Deyle Gail D
Transitional Doctor of Physical Therapy Program, Rocky Mountain University of Health Professions, Provo, UT, USA.
J Orthop Sports Phys Ther. 2005 Nov;35(11):708-21. doi: 10.2519/jospt.2005.35.11.708.
This article presents an overview of current concepts of evidence-based diagnosis using a variety of imaging modalities for a broad spectrum of musculoskeletal conditions and syndromes. There is limited but increasing evidence that physical therapists appropriately use diagnostic studies in clinical practice. Pathology revealed by diagnostic studies must be viewed in the context of the complete examination, as pathology is common in the asymptomatic population. Special diagnostic challenges are presented by patients with areas of referred pain, multiple injuries or multiple areas of pathology, neoplasms, and infections. Plain film radiographs have been overused in the clinical management of many conditions, including low back pain. Clinical decision rules provide simple evidence-based guidelines for the appropriate use of imaging studies.
本文概述了基于证据的诊断的当前概念,这些概念涉及使用多种成像方式来诊断广泛的肌肉骨骼疾病和综合征。虽然证据有限,但越来越多的证据表明物理治疗师在临床实践中恰当地使用了诊断研究。诊断研究揭示的病理情况必须结合全面检查来考虑,因为病理情况在无症状人群中很常见。有牵涉痛区域、多处损伤或多处病理区域、肿瘤和感染的患者会带来特殊的诊断挑战。在包括腰痛在内的许多疾病的临床管理中,普通X线平片被过度使用。临床决策规则为合理使用影像学研究提供了简单的循证指南。