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Author Topic: seeing dr tomo opinions needed please.  (Read 2125 times)

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Offline Alicat

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seeing dr tomo opinions needed please.
« on: June 12, 2012, 12:56:16 AM »
Just looking for a few opinions... I'm seeing the ortho surgeon tomorrow for the first time following a referral from the orthopedics department at a local health centre. In december I was in a rush and twisted at the knees and ankles to turn and go back on myself quickly and something gave way it felt as if my knee cap on my right knee shifted inwards towards my inner thigh, my knee was partially bent and stuck, I could bend it slightly (few MM maybe) but couldn't straighten it out at all, after some pressure on my knee and a bit of twisting it popped back and I could move the knee again and straighten it better. This is when the pain started I think maybe I was initially in shock. Decided not to go to a&e because I thought that it would be impossible to dislocate my knee and be able to put any weight on it afterwards (I think because my mum dislocated her knee from a fall and she was in a cast for ages made me think my injury was only minor) the next day the locking happened again and lasted a few hours this time before I could move it properly again. After 2 weeks on increasing pain from walking on it I decided to get checked out by my GP didn't see my regular Dr but this one referred me to the in-house physio saying I had definite patella pain and instability. After 2 and 1/2 months of waiting I was getting very fed up of waiting because my knee was just seeming to be getting worse; rang up to see how much longer physio would be and they'd lost my referral, they apologized and I got booked in an emergency slot to be seen. When I saw the physio she did an examination of my knee, she said she could tell I'd had a serious injury because my thigh muscles had pretty much given up compared to my good leg; she also mentioned that she suspected a large piece of cartilage was floating free, she told me my knee cap was mal-tracking and gave me some exercises to help build up the soggy thigh muscles in which I had to physically move my knee cap to a point it was more comfortable to bend my knee. On inspection of both my legs as a whole she mentioned that my entire leg was out of alignment and that to get my knees to point forward my feet had to point outwards almost like a penguin and that my feet sat on the floor in the wrong way, I wear insoles due to over-pronation anyway and have had 3 or 4 severe episodes of shin pain where I've been on crutches but since the insoles it hasn't re-occured; because of this the physio referred me back to the podiatrist to get my feet looked at again. Saw podiatrist who said nothing she could do and I nearly cried til she said she'd refer me to a knee specialist in town. Referral to orthapedics at the local health centre came through fairly quickly as far as NHS concerned I saw a joint specialist physio who did all sorts of investigations on my knee poking and prodding me (so much I was in absolute agony and tears the next day) she explained that in her opinion I was definitel mal-tracking and she could see I was in a lot of pain because I never fully straighten the knee when standing and put all weight on my other leg etc. Another new thing I learnt was I'm hypermobile and I hyper extend my knees. Was referred for physio and x-rays. Never received a physio appointment but when I rang up to check on my x-rays they said they needed discussing with the Dr so was given an appointment with the ortho doctor, he said nothing shown in the basic xray again I nearly cried because I was convinced I'd be fobbed off. Instead he did a full examination of my knee and quoted some big named terms which I can not remember! (will take pen and notebook tomo) and said that in his opinion from the way he feels my knee moving I'm looking at possible surgery so he referred me to the orthopedic surgeon which I was told would be upto 15 weeks but there was a cancellation and they fitted me in it so I see him tomorrow after only a couple of weeks wait :)

My symptoms are as follows...

clicking and grinding when walking, when I stand I never fully weight bear or equally weight bear on good knee due to intense pain, I have a constant sharp pain under my knee cap and very often get a sharp pain like I'm being stabbed through the knee cap, I have woken up in the night in a lot of pain with a locked up knee which feels like it has something wedged in it (its half bet and cant be bent back slightly but not straighten out past the point of the "wedge") often feel like my knee is going to give way and bend backwards on itself, can't stand straight legged due to pain so always have a slight bend at the knee to relieve the pain, if I forget and twist with my lower legs my knee cap feels as though it will pop out of place, if i sit too long in a chair I get a huge build up of pain in the inside of my knee deep under the kneecap, when i straighten my leg from a bent position it often feels like it is catching until it clicks loudly then i can straighten it more easily, it clicks more on extending than bending, going down stairs is much more painful than going up probably more which I've forgotten to write too.

If anyone has any ideas of what is going on so I can be a little better prepared to talk to the dr that would be great thanks. I'm worried I'll be told I'm a wuss and I should just live with it if that happens I will make sure they at least give me a MRI referral, probably go really well but I just worried.

Offline mnckiwi

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Re: seeing dr tomo opinions needed please.
« Reply #1 on: June 12, 2012, 03:17:14 AM »
Hi there, sounds awful, I'm from NZ where we also have a public system and all advantages aside, it can be terrible the way they put you through the ringer and make you wait etc.

