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Old 03-29-10, 07:03 PM   #1
phantomcow2
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Is my doctor ordering too many tests?

Here's the scenario: I've had repeated swelling in my right knee for several years now. It's currently swollen to a size I've never seen before, rendering my leg stiff and of minimal use. It hasn't happened for a little over a year. Anyways, I'm concerned because it's always the same knee and it recurs. I went to the hospital a few days ago, and they x-rayed the knee to find nothing wrong with the bone.

I was referred to an orthopedist, who I saw this morning. She drained 85ml of joint fluid from the knee and sent it off to a laboratory for testing. She then ordered a blood test for uric acid and something else (forget exactly what). I got a call later today saying that they suggest I get an MRI and my insurance has authorized it already.

I'm certainly not a doctor, but I feel like this is moving very fast and the MRI is excessive. I would have thought that the joint fluid and blood test would be conclusive enough, am I wrong? Even though my insurance covers an MRI, it's still probably very expensive and I'd rather not do it if my doctor is just ordering the test without crucial need.
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Old 03-29-10, 07:15 PM   #2
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MRIs are amazing. Get it done. Hopefully it will enable the doc to find out what's wrong.
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Old 03-29-10, 07:24 PM   #3
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It's a last ditch effort by the doctor to avoid amputating the leg,that's all.
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Old 03-29-10, 07:25 PM   #4
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I don't understand why amputation was not discussed yet.

Hack doctors!
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Old 03-29-10, 07:27 PM   #5
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BTW, if you're worried about claustrophobia, I have some things in my medicine bag that will help
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Old 03-29-10, 07:30 PM   #6
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I don't understand why amputation was not discussed yet.

Hack doctors!
They always try to run away,very dramatic and sad.
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Old 03-29-10, 07:33 PM   #7
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Obviously the fluid they drew from your joint needs to be tested for bacterial or viral infection. The uric acid test is to see if you have gout. The MRI will tell them if there is any physical damage to your knee.

Sounds appropriate to me - they're testing three (probably most) likely causes of your joint inflammation and swelling.
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Old 03-29-10, 07:33 PM   #8
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It's quite amazing what athletes do with a carbon prosthetic leg these days.
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Old 03-29-10, 07:44 PM   #9
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They always try to run away,very dramatic and sad.
They also forget the free drumstick!
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Old 03-29-10, 08:04 PM   #10
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Obviously the fluid they drew from your joint needs to be tested for bacterial or viral infection. The uric acid test is to see if you have gout. The MRI will tell them if there is any physical damage to your knee.

Sounds appropriate to me - they're testing three (probably most) likely causes of your joint inflammation and swelling.
I see. I'll know the results of the two tests before I go to the MRI. If indeed I have some infection or gout, I guess that waives the need for an MRI?
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Old 03-29-10, 08:04 PM   #11
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It's not like his present leg is that usefull.He stated that himself.
Hopefully they can retain his leg till he gets that janitor job at the big law firm this summer.
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Old 03-29-10, 08:08 PM   #12
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It's not like his present leg is that usefull.He stated that himself.
Hopefully they can retain his leg till he gets that janitor job at the big law firm this summer.
I went ahead and accepted that job, by the way. They sent me a mop with a carbon fiber handle as a welcome gift.
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Old 03-29-10, 08:12 PM   #13
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If you are unsure about a test, ask the doctor what action he would suggest in the case of each possible test outcome.
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Old 03-29-10, 08:17 PM   #14
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It's not like his present leg is that usefull.He stated that himself.
Hopefully they can retain his leg till he gets that janitor job at the big law firm this summer.
Did you use the proper work attire suggestions by your friends here in BF?
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Old 03-29-10, 08:22 PM   #15
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Not only can we get you employed in BF but I'm sure there are also experts here on using/buying a prosthetic leg.
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Old 03-29-10, 08:31 PM   #16
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I can make my own prosthetic leg. I actually referred my future employer to the post you're referencing in foo. So impressed were they with my ambition and desire to succeed in their organization that they handed me the carbon end of the mop on the spot.
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Old 03-29-10, 08:33 PM   #17
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If anything worry about them not doing enough. Seriously though man, that sucks. I've always thought I have problems with my knees but I just feel lucky now.
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Old 03-29-10, 09:34 PM   #18
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Did you ever injure the knee?

