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Author Topic: MRI scanners and the NHS  (Read 3903 times)

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Offline kscope09

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MRI scanners and the NHS
« on: March 17, 2010, 05:10:18 PM »
Someone posted not long ago about mri's eing alot better than they were 10 years ago.  when I had my mri in Feb 09 it realy din't show anything and my GP said my knee was fine, even though I knew it wasn't.  When I had a scope in august ithe OS found a lesion in the mfc, plicas and a tear in my acl and the fragment that came off was stuck in the posereo-lateral compartment.  My first thought when Iwas told this was, why didn't the mri pick these up?  I've noticed that plenty of other people on this forum have had mris show things like this, so why didn't mine shopw up?  I'm wondering now if it isbecause the scanner was old, so I'd thought I'd ask if this was likely.  Another thing i'd like to do is ask the hospical, "how many people limp in through your doors with excruciating knee pain only to be told there's nothing wrong with them.?"
Feb 08 Inurred right knee
18 months of physio, knee tracking but knee still painful
Aug 09 Scope - Small tear in acl, fragment found in postereo-lateral compartment, suprapatella and lateral plica and small defect in mfc.
May 10 Right knee feeling better but left knee causing trouble as a result o

Offline Lou123

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Re: MRI scanners and the NHS
« Reply #1 on: March 17, 2010, 07:07:27 PM »
Same thing happened to me, I had an mri that was supposedly 'low quality' it showed nothing abnormal, so I had several months of Physio. Then last month I had another scan done, as my physio is convinced there is something wrong.
The new scan showed fluid in the knee, but not much else. He is still convinced there is something more serious wrong, and that the scan has just missed it.
The annoying thing for me is that they want me to keep on with physio and other conservative treatments a while longer, instead of going ahead and doing a scope!

I have been asking the same questions, how can the scan just completely miss problems, that when scoped appear so extensive??

Offline kscope09

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Re: MRI scanners and the NHS
« Reply #2 on: March 17, 2010, 07:26:12 PM »
I understand that a scan can't see anything, plicas for example, but how it can miss something like a lesion in the articular cartliage, a torn acl and a loose body.  I know ther not perfect but other people seem to get their problems picked up?
Feb 08 Inurred right knee
18 months of physio, knee tracking but knee still painful
Aug 09 Scope - Small tear in acl, fragment found in postereo-lateral compartment, suprapatella and lateral plica and small defect in mfc.
May 10 Right knee feeling better but left knee causing trouble as a result o

Offline tez27

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Re: MRI scanners and the NHS
« Reply #3 on: March 17, 2010, 07:40:46 PM »
 My m.r.i showed a "bit of wear and tear" which at the time I accepted, had no choice I trusted the o.s roll on nearly a year knee still painfull went back to my o.s, at that time he had a look at the m.r.i while I was there and he spotted a couple of pockets of fluid that he decided did'nt look right so I had a scope in Jan diagnosis a ruptured a.c.l torn m.c.l and lot of scar tissue. I now would not trust any m.r.i  especialy when you see how much they cost and how long you have to wait to have one in the U.K.
 Tez 
L K injured 25th June 2008
scope Jan 5th 10
diagnosis ACL rupture
fiberous band excised from acl
ACLr July 19th 2010  scope on 24th Sept 2011
ACL has failed incorrect tunnel placement
23rd July 2012 1st stage of a 2 stage ACL revision
10th May 2013 2nd stage ACL revision

Offline kscope09

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Re: MRI scanners and the NHS
« Reply #4 on: March 17, 2010, 07:50:12 PM »
With mine it was six weeks before I got a letter asking me to make an appointment and then another six to have the scan and then upto 3 weeks to get the results.  what are the times like if you go private?

P.S. My scope was private and I only had to wait 3 weeks for that after seeing the OS.  Anything else i have done will have to be on the NHS apart from my physio.
Feb 08 Inurred right knee
18 months of physio, knee tracking but knee still painful
Aug 09 Scope - Small tear in acl, fragment found in postereo-lateral compartment, suprapatella and lateral plica and small defect in mfc.
May 10 Right knee feeling better but left knee causing trouble as a result o

Offline Lottiefox

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Re: MRI scanners and the NHS
« Reply #5 on: March 17, 2010, 07:59:33 PM »
As with all technology MRI has moved on - older scanners may be less efficient but there is a big factor that comes into play - the skill of the person reading the images. Ideally, during scan you'll have a senior radiographer or even the radiologist watching as the images are taken. As they see them, they can then flick images, ask for repeat sections or take a different cut if they have the ability to. There is also a big difference between a standard MRI and then more in depth T2 mapping that then further explores things such as cartilage damage depth, tears, etc etc. This can hone in on an area of concern and basically unpinck it. Again, big skill in reading the images. When I compare my standard MRI done at a mobile unit last year to a more comprehensive one at a hospital with additional T2 maps for 3 areas even I can see the difference - and it made a proper diagnosis more straightforward for the radiologist. Again, MRI might often need to be combined with X-rays or CT scans for the whole picture.

