Halvorsen J G, Swanson D
Department of Family Practice and Community Health, University of Minnesota, Minneapolis 55455.
J Fam Pract. 1990 Nov;31(5):521-9.
Radiology is an essential part of the family physician's office practice. Like most diagnostic tools, radiographs can provide valuable information, but they also have the potential to be abused. One of the first tasks in ensuring optimal use of any procedure is to establish criteria for proper patient selection. This article is a review of general and specific indications for office radiographs on both symptomatic and asymptomatic patients based on published expert consensus and studies that have examined indications for radiographs using clinical criteria. For symptomatic patients, indications are discussed for the following radiographs: extremities (traumatic and nontraumatic), skull, abdomen, chest, orbits, sinuses, facial bones, and spine. Indications for asymptomatic patients are discussed with specific attention to lumbosacral spine and chest radiographs. When appropriate indications are followed, the physician can avoid the problem of overuse and its consequent radiation and economic burdens, as well as the problem of underuse with its risk of incomplete evaluation.
放射学是家庭医生门诊业务的重要组成部分。与大多数诊断工具一样，X光片能提供有价值的信息，但也有可能被滥用。确保任何检查程序得到最佳利用的首要任务之一，是确立恰当的患者选择标准。本文基于已发表的专家共识以及运用临床标准研究X光片适应症的相关研究，对有症状和无症状患者进行门诊X光检查的一般及特定适应症进行综述。对于有症状的患者，将讨论以下X光片的适应症：四肢（创伤性和非创伤性）、颅骨、腹部、胸部、眼眶、鼻窦、面骨和脊柱。对于无症状患者，将特别关注腰骶部脊柱和胸部X光片的适应症。遵循适当的适应症时，医生可以避免过度使用及其带来的辐射和经济负担问题，以及使用不足及其导致评估不全面风险的问题。
