影象病例讨论

脊柱与四肢骨关节慢性病损手法治疗前后影像学检查病例分析the case analysis of the imageological examination before and after massage treatments which are the chronic diseases of the spine and limbs of the osteoarticular,广西中医药大学附属瑞康医院 韦贵康RuiKang Hospital Affiliated to Guangxi University of Chinese Medicine Wei Gui kang,我们在深入研究脊柱与四肢骨关节慢性病损手法治疗过程中，合理使用影像学（X线、CT、MRI）检查，作为检查常规，对提高诊断准确率及提高疗效很有帮助。现将一些典型的病例分折如下：While we are researching the treatment to the chronic diseases of the spine and limbs of the osteoarticular, its helpful for us to use imageological examination(X-rays,CT,MRI)reasonably to increase the accuracy rate of diagnosis and therapy. Now we share some typical examples for you:,微屈前推法、园筒整复法治疗颈曲变直病例,例1、吳X，男，31岁，颈僵痛伴眩晕半年，x线片提示：颈曲变直。手法治疗2天1次，5次后颈僵痛眩晕消失，x线片检查颈曲有改善。Example 1: Mr.Wu,male,31years old, he had already felt the neck stiff and pain and dizziness for half a year.X-rays reported:the curve of the neck became straightened.He accepted the massage once in two days.After 5 times,he felt better and the symptom disappeared.X-rays reported that the curve of the neck became better.,颈曲变直手法治疗后改善After the massage, the curve of the neck became better,治疗前before the treatment,治疗后after the treatment,例2、李x，女33岁，颈痛伴上肢麻痛3个月， x线片提示：颈曲变直。手法治疗2天1次，4次后颈痛伴上肢麻痛消失，x线片检查颈曲有改善。Example 2: Mrs.Li,female,33years old, she had already felt the neck pain and upper limbs numb for 3 months.X-rays reported:the curve of the neck became straightened.She accepted the massage once in two days.After 4 times,she felt better and the symptom disappeared.X-rays reported that the curve of the neck became better.,治疗前before the treatment,治疗后after the treatment,按语：1、40岁以前颈椎疾病伴有颈曲变直，通过手法、练功等方法，颈曲有不同程庋恢复，有利了临床症的消除或缓解。Note:1、If you have some diseases about cervical vertebra with the curve of the neck straightened before 40 years old,we can use massage、practice and so on to recover the curve of the neck. Through this way, the symptoms can be eliminated or relieved.,2、中年老年人，不强求颈曲恢复，应进行综后分析，对因治疗。2、The middle and the old dont need to recover the curve of the neck, they should analyze synthetically and then choose the right way for treatment.,俯卧均衡牵引架自制专利产品加手法治疗：症状伴有腰曲变直、或脊柱侧弯畸形、或骨盆两侧不等高随着症状消除或改善，复查x线片原异常者得到相应改善。Prostrate balanced traction frame (homemade patent product) with massage can be used:The curve of lumbar become straightened、the lateral bending of spine become abnormal or the both sides of pelvis become different.While those symptoms were eliminated or relieved,they took X-rays and it reported that the patients became better than before.,提法,左右摆法,腰曲治疗前The curve of lumbar before the treatment,腰曲治疗后The curve of lumbar after the treatment,治疗前后 before and after the treatment,动态推拉法,摆动整复法,侧弯治疗前the lateral bending before the treatment,侧弯治疗后the lateral bending after the treatment,闭孔小治疗前obturator formamen before the treatment,闭孔小治疗后obturator formamen after the treatment,手法治疗髋关节半脱位：顺向牽拉，反向复位。如患下肢外旋变长，采用下肢外展外旋、屈曲内收内旋伸直。The massage treats coxae subluxation:Follow the direction to pull、reverse the direction to restoration. If the legs external rotation become long,we should adopt abduction and external rotation、flexion adduction and internal rotation and to straighten it.,髋半脱治疗前coxae subluxation before the treatment,半脱治疗后coxae subluxation after the treatment,髌骨上移或下移测量法：髌股角测量 法，正常值100110，小于100为 髌骨下移，大于110 为髌骨上移。 髌骨下移手法一一收紧法 髌骨上移手法一一放松法The way to measure patella to move up or down:The methods of patellofemoral angle,the normal range is 100110.Below 100 is as patella to move down, above 110 is as patella to move up.The massage to treat patella to move down is called 一一Tightening Method The massage to treat patella to move up is called 一一Relaxation Method,正常髌股角the normal patellofemoral angle,髌骨上移patella to move up,髌骨正常与下移the normal patella and patella to move down,误诊误用手法、针灸治疗无效，手术后手法外烫中药治疗，完全康复病例。张某，女， 12岁，颈痛3个月，当地手法、针灸法疗3个月无效，来诊MRI检查为脊膜瘤，后手术治疗，术后行走失稳，两于发胀，采用手法、外烫中药，半年后完全康复。1年观察，完全康复。Previously,the patient accepted the wrong diagnosis、wrong massage and acupuncture with no effect.After the surgery we used massage and heating with Chinese herbal medicine as treatment.Finally the patient was cured.Miss Zhang,female,12years old, she had already felt the neck pain for 3 months.And the massage and acupuncture didnt make effect for her.MRI reported that it was spinal meningioma.Then she accepted the surgery. After the surgery she walked out of balance and her hands felt swollen. So we used massage and heating with Chinese herbal medicine as treatment.After half a year she was cured.And we observed her a year, she was totally cured.,手术前before the surgery,正位hemangioma,横切transection,术后即照，行走稍失稳，两手有些账the picture was right after the surgery, she walked out of balance and her hands felt swollen,术后横切after the surgery transection,术后手法加中药外烫，半年后MRI复查after the surgery, she used massage and heating with Chinese herbal medicine as treatment.After half a year she took MRI.,手法后横切after the massage transection,手术后3年，各症全消除，能正常参加学校体育活动，复查X线片After the surgery 3 years, all the symptoms were disappeared. She could take part in activities.This was the picture of X-rays,误诊误用手法病例：例1、陈某，女，65岁，背痛2年，曾按一般背痛治疗无效，后MRI捡查为胸9椎体血管瘤手术治疗而愈。The example of the wrong diagnosis and wrong massage:Example 1、Mrs.Chen, female, 65 years old, back pain 2 years. She had already accepted some treatments but had no effect.MRI reported that it was the 9th thoracic vertebra hemangioma. After the surgery she was cured.,胸椎体血管癅thoracic vertebra hemangioma,椎体血管瘤centrum hemangioma,例2、陈某，女，35岁，腰痛2年半，曾按腰椎间突出症采用手法、针灸、理疗等治疗无效，后MRI捡查为腰椎管脊膜瘤手术治疗而愈。Example 2、Mrs.Chen, female, 35 years old, loin pain two and a half years. She had already accepted massage、acupuncture、physiotherapy and so on for prolapse of the lumbar intervertebral disci. But had no effect.MRI reported that it was lumbar spinal meningioma. After the surgery she was cured.,脊膜瘤spinal meningioma,讨论,1、脊柱与四肢骨关节病损的诊治，要重视并合理选用影象学（X线、cT、MRI）检查，这对诊断、鉴别诊断与治疗方法的选用有重要意义。 Discuss1、The treatments for spine and limbs of the osteoarticular should value and choose imageological examination(X-rays,CT,MRI)reasonably. Its significant for us to diagnose、differential diagnosis and choose therapeutic m