アブストラクト
| Title | 殿部・下肢の痛み・しびれの診かた |
|---|---|
| Subtitle | 特集 : 脊椎由来の痛み・しびれの診かた |
| Authors | 細金直文* |
| Authors (kana) | |
| Organization | *杏林大学医学部整形外科学教室, 准教授 |
| Journal | MB Orthopaedics |
| Volume | 33 |
| Number | 3 |
| Page | 35-42 |
| Year/Month | 2020 / 3 |
| Article | 報告 |
| Publisher | 全日本病院出版会 |
| Abstract | 「Abstract」 殿部・下肢の疼痛やしびれは腰部脊柱管内外を通過する神経の障害により生じることが多い. これらを診断するうえでは, まず問診により腰椎由来の症状かどうか, その大まかな障害部位を見積もる. その後, 身体所見を取得し問診で得られた所見の確認さらなる絞り込みへと進めていく. その際には深部腱反射や病的反射, 筋力, 感覚, 疼痛を誘発する各種テストなどの正確な知識が重要である. いずれも単独では診断の正確性は高くないので, 画像所見も併せて総合的に判断する必要がある. また, 見落とされやすい円錐上部や円錐部の病変, 椎間孔狭窄などの存在を注意深く鑑別し, いずれの腰椎疾患にも該当する所見がない場合は梨状筋症候群や殿皮神経障害など, 腰椎以外に由来する疾患の可能性も検討する必要がある. |
| Practice | 臨床医学：外科系 |
| Keywords | 下肢伸展挙上テスト(SLR test), ラセーグ徴候(Lasegue sign), 腰椎椎間孔狭窄症(lumbar foraminal stenosis), 梨状筋症候群(piriformis syndrome) |
- 全文ダウンロード： 従量制、基本料金制の方共に968円(税込) です。
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