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Author Topic: Would an MRI help?  (Read 5489 times)

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Offline madkisso

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Would an MRI help?
« on: June 14, 2012, 06:47:59 AM »
Hi,
I finally saw on osteopathic surgeon today for my right knee.  My first doctor said I had a meniscal tear, put me on Diclofenac and sent me off to PT.  4 1/2 months later, I'm still on the Diclofenac (when I stop, my knee swells again) and while it is slightly better, I still can't walk a mile without discomfort.

Anyways, onto the MRI question.  The specialist told me he thinks it might be Patellofemoral pain instead and gave me two options:  Arthroscopic surgery or exercises for a month to see if it improves and then surgery.  He said he doesn't believe in MRIs.  Either the MRI shows nothing is wrong but you still feel pain, in which case you should get the arthroscopy.  Or, the MRI shows something is wrong but you feel fine, in which case you should do nothing.  I feel a little uncomfortable going into surgery without even trying to find out what exactly is wrong.  Should I insist on an MRI?  or would it not matter?  Any advice would be great and sorry for the length.
Michelle

Offline lorilove

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Re: Would an MRI help?
« Reply #1 on: June 14, 2012, 10:38:41 AM »
Did you not have an MRI with the first doctor?  What was his basis for determining you had a tear? 

It definitely would concern me if the second doctor flat out said he did not beleive in MRI's ever or did he say they were not the best diagnostic tool for your particular condition? 

At this point, I agree that you should ask for an MRI.  But note that they are not full proof.  I can't have MRI's myself and had to take the option to go to straight to surgery.  That made me nervous but helped when I read how often MRI's don't always tell the complete story of what is going on in the knee. So far it has worked out well - I am 15 hours post op right now and feeling great - better than I did 24 hours ago.

If you don't get the MRI, do make sure that you are comfortable with your Doctor's judgment as to taking care of what ever problem he finds in the scope but being conservative enough to not do too much.

Offline Maverick

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Re: Would an MRI help?
« Reply #2 on: June 14, 2012, 12:16:42 PM »
Lorilove, I am sorry to hear you are having such difficulties.  I agree with Madkisso, push for an MRI.  True, they are not full proof but they may show the OS something to allow you both to plan better.  I had a lateral meniscus tear in my left knee.  We both agreed not to do an MRI because I knew that there was something wrong in my knee and I knew it was a tear.  What we both did not know was that I also had a grade 4, bone on bone, cartilage defect that resulted in a microfracture.  A bit shocking for both of us. 

Best of luck!
1976 Arthoscopy, damaged cartilage
2007 Lateral release of the patella
2011 Meniscectomy and microfracture (grade 4)
2012 Debridement / Chondroplasty
2013 CRPS left knee

Thank you, Maverick

Offline lorilove

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Re: Would an MRI help?
« Reply #3 on: June 14, 2012, 04:35:20 PM »
Thanks Maverick but you have us backwords - I am doing great (lorilove).  Madkisso is having the issues.

FYI - My symptoms indicated a tear but when the doctor got in there it was soooo small he could barely find it.  There was always the risk that the MRI might not have shown it.  What was more surprising is they found significant OA wear then any of my x-rays indicated so they did a great bit of cleanup there.
« Last Edit: June 14, 2012, 04:40:16 PM by lorilove »

Offline Maverick

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Re: Would an MRI help?
« Reply #4 on: June 14, 2012, 04:43:52 PM »
Funny, I do that all the time :).  Madkisso, I failed to mention one other item.

I had a MRI in February to determine what was causing my pain after the MFX.  Nothing significant showed up on the MRI but my OS stated that although these are great tools, they do have limitations.  Since I am still having significant issues 9 months post surgery, my OS wants to do an exploratory arthroscopy surgery to see for himself what is going on.  So, looks like I am in the same boat as you :)

Good luck!
1976 Arthoscopy, damaged cartilage
2007 Lateral release of the patella
2011 Meniscectomy and microfracture (grade 4)
2012 Debridement / Chondroplasty
2013 CRPS left knee

Thank you, Maverick

Offline madkisso

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Re: Would an MRI help?
« Reply #5 on: June 14, 2012, 05:33:53 PM »
Thank you, everyone, for your replies.  They all helped and Lorilove, hearing you are well post-op has definitely calmed my nervesl.  I guess my main concern, well, 2 main concerns were/are that 1) no one has done an MRI at all.  My first doctor just told me based on symptoms and fiddling around with my knee that he thought it was a tear.  He had me get an X-Ray which seemed odd because he flat out said it wouldn't show tears.  And 2) that my second doctor, the specialist, was so dismissive of MRIs.  I understand that they don't show everything and with the way my knee is going surgery seems inevitable but...I would feel more comfortable if they had a better idea of what was going on inside, i.e. the doctors at least agreed on diagnoses.  Per everyone's advice, I think I will push for an MRI, but not sweat it if I have to go into surgery blind.  Thanks again, all.  It has just been so frustrating these past 4 1/2 months not knowing what was really wrong.

Offline minor_discrepancy

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Re: Would an MRI help?
« Reply #6 on: June 14, 2012, 05:43:17 PM »
Honestly, I think it's pretty weird that your doc does not like MRIs.  Even though their nature can be a little bit confusing, they are an amazing diagnostic tool.  Especially with knees, you can't just look at the outside and make an educated guess about what's going on.  I have a degenerative bone disease as a result of an accident.  Without the MRI, my doctor never would have diagnosed me.  On the outside, it just looks like a normal lesion in the cartilage.  I would strongly suggest you find someone who will do an MRI before you even think about surgery, unless it is merely exploratory arthroscopy.
02/21 (scheduled) OATS
4/09 Dislocated patella
6/09 LR + Chondroplasty, LB removal
2/12 Microfracture + Chondroplasty
7/13 Chondroplasty + Cleanup

Offline madkisso

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Re: Would an MRI help?
« Reply #7 on: June 21, 2012, 08:08:22 PM »
Thanks minor_discrepanc.  After thinking about it and everyone's suggestions, I have asked for a different Dr.  Inevitable though surgery might be, I am going to try and get an MRI first.  I feel a bit uncomfortable at having requested another Dr. since they all work in the same office.  Here's hoping things move forward and my knee actually gets fixed.  Thanks again all.