Min Hong nodded and shook his head and said, "I'll give you some medicine to relieve the pain!"

"But we still need to find out the cause of the disease, so we still need to prescribe some tests for you. Our doctors and your eyes are both human eyes, and no one can see through it."

"But now technology has developed, so you are very lucky. We can lend you some eyes to see."

"You definitely didn't come here just to guess a disease for you and then prescribe some medicine. When you go back, it won't work for you, and then you scold me for being useless with the hospital, right?"

“To solve a problem, we must find the root cause and solve the root cause.”

"For example, you want to go to Kyoto to find someone, and you ask me how to get there. I suggest you go by car or plane, but you insist on asking me if you can walk there if you have a compass? Of course I say yes!"

Hearing this, the middle-aged woman's husband smiled and said, "Professor Min, you really know how to joke. Nowadays, there are very few people walking to Kyoto. There are even fewer people walking to buy groceries."

"You are a professional, we listen to you."

He understood that doing an examination is like taking a car, in order to be more convenient and accurate. You have to say whether it can be reached with a compass and on foot. Who can say for sure. If you have nothing to do, you can eat well and you will have enough money to eat on the way.

I took the car back and forth several times.

"Then you have misunderstood. When it comes to medical treatment, I am professional, but when it comes to examinations, machines are objective."

"MRI, X-ray and blood routine, erythrocyte sedimentation rate and CRP, and a neuroelectromyogram. Remember to check for uric acid!" Min Hong said to Li Hongxing immediately after hearing this.

Lu Cheng immediately replied: "Brother, I'll give you the doctor's orders and you can write the check list!"

I thought to myself, Professor Min Hong’s words are not only medical skills, but also the art of speaking!

After Min Hong finished his instructions, he asked casually: "Besides the pain in your shoulders and elbow joints, have you ever had pain in other places?"

"Yes, occasionally. But it doesn't hurt as much as it does now. Sometimes the face hurts, and sometimes the back hurts." The patient seemed to have remembered something and replied.

After hearing this, Min Hong suddenly covered the medical record that Li Hongxing was writing with his hand.

Li Hongxing quickly looked up.

Lu Cheng also slowly stopped the inspections.

"So, do you usually have more pain on the left side or on the right side? I think you have more pain on the left side, right?" Min Hong suddenly asked.

After hearing this, the patient thought for a moment, then touched his left shoulder with his right hand that could not move at all before, and then said: "Doctor, you are absolutely right, I have severe pain here. Ouch!"

Immediately, the patient's left hand could no longer move, and his right hand began to protectively touch his left shoulder.

Lu Cheng was shocked when he saw this, and even the patient's husband was shocked.

When Lu Cheng was doing a physical examination just now, the patient's right arm and elbow were in severe pain and he couldn't even move!

But now.

There was a hint of fear in his eyes.

Min Hong pursed his lips and said, "Let's do an MRI and neuroelectromyogram of the head first!"

"Family, take the patient out for a rest first, and then come in to get the examination form. She must be a little tired."

The patient's family members nodded and naturally discovered something was wrong.

He immediately carefully supported his wife and walked out. However, when he came in, he was carefully holding his left hand and protecting her right hand. Now he was holding his right hand and protecting her left hand.

After the middle-aged man went out, he quickly opened the door and walked in. When he approached, his expression changed greatly and he said: "Professor Min, what is going on with my wife? Why is it so sudden?"

Min Hong was silent for a moment and asked: "Has she suffered any trauma recently? Or has she undergone surgery?"

"This symptom is most likely hysterical pain. If it is just hysterical pain, I would be worried that she may have other symptoms besides pain."

"I suggest you take her up to the sixth floor to see the psychological clinic."

"Her right and left hands are both able to move. Basically, local organic changes can be ruled out. However, central organic changes cannot be ruled out, so I suggest you go somewhere to find out the cause in a more systematic way."

"This? This, this, this?" The middle-aged man didn't want to accept this fact at all.

"Let's see the doctor first. Everything is still in the guessing stage now, and it may not be the worst-case scenario you imagined. I am an orthopedic surgeon. For questions from other departments, I suggest you ask the specialist.

"

"If the patient still has pain after they have ruled out the symptoms from the relevant departments, come back to us. I will not prescribe the examination for you," Min Hong said.

"Okay! That's all we can do for now." The middle-aged man said helplessly.

After he left, Min Hong did not rush to call the next patient, but said: "You must ask a few more questions about the symptoms of patients like this. Maybe every additional question you ask can help you overcome many obstacles!"

"This kind of hysterical pain is generally migratory, and the symptoms of this patient are completely different from those of anatomical and organic damage."

