Associate Professor Ye Zhewei, Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology
The Art of War and the Thirty-Six Stratagems have been regarded as the twin frontiers of the art of war, reflecting the profound connotations of resourcefulness and power in Chinese wisdom. The sixth of the Thirty-Six Stratagems is called “Sounding East and Striking West”, which means to attack here while actually attacking there. It is a strategy to create a false image to give the enemy the illusion of a surprise victory, the part of the false image of deception is not able to hurt the enemy, and the part of the real is the specific action to control the enemy. Ye Zhewei, Department of Orthopedics, Wuhan Union Medical College Hospital
In fact, many diseases of the human body will also this hand, at this time, if we are blinded by it, “headache to cure the head, foot pain to cure the foot”, it will delay the disease and make a big mistake. Now, and the usual means of deception of these diseases are exposed one by one, polishing the eyes of the majority of patients.
Deceptive means a: hip disease knee pain
The hip and knee have some common innervation, so some diseases of the hip joint, such as early femoral head necrosis, can appear ectopic pain, because it is “far” away from the hip joint is often ignored, easy to be misdiagnosed knee osteoarthritis or joint injury, but in fact is the radiological symptoms associated with femoral head necrosis. This pain can be caused by exertion, trauma, heavy alcohol consumption, excessive activity, stairs and other triggers.
Deception tactic two: lumbar disease and leg pain
Clinically, some patients with lumbar disc herniation only have leg pain, and the waist is different instead. In such patients, the nucleus pulposus of the disc mostly protrudes to one side, compressing and stimulating the unilateral nerve root, and the compression of the dural sac is not obvious. Sciatica mostly occurs gradually, starting with a dull pain and gradually increasing, and the pain is mostly radiating, from the buttock, posterior lateral thigh, lateral calf to the heel or dorsum of the foot, or in a few cases from the foot, lateral calf, posterior lateral thigh to the buttock first. The pain worsens during coughing, sneezing, and defecation. Other patients first show symptoms of urinary and fecal incontinence due to nerve compression. At this point, if the cause hiding in the lumbar region is not identified in time, the condition may be delayed or even aggravated.
Deception means three: cervical spondylosis shoulder pain, upper limb pain, dizziness and headache, leg weakness
Cervical spondylosis is a master of “sound and fury” and can create numerous illusions. In patients with neurogenic cervical spondylosis, numbness and pain in the upper limbs can occur due to pressure on the nerve roots of the upper limbs, and most of the symptoms in the neck are mild and easily concealed.
In cervical spondylosis of the esophagus type, difficulty in swallowing can occur due to the protruding cervical intervertebral disc compressing the esophagus, starting with itching and foreign body sensation in the pharynx, and then feeling difficulty in swallowing, with intermittent episodes, sometimes mild and sometimes severe. However, gastroscopy is normal, and the diagnosis can be confirmed by CT or MRI.
Spinal cord type cervical spondylosis may present with numbness and weakness of the limbs or trunk and lower limb movement disorders (such as weakness, shaking, leg weakness or easy falling). Lower limb paralysis or defecation disorders are caused by irritation of the lateral tracts of the spinal cord, and some are accompanied by urinary frequency, urinary urgency, urinary incontinence or fecal incontinence.
Sympathetic cervical spondylosis may present with headache or migraine, dull head, dizziness, occipital pain, bradycardia, low blood pressure, and increased gastrointestinal motility.
Vertebral artery type cervical spondylosis can compress the vertebral artery causing inadequate blood supply to the brain and episodes of headache with rotational, floating or shaking dizziness. There can be episodes of deafness, tinnitus, memory loss, etc.
Deception IV: Abdominal pain from cardiopulmonary disease
Acute abdominal pain caused by cardiopulmonary diseases is not uncommon. Cardiopulmonary diseases with acute abdominal pain as the first manifestation are easily confused with other abdominal disorders, causing difficulties in diagnosis.
Acute heart attack can be misdiagnosed as gastric perforation, acute cholecystitis and acute appendicitis due to abdominal pain with nausea and vomiting, respectively. The reason for this is that almost all of the vagal afferent fiber receptors are located on the surface of the inferior wall of the heart, and when the inferior wall of the heart is infarcted, the vagus nerve is stimulated by myocardial ischemia and hypoxia, and abdominal pain is produced.
Right upper abdominal pain can occur when inflammation of the right lower lung involves the diaphragmatic pleura.
In acute heart failure, venous reflux is impaired, the liver is acutely congested and enlarged, the peritoneum is acutely distended, and the gastrointestinal tract is bruised, causing severe pain in the right upper abdomen or epigastrium due to spasm of gastrointestinal smooth muscle, the severity of which is cool like that of acute abdomen.
Deception means five: heart and lung disease shoulder pain
When you have angina or heart attack, you often feel pressure, heaviness or pain behind the sternum. However, the pain is felt in the shoulder, not in the chest. Lung diseases may also irritate the diaphragm and cause shoulder symptoms.
The medical community now has a fairly deep understanding of the sound of disease. The “devil is a foot high, the path is a ten foot high”, the “sound of disease” is not terrible. Careful examination of the patient’s pain and related parts, comprehensive and objective analysis of the disease, and detailed clinical dynamic observation are the three main assets to overcome the disease.