Those years when I hung up and upgraded in the hospital

Chapter 35: Upgrading of MRI Reading Technique (Please collect and read)
"Dr. Fang, you did a good job in debridement. You did an excellent job in smoothing the broken ends of the muscles." After Huang Xuepei finished the operation, he praised Fang Yun.

The debridement was done well, and he felt comfortable suturing it.

Fang Yun laughed: "Brother Pei, I have only done debridement before, so I may be a little more familiar with it. Unlike Brother Pei, there are too many operations that require involvement."

Muscle suturing and tendon suturing are actually the specialty of hand surgery, a subspecialty of orthopedics. Trauma surgery is not particularly specialized in this area.

Orthopedics seems to be just one department, but in fact, it is complex, involves a wide range of areas, and has many subspecialties.

The trauma surgery department in Longxian People's Hospital mostly deals with fracture-related diseases. Most doctors only focus on this disease, but ignore too many diseases in other sub-specialties.

But in fact, hand surgery is also a branch of trauma surgery.

"Dr. Fang is very eloquent. Thank you for your hard work. Originally, you were just here to follow the assessment, and you had to be on duty in the emergency room." Huang Xuepei didn't know what Fang Yun was thinking at the moment, so he walked out of the operating room with a smile. To feel a little complacent.

Fang Yun is a follow-up examiner, and it is unknown whether he can be determined. He has a feeling of smiling at the clouds and the clouds.

After all, he is well-established and has successfully crossed the medical association's knife, which means he can sit firmly on the Diaoyutai.

Fang Yun didn't say much. After changing his clothes, he returned to the department.

Fan Youhua was reading the films carefully in the department at the moment. He was holding an MRI and looked calm.

Sitting in front of him was a young man with a sprained knee joint. He came to the emergency department. After the emergency department performed an MRI, he was pushed to the ward.

Fang Yun took a quick glance and saw that this young man was in his thirties. His left knee joint was swollen and his skin was red. He must have been iced.

After injury, it is better to use ice compress. If there is no ligament rupture, ice compress can be applied within 48 hours, and then converted to hot compress, which will help reduce swelling.

Fan Youhua saw Fang Yun, but this patient was a specialist in his disease during his master's degree. He was not particularly modest, but said: "Brother Yun, here is a patient with a knee sprain. I don't see any ligament damage or meniscus damage." It’s okay, would you like to take a look too?”

Of course Fang Yun would look at it. If he looked at the MRI, he might not be able to diagnose anything, but at least he could gain some experience in MRI reading.

Fang Yun took over another level, which is axial nuclear magnetism.

The sagittal and coronal views were pulled together in Fan Youhua's hands.

Fang Yun also had certain skills in MRI reading. Although it was only level 2, he could see quite a lot, so he looked at it with his only axial position.

For emergency knee trauma, the most important thing to look at is whether there are fractures, ligament injuries, and meniscal ruptures. If there are none, then it can be ruled out and the patient can be asked to put a plaster on or buy a brace online. , just fix it temporarily.

This is something within the specialist theory of orthopedics.

With a physical examination, it shouldn't be difficult to diagnose.

"I looked at the MRI and saw nothing special. Let's go to the operating room for a physical examination, which will be more comprehensive. If there are no problems, you can put a plaster on it. Just go back and rest." Fan Youhua said this to the young man.

"Okay, thank you doctor. The doctors in the emergency department actually said the same thing, but they said it was an orthopedic disease. It would be more reassuring to come to the orthopedic department for a visit." The patient replied.

"Of course, I want you to be more at ease, and you can be more at ease, and I am more at ease." As Fan Youhua spoke, he took the patient away, obviously feeling particularly reassured about his ability to read MRI scans.

Fang Yun was not in a hurry. After slowly reading all the MRI scans, he found no deformation or rupture of the anterior and posterior cruciate ligaments, which meant that there was no ligament rupture.

The triangular relationship of the meniscus is excellent, there should be no meniscal rupture, and the medial and lateral collateral ligaments are also in good condition.

