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Guo Zhonghua
When I was out of the clinic that morning, a mother walked into my office with a 2-year-old boy in her arms. "What's wrong with the kid?" I asked. "I fell and injured myself a few days ago, and I don't lift my arm, so please see what the problem is. The child's mother said.
I examined the child's wrist, elbow, and shoulder joints upwards to see if there was any swelling and bruising, and whether there was any tenderness. Although the child couldn't tell the condition, he couldn't help the pain.
Sure enough, when I touched the top of the boy's collarbone, the child cried and kept dodging. I noticed that the child also had some local swelling. Apparently, he had a problem with his collarbone.
The child's medical records on the computer showed that before this, he had seen two doctors, took X-rays of the shoulder and elbow joints, and reported no bone abnormalities, and the diagnosis was soft tissue injury. The doctor did not deal with it and only told him to go home for observation.
The parents of the child observed very carefully, and the child did not raise his arm or let him touch his left shoulder, so there must be a problem, so he came to the doctor again.
"You've already seen it twice, and there's no problem with the previous record, why are you looking for me again?" I asked.
"You're the old doctor, I want you to see if there's any problem. The child's mother said.
"There is a problem, it is a fracture of the clavicle. I said.
Ever since I examined my child's collarbone and compared the two sides, I knew what to expect. Although the X-ray report showed no fractures, a closer look at the film showed that the middle of the child's collarbone was still somewhat deformed. Apparently, the doctor in front did not examine the child's collarbone.
If the first doctor had carefully examined the injured area, the treatment would not have been delayed, and the parents would have been anxious to go back and forth.
Attaching importance to physical examination is a common topic, and physical examination is the basic skill of a doctor. In recent years, with the wide application of various examination equipment, many doctors have increasingly relied on examination results for diagnosis. This is clearly not true. In my opinion, a seemingly simple and routine physical examination is not only necessary, but also irreplaceable by any modern medical instrument. Physical examinations can not only help doctors have a more complete picture of the patient's condition, but also convey warmth and care to the patient.
Text: Department of Orthopedics, Ningxia Hui Autonomous Region Hospital of Traditional Chinese Medicine and Institute of Traditional Chinese Medicine Guo Zhonghua Editor: Zhang Haohua Yang Zhenyu Proofreader: Ma Yang Review: Qin Mingrui Xu Bingnan