n.

捻挫

関: distortion、strain

WordNet

a painful injury to a joint caused by a sudden wrenching of its ligaments
become stretched or tense or taut; "the bodybuilders neck muscles tensed;" "the rope strained when the weight was attached" (同)tense
(psychology) nervousness resulting from mental stress; "his responsibilities were a constant strain"; "the mental strain of staying alert hour after hour was too much for him" (同)mental strain, nervous strain
(physics) deformation of a physical body under the action of applied forces
injury to a muscle (often caused by overuse); results in swelling and pain
an intense or violent exertion (同)straining
use to the utmost; exert vigorously or to full capacity; "He really extended himself when he climbed Kilimanjaro"; "Dont strain your mind too much" (同)extend
a change (usually undesired) in the waveform of an acoustic or analog electrical signal; the difference between two measurements of a signal (as between the input and output signal); "heavy metal guitar players use vacuum tube amplifiers to produce extrem
the act of distorting something so it seems to mean something it was not intended to mean (同)overrefinement, straining, torture, twisting
the mistake of misrepresenting the facts
a change for the worse (同)deformation

PrepTutorEJDIC

〈手首・足首など〉‘を'くじく,ねんざする / くじき・ねんざ
…‘を'『引っ張る』 / (使い過ぎて)〈体など〉‘を'『痛める』,弱める / …‘を'『最大限に働かせる』,精一杯使う / 〈意味・規則など〉‘を'曲げる,こじつける,拡大解釈する / 〈液体〉‘を'『こす』;(液体から)〈固形分〉‘を'こして取る《+『out(off)』+『名』+『from』+『名』》 / 全力を尽くす,懸命に努力する / ぱんと張る / 〈C〉〈U〉『張りつめること』,張る力 / 〈C〉『筋違い』,ねんざ,くじき / 〈U〉(精神的に,極度に)緊張,重荷,過労 / 〈C〉骨のおれる仕事,激務
〈C〉家系,血統,種族 / 〈C〉品種 / 〈U〉《しばしばa ~》(遺伝的な)性質,体質 / 〈C〉《しばしば複数形で》《単数扱い》(音楽の)曲,一節 / 〈C〉口調,言い回し,文体
〈U〉(話・真実・事実などを)ゆがめること,曲げて伝えること / 〈U〉(形の)ゆがみ,ねじれ;〈C〉ゆがんだ(ねじれた)もの / (光の)ひずみ,収差

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/08/10 18:40:36」(JST)

wiki en

[Wiki en表示]

A sprain is damage to one or more ligaments in a joint, often caused by trauma or the joint being taken beyond its functional range of motion. The severity of sprain ranges from a minor injury which resolves in a few days to a major rupture of one or more ligaments requiring surgical fixation and a period of immobilisation. Sprains can occur in any joint but are most common in the ankle and wrist.^[1]

Symptoms

Pain
Swelling
Bruising
Decreased ability to move the limb
If a ligament ruptures, one may hear a popping sound
Difficulty using the affected extremity

Classification

First degree sprain - the fibres of the ligament are stretched but intact.
Second degree sprain - is a tear of part of a ligament, from a third to almost all its fibers.
Third degree sprain - is a complete rupture of the ligament, sometimes avulsing a piece of bone.

Diagnosis

A diagnosis of a sprain can often be made with a good degree of certainty by physical examination based on the clinical presentation and method of injury. In some cases, X-rays are obtained to ensure that there is no fracture. In some cases, particularly if the injury is prolonged or does not appear to be resolving as expected, magnetic resonance imaging (MRI) is performed to look at surrounding soft tissues and the ligament.^[2]

Causes

Sprains typically occur when the joint is taken beyond its functional range of motion.

Joints involved

Although any joint can experience a sprain, some of the more common include:

The ankle. It is the most common, and has been said that sprains such as serious ankle sprains are more painful and take longer to heal than actually breaking the bones in that area.^[3] See sprained ankle for more details.
The knee. Perhaps one of the more talked about sprains is that to the anterior cruciate ligament (ACL) of the knee. This is a disabling sprain common to athletes, especially in American football, football (soccer), basketball, pole vaulting, softball, baseball and some styles of martial arts. See Anterior cruciate ligament injury.
The fingers.
The wrist.
The toes.

Risk factors

There are certain factors which increase risk of sprains. Fatigue of muscles generally leads to sprains. When one suddenly starts to exercise after a sedentary lifestyle, sprains are quite common. While scientific studies are lacking, it is often thought that not warming-up is a common cause of sprains in athletes. Warming-up is thought to loosen the joint, increases blood flow and makes the joint more flexible.