This is Level 2 MRI reading technology. In the field of sports medicine, it is mainly what can be seen. If you want to look at it more carefully, the level of MRI reading technology may have to be upgraded.

There is basically no chance to see MRI reading in the Second People's Hospital of Long County. There is not even a CT there, let alone an MRI?
Therefore, Fang Yun had no such opportunity before.

Of course, the experience of MRI reading is already very high.

It was 2% at level 98 a long time ago, but Fang Yun just didn't have time to raise it directly to level 3.

After Fang Yun read this MRI, it suddenly became level 3 0%.

In fact, this change did not change much. It just made Fang Yun's anatomy around the knee joint clearer.In addition to being able to see ligaments, menisci, intercondylar fossa, cartilage and other layers, you can also see blood vessels, nerves, fat pads and things in the popliteal fossa.

And these, under normal circumstances, are actually not paid special attention to in emergency knee injuries.

Gastrocnemius head, this is the popliteal artery, this is the popliteal nerve, this is the companion of the popliteal nerve…

"Ok?"

When Fang Yun saw this, his expression suddenly changed. After blinking slightly, he discovered that there seemed to be a bulge in the shape of a section of the popliteal nerve.

However, at this raised part, the layer is broken. It should be that the plane selected is not good enough.

However, the MRI was done by our hospital, and Fang Yun could check all aspects in the image reading system, so he quickly opened the full spelling of the patient's name in the image reading system and found the MRI.

When I turned the page and looked at the sagittal T1 and T2 signal levels, I discovered that this patient really had a schwannoma.

This diagnosis is obvious. Schwannomas are benign tumors located within the nerve sheath. They may be asymptomatic, but if they continue to grow, they will compress the nerves. At present, they can also cause some local symptoms, such as compression of the nerves. Occasional numbness.

Moreover, in the popliteal fossa, changes in body position may lead to triggering numbness of the lower limbs.

Continuing to look at the tumor, the capsule is clear, the size is constant, it is located within the nerve sheath, and the nerve is out of shape.

After thinking for a moment, Fang Yun walked out and entered the operation room.

At this moment, Fan Youhua frowned: "When I just did the physical examination, were you numb for a moment?"

"Is it possible that this is nerve edema? Anyway, I checked your ligaments and other functions. They are all complete, and I did not find any positive results in the anterior drawer test or the rollover test."

"There should be no damage to the ligaments."

Fang Yun thought for a moment and knocked on the door: "You are Wang Yueming, right? You have a popliteal schwannoma, and it's quite big!"

"You must have often experienced numbness in your lower limbs before. It is a sudden numbness from the knee joint down, as if your elbow accidentally touched the radial nerve."

"It has happened many times. Is this a tumor?" The man named Wang Yueming turned his head and his expression suddenly changed.

"I always thought that the nerve in my foot was accidentally hit, just like my elbow."

Fan Youhua also looked sideways at this moment, his eyes shrinking slightly.

"Don't worry, it is a tumor, but it is benign and basically not malignant. However, if it continues to grow, it will compress the nerves and cause various neuropathies. It must be treated. However, you are in the emergency injury stage now, so you will definitely not treat it now."

"After the edema here is gone, you can do another operation to cut it off." Fang Yun said this and walked forward again.

After touching it for a while, I found a hard lump and pressed it lightly.

By squeezing the nerves, Wang Yueming took a breath of cold air.

Fang Yun asked: "Have you ever felt like this many times?"

"Hey!~~~"

"Doctor, you are so cruel. Even though you know this, you still have to try again." Wang Yueming hugged his legs, feeling a little aggrieved.

"It's okay, it's okay. This is a benign tumor. Dr. Fan, come and feel it. It's benign anyway. Try to feel the click..."

Wang Yueming's face instantly became aggrieved, but when he saw Fan Youhua approaching with a lively expression, he also felt helpless and desperate.

I just feel that the doctor's brain circuit is different from his.

(End of this chapter)