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Going for my MRI

post #1 of 21
Thread Starter 
Well, there was no known injury, but I haven't been able to do any exercise in nearly 3 weeks due to pain in my right knee (also known as "the good one"). The knee is stable, so I don't think it's an ACL tear.

My physician thinks it's trauma; the rheumatologist says it's osteoarthritis with secondary trauma; I have an appointment with an orthopod this week; I have an MRI scheduled in an hour.

I was hoping for Lyme disease or some other tick borne ailment (I had to treat my dog for Rocky Mountain Spotted Fever this past July), but the tests so far are negative.

I gave the doctors a mandate: GET ME BACK ON SKIS THIS WINTER!!!!!:
post #2 of 21
Maybe the waiting room will have Ski Mags. at any rate get well cause Winters com'in.
post #3 of 21
There is an alternative to mri and surgery. First why does a radioaligist read your mri and not the doctor Problem 1. Problem 2 is that the mri is a shadow picture that is very hard to read so why have some one other than the doctor tell you what is wrong.[not good}.The U.S. Ski Team own there own somtimes do not use there doctors instead see what they say about the alternative of ongley online web site. These guys are 20 years ahead of there time and the rest of the medical establishment is just starting to jump on board slowly.Dr Ongley has fixed my body from a bad back,injured knee as in bbinder case, neck, hips, and anything orthipedic surgery does if you have not totally blown your ligaments.Look him up you will be skiing this winter if you bite the bullet and go if not have a good time recovering from surgery you don't need. Find out what the Ongley difference is.
post #4 of 21
I very much identified with your posting. About 5 weeks ago, we had a cabin in Haleakala crater in Maui. Unfortunately, to get there requires a 6 mile hike with heavy backpack. The first 3 miles is downhill. By the time I got to cabin, my knee is sore. It continued to hurt after we hiked out, but naturally, I tried to ignore it and continued to do my activities. It only got worse. I had an x-ray and MRI. MRI showed chondromalacia. Ortho says it's treatable with phys therapy. Like you, I said I have a ski trip on Dec. 5. and the ultimate priority is to be ready for that. If I was going to need arthro surgery, do it quickly. Anyway, same as you, no specific trauma, but persistent pain with activity. Like every time I get up from chair. Bottom line, PT says I have weak quadriceps and not enough flexibility which is causing tracking problems with knee. All my research says she's right. However, the process seems painfully (no pun intended) slow. Good luck. Would be curious to hear what your MRI shows. Hopefully, you're younger than me and heal more quickly.
post #5 of 21
Thread Starter 
Thanks Maui Steve for your input. FWIW, I'll be 54 next week. About 5 years ago, I had similar experience as you described -- I have had previous partial MCL and ACL tears (never surgically repaired), and thought that I was heading for the knife for sure. Prior to seeing an orthopod, I went to PT (Kennedy Bros. in Boston -- fantastic guys by the way), and got the same diagnosis as you. Quadriceps/hamstring strengthening and ice became my new religion, and I recovered fully. In fact, each season I ski more difficult terrain and more bumps than ever before.

This, however, feels "different". There is no doubt that I am not anxious to undergo surgery, so I am in the information gathering stage. Worst case scenario (I hope) is a small cartilage tear floating within the breeze of my joint fluid and a little trim will take care of it.

Regarding alternative forms of therapy -- I am a scientist by nature and am therefore compelled to follow treatments that stand up to scientific scrutiny. No one is making any decisions for me -- I am getting input from some of the best docs that Boston has to offer. Not that a trip to Baja wouldn't be nice...
post #6 of 21
Sounds like you're going about it well, cross checking with various specialists and gathering all the info you can.

Hope it turns out well and that you can get to skiing as soon as the snow starts flying.

