l*******d
发帖数: 449 | 1 The greatest concern with SLNB is the potential of a false negative result,
which could increase the potential for axillary recurrence. However, despite
the approximately 5 to 10 percent false negative rate with SLNB found in
studies in which completion ALND has been done, several series suggest that
axillary recurrence rates are low after a negative SLNB alone in early stage
breast cancer (range 0 to 4.5 percent) [17-27].
http://www.uptodate.com/contents/sentinel-lymph-node-biopsy-for |
|
e****0
发帖数: 678 | 2 Endometrial hyperplasia types. Risk of cancer treatment
simple 1% Cyclic progestin
complex 3% Cyclic progestin
Simple atypical 8% THA or progestins
Complex atypical 29% THA or progestins
• Prolatinoma and hypothyroidism galactorrhea
• Anesthesia can reduce uterine activity if in the latent phase
• Contraceptive for lactating mother
Progestin-only oral contraceptive
• Pregnancy luteoma
African-ameri... 阅读全帖 |
|
v*****e
发帖数: 30 | 3 感谢Icetea!
Here is the info:
patient age: 41
Family history: no breast cancer family history
medical history: no
Breast cancer with modified right radical mastectomy (right breast) and
axillary lymph node
dissection on 20th of May, 2011.
A lump under her right armpit was self-found but it was not checked out
until 1 and a half months later.
Her histopathology report has revealed that a tumour which was noted to be
at 2.5cm from the top of the nipple, 2.5 cm from the nipple.
It is also rep... 阅读全帖 |
|
M***D
发帖数: 249 | 4 I don't think 太太的头得枕着老公的脖子睡, because of the relatively fixed
position of axillary nerve at posterior cord and at deltoid, any downward
subluxation of proximal humerus or traction force or blunt trauma may lead
to axillary nerve injury. (Steinmann and Moran 2001, J Am Acad Orthop Surg 9 |
|
V****n
发帖数: 651 | 5 不止80-90%
狐臭是由于一种叫做aprocine的汗腺:
http://en.wikipedia.org/wiki/Apocrine_sweat_gland
"Asians who have nearly complete loss of typical body odor, when compared to
Europeans and people of African descent, have significantly less of the
characteristic axillary odorants and variants in the ABCC11 gene, which is
expressed and localized in apocrine sweat glands"
人类祖先ABCC11基因在Rs17822931位置都是TT,东亚人种迁徙到西伯利亚，距今一两万
年左右出现T到C的SNP变异。产生的结果是耳垢变干（http://en.wikipedia.org/wiki/Earwax）和减少导致恶臭的aprocine汗腺（其实是细菌喜欢这种汗腺的关系）
... 阅读全帖 |
|
f******I
发帖数: 769 | 6
37 celsius is about 98 fahrenheit, and 37.1C is about 98.6F, which is not
feverish by definition,
but axillary temp is about 1 fahrenheit lower than oral temp which is about
1 F lower than rectal temp,
i've always taken 100.4F is the cutoff for fever, then again 98F in a
dialysis patient is also fever since they tend to stay hypothermic most of
the time, |
|
f******I
发帖数: 769 | 7
your mom has early stage invasive cancer, with axillary nodes negative, but
the size greater than 2cm, it's probably stage II, her age and menopause
state would help predict her prognosis,
things you need to look into is the cancer removed from surgery, if it is
hormone receptor(estrogen and progesterone) positive or negative; if it's
HER2 positive or negative(which she might benefit by taking herceptin); and
she is also at increased risk for breast cancer on her contralateral side(
her right s |
|
n******s
发帖数: 210 | 8 there are several ways to measure the temperature.(oral, axillary, anal)
different criteria of fever at different sites. |
|
d********1
发帖数: 77 | 9 Sorry I cannot type Chinese on this computer.
My wife (33 years old) has some 腿麻, 胳膊麻 etc lately. Her numbness is
sometimes on the left or right leg, arm, toes, fingers, and even face, but
never on all these places at the same time.
