alhamdulillah..syukur kerana masih lagi bernafas meneruskan perjalanan hidup ini. alhamudulillah...
xsabar betul nak cerita ape yang berlaku hari ni. this morning, we have ward round as usual, only at 2 Zamrud wif Dr. Amran n Dr. HO(Dr. Shuaibah i think)..not much, just got 3 patient, 2 of them had osteoarthritis n had undergone total knee replacement and the other one patient post MVA(post internal fixation), but currentlt developed painful at pelvic a area due to immobilization for 3 days.. after round, ask Dr. Amran to teach us how to look for signs of OA on Xray. he said "ok, tell me what do u find from this Xray."and we try to read it." this is the Xray of right knee joint in anteroposterior view(AP). " i start to guess. hehe.. " then, what else?" em.." there's reduction of the joint space due to cartilage depletion. then, presence of osteophytes and subchondral cyst.""ok, what else?" oh , seriously, we blurr! don't know what else..i try to get my friend's help, but..we all blank!! Dr said," we have 4 brains now?how come do u all din noe 4 cardinal sign of OA on Xray? what else? one more?" argh..we start to guess.. there's calsification at the subchondral but, we din noe what is that! at last.."ok, i nak pergi makan, lepas ni jumpe kt klinik. cari dulu jawapan, then tell me.." Dr pergi macam tu je. Aduhai..ape lah malang. I try to read n find the answer. Ok! Got it.. subchondral or subarticular sclerosis.. thanx Dr.. for sure we will remember this for good. One lesson!
Then, we go to the clinic. So many things happen there. At first, joining Dr Amran’s clinic. Ok! All patients are osteoarthritis. Nothing interesting than that but there’s ONE interesting case. There’s one patient, entering the room wif his mother. Guess what? He is deaf yet he can answer questions while seeing our lips. He can read the movement of our lips. Subhanallah..GOD had shown me how beautiful HIS creation..” DIA tidak menjadikan sesuatu dengan sia-sia”.. this patient came due to well localized pain at the plantar aspect of his right foot. Ok..i see Dr Amran try to localized where the pain is. Then, he ordered an Xray for him. I got blurr! Still don’t know what s goin on. Want to ask but…hurm. Alhamdulillah after that, we find this patient at bilik rawatan. One of the MO asks me to assist. He wants to do steroid injection for this patient. That Dr ask me, ever heard about plantar fasciitis?? Oh GOD! What is that? I never heard that term before.
When open the book, its state that, it refer to the pain under the ball of the heel, or slightly forward of this. Usually occurs in men between 30-60 years of age. It is worse on bweight bearing and marked tenderness along distal edge of heel contact area. This fasciitis can be diagnosed on XRay. Ok, now I understand why Dr. Amran order for the Xray to this patient. Alhamdulillah, at least I noe bout it! From Xray, usually we can see a bone ‘spur’ extending distally from this site. This conditioned sometimes associated wif gout, ankylosing spondylitis and Reiter’s disease. Treatment is conservative: anti-inflammatory drugs or local injection of corticosterois like in this patient. Patient also can have a pad under the heel to off- load the painful area.
Actually there’s many others new conditions we faced during clinics today. Maybe in other post I will tell about that. Enjoying my day ;) Alhamdulillah..