They aren't perfect but a lot depends on how good the person is using the images. Plus if the images are unclear (due to movement or whatever) then there isn't much they can do about geting an accurate view.

Indeed, a scope will always give more information plus it allows the knee to be moved about. But, it brings its own risks.  :)

Lottie
Bilateral patella OA since 2009, no surgeries.
Euflexxa working well x3 to current
Right forefoot CRPS post fusion surgery 2011
Refusing to let the ailing parts stop me....

Offline Lou123

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Re: MRI scanners and the NHS
« Reply #6 on: March 17, 2010, 09:30:44 PM »
I was lucky time wise with both of my scans, the first was on the NHS, I waited 3 weeks for the appointment after being referred, and had the results 3 days after that. I had my second done privately, I had the appointment the day after the referral was made, and had the results 2 days later.

I do understand that generally the NHS has long wait times though.

Just out of interest, how much did it cost to have the scope done privately??

Online Vickster

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Re: MRI scanners and the NHS
« Reply #7 on: March 17, 2010, 09:43:19 PM »
The cost of scopes privately depends on what is done and presumably which hospital and whether an overnight stay (plus need to add cost of pre and post op consultations, MRI, Xray etc)

This website lists 'standard' pricing - knee scopes are in the W range (meniscal repair for example is W8230 IIRC)

http://www.wpa.org.uk/medical/MedicalFees.aspx?heading_id=all 

I guess you just need to ask the hospital or your OS secretary :)

Just FYI - I have just had the claims statement from my insurance...other than physio...

Initial OS consultant - 375
Consultation with OS pre-op - 200
Arthroscopy - trimming and shaving  ;D - 725  (Arthroscopic meniscectomy (including debridement))
Anaesthetic - 270
MRI was 580
Further X-rays were 110 (initial ones done on NHS pre-referral)

Plus 600 odd of PT !!

PruHealth will be loving me right now  ;D
« Last Edit: March 17, 2010, 09:57:51 PM by Vickster »
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline kscope09

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Re: MRI scanners and the NHS
« Reply #8 on: March 17, 2010, 10:45:20 PM »
Consultation was 200 then I had the scope which was 2700.  The prurpose of the scope was to find out what was going on.  I had chrondoplasty, debridement of the acl and a loose body removed and plica excism.  After that the follow ups of which I had 5 were free, so I guess i got my money's worth there.  He also sent me for an mri.  Basically what happened was I went to my gp in about september and said that my other knee was giving me trouble because of the extra weightbearing it had done for so long and I got an appointment arranged for an mri that was coincidentally the day after one of my follow ups.  At this meeting the OS was worried about my progress and said I should ahve an mri and when I told him I was going for one that week he got his secretary to arrange for me to have both knees scanned.  When I got to the hospital for the scan I was told that this was impossible and that I would have to just ahve my right leg scanned and would get an appointment for the other leg.  With this one I had to wait another six weeks before I got the letter asking to make an appointment and managed to get the scan in another 3, then another 2 for the result.  They wouldn't even send it to the OS even though his secretary ahd arranged it.  i had to see my gp, get copies of the results and take them with me for the OS to look at.
Feb 08 Inurred right knee
18 months of physio, knee tracking but knee still painful
Aug 09 Scope - Small tear in acl, fragment found in postereo-lateral compartment, suprapatella and lateral plica and small defect in mfc.
May 10 Right knee feeling better but left knee causing trouble as a result o

Offline Clarkey

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  • Neil TheElephant knee packed up carrying his trunk
Re: MRI scanners and the NHS
« Reply #9 on: March 19, 2010, 03:26:33 PM »
I had an MRI scan done on the right knee privately in 2003 and all they could find was the kneecap was on the low end of normal and was not much wrong with the knee. In 2008 I had an MRI scan done again on the right knee and again knee was normal and could only see some swelling and fluid around the fat pad and thought it was not causing any problems.

When I had my scope done in November 2009 my OS had to remove the medial plica and fat pad which was causing problems for over 2 years but nothing was done about it.

I was fairly impressed with the NHS as my MRI scan did not take too long had one done within a couple of weeks and got results 4 weeks lator. Thats the only good thing so far the NHS have done as the rest has not been very good with poor diagnoses and aftercare.

I know the plica does not show up on an MRI scan but I am sure a test could have been done to see if it was the plica causing the pain and discomfort. I may need another MRI scan done on my right knee according to my physio, so will see what my OS says when I see him on the 30th March.