We went to our family doctor and he ordered a non-contrast brain MRI for her
. It turns out there is a sub-centimeter focus on her brain. Then our doctor
ordered a contrast MRI, the sub-centimeter focus is still there. Report 1)
below is the full report by the radiol... 阅读全帖 |
|
t*******g
发帖数: 286 | 10 1. Is ur daughter overweight/obese? any pubic/axillary hair? first, need to
differentiate between ture breast development and adipose tissue from
obesity. normally, breast development before 8 yo of age considered as
precocious purberty, but in african american obese girls, they may have
breast development at 7yo. for Chinese, use 8yr as cut-off age.
2. Final height mainly depends on parents height.
3. see general peds first, then they may refer to peds endocrinology. |
|
l**x
发帖数: 110 | 11 下面这个患者希望能得到版上医生专家的指导意见，危险多大，如何治疗，预后如何？
患者44岁，男，6年前因为肝癌做了肝移植 （符合米兰标准），之后无灾无病好几年。
去年2016年初发现轻微贫血，血色素12，因为当时在服小剂量阿司匹林，于是停服，看
看有没好转。托托拉拉到了年底，还是贫血，血色素10.5。医生说做个内镜。于是在胃
内发现一个肿瘤，内镜医生直觉是GIST。随后CT，但CT却没有异常。4月初第二次胃镜
，GIST依然还在，取样活检表明可能肝癌转移或者是非常罕见的HAC。第二次CT 报告大
小46x35mm，说比较第一次32mm变大了。可能第一次看片医生那天喝多了？肿瘤位置在
Fundus，非常接近GOJ。
AFP好久没有查了，因为肝上的情况一直很好，肝移植前AFP 100多，移植后AFP一直小
于2。上一次至少是2，3年前。也是疏忽了。现在AFP 254. 显然胃上这个要么是转移，
要么是HAC。
下周二医生还要安排一次PETCT，周三见外科医生，估计排除转移外就安排切除了。 求
这里的专家教授指点，这个情况如何是好？下面我贴上最近几个报告。
个人感觉肝移植后5，6年转移到胃实在... 阅读全帖 |
|
t**********8
发帖数: 551 | 12 来自主题: NextGeneration版 - 宝宝体温范围 最近气温变化很大，担心宝宝发烧，在网上查了正常体温范围，觉得挺有用的 和大家
分享
Measurement method Normal temperature range
Rectal 97.9° F to 100.4° F
Ear 96.4°F to 100.4°F
Oral 95.9°F to 99.5°F
Axillary (Armpit) 94.5°F to 99.1°F
Temporal artery (forehead) 95.0°F to 100.4°F |
|
M********e
发帖数: 2528 | 13 我不知道你是从哪里来的概念，比如“超过3个月以上喂养的实验概不算数？”，比如
科学实验从来不test超过3个月什么的，你是否读过任何文章啊？
下面是引用的综述的文章。
http://www.sciencedirect.com/science/article/pii/S0278691511006
在table3里列了很多研究转基因玉米及其他对动物的影响。在这个就有好几年研究啊。
这些研究结果都没发现转基因比传统育种的更risky。
不过我觉得我的确太闲了。
Table 3.
Impact of GM plant diets in multigenerational studies.
Plant Trait Reference & Funding Species Duration Parameters
Group (n = number of individuals per group) Mai... 阅读全帖 |
|
g*****y
发帖数: 1891 | 14 bless
如果不是脱臼或骨折的话，有没有可能是神经压迫或损伤，因为臂丛 brachial plexus
或 腋神经 axillary nerve 损伤也可能造成上肢不能外展
你们有没有在她腋下塞什么东西？ |
|
S**********s
发帖数: 4534 | 15 抵肩的地方垫个厚点硬点的东西， 不仅可以抵消可感后座， 还可以减少心跳和
subclavian/axillary artery脉搏对瞄准的影响。
其实冬天穿的衣服就够把.308的可感后座降低到夏天打.223的水平。 |
|
n**e
发帖数: 2026 | 16 今年初，美国科学促进会（AAAS）和皮尤研究中心（Pew Research Center）联合公布
的一项调查显示，88％的科学家认为转基因食品可安全食用，持这一看法的公众只有37
％。报告认为差距如此之大的一个可能原因是，三分之二的公众认为科学家对转基因食
品的健康后果没有清晰认识。这就是真正的原因吗？
根据报告全文，皮尤中心给19，984名科学家发出了调查问卷，3748人（18.8%）完成了
问卷调查。其中生物医学学科背景的科学家占50%。报告没有说明50%的生物医学背景是
否能够代表科学家总体的学科构成。更大问题是在这50%的科学家人群中，有多少人的
工作是与转基因作物的研究有关，以什么样的方式相关。报告没有提供任何信息。
由于这些关键信息缺失，88%的科学家相信转基因安全的说法毫无意义。在一个没有代
