寰枢关节半脱位误诊分析
Analysis of Misdiagnosis of Atlantoaxial Subluxation
李德成 1任彦景 1赵广义 2王芳芳 3张彦敏 3高冕 3牛苗苗1
作者信息
- 1. 050082 石家庄,联勤保障部队第九八〇医院康复医学科
- 2. 050082 石家庄,联勤保障部队第九八〇医院骨科
- 3. 050082 石家庄,联勤保障部队第九八〇医院健康医学科
- 折叠
摘要
目的 探讨寰枢关节半脱位的临床特点、误诊原因,并总结防范误诊措施.方法 对2022年1月至2023年3月收治的曾误诊的10例寰枢关节半脱位的临床资料进行回顾性分析.结果 10例分别因颈部疼痛、上肢放射性疼痛麻木、头痛、头晕、耳鸣等原因就诊,行颈椎MRI、头颅CT、经颅多普勒超声、纯音听阈测试等检查后,4例误诊为神经根型颈椎病,3例误诊为颈源性头痛,3例误诊为梅尼埃病.误诊时间7～14 d.10例均经颈椎X线侧位及齿突张口位检查确诊为寰枢关节半脱位,予间歇式牵引、手法整复治疗,治疗后随访3个月,上述症状均缓解或消失,无复发.结论 寰枢关节半脱位临床表现复杂多样且无特异性,容易误诊;临床医生应加强对本病的认识,全面分析病情,详细问诊查体,合理选择检查项目,认真鉴别诊断,以减少或避免误诊的发生.
Abstract
Objective To investigate the clinical characteristics and causes of misdiagnosis of atlantoaxial sublux-ation(AAS),and to summarize preventive measures.Methods The clinical data of 10 patients with AAS misdiagnosed and then treated from January 2022 to March 2023 were retrospectively analyzed.Results Ten patients presented with neck pain,upper limb radia-tion pain and numbness,headache,dizziness,and tinnitus.After cervical MRI,head CT,transcranial Doppler ultr sound(TCD),pure tone threshold test and other examinations,4 patients were misdiagnosed with cervical radiculopathy,3 patients with cervical headache,and 3 patients with Meniere's disease.Misdiagnosis lasted from 7 to 14 d.All the 10 patients were diagnosed with AAS by cervical X-ray and examination using open-mouth view of the odontoid,and were treated with in-termittent traction and manual reconstruction.At 3 months after treatment,the above symptoms were relieved or disappeared without recurrence.Conclusion The clinical manifestations of AAS are complex and non-specific,and it is more likely to be misdiagnosed.For clinicians,strengthening the understanding of the disease,comprehensive analysis of the condition,detailed examination,reasonable selection of examination items,and careful differential diagnosis are needed in order to reduce or avoid the occurrence of misdiag-nosis.
关键词
寰枢关节半脱位/误诊/神经根型颈椎病/颈源性头痛/梅尼埃病/X线检查/鉴别诊断Key words
Atlantoaxial subluxation/Misdiagnosis/Cervical radiculopathy/Cervicogenic headache/Meniere's disease/X-ray examination/Differential diagnosis引用本文复制引用
基金项目
河北省中医药管理局科研计划项目(2022448)
出版年
2024
国家科技期刊平台
NSTL
万方数据