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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.

DOI:10.7759/cureus.74639
PMID:39734960
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11682685/
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
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8ece/11682685/989a6b434867/cureus-0016-00000074639-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8ece/11682685/989a6b434867/cureus-0016-00000074639-i01.jpg

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本文引用的文献

1
Three Subtypes of Cutaneous Nerve Entrapment Syndrome: A Narrative Review.三种皮肤神经卡压综合征:叙述性综述。
Intern Med. 2024 Aug 15;63(16):2231-2239. doi: 10.2169/internalmedicine.2927-23. Epub 2024 Jan 13.
2
Diagnosis of posterior cutaneous nerve entrapment syndrome through history and physical examination.通过病史和体格检查诊断后皮神经卡压综合征。
BMJ Case Rep. 2022 Mar 2;15(3):e248661. doi: 10.1136/bcr-2021-248661.
3
A Rare Presentation of a Compression Fracture or a Typical Presentation of Lateral Cutaneous Nerve Entrapment Syndrome: A Diagnostic Error?
压缩性骨折的罕见表现还是外侧皮神经卡压综合征的典型表现:诊断错误?
Intern Med. 2022 May 1;61(9):1453-1455. doi: 10.2169/internalmedicine.8256-21. Epub 2021 Oct 12.
4
Pinch sign for acute lateral cutaneous nerve entrapment syndrome (LACNES).急性外侧皮神经卡压综合征(LACNES)的捏压征
BMJ Case Rep. 2021 Feb 26;14(2):e241421. doi: 10.1136/bcr-2020-241421.
5
Chronic Localized Back Pain Due to Posterior Cutaneous Nerve Entrapment Syndrome (POCNES): A New Diagnosis.由后皮神经卡压综合征(POCNES)引起的慢性局限性背痛:一种新的诊断。
Pain Physician. 2017 Mar;20(3):E455-E458.