兒科問題：心律不整及骨頭疼痛的可能病因-兒科

不明原因身體不適？

你好我想請教一個問題，我家小朋友12歲有心律不整史，做過電燒手術，從上個月開始每天心臟像被石頭壓住，發作差不多
2、3小時，小朋友在急診大哭大鬧然後還有他從3月開始不明因左側骨頭疼痛，像是鎖骨膝蓋手關節，在醫院門診照過x光抽血驗過免疫疾病還有超音波，但是報告醫切正常然後只有發現終絲脂肪瘤身心科也有做過心理評估一切都沒問題CHEST PA VIEW CHEST PA VIEW Date Of Examination:2023/04/28 13:26:37 Date Of RCP:2023/04/28 ＞ No definite cardiomegaly. ＞ No cavity or pneumonic patch is noted. ＞ Preserved bilateral costophrenic angle. 這是胸腔檢查MRI, whole spine (Tumor or PED.) MRI, whole spine (Tumor or PED.) Date Of Examination:2023/05/31 10:11:02 Date Of RCP:2023/05/31 Non-contrast magnetic resonance imaging study of whole spine was performed with the following pulse sequences: sagittal SE T1WIs, sagittal FSE dual-echo T2WIs, axial SE T1WIs and axial FSE T2WIs. ＞ No significant bony lesions, disc problems, intraspinal abnormalities, signal change or compression of the whole spinal cord can be identified. ＞ Presence of fatty filum terminale. CONCLUSION: no correlated gross structural abnormality can be found.這是mriSNCV lower,F wave - lower limb,EMG lower limb,MNCV-LOWER, H reflex lower limb, ”1. NCS: Essentially normal NCS of left lower limb, including tibial F waves and H reflex 2. EMG: Increased polyphasia over R’t Anal sphincter,borderline increased polyphasia over L’t Anal sphincter. Normal needle EMG over bil. AT and GN muscles. Conclusion: No electrophysiological evidence of neurological involvement.這是肌電圖DOPPLER,M-MODE+2-D ECHO, MMode/2D Measurements Aortic root 25 mm LVIDd 50 mm IVSd 7 mm EDV(MOD-sp4) 57 ml LAD 32 mm LVIDs 29 mm LVPWd 7 mm ESV(MOD-sp4) 26 ml LA Volume LVEF(MOD-sp4)54 % Doppler and color Doppler Measurements MV E 78.0 cm/s E’_Med 8.3 cm/s MR ERO MV A 52.8 cm/s E/E’_Med 9.4 1 MVA(P1/2t) MV dec time 0.2 s E’_Lat 14.3 cm/s MV max PG MV E/A 1.5 1 E/E’_Lat 5.4 1 MV mean PG LV IVRT AVA(I,D) TR Max PG 16.6 mm CO(LVOT) Ao max PG RVSP 21.6 mm CO(PV) Ao mean PG Qp/Qs AI P1/2t Conclusion ＆ Comments 1. Mitral valve prolapse, anterior leaflet, trivial mitral regurgitation. 2. Normal aortic valve with no aortic regurgitation. 3. Normal LV size, wall thickness and systolic function. 4. Normal tricuspid valve with trivial regurgitation. 5. Normal pulmonary artery systolic pressure. 6. Normal pulmonic valve with trivial regurgitation. 7. Normal RV size, wall thickness and systolic function. 8. Normal atrial size. 9. No pericardial effusion.這是心超這些都是在榮總做的 心臟是看成人心臟科羅力瑋醫師那我想問的是1.要看哪一科2.有推薦榮總的哪位醫師嗎3.可能是得了什麼