medical simulator

Radial head subluxation is the best diagnosis. It can be diagnosed through medical history, and no auxiliary examination is required.

Especially prone to occur in children.

Good guy, he just walked into a misunderstanding, and he hasn't come out yet. He even almost told the child's mother directly that your child's teacher is abusing your child. This is a history of trauma. You should sue her.

That's the damn stereotype.

And Zhou Cheng!

He was able to take the initiative to avoid this fixed thinking.

Even he himself wanted to diagnose her with radial head subluxation empirically, but Zhou Cheng avoided it.

It seems that he has pretended to be there again!

Moreover, the patient was specially brought from the ward into outpatient equipment.

Luo Yun really wanted to hit someone, so he squinted at Zhang Zhengquan, and found that his face was full of disbelief, as if he couldn't believe that his teacher Luo would make such a big mistake.

How swearing Luo Yun was just now, how embarrassing he is now.

Zhou Cheng explained honestly: "Ms. Luo, the main reason is that I haven't found any medical history that can be diagnosed. The diagnosis of radial head subluxation must be based on a clear medical history."

"Without such a medical history, I dare not make such a diagnosis."

"In fact, my first reaction was that her teacher lied, in order to avoid her trouble."

"So let the child's mother call to make sure."

"It's just that the child's teacher said at the time that our hospital was unreliable, and our doctors here were not good. I'm not Mr. Luo, you are so calm, so her mother didn't let me show it to the child."

"That's why I don't have a chance to make mistakes!" Zhou Cheng said these words!

Then he smiled back.

Zhang Zhengquan's eye circles shrank slightly, a little surprised, so Zhou Cheng could lick people so comfortably?

Luo Yun rolled his eyes——

You don't have no chance of making mistakes, but you are too cowardly!

Second Olympics.

1 Chapter [-] Live in Bengbu!

What Zhou Cheng said was beautiful, but Luo Yun didn't take it all seriously!

The patient's family chose not to trust Zhou Cheng because of his age and professional title, which was one of the reasons why he was able to avoid misdiagnosis.

However, Zhou Cheng's ability to think outside the box is not something that ordinary people can do.

Especially in the medical industry, some practitioners, even Luo Yun himself in many cases, like to show off their profound knowledge. Based on the fragmented information provided by the patients, they try to figure out the medical history that the patients themselves may have ignored. or symptoms.

Just like today, based on the plain film of the patient, Zhou Cheng deduced the fracture that even the old woman and daughter-in-law, and even herself, had forgotten.

This is the deduction ability you will have when you walk with a huge knowledge base and precise rule awareness, which represents your understanding and control over a disease!

And sometimes, precisely because of these controls, you will unconsciously formulate some symptoms of the patient!

Why is that?

Because during the exam, the questions are like this.

"Fracture Triad = Fracture!"

"Progressive dysphagia = esophageal inflammation or cancer."

"Elevation of ECG ST segment arch = myocardial infarction..."

There are too many examples of this.

In the diagnosis of radial head subluxation, the diagnosis needs to rely on the medical history, and there are the most common populations of this disease.

Child + parents brought + trauma history + elbow pain!

It can almost be diagnosed as radial head subluxation.

This is how to get started when learning about this disease, what is called getting started.

It is the teacher or the textbook that led you into this industry. Under normal circumstances, you will not suspect that the teacher led you in the wrong way!

So Zhou Cheng and Luo Yun have been asking for definitive medical history.

……

Of course, this kind of questioning may stop halfway, because in many cases, the reason is not important, and the important thing is to solve the problem.

Under such psychological control, Zhou Chengruo performed a subluxation of the radial head on the child.

Then check the dislocation and reset——

Once the activity is restored, the patient can be sent away directly.

While Luo Yun was scanning Zhou Cheng.

Zhou Cheng was secretly rejoicing in his heart.

I have always walked within the rules, and did not take the initiative to add definitions to patients based on my own understanding and experience!

I didn't show off my wide range of knowledge, and I didn't argue with the patient's family that although I was only a resident doctor, I was very good at it.Otherwise, Zhou Cheng felt that he might have stepped on the patient's thunder.

……

Things have come to this point.

Qiqi's mother could only take her child for an examination with tears in her eyes.

She originally thought that when she came to the hospital today, she just showed the child some symptoms after an injury, and she would recover immediately.

Can?

Although in the current situation, maybe my mother-in-law and my husband will not blame me for sending the child to have problems. After all, if I am not careful, I can't provoke cancer.

But, at this moment, Qiqi's mother really hopes that it is because she went to send Qiqi off, which caused her to be injured accidentally, and not that thing...

She walked briskly, and then called her husband who was on duty rather helplessly...

After this.

Only Zhou Chengsan started seeing the doctor step by step!

Because Luo Yun gave Qiqi an emergency MRI plain scan order, so the examination was done very quickly.

Half an hour later, Kiki's mother came up again with her in her arms.

However, there are no other family members accompanying him for the time being.

Zhou Cheng and Luo Yun had been thinking about the little girl all the time, so the first time the little girl returned to the consulting room was.

