Chapter 140 Damn it, you pretend to be B and still run away! (Please subscribe!)

Luo Yun looked at Zhou Cheng, who turned to explain to Zhang Zhengquan.

The eyes on Zhang Zhengquan's big black face opened forcefully, revealing an extremely complicated expression.

Zhou Chengcheng said: "Hysterical pain can actually be divided into two points. Hysteria is the main disease name, and pain is one of the manifestations of hysteria."

"Hysteria can also be called dissociative conversion disorder. It is a mental disorder caused by psychological factors acting on susceptible individuals. It is a mental illness."

"In addition to pain, its manifestations can also include twitching, cramps, sudden body paralysis, inability to move, or memory loss. It can also manifest as loud shouting, moodiness, difficulty breathing, blindness, etc..."

"Of course, other manifestations are not reflected in this patient. Let's talk about this patient first -"

"Hysterical pain is generally migratory."

"The pain symptoms of this patient are completely different from the pain caused by organic injury."

"Her pain is that she feels it, but she can also quickly stop feeling it. This is one of its characteristics."

"The simplest way to diagnose is to guide the patient a little deliberately to see if her pain can suddenly shift."

"Just like Teacher Luo just took advantage of his unpreparedness and suddenly disrupted the patient's train of thought!"

"She felt that the pain in her hand should be on the left side, and she also thought that the pain in her hand was on the left side, but in fact."

"We have all seen that when the patient first came in, the pain area the patient complained to us was actually on the right side..."

Zhou Cheng said so much to make Zhang Zhengquan understand him easily.

Zhang Zhengquan had a good relationship with him and helped him a lot. Zhou Cheng had long wanted to take him with him.

Luo Yun had already seen through the case just now, and so had Zhou Cheng, but Zhang Zhengquan didn't understand it at all, so Zhou Cheng could only break the disease into pieces and feed it to him, which could be regarded as reciprocating the favor.

So he continued to organize the language and continued:

"If there is metastatic pain, you should go to neurology or psychiatry for treatment. Our orthopedics department cannot cure this kind of thing."

"Hysterical pain often occurs after traumatic stress. But in most cases, the patient and his family can be sure that the patient has not suffered any trauma or surgery or other directional stress."

"However, stress is not called direct traumatic stress."

"In some special circumstances, situations that may be contrary to our values ​​may also arise."

"For example, if there is a traffic accident and you are the victim and you have to pay more, you may pretend that there are no symptoms at first, but the more you pretend, the symptoms will actually appear. The patient is also really in pain!"

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

"So, most of the patients we often see are adolescent girls. Maybe menopausal women are also more sensitive and there will be relatively more..."

Zhou Cheng talks eloquently and explains the profound things in simple terms.

Even Zhang Zhengquan nodded frequently.

The shock and astonishment at the beginning gradually turned into a sudden realization.

Zhou Cheng really explained the disease in detail. Although he did not summarize it, he explained everything from the pathogenesis to the reasons why it is more common in which group of people. It was not boring. Zhang Zhengquan really understood it.

"There is such a disease, I have never heard of it." Zhang Zhengquan was very surprised and bowed slightly to express his admiration and gratitude to Zhou Cheng.

Luo Yun just smiled and said, "Call the next patient to come in."

I felt quite helpless in my heart. Although I was surprised by Zhou Cheng's extensive knowledge, I didn't say much.

In fact, this disease is not a disease of joint surgery, but belongs to the psychiatric department. Luo Yun also encountered it several times in the joint department before he understood it. This is nothing. In the psychiatric department, this disease is also common.

series.

Zhou Cheng reads a lot, so it's okay if he realizes it.

Next time, I must look for a very professional disease treatment.

Zhou Chengzhun was about to raise his steps, but Zhang Zhengquan immediately said: "Brother Zhou Cheng, I'll shout."

Zhang Zhengquan knew in his heart that the purpose of his coming here today was just to earn a living. There were so many outpatients that he definitely didn't have time to do teaching rounds. Zhou Cheng was willing to say that he could learn something now.