"The simplest way to diagnose is to guide the patient a little deliberately to see if his pain can suddenly shift. If so, then he should be sent to whichever department he should send to. We in the orthopedics department can't cure it.

Something like this.”

"Hysterical pain often occurs after traumatic stress. I believe that patients and family members can confirm that the patient has not suffered any trauma or surgery. However, it may not only be caused by direct traumatic stress.

Excitement is called stress."

"The specific root cause is not something we as doctors can delve into. As far as I know, this kind of pain generally occurs in these few conditions."

"First, if you have to pay more for a traffic accident, you may not have similar symptoms at the beginning, but the more you pretend, the more they actually appear. The patient is also really in pain!"

"The second is reward addiction! For example, if someone shows pain and attracts more attention or pampering than usual, which she really wants, it will also appear."

Lu Cheng and Li Hongxing both nodded frequently.

"I have never heard of this kind of disease." Li Hongxing was very surprised.

Min Hong just smiled and said, "Call the next patient to come in."

The second patient came in soon.

She was an elderly woman with an obvious deformity of her right lower limb. She was short and obese. She limped in, and the person supporting her was a woman in her thirties who said, "Mom, walk slower.

, be careful not to trip over your legs."

After coming in, Lu Chengcheng quickly noticed that her right lower limb was obviously inverted, and her left lower limb was at least 4cm longer than her right lower limb. When she walked, her right leg swayed when her left foot touched the ground.

When my right leg landed on the ground, the pain was completely gone.

"Auntie, how many years have your legs been hurting?"

The woman next to her replied: "For more than ten years, it hurts when it rains, it hurts to walk, and now it hurts even when I sleep. I went to the county hospital and took medicine and it healed for a while, but now the pain is excruciating again."

"

"Have you ever taken any pictures at the county hospital?" Li Hongxing asked, looking at the plastic bag in her hand, which clearly said D County People's Hospital.

"Yes, there are, but they have been there for several months. Do you want to see them? Do you want to take a new one?" The woman said while taking out a lot of films inside: "When I went to the county hospital in the past, the doctor

It’s said that the previous films are of no use anymore.”

"I have a lot of them here. I still have them from ten years ago to now."

When Li Hongxing heard this, he immediately became excited and said, "It's useful. These films are the most useful."

Just kidding, these X-rays record the development and process of the patient's condition, how could they be useless? What they say is much more objective than what the patient and family members say.

There are many films, and they are arranged very neatly. They are all arranged in chronological order. In addition to X-rays, there are also CT and MRI, but both CT and MRI are of the lumbar spine!

Because there are so many movies, everyone in Lu Cheng has a movie to watch.

Although there is a slight time difference in recent months, the content in the film is only slightly different.

Very obvious knee osteoarthritis and knee deformity are very obvious on X-ray!

However, Lu Cheng took one look at it and murmured: "Traumatic arthritis! Has she had fractures before?"

Li Hongxing was stunned when he heard this. Is this traumatic arthritis?

How can you tell?

The two classic manifestations of osteoarthritis are joint space narrowing and articular cartilage wear and tear. This is written in the definition, and it is also very obvious to read when reading the film.

But shouldn’t the diagnosis of traumatic arthritis be made by asking the patient’s medical history?

Min Hong was also very surprised. Originally, he was planning to leave this X-ray to Lu Cheng and Li Hongxing as a lesson, but he didn't expect that Lu Cheng had revealed it just at the beginning.

Li Hongxing quickly asked: "Has she had any fractures before?"

The middle-aged woman hesitated for a moment, as if she was not sure, and then asked: "Mom, have you ever broken a bone before? The doctor is asking you."

Then he said with some embarrassment: "Doctor, this is my mother-in-law. She has been in good health since I got married, but her legs are not in good condition and she has not had any surgery."

The patient said: "Yes, it was when I was young, probably more than 20 years ago. At that time, I just went to work outside. I was hit and had an operation outside. A year later, I also removed the steel plate. The doctor

, how did you know?"

When Li Hongxing heard this, he thought (‵o′), it’s really true!

"It can be seen in the film." Li Hongxing could only reply like this, but when he read the film carefully, he was like, damn, the film didn't say the words "traumatic arthritis", and he didn't see the nails!

Is a deformed joint a sign of traumatic arthritis?

What's going on?

Min Hong said: "You are her daughter-in-law, right?"

"Yeah!" The middle-aged woman nodded.

"Her current condition is very serious. She can no longer walk, but her condition is okay for the time being and her muscles have not atrophied. She needs surgery to get better again." Min Hong said directly.
To be continued...