After a car accident in April, I'm in the fingers-crossed-for-ski-season club as well.
post #7 of 21
Bob, on your previous experience, how long did it take for full recovery. My recovery is very slow which is causing me some concern as I see snow piling up in utah where I will be (hopefully) in 2 months. I'm same age as you by the way. Unfortunately, I think that's contributing to slow recovery.
post #8 of 21
Thread Starter 
Steve,

On my patellar tracking issues, it was about a month of knee-specific-exercises-and-icing before I saw significant improvement. As far as full recovery goes, I really can't remember -- I probably did not care once I saw movement in the right direction.

FWIW, the patellar tracking problems never stopped my activity -- it just hurt more when I was finished -- even prior to diagnosis, vitamin I(buproen) and ice helped sonewhat.

Hope this helps -- I'll keep my fingers crossed for you. I get my MRI results with the othopod visit Wednesday.
post #9 of 21
I've been in PT with home exercises for about 2.5 weeks. This morning is the first day that I've seen improvement. small, but noticeable. It gives me hope for upcoming ski trip. Good luck with your MRI. Hopefully, no tears.
post #10 of 21
Thread Starter 
Just got back from the orthopod -- the MRI showed a horizontal meniscal tear and is not impeding range of motion, etc. In his experience, about 50% of these quiet down on their own with quadriceps strengthening and time -- the other 50% are surgical. So, we are going the conservative route -- he says that there should be no risk of additional wear and tear if the pain does not go away, and he can inject the joint with cortisone to get me through the winter.

All in all, probably the best news I could have received given the circumstances and my age!
post #11 of 21
Sounds like relatively good news. The important thing is that it doesn't screw up skiing for season. MY knee still hurts, but I think I'm headed in the right direction. Have fun this season.
post #12 of 21
Beware of lining up all these pricey tests. You must realize that many of these Docs are SURGEONS. Thats their bread and butter. The more tests, the more likely that a surgery is going to happen. The tests MUST be justified of course! If no instability is found, I would stay with PT. Even if you have surgery, having PT first and afterward while likely generate a better outcome. My left knee is ACL deficient since age 16, I'm going to turn 42 soon. I am biased, I'm a PT. FWIW
post #13 of 21
Thread Starter 
Good point -- I am very wary of being led down the primrose path, so to speak. You should know that I am a veterinarian, and am fully able to interpret the results of the tests on my own -- I feel that the docs are giving me their best advice; I respect their expertise, but the ultimate decision lies with me. Also FWIW, the surgeon that I consulted said "Hey, these things (the surgeries)are what I like to do", and then he told me to wait before getting cut.
post #14 of 21
Quote:
Originally Posted by cvj View Post
There is an alternative to mri and surgery. First why does a radioaligist read your mri and not the doctor Problem 1. Problem 2 is that the mri is a shadow picture that is very hard to read so why have some one other than the doctor tell you what is wrong.[not good}.The U.S. Ski Team own there own somtimes do not use there doctors instead see what they say about the alternative of ongley online web site. These guys are 20 years ahead of there time and the rest of the medical establishment is just starting to jump on board slowly.Dr Ongley has fixed my body from a bad back,injured knee as in bbinder case, neck, hips, and anything orthipedic surgery does if you have not totally blown your ligaments.Look him up you will be skiing this winter if you bite the bullet and go if not have a good time recovering from surgery you don't need. Find out what the Ongley difference is.
I agree that radiologists do a worthless job of diagnosis. I have had two surgeons tell me NOT to have surgery after radiologist reading MRI's said I should.

