Chapter 0006 Fractures that cannot be seen on CT (Part 2)
A few minutes later, Director Tian's resident physician, Chen Xiaobo, called from the operating room: "Director Tian, there are ecchymoses and swelling in front of the left knee."
"Xiaobo, the operation is suspended, and the patient is pushed to the imaging department for bilateral hip MRI. Yes, I will explain to the family, right now, immediately, immediately."
Real dashboard damage! If so, then there is a real possibility of hidden fracture of the femoral neck, which is one of the orthopedic traps.
Director Tian hung up the phone and cast an approving look at Yang Ping: "It's really a dashboard injury! You should be right. I will suspend the operation immediately and push the patient to have an emergency hip MRI. Thank you for reminding me!"
It was not easy for a deputy chief physician who led a team to admit his omissions in public and thank a young newcomer. It seemed that the atmosphere in this department was very good, and Yang Ping breathed a sigh of relief.
Director Han nodded slightly: "Well, if there is an hidden fracture of the femoral neck, the surgical method needs to be changed. Do you have any other opinions?"
No one spoke, Director Han said: "Then everyone goes to your places. Tianyuan, you go to the imaging department right away. I will go down later and look at the MRI together."
Director Han dismissed everyone and found a computer to read the patient's X-rays and CT scans carefully.
Song Zimo came over and asked Yang Ping softly: "This patient really has an occult fracture of the femoral neck? The occult fracture can't be seen on X-rays and CT, right? How did you see it?"
"You can tell with your eyes." Yang Ping said with a smile.
Song Zimo glared at him, and then said: "I'm going to go to the imaging department to have a look. Do you want to go down?"
Yang Ping didn't have anything to do. He didn't have any tasks assigned to him on his first day at work. Besides, he raised the doubt himself, so he definitely had to go and take a look.
Director Han came over at this time: "Come on, let's go down and take a look. I just looked again, and there is indeed something suspicious."
The three of them went straight to the imaging department, and many others followed Director Tian and had already gone to the imaging department.
The patient was also sent to the MRI room and preparations for examination began.
Director Han called Director Meng, Director of the Imaging Department, in advance. Director Meng was also waiting in the reading room. Director Han, Director Tian, Song Zimo, Yang Ping, and some graduate students and graduate students who were watching the excitement gathered in a big circle.
.
When everyone saw Yang Ping coming down, they all made room for him to stand inside. They were all curious as to whether there were any fractures, but they didn't notice it anyway.
"Old Han, what's wrong? I'm rushing to do an MRI on this patient. I just looked at his CT and X-rays. There's no femoral neck fracture?" Director Meng heard from several young orthopedic surgeons that he suspected a femoral neck fracture.
"Xiao Yang from our department raised a question. From the X-ray and CT, we saw an occult fracture. In order to clarify, we did an MRI. I will look at the MRI later. I also looked at the X-ray carefully. There is indeed something suspicious about this patient.
"Director Han said.
"That's it!" Director Meng stopped talking and quietly waited for the magnetic resonance image to appear on the screen.
The nurse in the MRI room checks whether there is any magnetic metal on the patient, asks if there are any contraindications such as cabin fever, and then signs a slip to confirm.
Magnetic resonance examination uses a magnetic field. If it is magnetic metal, it is not allowed to be brought in. Some magnetic metals are implanted in the body, and some are not allowed. The strong magnetism will move these metals.
Other non-magnetic metals are okay, but today’s implants are generally non-magnetic.
Magnetic resonance does not contain ionizing radiation, unlike X-rays and CT which do.
Tian Yuan's resident doctor Chen Xiaobo is assisting in moving patients, and attending physician Fang Yan is also among them.
"Brother Fang, why did Director Tian suddenly stop the operation and take the patient out for MRI?" Chen Xiaobo didn't understand.
"The new Dr. Yang said that our patient had a femoral neck fracture. Director Tian didn't see it, but he did." Fang Yan was not happy either.
The patient was on the operating table, and the anesthetist had inserted the puncture needle into the spinal canal. He almost injected medicine, but the operation was suddenly stopped, and he had to be pushed here for magnetic resonance imaging. Naturally, he felt a little unhappy.
"Who is the new guy? He's so awesome!" Chen Xiaobo asked.
"Let's wait until the MRI comes out." Fang Yan said.
"You guys too, why did you listen to the new doctor? He just pulled me off and did it when he said it. Doctors, let's go out and check it out." The technician also helped complain.
"When he said this, even if Director Tian doesn't pay attention to it, we are the ones who are tired." Fang Yan said.
When everything was ready, the technician pressed the switch on the outside console, and the moving tablet slowly carried the patient through the circle-shaped machine hole.
On this side, the two directors did not speak, and others also stopped talking. Everyone quietly waited for the test results.
The magnetic resonance examination takes a little longer than the ordinary examination, but Sanbo Hospital has introduced the world's most advanced 3.0T light-speed magnetic resonance, which is much faster than ordinary magnetic resonance scanning.
A few minutes later, pictures began to appear on the screen, and then filled the entire screen. Director Meng immediately grabbed the mouse and began to read the pictures. In fact, he was also curious about whether the patient had any fractures.
Director Han moved closer, and the others tried to surround them while keeping a certain distance from the two directors. The pictures were turned over, enlarged, passed one by one, turned over, and overturned.
Then a picture was locked and enlarged. Director Meng moved forward, pointed the mouse at a certain part, and looked at it for five minutes.
"It is true that there is a fracture in the femoral neck. Look, Old Han, here, T1 and T2---." Director Meng said firmly.
Director Han turned around and looked at Yang Ping behind him, then leaned over: Indeed! Broken bones!
This type of hidden fracture can be seen on X-rays and CT scans as lines on mosquito wings, which is very difficult to find.
"Broken, broken!"
When the answer came out, everyone looked at Yang Ping in unison.
Fang Yan and Chen Xiaobo came to the reading room from the MRI room. Did you hear that right? Really broken bones?
Director Han immediately told Director Tian: "Let's discuss it again with the patient's family. The informed consent for the surgery needs to be re-signed and the surgical procedure needs to be re-determined. It is best to use an extended PFNA to fix the femoral shaft and femoral neck at once. In this way, the surgery can be postponed until
Let's discuss it tomorrow and this afternoon. Fortunately, we need to do an MRI as soon as possible, otherwise we will fall into a trap."
"Thank you!" Director Tian patted Yang Ping on the shoulder.
"Please come down to my office." Director Han also patted Yang Ping on the shoulder.
Song Zimo felt a little miraculous, how did he see the fracture and how did he do it.
"Ding dong, help colleagues avoid diagnosis and treatment traps, and you will be rewarded with 1,200 points."
Now Yang Ping is used to the system and will not be surprised by the system's sudden sounds and subtitles.
This system should be changed to: a reward system for good people and good deeds, Yang Ping slandered.
Office of the Director.
Director Han and Yang Ping were across the desk and said sincerely: "I should thank you for what happened today. You saved Corey from a dispute. Have you ever studied imaging before?"
Yang Ping shook his head.
But he immediately said: "When I was at the People's Hospital, I studied almost all orthopedic imaging data one by one as long as they were stored in the computer system."
Director Han thought for a moment so that he could figure it out.
This is not a casual lie. Yang Ping has indeed worked very hard to study medicine. He used to study almost all the imaging data in the department at the People's Hospital, and he often went to the radiology department to ask for advice.
With such an accumulated foundation, coupled with systematic training, I can solidly develop my sharp eyes.
He can see the abnormalities on X-rays and CT films at a glance, no matter how subtle or difficult to distinguish.
