請幫忙看一下X光結果 - CHD

[Sandra]

1.名字：DIDI
2.年齡：3歲
3.犬種：柯基
4.性別：男
5.體重：13
6.病史：無
7.發病經過、症狀：於一歲多結紮後體重直線上升,從11公斤到17公斤,兩歲多醫師告知他的後腿似乎在痛,開始吃處方減重,於2008年10月第一次右後腳無法行走,於次日復原,體重14公斤,此後開始吃處方關節飼料,今年2月初第二次右後腳無法行走,雖亦於次日恢復行走能力,但右後腳於跑步時明顯無著地,並發現有肌肉萎縮現象.

8.醫師的診斷：CHD中度
9.醫師的治療方式：保守療法
10.請儘量提供相關檢驗資料、x光片、Video檔：
11.欲詢問醫生之問題：請幫我判讀左右腳CHD現在的嚴重程度

[Sandra]

因為圖真的太大了，怕壓縮之後就看不清楚，只好傳到相簿上，
補上相簿連結，共四張，有比較大張的相片，按右邊的放大鏡可以放大檢視，謝謝。

http://picasaweb.google.com.tw/winonawoo/DiDi_X#

[amy]

請提供狗狗走路的影像檔

[Sandra]

補上走路影片
http://sandra0731.pixnet.net/album/phot ... 510#pictop

謝謝

[Sandra]

呃..請問這篇文章有什麼不合規定的地方嗎?
不然怎麼都等不到醫生回覆呢QQ

如果有的話請告知喔，會立即更改的QQ

[Jennifer Yuchi Huang]

Hello,

DiDi's hip X-ray films show only mild arthritic change on right femoral neck. Right hip seems to have more joint laxity compared to left hip. His walking showed on the video is normal and no limping nor leg favoring noticed. Please keep in mind that the severity of arthritic change showing on the x-ray films does no necessarily match the severity of clinical signs such as joint pain and lameness. In DiDi's case, I think we need to first make sure the pain is from right hip. Palpation on the other joints is very important to rule out other possibility causing "sudden onset/fast recovery" kind of lameness such as patella luxation. I cannot evaluate the position of patella bones on the X-ray films very well because the hip is tilted and the hind legs are not parallel to each other. Please make sure your doctor check all the other joints for DiDi.

Jennifer Huang

[挫冰麻]

Hello,

DiDi's hip X-ray films show only mild arthritic change on right femoral neck. Right hip seems to have more joint laxity compared to left hip. His walking showed on the video is normal and no limping nor leg favoring noticed. Please keep in mind that the severity of arthritic change showing on the x-ray films does no necessarily match the severity of clinical signs such as joint pain and lameness. In DiDi's case, I think we need to first make sure the pain is from right hip. Palpation on the other joints is very important to rule out other possibility causing "sudden onset/fast recovery" kind of lameness such as patella luxation. I cannot evaluate the position of patella bones on the X-ray films very well because the hip is tilted and the hind legs are not parallel to each other. Please make sure your doctor check all the other joints for DiDi.

Jennifer Huang

譯：

從DiDi的臀/髖部X光片看來，只有顯示右大腿骨窩有輕微的關節炎，右髖部似乎較左髖部更有關節鬆弛的問題，
他的走路影片看起來是正常的，也沒有跛行或是屈膝，
請記得，關節炎變化的嚴重性，從X光片顯示的結果不必然與臨床症狀例如關節痛或是跛行相當，
在DiDi的案例中，我想我們必須先確認疼痛是來自右髖部，
觸診其他關節處是很重要的，特別是要[s]整理[/s]排除(rule out)[s]出[/s]其他可能導致突發性攻擊或是快速復原的跛行，例如膝蓋骨/髖骨脫臼，
我無法適切地從這張X光片中評估髖骨的位置，因為X光片顯示的臀部是傾斜的而且後腿也沒有平行對稱，
請確認你的醫師有檢查過DiDi的其他關節處。

Jennifer Huang醫師

譯者註：先排除其他導致突發性攻擊或是快速復原的跛行原因（例如膝蓋骨/髖骨脫臼）後，才可以探究是不是僅為髖關節因素造成的。

[Sandra]

非常謝謝Huang醫師與譯者，謝謝！

[挫冰麻]

Hello,

DiDi's hip X-ray films show only mild arthritic change on right femoral neck. Right hip seems to have more joint laxity compared to left hip. His walking showed on the video is normal and no limping nor leg favoring noticed. Please keep in mind that the severity of arthritic change showing on the x-ray films does no necessarily match the severity of clinical signs such as joint pain and lameness. In DiDi's case, I think we need to first make sure the pain is from right hip. Palpation on the other joints is very important to rule out other possibility causing "sudden onset/fast recovery" kind of lameness such as patella luxation. I cannot evaluate the position of patella bones on the X-ray films very well because the hip is tilted and the hind legs are not parallel to each other. Please make sure your doctor check all the other joints for DiDi.