Treatment

The first modality for a sprain can be remembered using the acronym RICE.^[4] The treatment of sprains depends on the extent of injury and the joint involved. Medications like non-steroidal anti-inflammatory drugs can relieve pain. Weight bearing should be gradual and advanced as tolerated.^[5]

Rest: The sprain should be rested. No additional force should be applied on site of the sprain. In case of, for example, a sprained ankle, walking should be kept to a minimum.^[6]

Ice: Ice should be applied immediately to the sprain to reduce swelling and pain. It can be applied for 10–15 minutes at a time (longer application of ice may cause damage instead of healing), 3-4 times a day. Ice can be combined with a wrapping to minimize swelling and provide support.^[6]

Compression: Dressings, bandages, or ace-wraps should be used to immobilize the sprain and provide support. When wrapping the injury, more pressure should be applied at the far end of the injury and decrease in the direction of the heart; the reason for this is that it more easily causes unnecessary fluid to be flushed back up the blood stream in order to be recycled. Compression should not cut off the circulation of the limb.^[6]

Elevation: Keeping the sprained joint elevated (in relation to the rest of the body) will also help minimize swelling.^[6]

Ice and compression (cold compression therapy) will not completely stop swelling and pain, but will help to minimize them as the sprain begins to heal itself. Careful management of swelling is critical to the healing process as additional fluid may pool in the sprained area.

The joint should be exercised again fairly soon, in milder cases from 1 to 3 days after injury.^[7] Special exercises are sometimes needed in order to regain strength and help reduce the risk of ongoing problems. The joint may need to be supported by taping or bracing, helping protect it from re-injury.^[7]

Functional rehabilitation

Prolonged immobilization delays the healing of a sprain, as it usually leads to muscle atrophy and stiff joint. The components of an effective rehabilitation for all sprain injuries include increasing range of motion and progressive muscle strengthening exercise. These should be taken care of without delay.^[8]

References

^ [1] Retrieved on 2010-02-16
^ Strains and sprains information Mayo Clinic. Retrieved on 2010-01-26
^ Holes Human Anatomy & Physiology, Shier, David, Jackie Butler, Ricki Lewis, Mc Graw Hill 2007, Eleventh Ed., p.157,160
^ Mnemonic medicalmnemonics.com 235
^ Sprain and Strain Symptoms and Treatment About Network. Retrieved on 2010-01-26
^ ^a ^b ^c ^d "Sprained Ankle". American Orthopaedic Foot and Ankle Society. March 2005. Retrieved 2008-04-01.
^ ^a ^b Ankle Sprains: Healing and Preventing Injury Written by familydoctor.org editorial staff. American Academy of Family Physicians. Reviewed/Updated: 08/06. Created: 01/96
^ Sprained ankle American academy of orthopedic surgeons. Retrieved on 2010-01-26

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

1. 足首の捻挫 ankle sprain
2. Ankle pain in the active child or skeletally immature adolescent: Overview of causes
3. 急性の手首の疼痛を有する成人患者の評価 evaluation of the adult with acute wrist pain
4. 足関節靱帯損傷（high ankle sprain） syndesmotic ankle injury high ankle sprain
5. 成人における足の痛みの評価と一般的な原因の診断 evaluation and diagnosis of common causes of foot pain in adults

English Journal

Sports injury and illness epidemiology during the 2014 Youth Olympic Games: United States Olympic Team Surveillance.

Nabhan D1, Walden T1, Street J1, Linden H1, Moreau B1.
British journal of sports medicine.Br J Sports Med.2016 Jun;50(11):688-93. doi: 10.1136/bjsports-2015-095835. Epub 2016 Apr 20.
BACKGROUND: To describe injury and illness incidence from the US Youth Olympic Team during the 2014 Youth Olympic Games (YOG).METHODS: Electronic health records of Team USA athletes registered for the YOG were reviewed for patient encounters during the 2014 YOG. Medical encounters were defined as al
PMID 27098886

Comorbid conditions are associated with healthcare utilization, medical charges and mortality of patients with rheumatoid arthritis.

Han GM1,2,3, Han XF4.
Clinical rheumatology.Clin Rheumatol.2016 Jun;35(6):1483-92. doi: 10.1007/s10067-016-3277-y. Epub 2016 Apr 23.
This study aims to examine the associations between comorbid conditions and healthcare utilization, medical charges, or mortality of patients with rheumatoid arthritis (RA). Nebraska state emergency department (ED) discharge, hospital discharge, and death certificate data from 2007 to 2012 were used
PMID 27106546

From the Horse Worker's Mouth: A Detailed Account of Injuries Experienced by Latino Horse Workers.

