第三腰椎横突综合征患者肌骨超声表现及误诊情况分析

Analysis of musculoskeletal ultrasonographic features and misdiagnosis of the third lumbar transverse process syndrome

摘要:

目的 分析第三腰椎横突综合征患者的肌骨超声表现及误诊情况。方法 前瞻性选取2017年5月—2020年12月河北省中医院收治的120例第三腰椎横突综合征患者作为观察组，另取同期该院健康体检者120例作为对照组，评价超声检查指标的可重复性，比较两组超声检查指标的差异。结果 对照组患者L₃、L₄、L₅部位多裂肌厚度和横断面积的可重复性信度系数均> 0.8，肌骨超声的可重复性较强。观察组患者L₃、L₄、L₅部位的多裂肌厚度、横截面积小于对照组（P <0.05）。观察组患者肌骨超声诊断前的误诊主要以腰肌劳损、肾结石为主，其次为股外侧皮神经炎和肾绞痛。结论 第三腰椎横突综合征患者肌骨超声检查主要为多裂肌厚度和横截面积的差异，其误诊以腰肌劳损和肾结石为主。

Abstract:

Objective To study the musculoskeletal ultrasound findings and misdiagnosis of the third lumbar transverse process syndrome.Methods We prospectively selected 120 patients with the third lumbar transverse process syndrome in Hebei Provincial Hospital of Traditional Chinese Medicine from May 2017 to December 2020 as the observation group, and another 120 healthy patients undergoing heath checkup during the same period in the hospital were selected as the control group. The reproducibility of the ultrasound scan measurements was analyzed, and the differences in these measurements between the two groups were compared.Results The reliability coefficients of the thickness and the cross-sectional area of multifidus at the level of L₃, L₄ and L₅ were all above 0.800, and the reproducibility of musculoskeletal ultrasound scan measurements was high. The thickness and cross-sectional area of multifidus at the level of L₃, L₄ and L₅ were lower in the observation group than those in the control group (P < 0.05). The erroneous diagnoses for the patients in the observation group before they underwent musculoskeletal ultrasound scan mainly include lumbar muscle strain and kidney stones, followed by lateral femoral cutaneous neuritis and renal colic.Conclusions The changes in the thickness and the cross-sectional area of multifidus characterize the pathological findings of the third lumbar transverse process syndrome, the erroneous diagnoses of which are mainly lumbar muscle strain and kidney stones.