Jennifer Huang

譯：

從DiDi的臀/髖部X光片看來，只有顯示右大腿骨窩有輕微的關節炎，右髖部似乎較左髖部更有關節鬆弛的問題，
他的走路影片看起來是正常的，也沒有跛行或是屈膝，
請記得，關節炎變化的嚴重性，從X光片顯示的結果不必然與臨床症狀例如關節痛或是跛行相當，
在DiDi的案例中，我想我們必須先確認疼痛是來自右髖部，
觸診其他關節處是很重要的，特別是要[s]整理[/s]排除(rule out)[s]出[/s]其他可能導致突發性[s]攻擊[/s]發病或是快速復原的跛行，例如膝蓋骨/髖骨脫臼，
我無法適切地從這張X光片中評估髖骨的位置，因為X光片顯示的臀部是傾斜的而且後腿也沒有平行對稱，
請確認你的醫師有檢查過DiDi的其他關節處。

Jennifer Huang醫師

譯者註：先排除其他導致突發性攻擊或是快速復原的跛行原因（例如膝蓋骨/髖骨脫臼）後，才可以探究是不是僅為髖關節因素造成的。

譯者於2009/4/23 13:41稍做更正如上，請查明！不好意思！

[Jennifer Yuchi Huang]

Hello!
First of all, I would like to thank the translator for the speedy job. Secondly, please allow me to make a correction so we don't cause a misunderstanding here. The "sudden onset/fast recovery" type of lameness I mentioned earlier can probably be understood better as "comes and goes" type of lameness, which means dog can be suddenly limping and the limping can resolve in a short period of time. The most common cause of this type of lameness is patella luxation (knee cap luxation). Hip luxation will not cause this type of lameness. I do not think DiDi has hip luxation according to the x-ray films and the clinical signs.

Jennifer Huang

[挫冰麻]

Hello!
First of all, I would like to thank the translator for the speedy job. Secondly, please allow me to make a correction so we don't cause a misunderstanding here. The "sudden onset/fast recovery" type of lameness I mentioned earlier can probably be understood better as "comes and goes" type of lameness, which means dog can be suddenly limping and the limping can resolve in a short period of time. The most common cause of this type of lameness is patella luxation (knee cap luxation). Hip luxation will not cause this type of lameness. I do not think DiDi has hip luxation according to the x-ray films and the clinical signs.

Jennifer Huang

譯：

哈囉！
首先，我想謝謝譯者如此迅速地工作，其次，請容許我做一補正，如此才不會在此造成誤解。
此種突發地發病與復原("sudden onset/fast recovery")的跛行，稍早我所提及的，較好的解釋為來與去( "comes and goes")的跛行，意思是狗兒會突然跛行，又在一段短的期間內復原，通常造成此類跛行症狀的原因為膝蓋骨脫臼（膝鞘脫臼）。
髖骨脫臼不會照成此類跛行。
根據X光片以及臨床症狀，我不認為DiDi是髖骨脫臼。

Jennifer Huang醫師

[Sandra]

DiDi跛腳的當下我有馬上帶他去給醫生檢查,醫生觸診後不認為是膝關節的問題,因此我們才會朝著是否為CHD的方向思考.
醫生說依照x光來看,DiDi的髖骨似乎曾經骨折過,那麼在這個情況下是否有可能造成他現在出現突發性的跛腳?(例如骨折處一直出現慢性的發炎或是在復原的過程中骨骼的架構不正確) 這項病史是否有可能加重CHD?
另外,他的跛行雖然在短期間內似乎有好轉,即恢復行走能力,但他在跑步時右後腳明顯沒有著地這件事卻是持續進行的.

謝謝Huang醫師的解答 也謝謝挫冰麻!