The knee is a very complex joint so an MRI to have a good look and figure out what is going on in there is the first step to figure out what is going on.  Hopefully the orthodeadic surgeon you are seeing specialises in knees. Once they know what's going on they can recommend the best course of treatment.

In terms of dislocating knee caps, I suffer from partial dislocations that pop back in again (subluxation) and although very painful, it is possible to walk afterwards.

Good luck  :)

Offline LAS

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Re: seeing dr tomo tomorrow
« Reply #2 on: June 12, 2012, 04:33:03 AM »
Sounds like you have a good size meniscus tear at the very least.   Bone on Bone and probably arthritis has set in.   If your knee is locking a tear is usually the reason why.  I have had  meniscus tears and the sharp pain came after the surgery because of the bone on bone. It feels like a knife in there.  I then had an injection of synvisc one which helped, about a 40% improvement but that is as good as it gets with that knee.   The maltracking sound like patella subluxation not to be confused with knee dislocation.   You really do need an MRI study to get to the bottom of things.  Ask the ortho doc to explain exactly what the diagnosis means,  have him show you the MRI and what the outcome will be for you.   It is improtant to know what to expect after surgery and surgery sounds inevitable.  Try to use crutches as much as possible and back off from the obvious activities that bother your knee.   Good Luck and please let us know the results.   
« Last Edit: June 17, 2012, 01:22:32 AM by LAS »

Offline Alicat

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Re: seeing dr tomo opinions needed please.
« Reply #3 on: June 12, 2012, 11:23:38 AM »
Very disappointed with my appointment. Dr didn't seem at all concerned, one of the X-rays they did showed my kneecap had definite overhang but he said he doubts anything wrong, had a lot of pain when he pressed on my knee which he said is just a bit of nerve sensitivity. Booking me an MRI just to check but made me feel like I was an inconvenience to him :-( I wrote a couple of pages of everything going on with my knee and he didn't even look at it I told him to keep it for my notes but he thrust it back at me. Sat at bus stop in tears! Least I got the MRI referral and if he says after that nothing wrong I'm asking for 2nd opinion, how the hell can you be in constant pain which is moderate with pain killers severe without if nothing's wrong??

Offline Alicat

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Re: seeing dr tomo opinions needed please.
« Reply #4 on: June 12, 2012, 11:46:29 AM »
He also made me walk about 4 paces and said my walking unaffected, anyone can see I limp! I've had strangers mention it :-/

Offline Alicat

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Re: seeing dr tomo opinions needed please.
« Reply #5 on: June 12, 2012, 03:29:36 PM »
decided I'm going to request a copy of todays xrays and try not to worry about it til after the MRI because it might show up something very obvious and proove I'm right that my symptoms aren't in my head.

Offline lisa424

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Re: seeing dr tomo opinions needed please.
« Reply #6 on: June 12, 2012, 05:28:53 PM »
Time to move on to another OS. You never want someone who won't listen to you or doesn't even seem to care. How rude.

Offline mnckiwi

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Re: seeing dr tomo opinions needed please.
« Reply #7 on: June 12, 2012, 09:58:27 PM »
Good that you're being sent to get an MRI, if there is something not right it will show up and you will get the help you need.

1st bit of advice, if after your MRI you aren't happy with yor OS, find another one, and take your xrays, MRI etc with you. If you feel like you weren't listened too, you need to find another OS.

2nd, never tell yourself that nothing's wrong or that it's all in your head. Chances are if your in sonsiderasble pain, it's not.

3rd bit of advice, surgeons will only look for very obvious surgical issues that they can fix. Not saying there aren't any for you, but I personally have had a lot of good results with a very good sports doctor, so finding one of those might be a good option for you, as they will look at the whole picture.

Offline LAS

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Re: seeing dr tomo opinions needed please.
« Reply #8 on: June 13, 2012, 04:06:31 AM »
One  of the reasons he is sending you for the MRI is because he couldn't see anything obvious.   Nothing showed up on my x-ray so the OS sent me for an MRI and indeed there was alot going on.    I hope the MRI is soon so you can get to the bottom of it.  I would suggest that you get another opinion just the same.   Here in the states it is quite common and relatively fast.   I don't know what your circumstances are but you should not be in pain!  LAS

Offline Alicat

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Re: seeing dr tomo opinions needed please.
« Reply #9 on: June 15, 2012, 03:24:22 PM »
Good that you're being sent to get an MRI, if there is something not right it will show up and you will get the help you need.