Carefully reviewed the NMR!

However, after reading it, both Luo Yun and Zhou Cheng looked stunned for a while.

Slowly let out a breath.

Then he looked at Kiki and Kiki's mother.

Seeing this, Qiqi's mother became even more nervous, and hurriedly asked, "Doctor, my Qiqi, what's going on here? Is there a problem?"

Luo Yun turned his head and said: "There is a problem. But this should not be a bone tumor, and there are no signs related to bone tumors. It looks more like bone fibrous dysplasia!"

When Zhang Zhengquan heard about this disease, he was stunned again, and even a little doubted whether he was in orthopedic training, why Luo Yun didn't know anything about it.

It's so hard to get enough food today!

He looked at Zhou Cheng innocently, and Zhou Cheng also saw the meaning in his eyes, but turned his head to look at Luo Yun, meaning that after Luo Yun finished speaking, let's explain this disease.

Seeing a doctor and teaching can be intertwined, but not at the same time.

Luo Yun continued:

"Mom Kiki."

"Actually, this kind of bone fibrous dysplasia usually occurs in the tibia, but hers is in the humerus, which is extremely rare."

"The probability is less than one in a thousand." Luo Yun is not a doctor specializing in orthopedics, so he said it a lot conservatively.

Qiqi’s mother hurriedly asked: “Then what kind of fibrous bone defect is this? Is there a serious sequelae? Is it important? How to deal with it?”

This is what she focuses on, whether it is rare or not.

"Poor fibrous structure is a structural problem."

"You can think of it this way, where we built the road, where cement should be used, mud was used, so it is very soft and the bone is very brittle!"

"It's not a tumor. It's because this part of the bone is relatively fragile, so there are symptoms, and only a small amount of stress can cause pain."

"It's just that although I have certain symptoms now, I don't need surgery. Don't worry."

When Qiqi's mother heard Luo Yun's words, she couldn't really feel at ease. She pulled Qiqi away from her legs, rubbed her nose, and said in a broken voice, "Doctor, how can I be so relieved? What should we do now? ?”

How big of a heart do you have to be to not care about your child's illness?

Although it wasn't cancer, she hoped that it would be good for her to transfer it to herself, so that her daughter wouldn't be harmed.

Luo Yun continued: "There is no need to do anything, and there is no need to deal with it now."

"This is a clinically common bone dysplasia, and it is only relatively common in children."

"And because she is a child, you can expect her bone to reshape automatically. You can expect it to recover on its own, and the chance of malignant transformation is very low!"

"Of course, if you are really worried, you have to wait until she is a little older, and then come back for a review. If you find that there is still such a structural groove, then do bone scraping to deal with it."

"She's still too young now, and her epiphysis isn't fully grown. If you deal with it rashly now, it may affect her normal growth. If the upper limbs are not equal in length by then, it will be troublesome." Luo Yun patiently explained not to deal with it now s reason.

Qiqi's mother immediately changed her expression when she heard the words, and said decisively: "Qiqi is a little girl, and her hands are not the same length, so it's not okay."

If you really look like this, not to mention making a living in the future, it will be difficult to find a partner!

Luo Yun nodded: "Yes, we just need to wait for her to grow up and the epiphyses are full, and then perform curettage depending on the situation."

"I'm still too young now, I'm afraid of damaging the epiphysis and affecting the growth of this hand."

"Then, the most important thing now is to protect her hand. You have to tell Qiqi herself that this hand should not be too forceful, not too naughty, and not fight with other children. It’s even worse.”

"Because her bone is very loose, just this one is very brittle, maybe even more brittle than crispy rice."

"Only after she grows into a normal structure, will she be able to resume normal activities."

Qiqi's mother breathed a sigh of relief for a moment, and asked, "So don't do anything now, just wait?"

At the same time, the stone in my heart fell to the ground.

When Luo Yun was about to answer, the woman's phone rang.

After seeing it, it was her husband who was calling. After connecting, her husband cursed and said on the phone: "Honey, how is Qiqi now?"

"Click on (these liars)."

"Playing in the dark under the lights!"

"That Teacher Wu, she saw our Qiqi had a dispute with other children this morning, so she pulled Qiqi hard, and she grabbed her elbow. She thought it would be fine to hide it, but I asked killed a few of her colleagues and a few children."

"Oh shit!"

"How is Qiqi now?"

Qiqi's mother was taken aback when she heard this.

At the same time, the expressions of Luo Yun and Zhou Cheng changed drastically!

The cause of subluxation of the radial head, it came.

But thankfully, it came too late!

Just say it was a coincidence.

Originally, to determine the trauma, consider the direction of subluxation of the radial head, but the teacher strongly disagreed.

Because it was determined that there was no trauma, I went to consider the direction of bone disease.

As a result, there was a history of trauma!

If the teacher is honest, the two of them felt that the radial head was subluxed from the very beginning, and then the child could move around after it was reset.

The range of motion has been restored, which means that the joint dislocation has been reset!