Rebirth of Medicine Practices the World

"After going to many hospitals, the patient could not get a clear diagnosis. He came to our hospital before the National Day and was admitted to the hospital for further examination."

"Currently, the blood test shows that except for a slight increase in creatine kinase, everything else is normal. The electromyography test suggests neuromuscular damage. Hey, such a report is equivalent to no report."

"Because of the holiday, we haven't had time to perform a muscle biopsy on him yet." Fang Hua said while pulling up the patient's trouser legs on both sides.

Sure enough, the patient's right thigh muscles near the knee joint were significantly atrophied, showing a "knee larger than the leg" shape.

Lin Lin had seen many patients like this in her previous life. The problem is that the relationship between the patient's main disease and this type of muscle atrophy is not very close. Therefore, it is easy for doctors to miss or misdiagnose them.

"Are your joints hurting?" Lin Lin didn't want to waste Fang Hua too much time, so she went straight to the point.

"pain."

"Which joint hurts?"

"That's it." The patient touched the right knee joint with his hand.

"Does it hurt a lot?"

"It's not very severe, but it hurts often. If you stand for a long time or walk a long distance, you will feel pain and feel very uncomfortable. After resting for a while, it will feel better."

"Do you usually do any exercise?"

"Yes, I like playing badminton very much."

"Oh, you have joint pain, can you still play badminton?"

"Okay, I put on the knee pads. Although it hurts, it's still bearable."

"That is to say, you play badminton through pain."

"Haha, you can put it this way, I like it so much, if it hurts a little, I will hit it as long as I can bear it."

"Are you right-handed?"

"right."

"When you play badminton, your right leg should use more force. For example, some forward stepping movements are completed by your right leg, right?"

"Yes, that's right. Hey, doctor, you are very familiar with playing badminton."

"I can't say it's very familiar, but I know a little bit about it," Lin Lin said, squatting down and putting her hand on the patient's right knee.

"Well, the skin temperature is normal, and there doesn't seem to be any obvious redness or swelling." Lin Lin thought of this, then held the patient's knee joint with one hand and squeezed it gently.

"Ah..." the patient cried out in pain.

"It hurts?"

"Well, it hurts. Hey, young man, why are your hands so strong? It seems that you are really a badminton expert." Haha, this patient is very obsessed with badminton.

"Teacher Fang, I will not do other examinations. I will tell you my opinion and ask Teacher Fang to correct me." Lin Lin did not want to repeat the neurological examination that Fang Hua had already done. First, it is unnecessary, and second, it cannot be done in Fang Hua's case.

Displayed in front of Hua.

"Oh, Xiao Lin, you have an opinion, please tell me." Fang Hua heard what Lin Lin said and knew that Lin Lin had her own idea.

"This patient's muscle atrophy is very characteristic. It is only limited to the knee joint. Moreover, Teacher Fang did a neurological examination and found no abnormalities. Other auxiliary examinations cannot provide directional opinions."

"However, this patient has a very obvious condition, which everyone has just seen, and that is knee joint pain, and the pain lasts for a long time and is not mild."

"Although the patient only discovered muscle atrophy in the past two months, I think his muscle atrophy lasted for more than two months. It just progressed very slowly and the patient did not pay attention."

"When I checked just now, I didn't use much force, but the patient already felt obvious pain. This characteristic symptom is meaningful for the diagnosis of this patient."

"I won't go into the diagnosis and positioning of this patient. In terms of qualitative diagnosis, I consider it to be 'painful muscle atrophy'. His muscle atrophy is related to the pain in the knee joint."

"So, the next examination may be around the knee joint, or you can ask an orthopedic consultation to see the patient's knee joint damage."

"Teacher Fang, this is my opinion. If I'm wrong, please correct me, Teacher Fang." Lin Lin stopped. He didn't want to analyze and explain too much in front of his teacher.

"Xiao Lin, have you ever seen such a patient?"

"Yes, Teacher Fang, I have seen patients like this. As long as the pain is dealt with, the muscle atrophy will generally no longer develop. As for whether it can be recovered and to what extent, it is difficult to say."

"Have you all seen and heard it? Ten years ago, Xiao Lin was my student. Now he is the president of the Affiliated Hospital of Yingzhou Medical College and the director of the Department of Neurology. In Yingzhou, he said he is second, and no one dares to say he is first.

."

"Do you know how diligent and serious he is when he studies?"

"Every medical record he writes can be used as a model medical record. Director Liang appreciates every medical record he writes and will always use it to praise him during case discussions."

"Every time I go to work, he has already read the patients in charge, thought up a treatment plan for the patients, and then asked for my opinion."

"What is active learning? This is active learning. Only in this way can we learn more and learn well. Don't look at him because he is young. Many of you are his juniors, and some of you are his seniors."

"What he asked just now, what he just analyzed, you haven't thought of, and I haven't thought of it either. Haha, it's such a coincidence today. If I hadn't met Xiao Lin, this patient would have been struggling for a while."

"I agree with Xiao Lin's analysis just now. In fact, I also know that there is such a diagnosis, but I have never seen a real patient. Now, I finally learned a trick from Xiao Lin. Thank you, Xiao Lin!

"

"Teacher Fang, you're so polite! Without Teacher Fang's careful teaching back then, I wouldn't be where I am today. Teacher Fang's generosity and magnanimity are more worthy of my learning in the future."

"No matter when or where you are, Teacher Fang will always be my teacher. Teacher Fang, I won't disturb you anymore."

"Okay, thank you again! Go and accompany your wife and son. Hey, your wife is so beautiful!"

"Haha, thank you Teacher Fang for your appreciation!" Lin Lin said goodbye to Fang Hua and left the ward.

Lin Lin, Meiyi and Houze left the ward and walked towards the hotel.

"How is it? Is it okay?" Meiyi asked. In Meiyi's heart, Lin Lin was invincible professionally.

"Fortunately, I have seen this kind of patient before."

"Haha, let me see, no patient can trouble you."

"Well, you can't say that. In medicine, no one can do this. In the face of disease, human beings are insignificant, and doctors are actually insignificant."

"I agree with this truth, but if you are limited to a certain aspect, you are invincible."