最近审阅: 24 十月 2020
最近更新: 02 十一月 2018

小结

定义

病史和体格检查

关键诊断因素

  • 存在的危险因素
  • 活动时疼痛加重
  • 疼痛部位:膝关节屈曲至 90 度时的膝关节前内侧面
  • 疼痛部位:肘关节外侧面
  • 疼痛部位:背屈踝关节的后内侧面或跖屈踝关节的前外侧面
  • 出现渗出
  • 关节交锁
  • 关节粘滞感
  • 关节活动度降低

其他诊断因素

  • 累及膝关节,10~15 岁
  • 累及肘关节,年龄为 11-21 岁
  • 距骨受累,十几岁至四十岁
  • 有累及膝关节或肘关节的外伤史
  • 累及膝关节或距骨的剥脱性骨软骨炎中的防痛步态
  • 累及膝关节的剥脱性骨软骨炎中的外旋步态
  • 缓解因素:非甾体抗炎药 (NASID)、休息、冰敷和抬升
  • 捻发音
  • 威尔逊氏试验
  • 四头肌萎缩

危险因素

  • 反复投掷/外翻应力
  • 体操/上肢承重
  • 踝关节扭伤/不稳定
  • 竞技运动
  • 家族史

诊断性检查

首要检查

  • 膝关节 X 线片
  • 踝关节 X 线片
  • 下肢全长 X 线片
  • 肘关节 X 线片
更多 首要检查

需考虑的检查

  • 计算机体层成像 (CT)
  • 磁共振成像 (MRI)
  • MR 关节 X 线摄影
  • 诊断性关节镜检查
更多 需考虑的检查

治疗流程

撰稿人

Professor of Clinical Orthopedic Surgery

University of California, San Diego

Rady Children’s Hospital

San Diego

CA

利益声明

HGC has acted as a consultant to OrthoPediatrics, undertaken research for Allergan, and is an associate editor for Developmental Medicine and Child Neurology. HGC is an author of a number of references cited in this topic.

Dr Henry G. Chambers would like to gratefully acknowledge Dr James L. Carey, Dr Jon Divine, Dr Michael Nett, and Dr Cedric Ortiguera, the previous contributors to this topic. JLC is an author of a number of references cited in this topic. JD, MN, and CO declare that they have no competing interests.

同行评议者展开全部内容

Orthopedic Surgeon

The Hughston Clinic PC

Columbus

GA

利益声明

JEM declares that he has no competing interests.

Centre Lead and Professor of Sports and Exercise Medicine

Consultant Trauma and Orthopaedic Surgeon

Barts and The London School of Medicine and Dentistry

Institute for Health Sciences Education

Centre for Sports and Exercise Medicine

Queen Mary University of London

Mile End Hospital

London

UK

利益声明

NM declares that he has no competing interests.

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