阿摩線上測驗
11.一位20歲的急性右側下背痛患者，主訴為坐著時症狀減緩，但久站會有明顯疼痛，尤其是身體前彎時症狀加
劇，此患者最有可能的問題為何？
(A)腰椎退化性關節炎
(B)腰椎間盤突出
(C)小面關節扭傷
(D)腰椎肌肉拉傷
統計： A(192), B(1076), C(361), D(2318), E(0) #2182265
詳解 (共 10 筆)
-年齡參考就好
若有錯誤，歡迎指正
右側下背痛，坐著時症狀減緩，但久站會有明顯疼痛，尤其是身體前彎時症狀加劇：
1. 單側下背疼痛 + Exaggerated factor: forward bending
(A)腰椎退化性關節炎 (clinical picture: Synovial hypertrophy, cartilage necrosis, ulceration, fibrillation, eburnation, instability, and bony overgrowth. All of which can contribute to spinal stenosis.)
(B)腰椎間盤突出
(C)小面關節扭傷 (exaggerated factor: ext. + rot.: contralateral-approximated; Ipsilateral-gapped)
(D)腰椎肌肉拉傷
2. 坐著時症狀減緩，但久站會有明顯疼痛
-> Sitting causes a reduction in lumbar lordosis compare with standing* / elicit pain by prolonged standing -> disc height loss & muscle fatigue (not much help from my aspect.) / without description about neuro-symptom (tricky)
(B)腰椎間盤突出
(D)腰椎肌肉拉傷
思慮不周，還請不吝指正
Ref.:
1. my opinion 僅供參考
2. Cho, I. Y., Park, S. Y., Park, J. H., Kim, T. K., Jung, T. W., & Lee, H. M. (2015). The Effect of Standing and Different Sitting Positions on Lumbar Lordosis: Radiographic Study of 30 Healthy Volunteers. Asian spine journal, 9(5), 762–769. https://doi.org/10.4184/asj.2015.9.5.762
3. Magee 6th ed. p. 643
4. Lindsey T, Dydyk AM. Spinal Osteoarthritis. [Updated 2021 Jul 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-
回樓上
肌肉要在被拉長時才能誘發疼痛
而坐著時肌肉不會被拉長呀
相較於站姿，坐姿時肌肉較不用出力
比較有問題的是B、D
題目說「急性右側下背痛」
HIVD是慢性，拉傷是急性
