I can see the status bar

Chapter 550 Unexplained spondylitis (May 5th, 20th update)
Sun Lien slowly chatted with Liu Baoguo, and gradually outlined Liu Baoguo's usual life trajectory and appearance.It has to be said that it is a very useful method to ask the medical history slowly like Old Pa.In the chat, Sun Lien has gradually grasped many suspicious things that are not even indicated in the status bar.

What concerned him the most was probably Liu Baoguo's legs.

Liu Baoguo's legs looked very strong. People who often work in the fields naturally have very well-developed leg muscles, which is not surprising.

But the shape...isn't quite right.

Sun Li'en palpated a little with his hands, and the confusion in his heart became more serious.Liu Baoguo's legs looked quite strong, but when touched by his hands, they felt a bit soft - this was not like the feeling a muscular person should have.What's more, the inner and outer gastrocnemius muscles of Liu Baoguo's calf, which should have been raised, are not too high, but the soleus muscle looks rather large.

This is... a decrease in muscle volume, right?Sun Li'en is a little uncertain, the content related to muscles is usually treated by surgery.He is unprofessional in judging the decrease in muscle mass.

If it's a loss of muscle mass... that'd be interesting.Sun Lien left the ward, returned to the office and sat down, and began to desperately urge Luo Ge to report quickly on WeChat.If it is really a decrease in muscle volume, then the muscle atrophy in the distal limbs is basically declaring that the patient is suffering from spondylitis or neurogenic muscular atrophy.But general neurogenic muscular atrophy is unlikely to cause persistent high fever, so spondylitis should be the most likely source.

To diagnose spondylitis, the report issued by the imaging department is the key.Imaging evidence is an important basis for the diagnosis of spondylitis.It's just pity for Brother Luo, who was arrested by Sun Li'en today.

"I checked the CT, and there is no sacroiliitis." It will take some time to issue the report, and Luo Ge's head was blown by Sun Lien's urging, so he simply reported the situation on WeChat, "But I checked it in the regular scan It's kind of weird."

Luo Ge stared at the screen, thought for a moment, took a photo with his mobile phone and sent it to Sun Lien, "The patient's L4-5 lumbar spine has several hardened spots with increased density. This is... a bit strange."

There are high-density sclerotic spots on the lumbar spine, which may be very important diagnostic evidence, but it may also be just a natural injury of the older human body.

This seems to be the diagnostic content of orthopedics again.Sun Lien put down his phone and thought about it for a while. The conventional thinking logic told him that he should wait until Yuan Pingan and the others came back to work tomorrow before organizing a consultation—Liu Baoguo's vital signs were stable, and his condition was not at risk of rapid deterioration, so there was no need to organize an emergency consultation.

But... Sun Li'en can't have anything on his mind.He was more curious than anyone else, even more curious than the patient himself, what kind of disease it was.

Take it as revenge on Yuan Ping'an.Sun Li'en was dark in his heart, who told you, Yuan Ping'an, to push me, Sun, to block the gun?Sun Lien didn't remember the other patients that night clearly, but Sun Lien still remembers the "bath" that the elder brother with bacillary dysentery gave Cao Yanhua.

"Hey, Doctor Yuan?" Sun Lien's revenge was not too late in three or four months. "I've got some ideas after looking at Liu Baoguo's case. Where are you with your sister-in-law?"

"That's right." When Yuan Pingan answered the phone, he was having dinner with Lin Yanan at the food stall at the entrance of the Fourth Courtyard.The young couple are both doctors, and it is really time-consuming to start a fire and cook together.Therefore, on this kind of working day, they either eat boxed lunch in the department or go to the cafeteria, or get together and order two dishes from the food stall at the door. "What do you think?"

"I just chatted with Liu Baoguo, and during the chat, I found that his calf muscles on both sides seemed to have lost some muscle volume." Sun Li'en didn't hide it, and directly stated his inference, "There is no sacroiliac muscle in the video. Arthritis, and I didn't find uveoconjunctivitis in the patient—but with this bilaterally symmetrical hypovolemia, I suspect it might be spondylitis."

The sacroiliitis and uveoconjunctivitis mentioned by Sun Lien are the diagnostic features of "ankylosing spondylitis". As a possible autoimmune system disease with unknown etiology, ankylosing spondylitis can cause partial spinal bone fusion, Since then, the patient has lost or even completely lost a part of the ability to move the spine.And with the development of ankylosing spondylitis, patients will gradually appear symptoms such as spinal deformation.

Ankylosing spondylitis can explain the decrease in muscle volume and low back pain, but it cannot explain Liu Baoguo's fever.Therefore, Sun Lien's diagnosis direction and thinking spread towards another kind of spondylitis-infectious spondylitis.

It is not uncommon for pathogenic bacteria to invade the spine and cause inflammatory reactions. The common clinical ones include suppurative spondylitis, tuberculosis spondylitis, Brucella spondylitis and so on.In other words, if it is confirmed that Liu Baoguo's CT images and decreased muscle volume are indeed manifestations of spondylitis, then we can follow this line of thinking to find the source of infection.

"No wonder you asked me if Yanan is here at the first sentence." Yuan Pingan laughed on the other end of the phone, "Okay, we are almost finished eating. I will take Yanan back to check after I buy the order CT image."

Sun Li'en chatted with Yuan Ping'an again, and was about to turn on his phone to see if he could order a takeaway, when suddenly he heard a knock on the door, "Doctor Sun, are you there?" It was Shen Qingmei's voice.

"Mr. Shen, please come in." Sun Li'en responded with a loud voice, and by the way, he quickly ordered a few times on his mobile phone, and ordered a braised chicken and rice.

"Doctor Sun, come and have a look in the ward." Shen Qingmei stood at the door and didn't come in. She said to Sun Li'en anxiously, "Boss Liu suddenly started coughing, and it was quite severe."

Sun Li'en stood up quickly, and rushed to the inpatient ward with Shen Qingmei.Nurse Xiao Guo saw Sun Lien's movements from the nurse's station and rushed over to help.

"Cough cough cough cough cough!" Liu Baoguo, who was chatting with Sun Lien calmly just now, coughed so hard that he could hardly breathe.His face was flushed from coughing, and it took a while for him to calm down a little.

"Mr. Liu, are you alright?" Sun Lien asked cautiously, and he quickly glanced at Liu Baoguo's status bar, this time the status bar has changed. "Pulmonary infection (00.08.13)" appeared at the end of the status bar list, and in front of the reminder of lung infection was a line of white words, "Spondylitis of unknown cause".

In other words, the judgment of spondylitis is not wrong, but the lung infection was... 8 minutes ago?Sun Li'en frowned, watching the nurse Xiao Guo carefully pat Liu Baoguo's back - this action is actually helpful for expectoration.

"Have you ever had such a cough before?" Sun Lien asked with a frown. He had a long-term fever, lung infection, and spondylitis. When these three diseases were combined, his first reaction was only two words, "tuberculosis".

　In the next few days, I can only keep updating on a single day-my girlfriend finished her defense on the weekend, and I took her to improve the food in the past. In order to keep updating for those few days, Sanguan can only save some manuscripts now ... Hope you all have a good time
　　
　
(End of this chapter)