My medical path

Chapter 83 This Diagnosis Is Wrong
Chen Bo's scanning and deduction process actually took about 1 minute, but for Deputy Director Zhao who was standing aside, he didn't want to waste this 1 minute here.

So he looked at Chen Bo and asked:

"Chen Bo, do you have any ideas? Is there something wrong with our diagnosis?"

Deputy Director Zhao's tone of voice was very flat, but those who cared could hear it. There was a trace of impatience and blame in Deputy Director Zhao's flat words.

"Director Zhao, please wait a moment. I want to ask the patient a question." Chen Bo turned to Zhang Jiahui and said:
"Have you ever had a chest injury before?"

Everyone, including Director Wei, was taken aback when Chen Bo suddenly asked such an irrelevant question.

Deputy Director Zhao frowned again...

Wu Zhennan and Zhang Yu started thinking about Chen Bo's question and fell into deep thought...

Young people like Ma Shangqu, Pang Minghui and Luo Ming are at a loss, not knowing why...

"Doctor, do you know that?"

When the patient asked this question, it was the doctor's turn to be surprised...

Everyone present did not make a sound at this time, but listened carefully to the patient's next words:

"I was in a car accident more than two years ago and broke a rib..."

Zhang Jiahui looked at Chen Bo and replied seriously.

He thought it was incredible. He was from another province, and he had never been hospitalized here. He didn't mention the injury during this hospitalization. How did this young doctor know about it?
Can you guess it just by touching me just now?
That's amazing too!
"That's right," Chen Bo said to himself when he heard Zhang Jiahui's answer:
"The trauma caused the fracture of the first rib, and after the fracture healed, redundant osteophytes appeared, resulting in a narrow gap between the clavicle and the first rib..."

When Chen Bo connected this process in series, the source of the whole disease was found.

"Director Wei, Director Zhao, I don't think he is a symptom caused by cervical spondylosis..."

After hearing the patient's exact answer, Chen Bo turned his head and said to everyone.

"Why do you make such a judgment?"

Deputy Director Zhao is really a little impatient now. He watched Pang Minghui's physical examination just now, and there is nothing wrong with him...

He felt that the diagnosis of cervical spondylotic radiculopathy by this patient was already a certainty, so now Chen Bo actually wanted to overturn the conclusion he had drawn, which made it difficult for him to accept.

Director Wei was also frowning at this time and thought deeply. Although he felt something was wrong after seeing Chen Bo's physical examination just now, he couldn't tell what it was...

So he wisely chose to remain silent for a while, waiting for Chen Bo to share his opinion.

After a few times of arguing with Chen Bo, Wu Zhennan realized that he and Chen Bo were not on the same level at all, so now he has become smarter, don't provoke Chen Bo easily...

Ma Shangqu and Pang Minghui are two young people, you look at me and I look at you, but their heads are still muddled.

"I started to feel something was wrong mainly because I saw the patient's hand." Chen Bo grabbed Zhang Jiahui's hand and showed it to everyone, and then said:

"Look at this hand, the hypothenar muscle and interosseous muscles have been significantly atrophied. This is a sign that the ulnar nerve has been injured for a long time and is relatively serious..."

"However, the patients with cervical spondylotic radiculopathy that we have seen clinically rarely have nerve damage to this extent..."

"Less does not mean no, can patients with cervical spondylosis not suffer from muscle atrophy?"

Deputy Director Zhao questioned.

Facing Deputy Director Zhao's questioning, Chen Bo responded with a calm expression.

"Put your face out in such a hurry, won't it hurt to slap it later?"

In his heart, Chen Bo sent Deputy Director Zhao a plaque with the words "Let's go, go well", and continued:
"Of course, cervical radiculopathy can also cause muscle atrophy, but..."

Chen Bo paused, and said in a more emphatic tone:
"However, if it is caused by cervical spondylosis of the nerve root, he should have very obvious nerve radiation pain, and this patient only has hand numbness and muscle atrophy as the main manifestations, and the pain is very mild. This is the first point."

Chen Bo looked at Director Wei, who signaled him to continue.

"The second thing that makes me suspicious is the patient's X-ray. Although we can see that the intervertebral disc herniation in cervical 5/6 and cervical 6/7 is obvious, but we look carefully at the X-ray. In fact, the nerve compression is not serious. In this case, it will There will not be such obvious muscle atrophy, I doubt it..."

Chen Bo looked at the crowd and continued:
"The last point is what I confirmed after asking the patient just now. The patient was injured more than two years ago and had a fractured first rib. This is worth noting..."

"The patient was injured more than two years ago, and the symptoms of upper limb numbness were two years ago. Is the two related?"

Zhang Yu seemed to have grasped the key point at this time, and asked in a hurry.

"That's right, the patient's symptoms appeared after the fracture. Let's look at the position of the film." Chen Bo enlarged the first rib on the film and continued:
"This location should be where the fracture was at the beginning, and now you can see a very obvious osteophyte..."

"So I have reason to suspect that there is compression when the brachial plexus passes through this part..."

Chen Bo paused, and expressed his judgment:

"So, I think this patient is not cervical spondylotic radiculopathy, but - thoracic outlet syndrome!"

Hearing this slightly unfamiliar term from Chen Bo, the office fell into a brief silence.

Director Wei nodded thoughtfully.

After Chen Bo's explanation, he felt that it was very reasonable. He had heard of this disease, but he still lacked the understanding of it.

After listening to Chen Bo's words, Deputy Director Zhao frowned even deeper, and there was still a hint of uneasiness on his face...

He has also heard of this disease, so after listening to Chen Bo's analysis, he feels that Chen Bo's judgment is very likely to be correct...

This is a bit embarrassing. From the beginning to the end, Chen Bo always questioned himself when he spoke. If Chen Bo is proved to be right this time, then he will be ashamed.

Deputy Director Zhao recalled the incident with the little girl last time, and he was also the one who lost face at home that time...

"This catastrophe doesn't have the humility and awareness that ordinary employees should have in the face of leaders, but he is like a hedgehog, unable to speak. What's the deal with this kind of person? I'd better stay away from him in the future..."

Deputy Director Zhao secretly made up his mind.

"Thoracic outlet syndrome?"

Zhang Yu was still muttering about the term Chen Bo said, thinking:

"This guy Chen Bo is pretending to be serious... Can this kind of disease be diagnosed?"

Ma Shangqu and Pang Minghui are very unfamiliar with this term, but Luo Ming has never heard of it.

"In addition to the judgments just mentioned, is there any further inspection method for this disease?"

At this time, Zhang Yu raised his own doubts.

This is a question that everyone wants to ask.

Director Wei and Deputy Director Zhao would definitely not take the initiative to ask this question, and it would be a bit of a drop in price if they took the initiative.

"We can do an electromyogram to see that the nerve conduction velocity of the brachial plexus is different in each segment. This should be able to judge..."

"This is a good way," Director Wei said at this time:

"I think Chen Bo's analysis is very reasonable. Director Zhao, why don't we take the time to do the operation first? After the electromyography is done and we rule out the disease, we can consider cervical spine surgery?"

"Then listen to the director and finish the inspection first..."

Hearing that Director Wei asked for his opinion at this time, Deputy Director Zhao pondered for a while, and then went down the donkey path.

When Deputy Director Zhao said this, everyone present could faintly hear it. It seems that Deputy Director Zhao was a little bit retreating this time?
And Chen Bo was slightly better in this discussion?
...............

(End of this chapter)