1st bit of advice, if after your MRI you aren't happy with yor OS, find another one, and take your xrays, MRI etc with you. If you feel like you weren't listened too, you need to find another OS.

2nd, never tell yourself that nothing's wrong or that it's all in your head. Chances are if your in sonsiderasble pain, it's not.

3rd bit of advice, surgeons will only look for very obvious surgical issues that they can fix. Not saying there aren't any for you, but I personally have had a lot of good results with a very good sports doctor, so finding one of those might be a good option for you, as they will look at the whole picture.

Thanks for your reply! I have gotten a copy of my xrays today and am looking forward to the MRI rather than stressing about the appointment now :) I think even if we took pain out of the equation and for arguments sake say I had the worlds worst pain threshold and just look at my other symptoms for example the knee feeling as though it'll bend backwards or that my knee cap is going to pop out then I know something isn't right just got to keep plugging away til they find the cause :) I will look into a sports dr thanks, actually one of the GPs at my dr surgery works for one of the premier league football teams too he examined me when I was having problems with shin pain so may have to go see him and ask him to refer me to a different knee specialist but going to try keep positive that MRI will show something up.  Spoken to a private knee specialist which is another option can have a consultation and then referal back to NHS if needed we'll see how it go :)

Offline Alicat

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Re: seeing dr tomo opinions needed please.
« Reply #10 on: June 15, 2012, 03:39:15 PM »
One  of the reasons he is sending you for the MRI is because he couldn't see anything obvious.   Nothing showed up on my x-ray so the OS sent me for an MRI and indeed there was alot going on.    I hope the MRI is soon so you can get to the bottom of it.  I would suggest that you get another opinion just the same.   Here in the states it is quite common and relatively fast.   I don't know what your circumstances are but you should not be in pain!  LAS

Thanks! Dr said MRI should get done within 5 weeks which isn't too bad for here when I had MRI scans when I was younger on my head the wait was months. I will definitely consider second opinion should things not go well I'm just trying to think he was prob just having a bad day :)

Offline Alicat

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Re: seeing dr tomo opinions needed please.
« Reply #11 on: June 15, 2012, 03:41:06 PM »
Time to move on to another OS. You never want someone who won't listen to you or doesn't even seem to care. How rude.

If he'd said don't think there is much wrong that physio can't fix and talked it through with me I'd of been happy after all I don't want to have to have surgery!! it was the lack of interest that really upset me, maybe because I'm a bit overweight he wasn't interested, who knows. Not going to let it get me down though :)

Offline LAS

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Re: seeing dr tomo opinions needed please.
« Reply #12 on: June 16, 2012, 03:08:27 AM »
I feel so bad but like you said don't let it get you down.   Once he sees the MRI if he still seems uninterested and can't help you move on to another orthopedic guy.   We all can have a bad day so just wait for the results.   If you are overweight he should be counseling you on how it affects your knees.  I am also a bit overweight but so far my doc has said nothing about it.    I think if you are morbidly obese then they might suggest a weight loss program and exercise.  It kind of sounds like he is waiting for the whole picture.   It is very common here that the docs push you in an out fast so don't take it personal yet.   On my first appointment with the OS he spent about 5 minutes with me but after the MRI he took more time to explain it.   They like to make money here and they do.   Let us know the results    LAS

Offline The KNEEguru

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Re: seeing dr tomo opinions needed please.
« Reply #13 on: June 16, 2012, 05:33:53 PM »
something gave way it felt as if my knee cap on my right knee shifted inwards towards my inner thigh, my knee was partially bent and stuck, I could bend it slightly (few MM maybe) but couldn't straighten it out at all, after some pressure on my knee and a bit of twisting it popped back and I could move the knee again and straighten it better. This is when the pain started

What you describe sounds like medial patellar dislocation, which is very unusual unless you have some anatomical abnormality such as a high patella or a badly-shaped groove (trochlear dysplasia). Maybe it was more a severe subluxation, rather than a full dislocation, but nonethless it clearly was the initiating problem.

Now you are woken
 
up in the night in a lot of pain with a locked up knee which feels like it has something wedged in it
which makes me wonder if you have a bit of loose material inside your knee which was knocked off during that first incident - this could be a chondral flap or a loose body. A chondral flap is a bit of loose joint cartilage, and a loose body (or 'knee mouse') is when the bit breaks off.

« Last Edit: June 16, 2012, 05:35:28 PM by The KNEEguru »
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Offline The KNEEguru

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Re: seeing dr tomo opinions needed please.
« Reply #14 on: June 16, 2012, 06:02:39 PM »
For reference, please also note that we have a Hypermobility board - http://www.kneeguru.co.uk/KNEEtalk/index.php?board=22.0
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