If not, did you ask about seeing a rheumatologist? It could be some kind of arthritic issue.

Alas, they order lots of tests, too.
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Old 03-29-10, 09:41 PM   #19
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I see. I'll know the results of the two tests before I go to the MRI. If indeed I have some infection or gout, I guess that waives the need for an MRI?
Not necessarily. The MRI is a good idea, especially if it's covered by insurance.
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Old 03-30-10, 12:06 AM   #20
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Not all of the time MRIs are authorized. You are very lucky to be able to get one. It's shows a very detailed section by section picture of what your knee and surrounding tissue looks like. If there is a tear in there, it will show. It's just an x-ray for soft tissue.
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Old 03-30-10, 01:39 AM   #21
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I spent 10-years fighting swollen knees and ankles. I'd get 3-6 months of great training in and almost get back into full shape and then my knee or ankle would swell up and hurt like hell for 2-3 weeks. I'd be on the couch the whole time taking all sorts of opiate drugs. The stupid thing was that they didn't do enough tests. They looked at me and figured I had a sprained ankle/knee and sent me on my way with pain-killers. One time they did do an xray, but of course I've never broken a bone in body.

So... this went on and off for 10-years straight until I met my wife. She pondered my symptoms, looked over my medical receipts and declared, " you might have gout!".. We went to a rheumatologist who stuck a huge fat needle in my ankle and tried to suck out some fluid. But it was on the tail end of an episode and most of the swelling had gone down. Found nothing! Blood-test showed slightly high uric-acid content, but that itself isn't conclusive as about 50% of gout patients don't show high uric-acid anyway. So... MRI was next and it showed the telltale signs of damage from rubbing and embedded uric-acid crystals. Been on some gout drugs for the past 2-years and haven't had a single attack since!

If they had done these tests 10-years ago when I first went in, I may still have had a chance as a pro bike racer.
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Old 03-30-10, 01:45 AM   #22
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I spent 10-years fighting swollen knees and ankles. I'd get 3-6 months of great training in and almost get back into full shape and then my knee or ankle would swell up and hurt like hell for 2-3 weeks. I'd be on the couch the whole time taking all sorts of opiate drugs. The stupid thing was that they didn't do enough tests. They looked at me and figured I had a sprained ankle/knee and sent me on my way with pain-killers. One time they did do an xray, but of course I've never broken a bone in body.

So... this went on and off for 10-years straight until I met my wife. She pondered my symptoms, looked over my medical receipts and declared, " you might have gout!".. We went to a rheumatologist who stuck a huge fat needle in my ankle and tried to suck out some fluid. But it was on the tail end of an episode and most of the swelling had gone down. Found nothing! Blood-test showed slightly high uric-acid content, but that itself isn't conclusive as about 50% of gout patients don't show high uric-acid anyway. So... MRI was next and it showed the telltale signs of damage from rubbing and embedded uric-acid crystals. Been on some gout drugs for the past 2-years and haven't had a single attack since!

If they had done these tests 10-years ago when I first went in, I may still have had a chance as a pro bike racer.
This same thing happened to me, but I had a doctor who couldn't be bothered to run a $15 uric acid test, but he could charge me and my insurance company for a super-expensive MRI! He kept telling me I had tendonitis, then when I got into nursing school I figured it out myself and went to a doc in a box and got a uric acid test, a diagnosis of gout and a $10 prescription and the problem was solved.




And people wonder why doctors aren't trusted.

At least PC2's doctor is being thorough.
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Old 03-30-10, 03:49 AM   #23
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And it'sw good to 1mm resolution, too. Far better than a CT scan.
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Not all of the time MRIs are authorized. You are very lucky to be able to get one. It's shows a very detailed section by section picture of what your knee and surrounding tissue looks like. If there is a tear in there, it will show. It's just an x-ray for soft tissue.
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Old 03-30-10, 04:34 AM   #24
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Given my history with swollen knees (turned out to be cancer), I'd say get as many tests as you need. Though if it were osteosarcoma, it probably would have shown up on the X-ray.
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Old 03-30-10, 09:44 AM   #25
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Don't worry, you probably just have gonococcal arthritis.
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