That being said I did google Dr. Ongley and came up with (among other links) this. http://www.msnbc.msn.com/id/11134499/ I wouldn't chance it, I'd find a good surgeon - they DON'T usually recommend surgery in my experience. They've been in there close up with the ligaments and such, and have seen too many people who don't need surgery once they get in.
post #15 of 21
Quote:
Originally Posted by Johnnys Zoo View Post
Beware of lining up all these pricey tests. You must realize that many of these Docs are SURGEONS. Thats their bread and butter. The more tests, the more likely that a surgery is going to happen. The tests MUST be justified of course! If no instability is found, I would stay with PT. Even if you have surgery, having PT first and afterward while likely generate a better outcome. My left knee is ACL deficient since age 16, I'm going to turn 42 soon. I am biased, I'm a PT. FWIW
Health care is an integrated venture. While PT plays an important role in healing and recovery, to imply that it is the end all, be all, is disingenuous. And to imply that all surgeons are money grubbing mountebanks is also disingenuous. PT and surgery both have their roles in medical management. Neither is necessarily better than the other, and people have been greatly helped by both approaches.

Quote:
Originally Posted by SkiMangoJazz View Post
I agree that radiologists do a worthless job of diagnosis. I have had two surgeons tell me NOT to have surgery after radiologist reading MRI's said I should.

That being said I did google Dr. Ongley and came up with (among other links) this. http://www.msnbc.msn.com/id/11134499/ I wouldn't chance it, I'd find a good surgeon - they DON'T usually recommend surgery in my experience. They've been in there close up with the ligaments and such, and have seen too many people who don't need surgery once they get in.
Are you a radiologist? Unless the answer is yes, I believe you are giving incorrect information. A radiologist is a specialty trained physican whose training emphasizes the diagnosis aspect of medical care. Very simply, there is no other physician more qualified to read and interpret radiological imaging studies. So to indicated that radiologists do a "worthless job" of diagnosing is completely off-base.

The frustration that you are describing relates to the difference between radiologic interpretation and clinical correlation. A radiologist works in a box, so to speak. He or she only sees the patient's imaging study along with a few lines of history. After a radiologist receives an imaging study, he or she will then do a few things. First and foremost, they will make a diagnosis based on the imaging findings; this is their primary role as physicians and there is no other physician specialty that can do a better job. Then, secondarily, they will offer a management plan; this is not their primary role, however, and they will often acknowledge this by stating that they "recommend" xyz be the management plan.

The surgeon, on the other hand, is a master of treatment and management. Their training primarilly emphasizes the management aspect of healthcare with a secondary emphasis on diagnosis. The fact that a surgeon disagrees with the radiologists management plan is not surprising at all.

I think it's important to note that the same medical condition may have many different clinical presentations. The best approach to medical care is to take advice from the physician with the most training in the given area in which the advice is sought. In the situation above, the radiologist and surgeon are both likely giving the best advice they can. The problem trying to be solved, however, is a clinical problem and in this case, the most appropriate authority is the Surgeon because this is his/her area of expertise.

I can understand the trepidation that many patients have when dealing with physicians, especially given the cost associated with modern day health care. I think it's always good to have some apprehension and skepticism about an individual's motivations. With this said, however, most physicians are not looking to take advantage of people. Sure physicians like to make money, but they are not going to compromise their principles while doing so. We do like to sleep at night. And no i'm not a doctor, but I am a few months short of graduating medical school.
post #16 of 21
Glen, excellent post, and I apologize for saying "worthless" about radiologists diagnoses. My thinking is that the liability issues push them to report things that aren't necessarily related to the issue at hand. It would seem that it is safer for them to report things that may be insignificant, then to miss something and be sued for it.

I had a back surgeon tell me (after a radiologist reported multiple disc issues in my back) that he could take 100 people off the street with no back pain at all and that 10 of them would be diagnosed by a radiologist as having disc problems. (My particular problem in this case was numbness in my leg, that could have been back related, but was in fact nerve damage in my leg.)

His comment was that what the radiologist saw was true, but was not causing the numbness nor any back problems - although he said someday it could.

Good luck with your career, you sound like you have your head squarely on your shoulders.
post #17 of 21
Quote:
Originally Posted by SkiMangoJazz View Post
Glen, excellent post, and I apologize for saying "worthless" about radiologists diagnoses. My thinking is that the liability issues push them to report things that aren't necessarily related to the issue at hand. It would seem that it is safer for them to report things that may be insignificant, then to miss something and be sued for it.

