利用高解析度超音波診斷肋骨骨折及輔助疼痛控制──病例報告

High-Resolution Sonography is Useful in the Diagnosis and Management of Rib Fracture - Case Report

背景：以放射線檢查診斷肋骨骨折有時是非常困難的，準確地發現肋骨骨折不但有助於止痛用藥更精準，也有助於使用其他替代的處置。個案報告：這位女性患者有乳癌的病史，在一次胸部鈍傷後便持續有胸痛的困擾，最初的放射線檢查不認為有肋骨骨折，但後來藉助高解析度超音波之輔助診斷出肌骨骨折。在超音波導引下實施骨折處注射局部止痛藥後，她的疼痛強度大幅改善。結論：超音波是一種高敏感性的診斷工具，可以發現輕微的、無位移的肋骨骨折；也具有區辨單純骨折與轉移性病灶之能力。

Objective: Diagnosing rib fracture with radiography is sometimes very difficult. Accurate disclosure of rib fracture can contribute to more specific medication and other alternative managements. Case report: A female patient with the history of breast cancer bothered by persistent chest wall pain with negative finding of rib radiography, but subsequently diagnosed with rib fracture by high-resolution sonography. Her pain intensity was significantly reduced after ultrasound-guided fracture site injection of local anesthetics. Conclusion: High-resolution sonography is more sensitive in detecting rib fracture, and it also possesses the capability of distinguishing between metastatic lesion and simple fracture.