Instructions for orthopedic patients
- Operative Orthopedics

These instructions for patients should facilitate communication with the Orthopedic surgeon specialist. In the Orthopedic outpatient Clinic, the specialist will talk to you to find out the reason for your visit, the duration of the complaints, whether they arose in connection with some trauma or spontaneously, whether you were treated with Physical therapy and how successful it was, whether you spend  and what kind of painkillers, how often and in what dose, on a scale from 0 to 10 how much would you estimate pain intensity, whether your pains wakes you from sleep. That part of the examination is called Anamnesis/ Hystory.

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This is followed by a Clinical examination/Status. With various clinical tests, in addition to the painful joint, adjacent joints are also examined, for example the spine and hip when examining the knee. The left and right joints are always compared.

After that, the orthopedic surgeon already has a certain suspicion about the disease and can place the so-called working diagnosis that can be changed after the diagnostic tests have been performed.

In orthopedics, apart from diagnostic tests, we use standard and special X-rays for examining bones. US can examine soft tissues, joint ligaments, tendons, verify effusion in the joint, hematoma in the muscle. With computerized tomography-CT, it is possible to examine bones and joints in layers, but without precise data on soft tissues. When we need a precise diagnosis of soft tissues, and partly bone morphology, we use Magnetic Resonance Imaging.

Magnetic resonance is a device that does not emit X-rays like X-ray and CT. No adverse effects have been described so far. It is a large electromagnet that positions water molecules that act like small magnets in one direction. The noise heard during recording is actually electromagnetic pulses that disturb the orientation of water molecules. The computer then reads how long it takes for these molecules to return to the same direction again. Black, various shades of gray and white are associated with that time. A high-quality recording requires a high-quality device, a recommendation of at least 1.5 T (Tesla), high-quality software and trained medical radiology engineers who will program device for each individual patient. Finally, the Radiologist who reads the images must be educated and experienced.

In rare cases, the Orthopedic surgeon may also request laboratory diagnostics from the patient's blood, most often these are CBC complete blood count, SE sedimentation and CRP- Creactive protein as indicators of inflammation, and less often Ac. uricum - uric acid in suspected gout. Note that elevated urates without clinical signs are not gout and do not require drug treatment.

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Finally, the doctor will make a diagnosis, as precise as possible, and explain to the patient the optimal method of treatment. He can also list other types of treatment and explain why he recommends one method and not others.