Lee Se W, Kim Dennis D, LE Phuong, Bartels Mathew N, Oh-Park Mooyeon
Montefiore Medical Center, New York City, NY, USA -
Montefiore Medical Center, New York City, NY, USA.
Eur J Phys Rehabil Med. 2017 Feb;53(1):72-80. doi: 10.23736/S1973-9087.16.04141-1. Epub 2016 Jan 28.
Few reports are available for the utility of diagnostic point-of-care (POC) ultrasonography for foot and ankle pain and diagnostic POC ultrasonography in physiatric practice has not yet been demonstrated.
To describe POC musculoskeletal ultrasonographic (US) findings by location of pain among patients presenting to a foot pain clinic and to evaluate the concordance rate between clinical diagnoses and US findings by region of the foot.
Retrospective chart review.
Outpatient clinic.
A total of 111 patients with foot and ankle pain.
Retrospective chart review of clinical notes and data from POC US evaluation of patients who presented to the foot pain clinic between November 2013 and January 2015. US evaluations were performed by two physiatric ultrasonographers.
The concordance rate of clinical diagnosis and findings from US imaging based on the location of foot pain.
One hundred eleven patients out of 205 patients who presented to the foot clinic (54.1%) had POC US evaluation during the initial visit. The data was analyzed for patients with a single location of pain excluding 21 patients with pain more than one location. The mean age was 55.1±14.3 years with 86.5% being female. The most common location of pain was the hindfoot/ankle (N.=71), followed by forefoot (N.=13) and midfoot (N.=6). The overall concordance rate between clinical and ultrasonographic diagnoses was 62.2% (56/90) with a higher concordance rate in the hindfoot (67.6%) compared to the rest of the foot (50% in midfoot, 38.5% in the forefoot, P=0.042). The most common reasons for discordance (N.=34) were failure to reveal abnormality on US (N.=20, 58%) followed by unexpected US findings (N.=7, 20.6%).
Concordance between clinical evaluation and POC US findings varies depending on the location of foot pain and often no US abnormalities were found in spite of clinical symptoms particularly in forefoot region.
These new findings will enhance the selective application of POC US and improve its clinical utility in physiatric practice.
关于即时检验（POC）超声诊断足踝疼痛的实用性的报道较少，且在物理医学实践中POC超声诊断尚未得到证实。
描述前往足痛门诊的患者按疼痛部位分类的POC肌肉骨骼超声（US）检查结果，并评估临床诊断与足部各区域US检查结果之间的符合率。
回顾性病历审查。
门诊诊所。
总共111例足踝疼痛患者。
回顾性审查2013年11月至2015年1月期间前往足痛门诊的患者的临床记录和POC US评估数据。US评估由两名物理医学超声检查人员进行。
基于足部疼痛部位的临床诊断与US成像结果的符合率。
205例前往足科诊所的患者中，111例（54.1%）在初次就诊时接受了POC US评估。对单一疼痛部位的患者数据进行分析，排除了21例疼痛部位不止一处的患者。平均年龄为55.1±14.3岁，女性占86.5%。最常见的疼痛部位是后足/踝（n = 71），其次是前足（n = 13）和中足（n = 6）。临床诊断与超声诊断的总体符合率为62.2%（56/90），后足的符合率（67.6%）高于足部其他部位（中足为50%，前足为38.5%，P = 0.042）。不符合的最常见原因（n = 34）是US检查未发现异常（n = 20，58%），其次是意外的US检查结果（n = 7，20.6%）。
临床评估与POC US检查结果之间的符合率因足部疼痛部位而异，尽管有临床症状，但US检查通常未发现异常，尤其是在前足区域。
这些新发现将加强POC US的选择性应用，并提高其在物理医学实践中的临床实用性。
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