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肌骨超声在即时护理中的应用。

Point-of-care ultrasound in musculoskeletal field.

机构信息

Collaborative Research Laboratory of Musculoskeletal Ultrasound in Medicine, Graduate School of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan.

Laboratory of Analysis and Control of Upper Extremity Function, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan.

出版信息

J Med Ultrason (2001). 2022 Oct;49(4):663-673. doi: 10.1007/s10396-022-01252-0. Epub 2022 Aug 23.

Abstract

The musculoskeletal field is relatively new in point-of-care ultrasound (POCUS), a modality that has been gaining significance with the evolution of ultrasound (US) equipment and high-frequency probes. Images have become progressively clearer over the past decade, making it possible to diagnose many pathological conditions without exposure to radiation. Ultrasonography reveals many soft tissue pathologies that cannot be visualized using plain radiographs, which have historically been the first choice for the evaluation of musculoskeletal disorders. US saves money and time compared to magnetic resonance imaging (MRI). Although it is difficult to diagnose a disorder inside bone, its surface can be visualized very clearly, and it is also possible to visualize cartilage. Furthermore, with POCUS, it is possible to confirm a disorder and the continuity of the fibrous structures of muscles, tendons, and ligaments. In addition, the understanding of pathological conditions of motor disturbances, such as nerve or muscle/tendon injury, nerve paralysis, adhesions of the tendons, and joint instability, is deepened by observing the movement of these structures. Peripheral nerves, even small branches, can be visualized, and pathological conditions can be pinpointed by observing the nerve morphology, continuity, and relationship with the surrounding tissues. Children can be examined in a safe, relaxed environment, without leaving their parents. In addition, US is significantly different from other modalities in that it can be used for both diagnosis and treatment. Being able to visualize target sites improves safety and route accuracy of needle insertion for injection or puncture. Musculoskeletal POCUS is indispensable in routine medical care and is a technique that medical residents should acquire.

摘要

在即时超声检查(POCUS)中,肌肉骨骼领域相对较新,随着超声(US)设备和高频探头的发展,该技术变得越来越重要。在过去十年中,图像变得越来越清晰,使得在不接触辐射的情况下诊断许多病理状况成为可能。超声检查揭示了许多无法使用普通 X 光片(X 光)观察到的软组织病变,X 光片一直是评估肌肉骨骼疾病的首选方法。与磁共振成像(MRI)相比,超声检查既省钱又省时。虽然很难诊断骨骼内部的疾病,但它的表面可以非常清晰地显示出来,也可以观察到软骨。此外,通过 POCUS,可以确认疾病以及肌肉、肌腱和韧带的纤维结构的连续性。此外,通过观察这些结构的运动,可以深入了解运动障碍的病理状况,如神经或肌肉/肌腱损伤、神经麻痹、肌腱粘连和关节不稳定。此外,还可以观察到外周神经,甚至是小分支,并通过观察神经形态、连续性以及与周围组织的关系来确定病理状况。可以在安全、放松的环境中对儿童进行检查,而无需离开父母。此外,超声检查与其他模态有很大的不同,它既可以用于诊断,也可以用于治疗。能够观察到目标部位可以提高注射或穿刺时针插入的安全性和路径准确性。肌肉骨骼 POCUS 在常规医疗保健中不可或缺,是医学住院医师应该掌握的技术。

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