Diagnosing regional pain: the view from primary care.

Diagnosing regional pain: the view from primary care.
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诊断局部疼痛:初级保健的观点。

DOI:
10.1053/berh.1999.0018
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发表时间:
1999
期刊:
Bailliere's best practice & research. Clinical rheumatology
影响因子:
--
通讯作者:
P. Croft
P. Croft
中科院分区:
--
文献类型:
--
作者:
P. Croft

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有一个普遍缺乏新的证据基础上,实用和有用的诊断分类区域肌肉骨骼疼痛的初级保健。然而,“红旗”系统,开发和现在成功地传播在管理下腰痛,似乎适用于其他区域疼痛的初始管理。在这一计划中,寻找严重疾病的体征和症状,它们的存在是对个别病人进行调查或转诊的指示。在缺乏这些指标的情况下,许多体征、测试甚至诊断标签的预测价值都很低,这就反对它们在初级保健中的常规使用。基于关节与非关节以及急性与慢性的分离的简单决定受到最近专家共识声明的青睐。此外,是否存在更广泛的疼痛,以及慢性疼痛的其他非特异性特征,可能有助于管理区域综合征。对症状、体征和诊断标签的预后价值的前瞻性研究仍然是该领域的研究重点。
There is a general lack of new evidence on which to base practical and useful diagnostic classifications of regional musculoskeletal pain for primary care. However, the'red flag' system, developed and now disseminated successfully in the management of low back pain, seems to be applicable to the initial management of other regional pain. In this scheme, signs and symptoms of serious disease are sought, and their presence is the indication for the investigation or referral of individual patients. In their absence, the low predictive value of many signs, tests and even diagnostic labels argues against their routine use in primary care. Simple decisions based on separation into articular versus non-articular, and acute versus chronic, are favoured by the most recent expert consensus statements. In addition, the presence or absence of more widespread pain, and of other non-specific features of chronic pain, is likely to be helpful in managing regional syndromes. Prospective studies of the prognostic value of symptoms, signs and diagnostic labels remain a research priority in this field.
DOI: 10.1001/archpsyc.1990.01810150039007
发表时间: 1990-03
影响因子: --
作者:
S. Dworkin;M. Korff;L. Leresche
通讯作者: S. Dworkin;M. Korff;L. Leresche
DOI: 10.1016/s0883-5403(96)80159-8
发表时间: 1996-01-01
影响因子: 3.5
作者:
Mancuso, CA;Ranawat, CS;Charlson, ME
通讯作者: Charlson, ME