Surgery Godfather
Chapter 1242 - 954: Eradicating Ignorance_2

Chapter 1242: Chapter 954: Eradicating Ignorance_2

Old Jin had once experienced difficulties in a surgery involving the removal of foreign bodies, and later spent a lot of time researching the extraction of foreign objects. He brought out all the imaging related to foreign bodies since the establishment of Sanbo Hospital to study. He also reviewed all learning materials related to foreign bodies, and then designed various diagnostic and localization methods for foreign bodies, as well as various surgical techniques. Later, many hospitals facing difficult cases of foreign body extraction sent their patients to Sanbo Hospital. At that time, Song Zimo was learning from Old Jin about foreign body extraction, and he also became an expert in it.

"It’s also called Gorham-Stout syndrome, the most distinct manifestation being spontaneous destruction and absorption of one or several bones. The cause of bone dissolution is not clear yet, and among known diseases, besides bone dissolution disease, no other diseases exhibit such imaging manifestations," Old Jin added explanation.

Song Zimo and Xu Zhiliang nodded in agreement. Song Zimo said, "Indeed, among known diseases, only bone dissolution disease matches this imaging presentation. However, bone absorption in bone dissolution disease is generally slow; this one absorbed entirely within a year, which is quite fast."

"This is the first time I’ve encountered such a case!"

Even though Old Jin had already given the diagnosis, everyone still had a blank mind, understanding the diagnosis in literal terms, but having no concept of the disease—causes, pathology, clinical presentation, diagnosis, treatment, and prognosis—all entirely lacking knowledge.

"This is also my first encounter. I had read related papers before, and I specifically delved into rare diseases in orthopedics, which is why I know about this disease," said Old Jin modestly.

"Old Jin is truly Old Jin, bone dissolution disease is a real rare disease. There was a case that took eight years to obtain an accurate diagnosis, finally diagnosed at Nandu Affiliated Hospital No. 1," Song Zimo still greatly admired Old Jin; his steady spirit of study had never changed.

That Old Jin knew about this disease meant he had put in a lot of effort. Previously, he had thoroughly reviewed all rare diseases published by the World Health Organization, poring over a wealth of documents and books, making him very familiar with these rare diseases. Otherwise, how could he recognize such a disease? Medicine is an empirical science; if you don’t know, you simply cannot fabricate it.

"Old Jin---you---this is impressive---"

Xu Zhiliang also admired Old Jin.

In medicine, any diagnosis prefixed with "idiopathic" indicates that the cause is still unclear. Many things about bone dissolution disease in medicine remain unknown, including immature treatment methods, dwelling in uncertainty.

"How can such a large chunk of bone just dissolve? It’s hard to grasp," said Li Guodong, quite troubled.

"There are many incomprehensible things in medicine; otherwise, why would we say that medicine is still in its infancy? Has the mechanism of the common cold been clarified clearly? Apparently not," Zhao Wenbo’s argumentative gene was awakened once more.

For such rare diseases, without systematic training in this area, facing such a disease makes obtaining the correct diagnosis virtually impossible. That is also why a case took eight years to receive a diagnosis; most doctors have information on common and prevalent diseases stored in their minds. As for rare diseases, even if there is knowledge, it is sporadic and extremely limited.

Thus, once a truly rare disease is encountered, in most cases, doctors circle around common and prevalent diseases. If they fail to break out of this cycle, it just ends there.

Since 2008, the World Health Organization has designated the last day of February each year as International Rare Disease Day to draw public attention to rare diseases. Currently, there are over seven thousand rare diseases, with approximately twenty million people suffering from rare diseases in China, showing that the absolute number is still significant.

We are more familiar with rare diseases such as phenylketonuria, thalassemia, and osteogenesis imperfecta, etc. Osteogenesis imperfecta is commonly known as "Glass Doll." Most rare diseases are related to genetics, as each individual carries about 5-10 defective genes. If both parents have a similar defect, there is a possibility of giving birth to a child with these genetic rare diseases.

"Bone dissolution disease is just a descriptive diagnosis; as for the cause, it is currently impossible to determine." Song Zimo said.

Dr. Jin said, "Right, actually, I arrived at this diagnosis using the process of elimination. After ruling out inflammation, infection, tumor, and osteoporosis among other causes, only bone dissolution disease could explain it. Besides bone dissolution disease, from the cases I’ve seen and the literature I’ve read, no other cases exhibit such extensive bone absorption. Professor Huang Zhong at Nandu Affiliated Hospital No. 1 diagnosed a case of bone dissolution disease. At that time, the patient had undergone femoral surgery and the fracture never healed, with the gap between the fractures growing wider. The patient had bounced around many hospitals without receiving a diagnosis, underwent multiple failed bone graft surgeries, and it was only after eight years did Professor Huang Zhong finally make the diagnosis; he even wrote a paper and made a case report about it."

"So, how is it treated?" Zhang Lin asked.

Dr. Jin said, "First we use zoledronic acid or denosumab for medicinal treatment to stop further bone absorption and increase bone density. Then consider implanting a femoral prosthesis to replace the absorbed bone. However, I have been thinking whether an Ilizarov Limb Lengthening could be attempted for treatment?"

"This disease’s---major characteristic---is bone absorption, a vast area---of absorption. Normally, bone---absorption and formation are balanced. Once---the balance is disrupted, the scales will tip to one side. Now this disease---is heavily inclined towards bone absorption, so---using---bone lengthening technique---might not work, as bone formation is a prerequisite for bone lengthening, which Ilizarov also utilizes---the principle of distraction to stimulate bone formation," Xu Zhiliang stammered as he spoke.

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