Swanberg JE1, Clouser JM2, Bush A3, Westneat S3.
Journal of immigrant and minority health / Center for Minority Public Health.J Immigr Minor Health.2016 Jun;18(3):513-21. doi: 10.1007/s10903-015-0302-1.
Horse breeding farms are hazardous. Yet, little is known about the injuries of Latino horse workers. This study assesses Latino horse workers' injury prevalence, describes their injuries, and analyzes differences between injuries receiving medical versus those receiving first aid care. Data were gat
PMID 26458955

Japanese Journal

Association between Cumberland Ankle Instability Tool score and postural stability in collegiate soccer players with and without functional ankle instability

Physical therapy in sport 32, 29-33, 2018-07
NAID 120006528409

足関節捻挫として見過ごされている症候群

臨床整形外科 53(5), 419-426, 2018-05
NAID 40021616694

足関節捻挫の病態と治療 (特集足関節捻挫の病理とリコンディショニング)

日本アスレティックトレーニング学会誌 = Japanese journal of athletic training 3(2), 117-126, 2018-04
NAID 40021692637

Related Pictures

★リンクテーブル★

リンク元	「100Cases 16」「捻挫」

「100Cases 16」

Sprain
	Classification and external resources
	A sprained ankle with bruising.
ICD-10	T14.3
ICD-9	848.9
MedlinePlus	000041
MeSH	D013180

　　[★]

☆case16　膝の痛み

■glossary

indigestion 消化障害、消化不良

■症例

80歳　男性

主訴：左膝の痛みと腫脹

現病歴：左膝の痛みを2日前から認めた。膝は発熱・腫脹しており、動かすと疼痛を生じる。時々胸焼けと消化不良が見られる。6ヶ月前のhealth checkで、高血圧(172/102mmHg)と血中クレアチニンが高い(正常高値)こと以外は正常といわれた。その4週間数回血圧を測定したが、高値が継続したため、2.5mg bendrofluamethizide(UK)/ベンドロフルメチアジド bendroflumethiazide(US)で治療を開始した。最近の血圧は138/84 mmHgであった。

喫煙歴：なし。

飲酒歴：一週間に平均4unit。

既往歴：股関節に中程度(mild)の変形性関節症

家族歴：特記なし

服薬歴：アセトアミノフェン(股関節の疼痛に対して)

身体所見 examination

　血圧 142/86mmHg。体温37.5℃。脈拍88/分。grade 2 hypertensive retinopathy(高血圧症性網膜症)。心血管系、呼吸器系に検査場異常なし。手にDIPにヘバーデン結節なし。

　左膝が発熱し腫脹している。関節内に液、patellar tap陽性。90℃以上膝関節を屈曲させると痛みを生じる。右の膝関節は正常に見える。

検査　 investigation

　生化学：白血球増多、ESR 上昇、尿素高値、グルコース高値

　単純X線：関節間隙やや狭小。それ以外に異常は認めない。

■problem list

　#1 左膝の痛み

　#2 胸焼け

　#3 消化不良

　#4 高血圧

　#5 クレアチニン正常高値

　#6 股関節の変形性リウマチ

　#7 高血圧性網膜症

■考え方

　・関節痛の鑑別診断を考える。

　・VINDICATEで考えてみてもよいでしょう。

　・関節痛の頻度としては　外傷＞慢性疾患(OAなど)＞膠原病＞脊椎疾患＞悪性腫瘍

■関節痛の鑑別疾患

DIF 282

V Vascular 血友病 hemophilia, 壊血病 scurvy, 無菌性骨壊死 aseptic bone necrosis (Osgood-Schlatter diseaseとか)

I Inflammatory 淋疾 gonorrhea, ライム病 lyme disease, 黄色ブドウ球菌 Staphylococcus, 連鎖球菌 Streptococcus, 結核 tuberculosis, 梅毒 syphilis, 風疹 rubella, 単純ヘルペス herpes simplex, HIV human immunodeficiency virus, サイトメガロウイルス cytomegalovirus

N Neoplastic disorders 骨原性肉腫 osteogenic sarcoma, 巨細胞腫 giant cell tumors

D Degenerative disorders degenerative joint disease or 変形性関節症 osteoarthritis

I Intoxication 痛風 gout (uric acid), 偽痛風 pseudogout (calcium pyrophosphate), ループス症候群 lupus syndrome of hydralazine (Apresoline) and procainamide, gout syndrome of diuretics

C Congenital and acquired malformations bring to mind the joint deformities of tabes dorsalis and syringomyelia and congenital dislocation of the hip. Alkaptonuria is also considered here.