The time in the outpatient clinic is squeezed in, and there is no time to waste.

The second patient came in soon.

She is an elderly woman with obvious deformity of her right lower limb. She is short, obese, with dark complexion and half-white hair that is not well taken care of.

She limped in, and the person supporting her was a woman in her thirties. She said, "Mom, walk slowly, and be careful not to trip over your legs."

After coming in, Zhou Chengcheng quickly noticed that her right lower limb was obviously inverted and her lower limbs were obviously unbalanced.

The left leg is much longer than the right leg. When walking, after the left foot touches the ground, the right side of the body swings.

When his right leg landed on the ground, he frowned and gritted his teeth. It seemed that every step he took was completely painful!

"Ao'an, please sit down first. How many years have you had pain in your leg?" Zhang Zhengquan immediately asked the patient to sit down.

The middle-aged woman next to her replied: "My mother has been in pain for more than ten years. It hurts when it rains, it hurts when walking, and now it hurts even when sleeping. I was treated in the county hospital and took medicine and it healed for a while.

Now the pain is excruciating again.”

"Have you ever taken any pictures at the county hospital?" Zhang Zhengquan asked, looking at the plastic bag in her hand, which clearly said C 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 useless to talk about previous films.”

"So I take pictures every time I check again. I have a lot of pictures here."

“I still have the ones from ten years ago to now.”

When Luo Yun heard this, he immediately became energetic and said quickly: "It's useful. These films are the most useful!"

Just kidding, these X-rays simply objectively record the development and course of the patient's condition, how could they be useless?

Neither patients nor their families can tell their medical history in such detail and objectively. This complete set of X-rays can be said to truly record the development and evolution of a disease.

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!

It can be seen that either this old woman is a very particular person, or the middle-aged woman next to her, who is not sure whether she is her daughter-in-law or her daughter, takes good care of herself.

Because there are so many movies, everyone in Zhou Cheng’s group has a movie to watch!

Let’s look at the most recent films first. The plain films taken a few months ago may be different from the current condition due to the time gap, but the content in the films is only slightly different.

The one Zhou Cheng is holding is from one year ago, the one that Luo Yun is holding is the most recent one, and the one that Zhang Zhengquan is holding is from nine months ago.

When Zhou Cheng read the X-ray, he discovered very obvious knee osteoarthritis!

Knee varus deformity.

Luo Yun, on the other hand, after flipping through several films one by one, his heart moved again!

Good guy, this movie is interesting again, so he looked at Zhang Zhengquan and asked: "Zhengquan, did you see anything?"

Zhang Zhengquan's face immediately froze when he heard this, his eyes continued to open a little wider, and after looking more carefully, he turned around and replied: "This is knee arthritis!"

When Luo Yun heard this, he rolled his eyes.

Ah tui!

What the hell?

Are you embarrassed to say such an extremely unprofessional diagnosis as arthritis?

Arthritis is also divided into many categories, including osteoarthritis, septic arthritis, tuberculous arthritis, gouty arthritis...

However, considering that Zhang Zhengquan was not a joint surgeon, Luo Yun did not complain about him.

Before Luo Yun turned to look at Zhou Cheng, Zhou Cheng asked the middle-aged woman: "Has your mother ever had a fracture before?"

Upon hearing this, Zhang Zhengquan immediately turned to look at Zhou Cheng.

Ever had a broken bone?

How did you get it?

Brother Zhou Cheng, are you a doctor or a fortune teller?

This is not easy to say nonsense!

When Luo Yun heard this, his expression flashed.

In addition to the types of inflammation, the causes of arthritis can also be divided.

This patient indeed has classic osteoarthritis.

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?

The diagnosis of traumatic arthritis is a causative diagnosis. Generally, this diagnosis can be made routinely by asking the medical history to complete the diagnosis.

Because you don’t even ask, how do you know if it’s trauma?

Traumatic arthritis…

Of course, the traumatic experience of traumatic arthritis will be permanently written on a person's body, and it requires highly advanced film-reading skills to be able to see that the patient has had fractures or injuries in the past.

This is a very professional reading technique.
To be continued...