Wittich Christopher M, Ficalora Robert D, Mason Thomas G, Beckman Thomas J
Division of General Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA.
Mayo Clin Proc. 2009 Sep;84(9):831-6; quiz 837. doi: 10.4065/84.9.831.
Patients commonly present to primary care physicians with musculoskeletal symptoms. Clinicians certified in internal medicine must be knowledgeable about the diagnosis and management of musculoskeletal diseases, yet they often receive inadequate postgraduate training on this topic. The musculoskeletal problems most frequently encountered in our busy injection practice involve, in decreasing order, the knees, trochanteric bursae, and glenohumeral joints. This article reviews the clinical presentations of these problems. It also discusses musculoskeletal injections for these problems in terms of medications, indications, injection technique, and supporting evidence from the literature. Experience with joint injection and the pharmacological principles described in this article should allow primary care physicians to become comfortable and proficient with musculoskeletal injections.
患者通常因肌肉骨骼症状就诊于初级保健医生处。获得内科认证的临床医生必须了解肌肉骨骼疾病的诊断和管理，但他们在该主题上往往接受的研究生培训不足。在我们繁忙的注射实践中最常遇到的肌肉骨骼问题，按出现频率从高到低依次为膝盖、转子滑囊和盂肱关节。本文回顾了这些问题的临床表现。还从药物、适应症、注射技术以及文献中的支持证据等方面讨论了针对这些问题的肌肉骨骼注射。通过本文所述的关节注射经验和药理学原理，初级保健医生应能熟练并自信地进行肌肉骨骼注射。
