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后皮神经卡压综合征的诊断技术

Diagnostic Techniques for Posterior Cutaneous Nerve Entrapment Syndrome.

作者信息

Watari Takashi

机构信息

Integrated Clinical Education Center, Kyoto University Hospital, Kyoto, JPN.

General Medicine Center, Shimane University Hospital, Izumo, JPN.

出版信息

Cureus. 2024 Nov 27;16(11):e74639. doi: 10.7759/cureus.74639. eCollection 2024 Nov.

Abstract

This case report highlights the diagnostic process for posterior cutaneous nerve entrapment syndrome (POCNES) in an older adult female patient, with an emphasis on using video demonstrations to guide clinicians. POCNES should be diagnosed based on a combination of specific clinical features, including localized back pain accompanied by pinpoint tenderness lateral to the spinous process, cutaneous sensory abnormalities over the area of pain, severe pain response to pressure on the tender point, and normal clinical and imaging findings. This case demonstrates how these criteria were identified via a thorough physical examination captured on video to provide a visual guide for clinicians. The use of a lidocaine injection at the tender point confirmed the diagnosis, offering immediate relief. The video in this report serves as a practical tool for clinicians to accurately diagnose POCNES, particularly when standard imaging and tests remain inconclusive.

摘要

本病例报告重点介绍了一名老年女性患者的后皮神经卡压综合征(POCNES)的诊断过程,强调使用视频演示来指导临床医生。POCNES应根据特定临床特征的组合进行诊断,包括局限性背痛伴棘突旁点状压痛、疼痛区域的皮肤感觉异常、对压痛点施压时的剧痛反应,以及正常的临床和影像学检查结果。本病例展示了如何通过视频记录的全面体格检查来确定这些标准,为临床医生提供视觉指导。在压痛点注射利多卡因证实了诊断,并立即缓解了疼痛。本报告中的视频是临床医生准确诊断POCNES的实用工具,尤其是在标准影像学检查和测试仍无定论时。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8ece/11682685/989a6b434867/cureus-0016-00000074639-i01.jpg

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