Department of Readaptation, HFR Fribourg Hôpital cantonal, chemin des pensionnats 2-6, 1708, Fribourg, Switzerland.
J Med Case Rep. 2024 Apr 12;18(1):175. doi: 10.1186/s13256-024-04489-0.
This report involves the first publication describing a case of parietal abdominal pain due to lower limb length discrepancy.
A Caucasian male patient in his 50s was referred to our rehabilitation department with chronic abdominal pain that began in childhood. This chronic pain was associated with episodes of acute pain that were partially relieved by grade 3 analgesics. The patient was unable to sit for long periods, had recently lost his job, and was unable to participate in recreational activities with his children. Investigations revealed contracture and hypertrophy of the external oblique muscle and an limb length discrepancy of 3.8 cm (1.5 inches) in the left lower limb. The patient was effectively treated with a heel raise, physiotherapy, intramuscular injection of botulinum toxin, and lidocaine. The patient achieved the therapeutic goals of returning to work, and reducing analgesic use.
Structural misbalances, as may be caused by lower leg discrepancy, may trigger muscular compensations and pain. Complete anamnesis and clinical examination must not be trivialized and may reveal previously ignored information leading to a proper diagnosis.
本报告涉及首例因下肢长度差异导致的腹壁疼痛病例的描述。
一名 50 多岁的高加索男性患者因慢性腹痛就诊于我院康复科，该腹痛始于儿童时期。这种慢性疼痛伴有急性疼痛发作，部分可通过 3 级镇痛药缓解。患者无法长时间坐立，最近已失业，无法与孩子们参加娱乐活动。检查发现患者的腹外斜肌挛缩和肥大，以及左下肢相差 3.8 厘米（1.5 英寸）的肢体长度差异。该患者经足跟垫高、物理治疗、肉毒毒素肌内注射和利多卡因治疗后效果显著。患者达到重返工作岗位和减少镇痛药使用的治疗目标。
结构失衡，可能由小腿差异引起，可能引发肌肉代偿和疼痛。完整的病史和临床检查不容忽视，可能会发现以前被忽视的信息，从而做出正确的诊断。
