Sun Lien slowly chatted with Liu Baoguo, gradually outlining Liu Baoguo's usual life trajectory and appearance. It has to be said that slowly asking about medical history by learning from Lao Pa is a very useful method. Sun Lien has gradually mastered many suspicious points that are not even prompted by the status bar during the chat.

What he cared about the most was probably Liu Baoguo's legs.

Liu Baoguo's legs look very strong, and people who often work in the fields will naturally have very developed leg muscles, which is nothing strange.

But the shape...is not right.

Sun Lien started to palpate a little, and his confusion became even worse. Liu Baoguo's legs looked quite strong, but when they touched them, they felt a little soft - this was not like the touch that a muscular person should have. What's more, Liu Baoguo's calf part, which should have been bulging, was not too high on the inside and outside sides of the gastrocnemius muscles, on the contrary, looked larger.

This is... the muscle capacity is reduced, right? Sun Lien is a little confused. The content related to muscle is generally treated by surgery. He is not professional in judging the muscle capacity decrease.

If this is a decrease in muscle capacity... that would be very interesting. Sun Lien left the ward, returned to the office and sat down, and began to desperately urge Luo Ge on WeChat to report it quickly. If it is a decrease in muscle capacity, the muscle atrophy that appears at the distal end of the limb is basically equivalent to declaring the patient suffering from spondylitis or neurogenic muscular atrophy. However, general neurogenic muscular atrophy is unlikely to lead to a continuous high fever, so spondylitis should be the most likely root cause.

To diagnose spondylitis, the report issued by the Imaging Department is the key. Imaging evidence is an important basis for diagnosing spondylitis. But I feel sorry for Brother Luo, who was arrested by Sun Lien today.

"I've seen it. There's no sacroiliac arthritis." It took some time to issue the report. Brother Luo's head was urging by Sun Lien, so he simply reported the situation on WeChat first. "But I saw a little strange place in the sweep."

Brother Luo stared at the screen, thought for a while, and took a photo with his mobile phone and sent it to Sun Lien, "The patient's L4-5 lumbar vertebrae has several hardening points with increased density, which is... a bit strange."

There are high-density hardening points on the lumbar spine, which may be very important diagnostic evidence, but it may also be just natural damage to the older human body.

This seems to be the diagnosis of orthopedics. Sun Lien put down his mobile phone and thought for a while. The conventional thinking logic told him that he should wait until Yuan Ping'an and the others come back to work tomorrow before organizing a consultation. Liu Baoguo's vital signs are stable and his condition does not have a risk of rapid deterioration, so there is no need to organize an emergency consultation.

But... Sun Lien couldn't have anything to do. He was curious than anyone else, and even more curious than the patient himself, what kind of disease was this?

Just treat it as revenge on Yuan Ping'an. Sun Lien's heart was dark. Who asked you, Yuan Ping'an, to push me, Sun to block the gun? Sun Lien, the other patients that night, couldn't remember it clearly, but Sun Lien still remembered the "bath" that brother with bacterial dysentery.

"Hey, Dr. Yuan?" Sun Lien's revenge was not too late for three or four months. "I have some ideas when I look at Liu Baoguo's case. Are you with my sister-in-law?"

"Yes." Yuan Ping'an was eating with Lin Yanan in the food stall at the entrance of the Fourth Hospital when answering the phone. The couple were both doctors, and it was a bit time-consuming to start cooking together. Therefore, on such working days, they either eat boxed lunches in the department or go to the cafeteria, or they would get together and order two dishes in the food stall at the entrance. "What do you think?"

"I just chatted with Liu Baoguo, and during the chat, I found that his calves seemed to have some muscle capacity decreased on both sides of his calves." Sun Lien did not hide it and directly explained his inference. "No sacroiliac arthritis was found on the image, nor did I find that the patient had vas conjunctivitis - but the symptoms of this symmetrical muscle capacity reduction on both sides were suspected to be spondylitis."

The sacroiliac arthritis and vacuconjunctivitis mentioned by Sun Lien are diagnostic features of "ankylosing spondylitis". As a possible autoimmune system disease whose cause is unclear, ankylosing spondylitis will lead to bone fusion of part of the spine, and the patient will lose or even completely lose part of the ability to move the spine. And with the development of ankylosing spondylitis, the patient will gradually experience symptoms such as spinal deformation.

Ankylosing spondylitis can explain the reduction of muscle capacity and back pain, but it cannot explain Liu Baoguo's fever. Therefore, Sun Lien's diagnosis direction and ideas spread towards another type of spondylitis - infectious spondylitis.

It is not uncommon for pathogenic bacteria to invade the spine and cause inflammatory reactions. Common clinical cases include suppurative spondylitis, tuberculous spondylitis, brucellosis, etc. In other words, if Liu Baoguo's CT image and reduced muscle capacity are indeed manifestations of spondylitis, you can follow this idea to find the source of infection.

"No wonder you asked me if Ya Nan is here in the first sentence?" Yuan Ping'an smiled on the other end of the phone, "Okay, we're almost finished eating. After buying the order later, I will take Ya Nan back to see the CT picture first."

Sun Lien chatted with Yuan Ping'an for a few more words, and was about to open his phone to see if he wanted to order a takeaway when he suddenly heard a knock at the door, "Doctor Sun, are you here?" It was Shen Qingmei's voice.

"Mr. Shen, please come in." Sun Lien responded loudly, and quickly ordered a few times on his phone, and ordered a braised chicken rice.

"Doctor Sun, come to the ward for a look." Shen Qingmei stood at the door and didn't come in. She said to Sun Lien anxiously, "Mr. Liu suddenly started coughing, and he coughed very badly."

Sun Lien quickly stood up and hurried to the hospitalization ward with Shen Qingmei. Nurse Xiao Guo saw Sun Lien's actions from the nurse station and rushed over to help.

"Cough cough...cough cough cough!" Liu Baoguo, who was still calm and chatting with Sun Lien just now, was almost unable to breathe. His face was flushed, and it took him a while to calm down.

"Mr. Liu, are you okay?" Sun Lien asked carefully. He quickly glanced at Liu Baoguo's status bar. This time the status bar changed. "Pulmonary infection (00.08.13)" appeared at the end of the status bar list, and in front of the prompt for lung infection, there was a line of white words, "Spondylitis due to unknown reasons."

In other words, the judgment of spondylitis is correct, and the lung infection is...it was only eight minutes ago? Sun Lien frowned and saw nurse Xiao Guo carefully patting Liu Baoguo on the back - this action helps relieve phlegm.

"Have you ever coughed like this before?" Sun Lien asked with a frown. He had a long-term fever, lung infection, and spondylitis. The three symptoms combined together, his first reaction was only two words, "tuberculosis".
Chapter completed!