最近审阅: 24 十月 2020
最近更新: 07 八月 2020

小结

定义

病史和体格检查

关键诊断因素

  • 存在的危险因素
  • 位于支持带输送鞘上方和周围
  • 疼痛随运动增加而加剧
  • 对麻醉药物注射的响应
  • 手指屈曲和伸展时的疼痛性弹出感(扳机指)
  • 在掌骨头处的可触及结节(扳机指)
  • 腕桡侧出现局限性疼痛、压痛和肿胀(De Quervain 病)
  • 腕关节附近的疼痛和肿胀(交叉综合征)
  • 桡骨背结节处疼痛、肿胀和压痛(拇长伸肌腱鞘炎)
  • 尺侧腕疼痛(尺侧腕伸肌腱鞘炎)
  • 舟骨结节上方掌侧腕横纹处以及沿肌腱方向疼痛(桡侧腕屈肌腱鞘炎)。

其他诊断因素

  • 症状持续几周至几个月

危险因素

  • 40~50 岁和 50~60 岁年龄段
  • 女性
  • 具有相似病理机制的常见并发症(狭窄性肌腱病变或神经病变)病史
  • 累及惯用手
  • 胰岛素依赖型糖尿病
  • 妊娠和哺乳
  • 退行性关节疾病或外伤

诊断性检查

首要检查

  • 高分辨率超声扫描
更多 首要检查

需考虑的检查

  • 受累手部和腕部 X 线平片
  • 全血细胞计数 (FBC)
  • 红细胞沉降率 (ESR)
  • C 反应蛋白 (CRP)
  • 核磁共振成像 (MRI)
  • CT 扫描
更多 需考虑的检查

治疗流程

撰稿人

Professor

Department of Orthopaedic Surgery and Rehabilitation

University of Chicago Hospitals

Chicago

IL

利益声明

JMW receives research funding from the US Department of Defense and American Society for Surgery of the Hand. She receives a salary as deputy editor of Journal of Hand Surgery and updates editor of the textbook Skeletal Trauma.

Dr Jennifer Moriatis Wolf would like to gratefully acknowledge Dr Doug Campbell, Dr Peter Evans, and Dr Shafic Sraj, the previous contributors to this monograph. DC, PE, and SS declare that they have no competing interests.

同行评议者展开全部内容

Assistant Professor of Orthopedic Surgery

Harvard Medical School

Brigham and Women's Hospital

Boston

MA

利益声明

PEB declares that he has no competing interests.

Director and Head

Department of Plastic, Hand and Reconstructive Microsurgery and Burns

Ganga Hospital

Coimbatore

India

利益声明

SRS declares that he has no competing interests.

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