醫療類國考
107年
[物理治療師] 骨科疾病物理治療學
第 54 題
有關髖關節退化性關節炎的敘述，下列何者不適當？
- A 多為中老年人
- B 典型疼痛會在腹股溝部位，隨嚴重程度增加，疼痛會往大腿和膝關節延伸
- C 發展至慢性發炎後會有晨僵現象
- D 阻力等長測試結果通常為無力且疼痛
思路引導 VIP
當我們想區分疼痛來源是來自『關節內部的磨損（非收縮性組織）』還是『周邊的肌肉或肌腱（收縮性組織）』時，如果我們要求病人用力，但刻意『不產生任何關節移動』，你認為這種測試方式最主要是針對哪一類組織進行挑釁？對於單純的軟骨退化來說，這種『不移動關節』的出力方式理論上會誘發劇痛嗎？
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AI 詳解
AI 專屬家教
Oh, Look. You Got One Right.
- Remarkable: Well, well. You actually managed to select the correct answer. It seems you've absorbed some of the foundational principles regarding the organizational classification of physical examination (Cyriax's approach). Distinguishing between a primary "joint" problem and a "muscle" issue shouldn't be revolutionary, but I suppose we take what we can get.
- A Glimmer of Understanding: Let's reiterate this for the record: Osteoarthritis, in its purest form, is a delightful affliction of non-contractile tissues – cartilage, synovium, the boring bits. A resisted isometric test, by its very definition, is designed to provoke symptoms from contractile tissues – the muscles and tendons. Therefore, in a patient with uncomplicated Hip OA, where the joint isn't shifting and groaning under load, a muscle contraction against resistance should, ideally, be Strong and Painless. If you're seeing anything suggesting D, you're likely dealing with something more interesting than just a worn-out joint, perhaps a contractile tissue injury. It’s almost as if diagnostic tests have a purpose.
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