最常使用的方法。本研究是以超音波檢查為標準檢查並比較其與理學檢查的異同，並且探討其中異同的情形與原因。方法： 由本院復健部門診篩選受試者進入本研究。有56位肩膀疼痛的病患接受理學檢查及超音波檢查。包括25位男性，31位女性；平均年齡53.2歲。其中右側肩膀病變有32位，左側病變有24位。理學檢查包括Speed's test、Empty can test及Hawkins-Kennedy impingement test。超音波檢查則使用10MHz線性探頭，採標準檢查方式來檢查肩部。結果：結果顯示，Speed's test陽性檢查結果和超音波檢查顯現肱二頭肌長頭肌腱炎，及Empty can test 陽性結果和超音波檢查脊上肌肌腱斷裂有顯著正相關。除Speed's test之外，其餘理學檢查來偵測肩關節軟組織病變的敏感性都不超過50%，但特異性均超過80%。結論：由本研究得知，理學檢查與超音波檢查在臨床使用上仍有其限制。兩者配合使用檢查肩膀疼痛患者，將可以幫助我們做出正確的診斷，決定最適合患者的治療方式。
並列摘要
Background and Purposes: Shoulder disorders with disability and pain are common musculoskeletal problems. Ultrasonography and physical examinations are most frequently used for differential diagnoses of these disorders. Objectives of this study included 1) to examine the correlations between physical examinations and ultrasonographic evaluations; and 2) to estimate the practicality (sensitivity and specificity) of ultrasonography in shoulder disorders. Methods: Physical examinations and ultrasonography were performed on 56 patients (25 males, 31 females) with shoulder pain. Physical examinations included Speed's test, the empty can test and Hawkins-Kennedy impingement test. Ultrasonographic examinations were conducted with a 10 MHz linear transducer on the rotator cuff, biceps muscles and subdeltoid bursa. Results: There were significant correlations between Speed's test and biceps tendinitis, and between the empty can test and supraspinatus tendon tear in ultrasonography. Sensitivities of these physical examinations, except for Speed's test, were less than 50%, and specificities were greater than 80%. Conclusion: Both physical examinations and ultrasonography can be considered as primary diagnostic techniques, and should be used whenever possible to improve diagnosis and treatment.
延伸閱讀
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