Vomer Rock P, Lewno Adam J, Udoh Imoh, Albano-Aluquin Shirley, Pujalte George G A
Department of Family and Community Health and Department of Orthopedics, Division of Sports Medicine, Duke University, Durham, USA.
Family Medicine, Mayo Clinic Jacksonville Campus, Jacksonville, USA.
Cureus. 2023 Feb 22;15(2):e35322. doi: 10.7759/cureus.35322. eCollection 2023 Feb.
The COVID-19 pandemic has highlighted the utility of telemedicine, with rapid incorporation throughout 2020. Telemedicine is a timely, safe, and effective means of evaluating, triaging, and treating patient conditions, including those of the musculoskeletal system. Hand and wrist complaints are frequently encountered in the primary care setting, and some can have serious consequences if not promptly diagnosed. Prior to the pandemic, over a quarter of the nation's allopathic degree-granting medical schools had initiated telemedicine training as part of the preclinical phase of their curriculum, and about half had implemented it into clerkships prior to the pandemic. Despite rapid acceptance, increased ease of access, and prior attempts to incorporate telemedicine into the educational curriculum, telemedicine evaluation continues to pose challenges to both the patient and provider. This is likely due to a lack of established protocols outlining clinical data collection through a virtual interface. Although telemedicine requires the patient to perform a physical examination, it allows the physician to collect clinically important information while observing the patient in their home environment.
The aim of this paper is to provide a step-by-step method to evaluate and triage hand and wrist complaints.
Our group has created a step-by-step evaluation pathway to help physicians direct their patients through typical hand and wrist examination elements, including inspection, palpation, range of motion (ROM), strength, special, and functional testing.
We have developed a table of evaluation questions and instructions and a glossary of images of each maneuver to facilitate hand and wrist examination via telemedicine.
This paper provides a guide for extracting clinically relevant information while performing telemedicine examinations of the hand.
2019年冠状病毒病（COVID-19）大流行凸显了远程医疗的效用，在2020年期间迅速得到采用。远程医疗是评估、分诊和治疗患者病情（包括肌肉骨骼系统疾病）的一种及时、安全且有效的手段。手部和腕部疾病在初级保健环境中经常遇到，如果不及时诊断，有些可能会产生严重后果。在大流行之前，全国超过四分之一授予医学博士学位的医学院校已将远程医疗培训作为其课程临床前期的一部分启动，约一半院校在大流行之前已将其纳入临床实习。尽管远程医疗迅速被接受、使用更加便捷，并且此前曾尝试将其纳入教育课程，但远程医疗评估对患者和提供者来说仍然具有挑战性。这可能是由于缺乏通过虚拟界面概述临床数据收集的既定方案。虽然远程医疗要求患者进行体格检查，但它使医生能够在观察患者居家环境的同时收集重要的临床信息。
本文旨在提供一种逐步评估和分诊手部及腕部疾病的方法。
我们团队创建了一个逐步评估路径，以帮助医生指导患者完成典型的手部和腕部检查项目，包括视诊、触诊、活动范围（ROM）、力量、特殊检查和功能测试。
我们制定了一份评估问题和说明表以及每个操作的图像术语表，以促进通过远程医疗进行手部和腕部检查。
本文为在进行手部远程医疗检查时提取临床相关信息提供了指南。
