medical simulator

"Okay!" The girl walked out worriedly.

Although Zhou Cheng looked at the girl's back, he felt a little inexplicably complicated, but there was nothing he could do about it.

Sports injuries occur more frequently in young people.

This may affect her life, and even affect her future.

But this has become a fact.

Body-oriented, this sentence is easy to say but hard to do!

Aren't most young people paying for their bodies?

Zhou Cheng looked at Luo Yun, but Luo Yun didn't say much.

I just thought to myself, there seems to be nothing wrong with it, I didn't say anything that shouldn't be said, and I said everything that should be said, as for any words of comfort, Luo Yun couldn't say it right now.

Just because the patient's condition will have a great impact on their life, we should not exaggerate or minimize the consequences of their own disease.

This is extremely unprofessional.

This kind of mistake, Zhou Cheng, a shy turtle, would definitely not make it.

Alas, the patient's condition is too simple.

Wait for the next one.

Look for another chance.

……

"next."

The next patient was also a young man, about 24 or [-] years old, accompanied by a girl who seemed to be a couple or husband and wife.

But when they came, they were still holding plain films, which seemed to be from the No. 1 People's Hospital in Shaxian County.

Did you come here after seeing a doctor in another hospital?

That must be quite troublesome, Luo Yun's mood began to get excited.

Zhou Chengcheng asked about the medical history.

Then I found out that this is a couple, and the wedding was held only two days ago.

The patient is a young man.

According to his statement, he was injured when he broke through the door to pick up his relatives.

At that time, Hongbaoyu opened the crack of the door, so he stretched his legs in, preparing to physically refuse to close the door, and then he was pinched by the bride's support group!

After the young man finished speaking, the woman next to him said a little embarrassedly: "Doctor, is my husband's situation serious?"

"Our wedding ceremony was completed, that is, we went to the hospital to see it yesterday."

"After taking a picture, the doctor over there said that there might be an operation. We are worried, so we plan to come here to have a look again." The woman replied a little helplessly.

Welcoming the bride is a traditional ceremony in the Hua Kingdom. Opening the door of the bride's boudoir is a joy in the wedding process, and she can't control other people.Just a little bit apologetic.

Lu Cheng took the film bags from the family members, sorted the front and back one by one, and hung them on the film reader.

Lu Cheng opened the medical record and glanced at it a little.

After picking out the positive signs and negative signs, I turned my attention to the MRI.

Summarize in your heart.

"The patient has a history of trauma."

"There is knee joint pain at present, no osteophyte on X-ray, no fracture line. The joint space is normal, the patellofemoral joint space is normal, and there is no high and low patella. So soft tissue injury is considered."

"At present, the patient has no special positive signs, so."

Lu Cheng then looked at the T2 phase of the NMR.

MRI reading is divided into layers.

Beginner doctors, when looking at MRI, they only look at black and white, looking for signs of edema!Anyway, just ask where is the swelling?

But doctors who have reached a certain level can directly read the anatomy from the film.

The information revealed by the NMR is too much, even the deformation of the nerves can be read, so Zhou Cheng didn't read the NMR report...

In addition to being able to read the anatomy, the MRI reading of the knee joint also has its own reading skills!

First look at the anterior and posterior cruciate ligaments, then the medial and lateral collateral ligaments, and then the menisci.

However, when he saw the front fork, Zhou Cheng frowned fiercely.

The anterior fork, the full name of the anterior cruciate ligament of the knee joint, starts from the front medial side of the intercondylar eminence of the tibia, heals with the front horn of the lateral meniscus, obliquely goes posteriorly and superiorly laterally, and attaches to the medial side of the lateral femoral condyle in a fan shape.

On the NMR plane, the routinely displayed signal is——

Black.

Now it is whitish, there must be edema, but continuity?

broken!

The rear fork also has edema.

Medial collateral ligament, torn.Lateral collateral ligament, normal.

Look at the meniscus again.

There is also damage to the meniscus, also a classic medial meniscus rupture. III degree injury.

The damage of the meniscus is 3 degrees on the nuclear magnetic resonance. The first degree of damage is a point or a white line that does not break to the top or bottom of the meniscus. The second degree of damage is a rupture of one side, which is a half-layer tear.A third-degree injury is a full-thickness tear.

When visiting an outpatient clinic, the required knowledge reserve is much higher than that in the ward.

When Zhou Cheng was reading the film, Luo Yun also finished reading the film. The mouth covered by the mask made a strange shape, and the eyes shone with light.

It's coming, it's coming.

This is the medial knee injury triad of sports medicine, and here it comes.

Zhang Zhengquan pretended that he knew it well, and looked for white marks on the MRI plane with his hands, and finally pointed to the fat pad inside the knee joint, rolled his eyes at Luo Yun, meaning, Teacher Luo, is there a problem here?

Luo Yun was so angry that his chest rose and fell violently.

"I'll talk about it later." Cursed in a low voice, she didn't want to reveal the answer to the mystery in advance. If the answer is revealed, what should I do?