表性并且无法排除偏向性的样本中调查，科学家相信转基因安全从1%到99%与88%没有任
何不同。好消息是超过半数的美国民众认为转基因不安全。
2012年10月，美国科学发展协会以官方名义（Board of Directors ）抛出了一个反对
转基因标识声明（附录1）。目的就是诱导民... 阅读全帖 |
|
n**e
发帖数: 2026 | 17 【 以下文字转载自 WaterWorld 讨论区 】
发信人: nile (nile), 信区: WaterWorld
标 题: 美国科学促进会《科学》大旗下的转基因谎言
发信站: BBS 未名空间站 (Fri Oct 30 10:18:45 2015, 美东)
今年初，美国科学促进会（AAAS）和皮尤研究中心（Pew Research Center）联合公布
的一项调查显示，88％的科学家认为转基因食品可安全食用，持这一看法的公众只有37
％。报告认为差距如此之大的一个可能原因是，三分之二的公众认为科学家对转基因食
品的健康后果没有清晰认识。这就是真正的原因吗？
根据报告全文，皮尤中心给19，984名科学家发出了调查问卷，3748人（18.8%）完成了
问卷调查。其中生物医学学科背景的科学家占50%。报告没有说明50%的生物医学背景是
否能够代表科学家总体的学科构成。更大问题是在这50%的科学家人群中，有多少人的
工作是与转基因作物的研究有关，以什么样的方式相关。报告没有提供任何信息。
由于这些关键信息缺失，88%的科学家相信转基因安全的说法毫无意义。在一个没有代
表性并且无法排除... 阅读全帖 |
|
t*******g
发帖数: 286 | 18 thanks diarrhea,
she is 58 and noticed that lump for almost 30yrs which I think could be
obstruction of breast duct. now problem is there's nipple retraction. I
checked it and the mass is about 3X3cm in the upper quadrant. not adhere to
thoracic wall but kind of stick to skin. boundary is not so clear. there's
no enlarged axillary LNs.
I just wanna make final diagnosis by doing mammogram, or excisional biopsy
before going back to china for treatment. |
|
l**x
发帖数: 296 | 19 III score 8 is high grade, not good
Low grade: score 3-5
Intermediate grade: score 6,7
High grade: score 8,9
This is histological grading of invasive ductal carcinoma of breast, based on tubular formation, mitotic count, and nuclear grade.
The link is about cancer staging, which means how extensive the tumor is involved, eg if there is axillary lymph node involved, if there's distant metastasis. |
|
c******n
发帖数: 492 | 20 21. A 12-year-old girl is brought to the physician
by her mother
because of heavy vaginal bleeding since her first
menstrual period began 1
week ago. She has to change sanitary pads every 2
hours, and her
mother is concerned that this is not normal. Her
blood pressure is 80/60 mm
Hg, and pulse is 110/min. Breast and axillary and
pubic hair
development are Tanner stage 4. Pelvic examination
shows normal external
genitalia, a small normal-appearing cervix, and a
small uterus. Her
hemoglobin level ... 阅读全帖 |
|
i**********d
发帖数: 853 | 21 首先声明：我的分数很普通，所以这个帖子也没有任何炫耀的意思，只是我在考前
，每天都来看看有没有考经，也经常拿自己的模考成绩和考经中的对照一下，看看自己
复习的效果，从前辈的考经中学到很多。所以，本贴得唯一目的是：希望能给还在准备
step1的朋友们一点提示，吸取我的教训，都考出一个好成绩。
正文：
我是8/06/2012考的Step1，昨天（8/29/2012）早上9:19am拿到成绩---242/85，还
好，和自己估计的成绩240 +/- 5基本一致。万分感谢我的家人的理解和支持，十分感
谢曾经一起学习的战友们和校友们的鼓励和帮助，感谢麦地版的前辈们的考经和经验介
绍。曾经许诺一旦成绩上了230，就写一篇考经，下面就把我的备考经历和一点心得体
会向麦地版的战友们作一汇报，也算是对自己这段人生的一个总结：
一、题库、模考及考试成绩+时间：
UW qBank: 正确率最早25%，考前80-90%
Kaplan qBank: 只做了解剖、遗传，没有统计正确率
Dec 18, 2011, Form3 --- 350
Feb 25, 2012， F... 阅读全帖 |
|
i**********d
发帖数: 853 | 22 Jeff的75条口诀：
1).
