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一名10岁患有颈椎肿瘤儿童的小儿颈部疼痛,通过直接就诊物理治疗进行评估和管理:病例报告

Pediatric neck pain of a 10-year-old child with cervical spinal tumor evaluated and managed in direct access physical therapy: a case report.

作者信息

Henderson Virginia K, Brismée Jean-Michel

机构信息

Texas Children's Hospital, Department of Physical Therapy, Houston, TX, USA.

Department of Rehabilitation Sciences, Center for Rehabilitation Research, Texas Tech University Health Sciences Center, Lubbock, TX, USA.

出版信息

J Man Manip Ther. 2024 Jun;32(3):335-342. doi: 10.1080/10669817.2024.2319427. Epub 2024 Feb 28.

Abstract

INTRODUCTION

Differential diagnosis of pediatric neck pain requires age-appropriate communication and assessment tools. Recognizing these age-related nuances is critical, emphasizing the role of physical therapists in assessing and managing pediatric patients while ruling out severe pathologies.

CASE DESCRIPTION

A 10-year-old male presented to physical therapy with a five-week history of increasing neck pain. A thorough history and segmental cervical examination considering the patient's age and development, led to patient referral to the emergency department. This case underscores the significance of comprehensive evaluation in pediatric neck pain management.

OUTCOMES

The patient was diagnosed with Langerhans Cell Histiocytosis (LCH). LCH primarily affects children and is treated with chemotherapy. Chemotherapy reduced the tumor, revealing C2 vertebral body damage. The patient underwent C1-C3 fusion surgery, a standard procedure for atlanto-occipital region stabilization in children. The patient was advised to restrict motion for 6 months while monitoring for tumor growth.

DISCUSSION-CONCLUSION: Pediatric neck cancer presents diagnostic challenges due to varied symptoms, but research highlights specific indicators to assist with differential diagnosis. This case emphasizes the need to recognize the complexities of pediatric neck pain and perform a thorough age-appropriate evaluation.

摘要

引言

小儿颈部疼痛的鉴别诊断需要适合其年龄的沟通和评估工具。认识到这些与年龄相关的细微差别至关重要,这凸显了物理治疗师在评估和管理小儿患者同时排除严重病症方面的作用。

病例描述

一名10岁男性因颈部疼痛逐渐加重5周前来接受物理治疗。结合患者年龄和发育情况进行了全面的病史询问和颈椎节段检查后,患者被转诊至急诊科。该病例强调了在小儿颈部疼痛管理中进行全面评估的重要性。

结果

患者被诊断为朗格汉斯细胞组织细胞增多症(LCH)。LCH主要影响儿童,采用化疗进行治疗。化疗使肿瘤缩小,显示出C2椎体损伤。患者接受了C1-C3融合手术,这是儿童寰枕区域稳定的标准手术。建议患者限制活动6个月,同时监测肿瘤生长情况。

讨论-结论:小儿颈部癌症由于症状多样而存在诊断挑战,但研究突出了有助于鉴别诊断的特定指标。该病例强调了认识小儿颈部疼痛复杂性并进行全面的适合其年龄的评估的必要性。

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