Zhou Cheng thought for a while, and then asked the young man again: "When you were walking, did you ever feel suddenly stuck?"

In his heart, he thought to himself, how ruthless was this f*ck trapped, so forced?

It's like this, Zhou Cheng felt that there was something strange about this matter.

Although it can be seen that there is damage now, if the ligament is broken if it is caught by the door, it is easy to say, but the meniscus will be crushed, what a coincidence?

Therefore, Zhou Cheng felt that this young man might have been injured before, and the ligaments might not have been broken at that time, but there were still remnants, and then the pinch just happened to completely wipe out the last trace of remnants!

"Or do you feel unsteady?"

The auxiliary examination is only an auxiliary examination, and it is still necessary to determine whether the patient himself has symptoms!

"No." The woman replied helpfully.

Then he looked at his husband: "Isn't it?"

"It seems not." The young man recalled.

Then he said uncertainly: "But I haven't walked much since I got married, but the night before my wedding, when I was playing ball, I suddenly felt a twitch."

"But it's not as painful as it is now." The man vowed.

Zhou Cheng said: "Then you should have been injured when you were playing?"

The young man squinted his eyes and said, "It's normal to have bumps and bumps when playing basketball, so I don't really care about it!"

"And I often take off to catch the ball, dribble, and collide. Does it matter? I have been playing for more than ten years, and I have always been pretty good." The young man frowned.

He loves to play, for no reason, just loves it.

If Zhou Cheng wants to deprive him of his current hobby, what should he do?

Zhou Cheng licked his lips and said, "Yes, you play ball often, that's right."

"But your MRI showed a rupture of the meniscus, and it was still a rupture in the body, not the front foot."

"At the same time, you have ruptures of the ACL and MCL."

"These two are not the same injury mechanism."

"So, I'm guessing that it might be like this, playing alone, it didn't break your ligaments, but it broke your meniscus."

"The meniscus is like our insole, and it is very brittle. If you use too much force, it may break open. But, at that time, your ligament may not be completely broken, and then you were caught by the door."

"The ligament that was still good was also pinched off." Zhou Cheng explained.

When the young couple heard this, they were stunned.

"Is that so? Doctor?" The young man touched his head, his expression uncertain for a while.

The woman also looked at her husband with a suspicious look on her face.

"You didn't say before that you were injured while playing?"

It seemed that the two of them were having a bit of a rivalry, maybe the young man felt that his wife had hurt him, but the woman just proved part of her innocence at this moment.

Luo Yun frowned when he heard Zhou Cheng's words!

Because of this point, Luo Yun didn't think about it before.

No matter how the injury was, understanding the patient’s condition is of no help. No matter how the injury was, the ligament is broken or is it broken, should an operation be performed or should it be performed?

However, although it does not affect the patient's treatment, Zhou Cheng's theory seems to be able to truly explain the root cause of the current symptoms!

Eh?

Good guy, I didn't expect this crop!

This Zhou Cheng?

How did he think of it?

Although it is said that the traceability of the disease is not important to the treatment of the patient itself.However, it is very important for doctors to accurately interpret the types of diseases and to understand the disease itself more deeply!

How was the injury, the mechanism of the injury, can guide the follow-up functional exercise, and the associated symptoms and injuries that need to be considered when encountering other types of diseases!

This week?

How could he think in this direction?

Luo Yun himself, after seeing the patient's MRI results, has been thinking about how to perform the surgery.

When you encounter a problem, you should solve the problem first. This is a natural logic!

However, this is a good thing for the patient. Thinking about how to treat it is conducive to the recovery of the patient, but it is not conducive to one's own understanding of the disease and improvement of diagnostic capabilities.

It is also not conducive to analyzing cases.

Luo Yun's eyes kept turning, this time, Luo Yun considered too many things.

seemingly?

Being pretended by Zhou Cheng again!

Zhou Cheng also noticed the change in the expressions of the two of them.There was no time to see the change in Luo Yun's expression.

He hurriedly said: "Actually, what is the specific reason now is not too important. The important thing is that in this situation, surgery must be done, otherwise, the damage to your joints will be great."

"It is very likely that it will affect your normal walking behind."

Zhou Cheng didn't dare to dwell on the reason anymore, don't make this newly married couple divorce, then the loss outweighs the gain.

The knee joint is unstable, and the meniscus is broken. If there is no surgery to deal with it, then wait for the joint to be replaced in your thirties.

However, what Zhou Cheng said made the young couple a little bit on guard, and asked, "Doctor, I'm going to have an operation? Can your hospital do it?"

They were a little suspicious, whether it was because Zhou Cheng tricked them into having an operation, and that's why he said such a big set of possibilities!

Zhou Chengcheng looked at Luo Yun.

Whether this can be done, Luo Yun said, he still doesn't know how to do it, so it's hard to answer.

Luo Yun quickly said: "In your case, you may still need to go to Attachment [-] or Attachment [-]. Our hospital does not have such equipment. We can do it if it is open to the public, but the incision is too big, and it cannot save costs."