课件：骨结核英文七年制.ppt

Thanks 后面内容直接删除就行 资料可以编辑修改使用 资料可以编辑修改使用 主要经营：网络软件设计、图文设计制作、发布广告等 公司秉着以优质的服务对待每一位客户，做到让客户满意！ 致力于数据挖掘，合同简历、论文写作、PPT设计、计划书、策划案、学习课件、各类模板等方方面面，打造全网一站式需求 * * * * Diagnosis Clinical examination Systemic and regional lymph nods: single rather than multiple appearance Local swelling Cold abscess: without rubor and calor Local heat and redness are usually absent, and tenderness is minimal. Sinus tracts: multiple appearance, periarticular tenderness and percussing pain Joint function: inside the joint or outside the joint Systemic symptoms: mild except for child Diagnosis Radiographic Findings (6-8 weeks after) Skeletal TB TB of the cancellous bone: Central lesion: bone necrosis Peripheral lesion: bone lysis TB of the cortical bone: layer periosteum proliferation shuttle-like inflation TB of the metaphysis: Diagnosis Radiographic Findings TB of the synovial membrane : The earliest findings in the radiograms are regional bone atrophy, soft-tissue swelling, and capsular distention. These changes are due to synovitis and are nonspecific. Tuberculous panarthritis : The above changes are followed by peripheral erosion of the bone and destruction of the subchondral bone, with the joint space narrowing. ? Diagnosis Lab test blood rt. 10% pt. white cell The sedimentation rate: non-pathognomonic for tuberculosis but alters early than X-ray (male 15mm/h; femal20mm/h) Tuberculin skin test: immunocompetent patients: always postive immunocompromised patients: 33% postive Diagnosis Lab finding Bacteriologic examination (the tubercle bacillus culture) (3~6weeks) or histological examination of pus or biopsy specimen. Positive Rate of Culture for M. tuberculosis on smear pus: 70% granulomas or caseation (or cheesy) necrosis area:43% joint asperation or dead bone:35% Positive Rate of Pathological exam: 70 - 80% (Langerhans giant cells ) MRI and PCR use for early diagnosis Method of Joint Aspiration for TB Differential Diagnosis Rheumatoid Arthri