Banner - Hide this banner





Author Topic: Saw orthopedic doc, not sure he is right.  (Read 1271 times)

0 Members and 1 Guest are viewing this topic.

Offline ninjagirl

  • MINIgeek (20-50 posts)
  • **
  • Posts: 20
  • Liked: 0
Saw orthopedic doc, not sure he is right.
« on: September 11, 2006, 10:45:40 PM »
Hi everyone. I posted before about knee pain that cleared up.

While playing volleyball saturday (simple picnic game) I went to get the ball when it felt like my foot got stuck, my knee (and rest of body) kept moving, I heard a loud snapping/popping noise. When I fell to the ground I half expected my leg to be twisted weird b/c of what I felt and how it sounded.  I couldn't get up. It hurt everywhere, it wasn't one side. As I was falling there was a guy standing about 8 ft away who said "I heard that, thats not good, she's hurt". Thats how loud the popping was.   I went to the ER, took x-rays, nothing broke.  Its still swollen. I can't really put weight on it. I can bend it slightly. Hurts if I go too far. 
I went to the orthopedic doc today. They do an emergency thing there where they just have people come in. I waited for EVER and the doc was with me about 10 mins. Put some sort of blocks under my legs tried pulling on them, etc. He said he thinks the MCL tore. Thats it. He didn't even listen to my full story. I didn't really get to tell him my knee made those horrible noises.   When he felts my knee, it hurt along the inside and also along the outside.  Its swollen everywhere.  He said he wants me to try PT, come back in 2 weeks.  If still problems he THEN will do MRI.

So, is it normal not to do an MRI in this situation?! I assumed he would just definitely do it? Looking online at symptoms what happened to me most describes the ACL.  He didn't tell me not to do certain things. He just said ice it, motrin, elevate. 

What do you think?  Thanks.

Offline Arnoldplum

  • Regular Poster
  • ***
  • Posts: 55
  • Liked: 0
  • Easy does it.. but do it!
Re: Saw orthopedic doc, not sure he is right.
« Reply #1 on: September 11, 2006, 11:29:50 PM »


                   Hi Ninja,
                               Very sorry to hear what happened, was that popping sound a dislocation?  ie, while your foot was firmly planted did the twisting motion cause thigh bone and shin bone to be displaced. I wonder what could have caused an audible pop.
            Firstly, believe!! Your not alone. I was equally dismayed by the apparent lack of interest or urgencey taken towards the intial assesment of my injurey < similar to yours> at the end of july. Ive learned since that it is actually quite normal for the consultant to wait for a couple of weeks for the swelling to subside before peforming a clinical assesment, when he will try to assertain the extent of the damage by means of manipulating the leg in a few positions. So dont worrie your not being neglected... although i know only too well that thats exactly what it feels like with these guys.. its like part of there training to have quite a cold and detached interface with the general flow of patients they deal with, as they may have to deal with 50 such cases in a day!
 gonna start a new message cos im so slow...

Offline ninjagirl

  • MINIgeek (20-50 posts)
  • **
  • Posts: 20
  • Liked: 0
Re: Saw orthopedic doc, not sure he is right.
« Reply #2 on: September 12, 2006, 12:45:32 AM »
Thanks for the response, I feel slightly better.  :-\    I dont know what the audible pop was and it wasn't just a pop it was a pop and some other horrible noises. I guess a tearing noise is the only way to describe it.  Then the POP!   

I dont even know how long I am supposed to use crutches?!  Keep my brace on?  I go to Seattle on Monday and I dont know if I am supposed to bring crutches or what?!

oh well...

Offline Linds

  • SuperKNEEgeek
  • *****
  • *
  • Posts: 4097
  • Liked: 3
  • worry about what you can change!
    • Linney and Kitty's Website
Re: Saw orthopedic doc, not sure he is right.
« Reply #3 on: September 12, 2006, 01:27:53 AM »
Hi..
an MRI would be a good next step after a thorough physical exam.. a well trained OS can usually tell more from a physical exam of hte knee than anything else.  There is no point on doing an MRI now, with all that swelling... it probably wouldn't be very clear. I injured my ACL and meniscus back about 4 months ago now, and my OS did a physical exam at two weeks, then again at 3 months... now we're waiting for an MRI. unfortunately.. injuries like this... are very slow to heal and you just have to take your time. Getting started at PT asap is probably a good plan, so you can get back your range of motion, reduce hte swelling.. and not lose too much muscle.  I'm no professional but ot me it seems like your doc is doing the right things.   My OS took the ACL injury as being the biggest problem. we worked on getting that settled down and then the other injuries seem clear.  In most cases an OS can tell if you've injured your ACL just by wiggling your knee,, this way and that to test it's stability. But sometimes it can be hard to tell when the injury is acute.

Hope that helped. Hang in there

Linds
1997 Scope RK
2002 LR RK
2002 Scope and hematoma evac RK
2004 LR LK
May 06 Fall from Horse, partial ACL tear and meniscus injury, Tibial plateau injury
2007 Scope, Plica Excision and Debride LK
2009/2010- Possibly Ankylosing Spondylitis?