I had a back surgeon tell me (after a radiologist reported multiple disc issues in my back) that he could take 100 people off the street with no back pain at all and that 10 of them would be diagnosed by a radiologist as having disc problems. (My particular problem in this case was numbness in my leg, that could have been back related, but was in fact nerve damage in my leg.)

His comment was that what the radiologist saw was true, but was not causing the numbness nor any back problems - although he said someday it could.

Good luck with your career, you sound like you have your head squarely on your shoulders.
You are exactly correct on the liability issue. It is an unfortunate consequence of our legal climate here in the states that physicians are forced to "overreport" things lest they get sued for it later on. It's called "defensive" medicine and it's the bane of american medical practice.

And it sounds like you have a good surgeon who actually takes time to explain things. For fun one time, though, you should ask him to put in writing what he said about 10/100 having asymptomatic radiological abnormalities.

Thanks for the good words... hopefully my career gives me many ski days.
post #18 of 21
Well from what I hear medical conferences often are at ski resorts, and don't start until mid to late afternoon.
post #19 of 21
AS far as the msnbc storey about Dr. Ongley I believe that it left you thinking that it may or may not work. However to have sdomeone like Phil U.S.Ski Team coach say that the athletes don't know there own bodies is crazy they make there living with there bodies. I believe that to be a pro athlete you know your bodies dynamics beter than your coach does. I personally told T.J. Lanning about Dr. Ongley for about three or four years before he made up his mind to try it seeing his whole body ached. He tryed it and know the new Ski Racing headlines read healthy and hungry due to results from New Zealand this summer by beating up on some big name skiers. Does Phil know that in 2006 T.J. came with me to meet Ongley and pay for his own treatment. This is why he is free from pain. Don't listen to the nay sayers that never tryed it.Ongley is the real deal and the medical industry should try some of his technics and aviod costly surgerys when possible. Here is the problem medical establishment can't pay for there large houses or big fancy cars with out performing surgery. The only reason Dr.Ongley can't call himself a Dr. in U.S. is that he did not do a residence in the U.S. He has more degrees such as gynecologist, orthipdic, pharmaceutical, oriental medicine and others. He was schooled in Ireland were Drs. recieve two more years of training than American Drs. do. As far as Dwight Stone I asked Ongley about it and he said as if I hurt that man he is a big baby. Listen to experience. The Ongley's are real people not stuffy Drs. they love to talk to people and learn.

There is a saying tell me what you want I believe you.
post #20 of 21
Thread Starter 
It's been two weeks since I met with the Orthopod, so I thought I'd give an update.

I got a copy of the MRI results in the mail, and it was a distressing read (as I expected). In addition to the meniscal tear there was evidence of a chronic sprain to the fibular collateral ligament, a partial tear to the popliteal tendon, and a chronic patellar tendinosis. Plus the radiologist saw evidence of the Osgood Schlater's disease I experienced as a child ( I thought that was a good catch ). Yes, we can all argue that the MRI was "over-read", but as mentioned earlier in this thread, the radiologists job is to report all the findings. And no, the radiologist did not make any recommendations (also as expected).

SO, I have gone ahead and followed my surgeon's advice: I have stopped running (hopefully not forever) to minimize further impact injury. I have stepped up my quadriceps and hamstring exercises, have gone back on my road bike (18 miles this past Sunday), and spend (so far) 30 minutes every 1-2 days on either my skier's edge machine or the elliptical trainer. And ice is my new religion.

So far, so good. The knee feels a little "strange", but no clicking or restriction to the range of motion. No pain, although I am taking NSAIDS. Less weakness than I felt a week ago. I plan to increase all the forms of exercise, and be on skis by early December (although I may stick to mostly groomers until January)
post #21 of 21

cvj...you are totallly full of s**T

be a troll elsewhere
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