Chloramphenicol inhibits 50S peptidyltransferase.
喷着氯气的ram(羊)拦住(抑制) 50岁的亚裔太太搬家(转移)(50S亚基肽键转移酶)
Clindamycin & chloramphenicol block peptide bond formation.
克林顿用氯气 吓唬老婆 --> 防止太太贱(肽键)形成
Aminoglycosides bind 30S and inhibit formation of the initiation complex and
cause misreading of mRNA.
Amigo绑架了30S亚裔,抑制了她婚姻的起始,造成她男友的误读
Macrolides block translocation.
带着大沿帽子的人（城管？）挡道--> 不让别人换地方translocation
2).
下肢淋巴回流：
小隐隐于城外蝈蝈窝棚，大隐隐于城内富人水沟
（小隐收集小腿外侧淋巴液，注入腘窝；
大隐收集下肢内侧淋巴液，注入腹股沟；）
3)
imprinting diseas... 阅读全帖 |
|
i**********d
发帖数: 853 | 23 首先声明：我的分数很普通，所以这个帖子也没有任何炫耀的意思，只是我在考前
，每天都来看看有没有考经，也经常拿自己的模考成绩和考经中的对照一下，看看自己
复习的效果，从前辈的考经中学到很多。所以，本贴得唯一目的是：希望能给还在准备
step1的朋友们一点提示，吸取我的教训，都考出一个好成绩。
正文：
我是8/06/2012考的Step1，昨天（8/29/2012）早上9:19am拿到成绩---242/85，还
好，和自己估计的成绩240 +/- 5基本一致。万分感谢我的家人的理解和支持，十分感
谢曾经一起学习的战友们和校友们的鼓励和帮助，感谢麦地版的前辈们的考经和经验介
绍。曾经许诺一旦成绩上了230，就写一篇考经，下面就把我的备考经历和一点心得体
会向麦地版的战友们作一汇报，也算是对自己这段人生的一个总结：
一、题库、模考及考试成绩+时间：
UW qBank: 正确率最早25%，考前80-90%
Kaplan qBank: 只做了解剖、遗传，没有统计正确率
Dec 18, 2011, Form3 --- 350
Feb 25, 2012， F... 阅读全帖 |
|
i**********d
发帖数: 853 | 24 Jeff的75条口诀：
1).
Chloramphenicol inhibits 50S peptidyltransferase.
喷着氯气的ram(羊)拦住(抑制) 50岁的亚裔太太搬家(转移)(50S亚基肽键转移酶)
Clindamycin & chloramphenicol block peptide bond formation.
克林顿用氯气 吓唬老婆 --> 防止太太贱(肽键)形成
Aminoglycosides bind 30S and inhibit formation of the initiation complex and
cause misreading of mRNA.
Amigo绑架了30S亚裔,抑制了她婚姻的起始,造成她男友的误读
Macrolides block translocation.
带着大沿帽子的人（城管？）挡道--> 不让别人换地方translocation
2).
下肢淋巴回流：
小隐隐于城外蝈蝈窝棚，大隐隐于城内富人水沟
（小隐收集小腿外侧淋巴液，注入腘窝；
大隐收集下肢内侧淋巴液，注入腹股沟；）
3)
imprinting diseas... 阅读全帖 |
|
e****0
发帖数: 678 | 25 • Exaggerated deep tendon reflexes can be seen in lock in syndrome.
• Non bleeding varices are managed with nonselective beta-
adrenergic antagonists, such as propranolol.
• Sclerotherapy, endoscopic band ligation, and surgery are
indicated after a patient has a first episode of variceal bleeding.
• TIPS is a last resort in variceal bleeding unresponsive to
medical and endoscopic intervention.
