Such an extraordinarily professional description was difficult for even Lu Cheng to digest for a while.

The chief complaint and present medical history are still text descriptions that can be understood by humans, but the specialist examination, it is really too professional, Lu Chengcai has only been in the department for half a month, and the written part of the specialist physical examination still needs to be copied and pasted, how can it be fully understood?

However, as a graduate student in orthopedics, the most basic professional foundation is still there.

He vaguely felt that the content of this voice was a remarkable thing, even if it was an auditory hallucination, it was definitely possible that it was like in a certain movie, which helped him professionally a lot.

It's a pity that with Lu Cheng's current professional knowledge, just listening to it once, there will definitely be no way to fully understand it, if only he could see it.

Lu Cheng thought so, as if everything was as he wished, and the voice that had just appeared was directly written in front of him.

From the complaint to the diagnosis, word for word.

And, at the back of the diagnosis, there are two + signs that I don't know what they do.

Seeing these words, Lu Cheng's knowledge reserve immediately came to mind.

The meniscus is the soft tissue between the femur and tibia inside the knee joint, similar to the insole between the foot and the sole, protecting the direct friction between the foot and the sole.

But for some reasons, the insole, that is, the meniscus, can be damaged.

If the meniscus is directly gone, it may be nothing, the big deal is not to pad the insoles, more friction, but if the insoles are tattered and rolled up, then the damage to the feet and soles will be very huge.

This is a ruptured meniscus.

Thinking of this, Lu Cheng subconsciously focused his gaze and consciousness on the plus sign behind the diagnosis.

This plus sign, isn't it an extended description?

Sure enough, the plus sign unfolded in an instant.

There are a few frames below!

1. Trauma, knee pain.

2. Progressive aggravation, relieved at rest, aggravated when walking or going up and down stairs, and entrapment.

The system only summarized and did not give a detailed explanation, but Lu Cheng's knowledge reserve made up the explanation by himself.

If the insole is still used as an analogy, then the broken insole may roll up and form an obstacle between the foot and the sole, resulting in the shoe and the sole of the foot can not fully fit and form an angle of less than 180 degrees.

Of course, this is only the clinical manifestation, that is, the patient's own feelings, but these things can give us a direction of diagnosis.

If you continue to go deeper in this direction, then you need to do a relevant physical examination of the meniscus.

Lu Cheng muttered as if endorsing: "Orthopedic physical examination, four principles, depending on the touch." ”

"This physical examination is written in strict accordance with the standards. ”

"Straightening is limited, just a kind of pointing, if the body examination, both straightening and flexion are limited, it is a stiff joint, which is equivalent to the whole joint is adhesed, similar to the kind of glue between two pages of paper, which cannot be torn apart. This possibility can be completely identified through physical examination. ”

"There may also be osteophytes, which are equivalent to stones in the crack of the door and can't close the door. Osteophytes are free from normal human bones and can be identified by films. ”

"There is also the possibility of avulsion fractures, similar to osteophytes, but the difference is that osteophytes are not growing normally, and the bones are born in abnormal positions, whereas osteophytes are small bones that are avulsed directly from the normal bones of a person. Ordinary films are completely identifiable. ”

“……”

Thinking of this, Lu Cheng's heartbeat accelerated by N times.

Medicine is extremely rigorous, extremely broad and profound medicine, and it is extremely difficult to get through these things, but if, in the future, every time you encounter a disease, you can have this kind of similar summary.

Even if I'm a pig, I guess I can grow up quickly.

Medicine is complex, unless there is a professor's huge knowledge system, with profound knowledge can be forcibly sorted out by oneself, others, even some attending physicians, may not know much about specialized diseases.

It's not that they're not up to the mark, it's just that they haven't formed a complete framework yet.

The more Lu Cheng thought about it, the more he wanted to continue looking down.

"3. Physical examination: range of motion, McMurray's sign, anterior and posterior drawer test, lateral stress test. ”

Just these words, although they are all included in the physical examination, if he is not listed separately, it is difficult for Lu Cheng to think of doing their role.

But now?

Lu Cheng quickly reacted because he had the previous idea.

Range of motion is used to distinguish it from joint stiffness.

McT's sign is a very professional and directional examination for meniscus injury, although it is not unique to meniscus injury, but it can provide extremely sensitive information for the diagnosis of the disease. That's the point.

In the case of an avulsion fracture, it can only be avulsed from four ligaments near the knee joint.

The anterior and posterior drawer test examines the anterior and posterior cruciate ligaments, and the lateral stress test examines the medial and lateral collateral ligaments for tears. If so, the patient will have an imbalance in the strength of the soft tissues of the knee joint, resulting in joint instability.

It's like a person being pulled in four directions by four people, and the person will definitely not move, but if a person lets go, then it is estimated that the person will fall directly.

These are the details of learning!

Lu Cheng was eating this feast and continued to look down.

The patient's McCericula sign is positive, and the anterior drawer test is suspiciously positive, which means that the patient's differential diagnosis is suddenly narrowed to two types: anterior cruciate ligament tear and meniscus rupture.

Of the two, the best way to diagnose is MRI.

I saw it written underneath.

4. Auxiliary examination, missing. Recommendation: MRI of the right knee (confirmed) and x-ray of standing anterolateral view of the right knee (excluding differential diagnosis).

5. The next possible next step is surgery. (Possible indication for surgery: meniscus rupture.) Possible surgical methods: 1. Meniscus plasty, 2. Meniscus excision 3. Meniscus suture. In view of the current age of the patient, the recommended order of surgical modalities is: 3.1.2. ）

(Suspicious indication for surgery: ...... ）

To be honest, on the fourth point, Lu Cheng can still understand it, but on the fifth point, Lu Cheng can't understand it directly. Because although he knew that he was going to have surgery, he didn't know why he was going to have surgery, what surgery to do, why he had to do it.

It's all worth digging into......

After reading the plus signs of the two diagnoses, Lu Cheng also determined that the patient's final diagnosis was lateral meniscus rupture and anterior cruciate ligament injury according to the opinions of the senior physician during the ward rounds this morning.

However, this ligament injury is not a rupture, so no special treatment is required.

With the regret of not knowing why he had surgery, Lu Cheng walked to bed 16, and he was going to take another look at the MRI of bed 16......