This doctor is already middle-aged, and he's only just started practicing medicine.

Chapter 65 The Carnivorous Director Lin!
Upon hearing this, the girl frowned slightly and asked, "Dr. Lu, can you find so much information just from a physical examination?"

"Hmm... Some cases can be detected by examination, while others cannot. Your case is rather special, so we can make a guess by gathering only basic information."

"It's not a confirmed case either."

After Lu Cheng finished replying, he washed his hands with hand sanitizer and went to the computer to watch the film. He then asked, "Why did you ask that? Are you in the industry too?"

"My wife works at Longfeng Maternity Hospital!" the man said with a restrained expression.

The girl immediately said, "Dr. Lu, I'm a nurse."

Lu Cheng immediately said, "Since you are a nursing major, it will be easier to communicate. A physical examination is just a guess; a diagnosis requires comprehensive information."

"Let's talk after we see the scans! Give me your medical record." Lu Cheng's voice was more mature and steady.

The patient nodded, gesturing for her boyfriend to hand over the medical record: "Okay."

But then her eyes darted around, she blinked, and asked, "Doctor, isn't joint dislocation something orthopedic surgeons treat? You're an emergency room doctor, do you treat that too?"

As they spoke, the girl sat down on the yellow-painted wooden stool, her brows furrowed slightly, her expression filled with doubt.

“I used to be a resident in orthopedics. Joint dislocation is an emergency case and is not specifically classified under any department.”

"Of course, we also called the orthopedics department, and the orthopedic doctor on duty today said he couldn't handle your joint dislocation."

“Of course, you can also be transferred to other hospitals after my diagnosis, such as the Traditional Chinese Medicine Hospital or the State People’s Hospital,” Lu Cheng said.

Patients have the right to informed consent and informed refusal, and those who are professionals in the field should respect this right even more.

Tian Zhuang had already retrieved the patient's X-rays, but his skill level only allowed him to detect dislocations. Knowing he wasn't good with words, he didn't say much...

Plain radiographs are mainly used for initial screening to determine whether there are fractures and whether the bones are properly aligned.

It is a relatively simple auxiliary examination.

Lu Cheng looked at it for about a minute and a half, and after browsing the most crucial parts, he explained to Tian Zhuang: "Tian Zhuang, look, the bone lines of the humerus and radius and ulna are intact, without fracture lines or deformities."

"The humerus and glenoid fossa are separated, with the humerus located below the coracoid process, which is an anterior dislocation."

"It can be seen that the joint capsule is not dislocated, and the space of the acromioclavicular joint is narrowed. It is not a grade II injury, but a grade I injury."

"In such cases, we can wait until the injury is repositioned before conducting a physical examination to help diagnose whether there is a rotator cuff injury."

Lu Cheng's words were very logical and professional, but the difference between his sub-specialty and his actual profession was too great, which left Tian Zhuang bewildered and looking conflicted.

He didn't know much about orthopedics, let alone a subspecialty like joint dislocation.

Despite his lack of understanding, he patiently followed Lu Cheng's explanations and read as much as he could.

Lu Cheng didn't care about anything else and started writing the medical record after finishing his explanation.

……

But when Lu Cheng was halfway through writing the medical record, a voice interrupted: "Little Lu, what do these English words you wrote mean?"

Upon hearing this, Lu Cheng immediately looked up: "Director Lin, what brings you here?"

After asking Lu Cheng, he felt like an 'outsider'. What else could it be? The senior doctors in the orthopedics department must have called Director Lin over, right?
Upon hearing Lu Cheng mention Director Lin, the girl and man's expressions lit up, and they began to recount their "brief medical history" to Lin Qianlong once again!
Lin Qianlong explained with a smile: "I don't specialize in orthopedic diseases. Our Dr. Lu Cheng is the one who specializes in orthopedic diseases in our department. He is much more knowledgeable than me in the treatment of joint dislocations."

"Please wait outside for a moment. Dr. Lu and I will discuss your diagnosis and treatment in detail and then we will tell you the results later."

The girl was taken aback and a little scared when she heard this: "Director Lin? Is this very troublesome?" Lin Qianlong said: "It's not really troublesome, it's just a matter of whether we can handle it."

"Let's discuss this carefully."

The girl and the man left the house helplessly, their expressions conflicted.

……

After the patient left, Lu Cheng carefully explained to Lin Qianlong, "Director Lin, the Apprehension test for the shoulder joint may indicate anterior shoulder dislocation."

"If the symptoms are relieved during the relocation test, an anterior shoulder dislocation can be diagnosed."

"The Release test is based on the Relocation test with the force removed. If the shoulder symptoms reappear, it can be confirmed with double insurance... This is a diagnostic trick for anterior shoulder dislocation without X-ray examination."

At this point, Lu Chengdao said, "Square shoulder deformity, abduction, limited range of motion, and pain are signs of suspected shoulder dislocation. Palpation of the humerus below the coracoid process confirms the diagnosis, which is subcoracoid dislocation of anterior shoulder dislocation."

"The three major tests are important signs for diagnosing anterior shoulder dislocation during physical examination, while palpation of the acromioclavicular joint and the position of the joint capsule are used to determine the grade of the injury."

“If the graded guidance for treatment is written in more detail, even if we don’t get it back in place, it’s a matter of skill level, not a diagnostic problem!” Lu Cheng replied meticulously.

"A plain X-ray can preliminarily rule out any accompanying fractures."

“If there is a hidden fracture, it cannot be detected by a plain X-ray.”

Although he didn't know why Lin Qianlong had come, Lu Cheng did his best to inform Lin Qianlong of his actions.

Lin Qianlong felt a chill run down his spine after hearing Lu Cheng's words.

Lu Cheng is a professional surgeon, a fact that can be confirmed by his very solid surgical fundamentals.

But what's the typical diagnostic approach in surgery? Simple and straightforward: look at the images; if it's there, it's there; if not, cut it out…

But what did Lu Cheng do?

The process begins with physical signs, followed by subtyping, then further investigation of specific physical signs to confirm the diagnosis, and finally grading.

This is something that all medical departments should do, but 95 percent of surgeons don't do it with such meticulousness and care.

To see the whole leopard from a single spot.

"Xiao Lu, so you mean that you can treat not only tendons but also joint dislocations?" Lin Qianlong touched his short chin, his small eyes narrowing into slits.

Lu Cheng's explanation of the theory, in terms of both form and depth, has a bit of a formal academic feel to it.

Perhaps Lu Cheng was really 'just average' in the hospitals where he did his internships and residency training before, but this is a county hospital, and a remote county hospital at that!

It cannot be generalized.

Lu Cheng said seriously, "Director Lin, we can't say we know how to do it, but we will only do it if we encounter a suitable diagnosis and classification."

"I didn't have much experience before, so I could only put in the hard work."

Lu Cheng had a general understanding of these points before the additional training, and he had also treated joint dislocations on his own, but certainly not as detailed, in-depth, or professional as he was now.

These are really tedious tasks. If you have experience, you don't need to go through all this trouble. You can basically determine what's wrong and how to treat it with just one glance.

Of course, while kung fu may be clumsy, it is indeed useful and can minimize the risk of making a diagnosis for a patient!
"Then let's do it! We'll do what orthopedics doesn't do!" Lin Qianlong grinned, a playful smile playing on his lips.

(End of this chapter)