• Ischemic colitis
CT—thickening of eth bowel ... 阅读全帖 |
|
e****0
发帖数: 678 | 26 • leukemia
ALL AML CLL
child adult elderly
BM lymphoblasts 25%myeloblasts
lab Lymphocyte 5000, mature-appearing cells
• Osgood-schlatters disease
Adolescent male athletes
Traction apophysitis—quadriceps tendon put the traction on the
apophysis of the tibial tubercle where patellar tendon inserts.
A firm mass =heterotopic bone formation
Pain can be reproduced by extending the kne... 阅读全帖 |
|
i**********d
发帖数: 853 | 27 75条口诀：
1).
Chloramphenicol inhibits 50S peptidyltransferase.
喷着氯气的ram(羊)拦住(抑制) 50岁的亚裔太太搬家(转移)(50S亚基肽键转移酶)
Clindamycin & chloramphenicol block peptide bond formation.
克林顿用氯气 吓唬老婆 --> 防止太太贱(肽键)形成
Aminoglycosides bind 30S and inhibit formation of the initiation complex and
cause misreading of mRNA.
Amigo绑架了30S亚裔,抑制了她婚姻的起始,造成她男友的误读
Macrolides block translocation.
带着大沿帽子的人（城管？）挡道--> 不让别人换地方translocation
2).
下肢淋巴回流：
小隐隐于城外蝈蝈窝棚，大隐隐于城内富人水沟
（小隐收集小腿外侧淋巴液，注入腘窝；
大隐收集下肢内侧淋巴液，注入腹股沟；）
3)
imprinting disease: ch... 阅读全帖 |
|
i**********d
发帖数: 853 | 28 75条口诀：
1).
Chloramphenicol inhibits 50S peptidyltransferase.
喷着氯气的ram(羊)拦住(抑制) 50岁的亚裔太太搬家(转移)(50S亚基肽键转移酶)
Clindamycin & chloramphenicol block peptide bond formation.
克林顿用氯气 吓唬老婆 --> 防止太太贱(肽键)形成
Aminoglycosides bind 30S and inhibit formation of the initiation complex and
cause misreading of mRNA.
Amigo绑架了30S亚裔,抑制了她婚姻的起始,造成她男友的误读
Macrolides block translocation.
带着大沿帽子的人（城管？）挡道--> 不让别人换地方translocation
2).
下肢淋巴回流：
小隐隐于城外蝈蝈窝棚，大隐隐于城内富人水沟
（小隐收集小腿外侧淋巴液，注入腘窝；
大隐收集下肢内侧淋巴液，注入腹股沟；）
3)
imprinting disease: ch... 阅读全帖 |
|
l**x
发帖数: 110 | 29 知道这个版的专业医生很多，所以占宝地求指点。恳请大家一点给点指导，下一步怎么
办合适？
患者44岁，男，6年前因为肝癌做了肝移植 （符合米兰标准），之后无灾无病好几年。
去年2016年初发现轻微贫血，血色素12，因为当时在服小剂量阿司匹林，于是停服，看
看有没好转。托托拉拉到了年底，还是贫血，血色素10.5。医生说做个内镜。于是在胃
内发现一个肿瘤，内镜医生直觉是GIST。随后CT，但CT却没有异常。4月初第二次胃镜
，GIST依然还在，取样活检表明可能肝癌转移或者是非常罕见的HAC。第二次CT 报告大
小46x35mm，说比较第一次32mm变大了。可能第一次看片医生那天喝多了？肿瘤位置在
Fundus，非常接近GOJ。
AFP好久没有查了，因为肝上的情况一直很好，肝移植前AFP 100多，移植后AFP一直小
于2。上一次至少是2，3年前。也是疏忽了。现在AFP 254. 显然胃上这个要么是转移，
要么是HAC。
下周二医生还要安排一次PETCT，周三见外科医生，估计排除转移外就安排切除了。 求
这里的专家教授指点，这个情况如何是好？下面我贴上最近几个报告。
个人感觉肝移植后5，6年转... 阅读全帖 |
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v*****e
发帖数: 30 | 30 国内的好朋友最近诊断乳腺癌。她有一个年幼的孩子，真的很替她着急担心。最近化疗
两个疗程之后，白细胞下降得很厉害。这里附上她的诊断和问题，这里哪位好心的大侠
能给回答一下？ 她已经把问题翻译成了英文.
