Giles L G, Crawford C M
National Centre for Multidisciplinary Studies of Back Pain, Townsville General Hospital, Queensland, Australia.
Can J Psychiatry. 1997 Feb;42(1):44-8. doi: 10.1177/070674379704200106.
Spinal pain with or without referred pain is a major and costly health problem that can arise from many anatomical structures. Sophisticated diagnostic imaging devices cannot show some of these structures, and frequently imaging provides only a shadow of the truth. This review illustrates how symptoms may well have an organic cause that is not detectable by current methods of examination, including imaging.
This study reviews some histopathological findings that can be associated with spinal pain with or without referred pain but cannot be seen on imaging.
Some histopathological changes illustrate imaging device limitations.
Awareness of the considerable limitations of even sophisticated imaging devices is necessary when managing patients with acute or chronic spinal pain with or without referred pain. Symptoms may well be genuine and not of psychogenic origin: a diagnosis of malingering, therefore, should not be made lightly.
伴有或不伴有牵涉痛的脊柱疼痛是一个重大且代价高昂的健康问题，可能源于多种解剖结构。精密的诊断成像设备无法显示其中一些结构，而且成像往往只能提供部分真相。本综述阐述了症状很可能存在当前检查方法（包括成像）无法检测到的器质性病因。
本研究回顾了一些可能与伴有或不伴有牵涉痛的脊柱疼痛相关但无法在成像中看到的组织病理学发现。
一些组织病理学变化说明了成像设备的局限性。
在处理伴有或不伴有牵涉痛的急性或慢性脊柱疼痛患者时，有必要认识到即使是精密成像设备也存在相当大的局限性。症状很可能是真实的而非心因性的：因此，不应轻易做出诈病的诊断。
