这个病人有肩膀不稳定或骨损伤吗?
Jolanda J Luime1, Arianne P Verhagen, Harald S Miedema
1The Netherlands Expert Centre for Work-related Musculoskeletal Disorders, Erasmus, University Medical Center Rotterdam, Rotterdam, The Netherlands. b.koes@erasmusmc.nl
JAMA
|October 28, 2004
概括
精确诊断肩部不稳定可以通过特定的临床测试,如搬迁和前部释放. 然而,诊断关节内病理 (IAP) 需要进一步调查,双肩负荷I和II测试显示有希望.
科学领域:
- 整形外科 整形外科 整形外科
- 诊断的准确性 诊断的准确性
- 肩部生物力学 肩部生物力学
背景情况:
- 肩部疼痛的诊断通常依赖于病史和临床测试.
- 这些方法对于肩部不稳定或关节内病理 (IAP) 的诊断准确性尚不清楚.
研究的目的:
- 系统地分析临床试验和患者病史的诊断准确性,以确定肩部不稳定性和IAP.
主要方法:
- 在多个数据库 (PubMed,EMBASE,CINAHL) 进行了全面的文献搜索.
- 符合条件的研究将病史项目或体检测试与参考标准进行了比较.
- 使用诊断准确性研究质量评估 (QUADAS) 清单来评估方法质量.
主要成果:
- 搬迁和前部释放测试证明在诊断肩部不稳定性 (LRs从6.5到8.3) 中具有实用性.
- 双臂负荷I和II,Mimori疼痛挑和内部旋转阻力强度测试显示出诊断腹腔病变的前景 (LRs从7.2到29不等).
- 其他几种常见的测试被发现是不那么有用的;没有确定历史记录或初级保健临床测试的准确性研究.
结论:
- 搬迁和前部释放测试得到了最佳证据的支持,用于诊断肩部不稳定.
- 关节内病理 (IAP) 的诊断准确性,特别是部撕裂,不太清楚,但双肩负荷I和II,Mimori疼痛挑和内部旋转阻力强度测试是最有希望的.
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