Specimen Type: Specimen of modified radical mastectomy right breast
Tumour Site/Location: 2.5 cm from the top of the nipple
Size of Tumour: 2.5 x 2.3 x 1.4 cm
Tumour Type: Mucinous carcinomas, ductal carcinoma in situ was seen around
the surrounding area (low and intermediate grade)
Histologic Grade: (blank)
Intravenous Tumor Thrombus: (+) Nerve Invasion: ( - )
Nipple: no cancer cell ... 阅读全帖 |
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I****a
发帖数: 407 | 31 Paget-Schroetter disease, the one that can get you into malpractice trouble
if you just send those patients home with Lovenox and Coumadin. Untreated
symptomatic patients can sustain long-term disability from venous
obstruction resulting in significant loss of occupational productivity and
quality of life.For the same reason, early catheter directed thrombolysis
followed by anticoagulation and surgical intervention are recommended.
It is also known as Paget-von Schrötter disease or upper ex... 阅读全帖 |
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A*******s
发帖数: 9638 | 32 发信人: Icetea (冰瓜儿), 信区: Medicalpractice
标 题: Re: 【征文活动】 有趣的临床综合症。
发信站: BBS 未名空间站 (Sat Oct 8 15:17:55 2011, 美东)
Paget-Schroetter disease, the one that can get you into malpractice trouble
if you just send those patients home with Lovenox and Coumadin. Untreated
symptomatic patients can sustain long-term disability from venous
obstruction resulting in significant loss of occupational productivity and
quality of life.For the same reason, early catheter directed thrombolysis
followed by anticoagula... 阅读全帖 |
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R*******t
发帖数: 367 | 33 习惯早起了，加上这周做procedure, 早开始早结束。发帖的时候还没有出门上班呢，
太早了。一般第一台七点半开始，现在做了两个肝，一个肾。今天安排的最后一病人是
个年轻人，HIV positive, active TB, multiple enlarged axillary lymph nodes up
to 5 cm, some of the nodes are necrotic. 大家得隔离衣隔离口罩全副武装，要先
抽脓在活检。 希望到了下午不回太累手抖把自己扎到。 |
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R*******t
发帖数: 367 | 34 I am a strong advocate for annual screening from the age 40, or earlier if
there is strong family history of family cancer. Screening MRI should also
be considered when calculated Gail score of lifetime breast cancer risk more
than 25%.
A Sweden study with 30 years trial has proven screening mammogram does save
lives, and they only used one-view screening mammogram rather than The two-
views that we use here as standard protocol.
Now there are lots of debates if we should start from 50 or do it ... 阅读全帖 |
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R*******t
发帖数: 367 | 35 来自主题: Medicalpractice版 - 两个病例 Chylous leak would be very rare, and most are associated with axillary nodal
dissection, which this patient did not have.
It all depends on the hospital tradition, and how cooperative the two
departments are. I haven't said no to a surgeon if there is anything I could
help in a case. It is not for the surgeon or 帮 外科 扫尾, it is for the
patient. |
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a*********d
发帖数: 2763 | 36 case 3
A 30-year-old man sees his primary care physician for routine follow-up and
is documented to have a serum calcium concentration of 12.9 mg/dL. He is
admitted to the hospital directly from the clinic for further evaluation and
treatment. The patient states that he has a 5-year history of sarcoidosis,
but admits to nonadherence to his follow-up care and treatment regimen. He
had 1 episode of nephrolithiasis approximately 1 year ago and was told that
his kidneys are “abnormal.” Before admiss... 阅读全帖 |
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A*******s
发帖数: 9638 | 37 See pic below.
The patient has difficulty to raise the arm above the shoulder. Consequently
he could not comb the hair. He was found to have axillary nerve injury with
deltoid weakness.
Any explanation for the presentation in the pic?
★ 发自iPhone App: ChineseWeb 8.6 |
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D**R
发帖数: 371 | 38 it could be secondary to rotator cuff injury which may lead to the current
presentation. it will be helpful if you could post another picture to show
that the affected side arm cannot be elevated above the head.
it could be due to axillary nerve injury or due to C-5 nerve root
impingement. |
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A*******s
发帖数: 9638 | 39 MRI Shows no rotator cuff tear. It is axillary nerve injury on EMG/NCV. I
just don't understand this pic.
★ 发自iPhone App: ChineseWeb 8.6 |
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