MRI: diseases — симптомы, диагностика и лечение

A stroke is an acute circulatory disorder in the brain, in which a section of brain tissue stops receiving oxygen and dies. This is a condition where literally minutes count: every minute without blood flow, about two million nerve cells die. That is why the main thing that everyone should know is not the names of drugs, but how to recognize a stroke in a minute and immediately call an ambulance. Trying to “lie down,” take a blood pressure pill, or wait until the morning is the most common and most expensive mistake.

The menisci are two cartilaginous crescents between the femur and tibia that act as pads: they distribute the load across the joint, absorb shock and keep the knee from excessive displacement. Their rupture is one of the most common findings in the knee joint and at the same time the most overrated. The statement “the meniscus is torn, which means surgery is needed” sounds logical, but has long been refuted: for a degenerative tear in a middle-aged person, the correct program of physical therapy gives results no worse than arthroscopy, and this has been confirmed by large international studies. Moreover, altered menisci are found on MRI in many people over fifty years of age who do not complain of anything at all. Therefore, they operate not on a snapshot, but on a specific situation: a true blockade of the joint, a fresh traumatic rupture in an active person, a displaced flap that mechanically prevents the joint from working.

The anterior cruciate ligament runs inside the knee joint and keeps the tibia from moving forward and from excessive rotation. Its rupture is an injury that almost always occurs without any contact with an opponent: a person brakes sharply, turns on the supporting leg or lands poorly, hears or feels a click, and after an hour or two the knee swells. There are two misconceptions here. The first is “if I walk, then the ligament is intact”: a torn ligament does not interfere with walking in a straight line, problems begin when turning and on uneven surfaces. The second is “I’ll lie down and it will heal”: a completely torn ligament inside the joint does not heal on its own, because it is washed by the joint fluid and its ends diverge. At the same time, not everyone needs surgery - and this is the third, most important detail, which is talked about least often.

A herniated disc is the release of the internal contents of the disc beyond its outer ring. The diagnosis sounds alarming, and most patients immediately think about surgery. In reality, the picture is different: a significant proportion of hernias exist asymptomatically, and of those that cause pain, the majority resolve conservatively within 6-12 weeks. Moreover, large hernias and sequesters often decrease or completely resolve on their own - the body “digests” them. Surgery is necessary for a minority, but there are a few situations where delay is unacceptable.

Myocarditis is an inflammation of the heart muscle, most often caused by a common viral infection. This is its main feature: the disease begins not as a heart disease, but as a cold, and a person associates weakness and shortness of breath with a recent virus, and not with the heart. Most cases are mild and end with complete recovery; no one will ever know about them. But there is another side: it is myocarditis that remains one of the leading causes of sudden cardiac death in young people and athletes, and almost always due to physical activity to which the person returned too early. Therefore, this disease has one rule that is worth knowing before any diagnosis: after any infection with a fever, you cannot immediately return to heavy training, and if after the virus you develop chest pain, shortness of breath or a feeling of interruptions in the heart, this is a reason to be examined and not wait it out.

Cardiomyopathy is a group of diseases in which the heart muscle itself suffers: it either stretches and weakens, or thickens excessively, or loses its ability to relax. The key difference from other heart diseases is that the cause lies in the muscle itself, and not in narrowed arteries, high blood pressure or damaged valves. Hence the main practical feature: cardiomyopathy often first appears in young and apparently absolutely healthy people. It is worth mentioning separately about the hypertrophic form - it is hereditary and remains the leading cause of sudden cardiac death in young athletes. That is why its detection in one person automatically means the need to examine his close relatives, even if they feel great. And one more thing that is most often asked: the phrase “the heart is enlarged” in the conclusion of an x-ray or ultrasound is not a diagnosis in itself - it requires clarification of what exactly is enlarged and why.

The temporomandibular joint connects the lower jaw to the skull and remains the only paired joint of the body that cannot work as halves separately: both sides move simultaneously, and a problem with one inevitably affects the other. Inside the joint lies a cartilage disc - a pad that slides along with the head of the jaw every time the mouth opens. It is this sound that is most often associated with the sound that brings people to the doctor. Two opposing and equally incorrect opinions have developed around this sound: “it clicks, it means there’s nothing wrong with it, everyone clicks” and “it clicks, it means the joint is destroyed.” The truth is in the middle and quite specific: an isolated painless click without restriction of mouth opening is actually observed without treatment. But a click along with pain - or a click that suddenly disappeared simultaneously with the ability to open your mouth wide - is no longer the norm, but a reason to see a specialist, and in the second case in the coming days.

Multiple sclerosis is a chronic disease in which the body's own immune system attacks the myelin sheath of nerve fibers in the brain and spinal cord. The name is misleading: “sclerosis” here has nothing to do with memory or old age, but refers to areas of scarring scattered throughout the nervous system. Mostly young people aged 20–40 years are affected. Previously, a diagnosis was perceived as a death sentence, but today there are drugs that change the course of the disease and postpone disability for years - provided that treatment is started early.