I forgot how much it cost for a private MRI scan back in 2003 think it may have been over 700 as there were less machines then and cost more to run but have gone down since with more MRI scanners available.

Nick :) {2010} :)
RK: PFPS, Arthrofibrosis, Tendinopathy, Five cortisone injections
16/01/18 Anterior interval release, distal patella excision, lateral meniscal repair
18/07/14 Anterior interval release  
16/11/09 Medial plica excision, fat pad trimming

Offline kscope09

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Re: MRI scanners and the NHS
« Reply #10 on: March 19, 2010, 04:04:53 PM »
They never did a plica stutter test or a lachman for the acl on me.  They'd just feel the kneecap and say, "you've got some swelling there and you need to get it on track."  Then I'd do the exercises andhave mcconnel taping and the last pt before the scope said.  "Your knee is now tracking fine, so there's nothing wrong with your knee and the pain musty be in your head.  By then I'd had an mri and an ultrasound and neither had shown anything, she made me feel like such a time-waster and I knew there was somethign wrong but I couldn't prove it.  Even when she said it was tracking it still ahd rice crispies in it and I would ask her to feel the top of my kneecap when I sat on the redge of the couch and moved the leg back and forth and she would never do it.  She just did the tests that she knew and wouldn't do as I asked.  I went to a Gp who did do as I asked and she said my knee felt terrible, so I knew then I was right.  After the scope the rice crispies went away and I'm doing everything I can to make sure they don't come back.
Feb 08 Inurred right knee
18 months of physio, knee tracking but knee still painful
Aug 09 Scope - Small tear in acl, fragment found in postereo-lateral compartment, suprapatella and lateral plica and small defect in mfc.
May 10 Right knee feeling better but left knee causing trouble as a result o

Offline kneetmare

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Re: MRI scanners and the NHS
« Reply #11 on: March 19, 2010, 07:16:06 PM »
hey ppl i had a MRI done a while back on NHS and they found quite alot but failed to mention for some reason. they told me about complete ACL tear and medial meniscus tear and they mentioned MCL damage. the only reason i know this because after my op they left everything about me on a table nxt to me, so naturally i had to have a noisey. took a pic of MRI report and been trying to translate ever since lol was a week ago. i don't know if the reason they didnt tell me was because it would heal it self, but still i would like to know. on that note could anyone tell me what this means an if its anything to worry about.

'there has been an osteochondral impaction of the lateral femoral condyle on the posterio-lateral tibical with associated bone oedema and mild flattening of femoral condyle.' 

don't know if it all spelt right, camera on phone not the greatest. also when i got MRI it was 2wks after i done injury and leg was in a real bad way, it felt like my knee was moving whole time during MRI but there is no mention of 'blur' on report. the surgeon also told the nurse he was 'impressed' by what he found in knee so think that might mean there was more damage the MRI suggested. meet the OS in 2 wks so hope he can give me full details

Offline Clarkey

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  • Neil TheElephant knee packed up carrying his trunk
Re: MRI scanners and the NHS
« Reply #12 on: March 20, 2010, 10:36:18 AM »
Kscope I know how you felt being told it all in your head the knee pain as a NHS physio I saw told me that it must be in my head the knee pain I am feeling and more and less had to force him to let me see an OS as he seemed reluctant to let me see one. I am sure I would have been discharged if he had it his way and glad I saw an OS as he spotted the problem saying there some damage towards the bottom of the knee. There seem to be a lot of bad physio's out there but there are some excellent ones as well as I found a good physio who thinks I still have a knee problem and happy for me to see an OS.

I think physio's should go on a refreshers course once a year and be checked if thay are doing there job to a high standard by a senior physio with many years experience.

Nick :) {2010} :)
RK: PFPS, Arthrofibrosis, Tendinopathy, Five cortisone injections
16/01/18 Anterior interval release, distal patella excision, lateral meniscal repair
18/07/14 Anterior interval release  
16/11/09 Medial plica excision, fat pad trimming

Offline kscope09

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Re: MRI scanners and the NHS
« Reply #13 on: March 20, 2010, 11:54:04 AM »
I think they should be trained to listen to their patients.  I had three pts pre op, 2 private and one NHS and the NHS pt kept blocking me from having an mri.  He said he couldn't justify me having one, he said the pain was just the ghoast of an old injury and that I could do anything I waqnted with me knee.  he was able to block the mri because the gp I waqs seeing at the time wouldn#
't send me for one without discussing it with the physio, I pleaded for one and this happened twice before I went to another GP when my injury was nearly a year old and he ddn't hesitate to send me for an mri.
Feb 08 Inurred right knee
18 months of physio, knee tracking but knee still painful
Aug 09 Scope - Small tear in acl, fragment found in postereo-lateral compartment, suprapatella and lateral plica and small defect in mfc.
May 10 Right knee feeling better but left knee causing trouble as a result o