下腰痛的影像学过度诊断及对策

下腰痛的发病率很高,就诊的患者人次居骨科就诊患者的首位。当前临床上存在下腰痛影像学的"过度检查",原因包括医方的利益驱动、医生过分依赖影像学、医生的防御性医疗以及患者方面的因素。针对下腰痛患者不同的症状和体征选择个性化的影像学检查和诊断是解决该问题的主要办法。

Causes and Strategies of Excessive Imaging for Low Back Pain

Low back pain is one of the most frequent problems treated by orthopae dic surgeons. Although imaging technology has greatly improved the convenience a nd quality of the diagnosis of low back pain, there is evidence of excessive ima ging for low back pain in China now. The possible causes for the overutilization of imaging techniques include a profit making motive from hospital, doctor's de pending overly on imaging studies, defensive medicine and patient's selection. F or optimal patient care, imaging studies should be performed in an individuated manner according to a careful history taking and physical examination.