橘田 綾菜

Ayana KITTA

東京女子医科大学八千代医療センター

Department of Orthopaedic Surgery, Tokyo Women's Medical University, Yachiyo Medical Center

キーワード : paediatric, orthopaedic, cartilage, growing period

整形外科を表す「Orthopaedics」はギリシャ語を語源とし「まっすぐ」を表す「Orthos」と「小児」を表す「paedios」の合成語である．「Orthopaedics」は「小児の身体の変形を予防し矯正する技術」を意味する．少子高齢化社会が進み，整形外科の起源となった小児運動器疾患を外来で診察する機会が減り，見逃しや診断遅延が問題となっている．小児は発育・発達途中であるため，早期治療介入が必要な疾患を，適切な時期に診断する必要がある．従来の整形外科外来診療では単純Ｘ線が主な画像診断ツールであり，骨を中心に病態を考えることが常であった．しかし，成長期であるこどもの関節は軟骨が多く，単純Ｘ線を読影するときには想像力を働かせなければならない．近年，超音波診断装置の高画質化により，運動器構成体を観察することが可能となった．被曝がなく，低年齢でも鎮静が不要である超音波検査は，小児では特に有用といえるだろう．

"Orthopaedics" is a Greek word derived from "orthos" meaning "straight" and "paedios" meaning "child". Orthopaedics means "the technique of preventing and correcting physical deformities in children". Due to the declining birthrate and aging population in Japan, there are fewer opportunities for outpatient examinations for paediatric musculoskeletal diseases, which were the origin of orthopaedics. As a result, missed or delayed diagnosis has become a problem. It is necessary to diagnose diseases that require early intervention at an appropriate time since children are still growing and developing. In conventional orthopaedic outpatient clinics, X-rays are the main diagnostic imaging tool, and the pathology is investigated based mainly on bones. However, the joints of growing children have a lot of cartilage, and it is necessary to use our imagination when reading X-rays. In recent years, the high image quality of ultrasound imaging systems has made it possible to observe the musculoskeletal components. Ultrasonography is especially useful in children because it is free of radiation exposure and can be performed without sedation even in younger children.