"Dr. Li, could you help with a consultation for the patient who caused a disturbance this morning? Professor Wu has admitted the patient for hospitalization and promised to find out the true cause of the illness."
Ruan Xiaoqin showed no embarrassnt or guilt regarding this matter.
He seed to think that being unable to find the cause and making a misdiagnosis was only natural.
"Alright, let take a look."
Li Jingsheng did not refuse.
He is not a doctor in the second group, but his girlfriend is, and he often assists Professor Wu in surgeries, so he has sowhat of a half status as a second group’s doctor.
"Have the patient’s scans been taken?"
"Yes, but he seed very resistant and only agreed to the cheapest X-ray."
"That should be sufficient. Was there any abnormality found in the CT scans taken previously?"
Li Jingsheng asked again.
"The CT scan results at the ti were very similar to arthritis."
Ruan Xiaoqin stated with certainty.
"Can I access the patient’s records by logging into my own account?"
"You should be able to."
When Li Jingsheng and Ou Qinglan ca in, this ti Dr. Qin did not leave.
Because he had already changed seats.
The seat next to Ou Qinglan was mostly empty now.
Dr. Qin also didn’t want to be kicked out of the office every ti Li Jingsheng ca over. It was quite awkward.
So, he voluntarily asked to change seats.
After all, there was no fixed seating in the office.
Li Jingsheng sat next to Ou Qinglan, opened a computer, and logged into his personal account.
Directly entering the unresolved cases, he saw the patient’s records.
Chen Helili, male, 26 years old, self-reported a thumb injury on the right hand from playing ball a year ago, not treated at the hospital. Subsequently, injured the sa spot again, experiencing unbearable pain and swelling in the thumb, then ca to the Second Hospital for treatnt...
The dical history was described very clearly.
It’s estimated that Dr. Ruan blushes every ti he reads it.
No matter what, such an unresolved case would surely cause so embarrassnt for the first diagnosing doctor, especially after so many treatnts.
Reviewing the patient’s previous CT scans, they indeed resembled arthritis.
The previous ultrasound showed destruction in the tacarpal bone of the right hand thumb with surrounding low echo, indicating a possibility of inflammation.
Seeing this, Li Jingsheng felt that it couldn’t be entirely Ruan Xiaoqin’s fault.
Any other doctor looking at these images might also have treated it as arthritis.
He reviewed the X-ray taken today, which revealed significant osteolytic destruction at the base of the proximal phalanx of the thumb.
"The patient kept calling a quack, I was infuriated. I’m truly innocent. The first ti he ca, I arranged an X-ray, the results pointed towards osteoarthritis, so I treated it as arthritis.
The second ti, there was still no improvent, another ultrasound suggested a high likelihood of inflammation. I prescribed dication for arthritis again.
The third visit still showed no improvent. I was worried about misdiagnosis, so I did a CT scan to prevent a missed diagnosis, and even conducted biochemical tests: low-density lipoprotein was 1.54mmol/L, uric acid was 465umol/L.
This ti, I suspected a possible tuberculosis because I had read about similar cases in books.
Unexpectedly, the treatnt was still ineffective. I explained it might be tuberculosis combined with gout and proposed an MRI which he refused, then started calling a quack and accusing of scamming him out of money. Honestly, in the previous two tis, I used the most cost-effective X-ray or ultrasound for tests."
Ruan Xiaoqin, looking extrely wronged, explained to Li Jingsheng and also to the rest of the office colleagues.
No one wants to be labeled as a black-hearted doctor who intentionally scams patients for money.
"Patients don’t understand these things; it’s normal for them to curse without basis, just ignore it."
While saying this, Li Jingsheng had already started looking at today’s X-ray of the patient again.
This condition likely isn’t as simple as it seems.
For any difficult-to-treat arthritis or tuberculosis, if dicated for such a long period, there should be so improvent.
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