摘要
本文回顾分析浙江大学医学院附属第一医院疼痛科2018年4例以腰腿痛就诊,最后诊断并非腰椎间盘突出症,而是其他疾病的诊治经过。4例患者均以腰腿痛就诊,都曾按腰椎间盘突出或局部神经根炎性水肿进行治疗,治疗效果均不明显。经完善相关检查甚至多学科会诊后确定其病因分别为IgG4相关性肾病、骶髂关节炎、盆腔血肿压迫坐骨神经干、硬膜外血管畸形。因此强调指出,腰椎间盘突出症只是腰腿痛病因之一,也是临床许多疾病的症状。由于临床医师有先入为主的思想,或缺乏相关知识,易将以腰腿痛为主要表现的疾病误诊为腰椎间盘突出,应引以为戒。
Four patients with lower extremities and low back pain were finally diagnosed as non-disc herniation,but other diseases in the department of Pain Medicine of First Affiliated Hospital of Zhejiang University in 2018.The four patients used to be treated by the diagnoses of herniation of intervertebral disc or inflammation and edema of local nerve root,but the treatment effect was not obvious.Through the further refinement of relevant examination and multi-disciplinary consultation,the etiology and diagnosis was IgG4 related nephropathy,inflammation of sacroiliac joint,compression of sciatic nerve trunk by pelvic hematoma,and intraspinal epidural vascular malformation respectively.Therefore,lumbocrural pain is a common symptom of many clinical diseases,and disc herniation is only one of the causes.Some clinicians have a preconceived idea or lack of relevant knowledge,and easily misdiagnose the lumbocrural pain as disc herniation,and this should be a warning.
作者
章沿锋
郭雪娇
李云泽
冯智英
Zhang Yanfeng;Guo Xuejiao;Li Yunze;Feng Zhiying(Department of Pain Medicine,the First Affiliated Hospital of Zhejiang University,Hangzhou City,Zhejiang Province 310003,China)
出处
《中华疼痛学杂志》
2020年第4期301-307,共7页
Chinese Journal Of Painology
关键词
腰痛
腿
腿部
误诊
Low back pain
Leg
Diagnostic errors