Offline Arnoldplum

  • Regular Poster
  • ***
  • Posts: 55
  • Liked: 0
  • Easy does it.. but do it!
Re: Saw orthopedic doc, not sure he is right.
« Reply #4 on: September 12, 2006, 04:09:38 AM »


                 Secondly shmeckondly
                                               Baisicly im as new to all this as you, but think the MRI thing is a very hot topic. Clearly you can relax in the short term as you have to let things settle down as linds was saying.And it does seem that your at least with a consultant who wont hold back in using whatever diagnostic tools as and when appropriate... and 2 weeks isn't long..
               Its a hot topic for me because i feel that i have a gross instability and need an MRI to diagnose the extent of the damage to have an accurate prognosis on what i can expect from my knee and what surgical opptions there may be. I dont know at this stage if my consultant will deem it necessary to do that, and natually im afraid that certain damage could be missed... But it sounds anyway like your in good hands....   chill 
                                                           Arny

Offline Janet

  • SuperKNEEgeek
  • *****
  • Posts: 3679
  • Liked: 2
Re: Saw orthopedic doc, not sure he is right.
« Reply #5 on: September 13, 2006, 12:56:07 AM »
My daughter had a 3- tear of her MCL and never had an MRI. At the beginning she was too swollen and too sore to do a really thorough exam (although it was obvious the MCL was torn....her lower leg could be moved way too far to the outside). The OS put her in a brace and had her start PT (with strict instructions for the PT to leave the brace on during sessions) then saw her again in a couple weks later to reevaluate to make sure her ACL wasn't also involved. At that point, he didn't feel the MRI was necessary. She eventually healed and has had no further problems, although the rehab took longer than she expected.

Remember that an MRI is not a magical thing. It is simply one more test that the doctor uses to make a diagnosis. And unfortunately, MRIs are not always accurate. They sometimes show things that aren't there or miss things that are. So while they are a good test, they should not be used alone, but only along with a good exam and history.

Janet
Torn quad tendon repair & VMO advancement 4/99, MUA with LOA 10/99, Patella baja and arthrofibrosis, LR & medial release & LOA 5/01, LOA & chondroplasty 6/03,TKR on 11/06, MUA 12/06. From perfect knees to a TKR in 7 years, all from a fall on a wet floor...and early undiagnosed scar tissue.

Offline Arnoldplum

  • Regular Poster
  • ***
  • Posts: 55
  • Liked: 0
  • Easy does it.. but do it!
Re: Saw orthopedic doc, not sure he is right.
« Reply #6 on: September 13, 2006, 02:15:57 AM »


                     Janet, thanks
                                       Thats encouraging news, although i donno if cuciates are more of a problem in terms of their re tightening properties.. I guess it depends on weather the tear is patial or weather its hanging on by one fiber!
                     Im afraid im a case of being obsessed with majical things, but that comes from being left to find things out for yourself. This forum is helping me buckets and spades in figuring out what ive done and this is great for overcoming the fear that arises from the uncertainity.
                     I will take it on board that the MRI thing is not the "be all and end all"
                                    :-X Arns

Offline emphatic

  • Forum Faithful
  • ****
  • Posts: 365
  • Liked: 0
Re: Saw orthopedic doc, not sure he is right.
« Reply #7 on: September 14, 2006, 04:29:20 PM »
One thing to keep in mind about MRIs...

If the injury is a torn ligament and the doctor can appreciate the extent of the tear on clinical exam, most of the time, there is no need to do an MRI. Most doctors, in this type of situation, will only get an MRI to confirm what they already know.

The MRI has actually served to lessen the doctors' reliance on learning to do a excellent exam -- learning to feel what a torn MCL feels like, learning what a meniscus tear feels like, learning what an ACL tear feels like.

I remember knee exams 20 years ago -- before the MRI was available. The docs spent several long minutes carefully manipulating the knee through several tests -- and they didn't miss the diagnosis very often.

Where an MRI is most useful is when the type of injury isn't clear, no tear can be appreciated on exam, and yet there are signs and symptoms indicating the presence of a tear.

Unfortunately, a lot of soft-tissue injuries -- with no meniscus or ligament tear present -- muddy the diagnostic waters and the patients' demands for an MRI are what gets the MRI done. Then the patient comes back to the exam room and the doctor has nothing different to offer than what s/he offered in the first appointment.

The MRI shouldn't be a subsitute for an excellent clinical exam. If your doctor isn't even examining you and immediately talking MRI, it might be a signal to find a new doctor.

On the other hand, if you got a good clinical exam and a diagnosis, but did not get an MRI, please don't feel slighted... you might just be one of the lucky ones. Follow through with your doctor's advice, and if you're still having problems, do return and let him know. Many good clinicians are far more patient than their patients.

Meg

Offline *Tiffany

  • SuperKNEEgeek
  • *****
  • Posts: 1931
  • Liked: 2
  • Never too late to be what you might have been.
Re: Saw orthopedic doc, not sure he is right.
« Reply #8 on: September 14, 2006, 04:30:31 PM »
Listen to your gut.  Keep looking if it really doesn't seem right. 

All doctors are not right, or right for you . 

T
Age 8/Bilateral -Lateral Release '85
Bilateral Patella Resurfacing '86
Bilateral TTT '88
Bilateral- Lateral Release '03.     
Bilateral PFJR '05
PRJ to TKR 1/16/07
PRJ to TKR 6/19/07
TKR Revision  8/17/10
Total Hip Replacement 11/5/15
Rt Elbow Reconstruction 4/27/1
Patellectomy 2/2020















support