I am not sure what to think about this....please help me sort this out.

[Jean in Newcastle]

according to her, the reason that the diagnois is different each time is because she is peeling away layers...she is treating the most obvious symptom first, then the next and the next, until she unburies the real problem. But each symptom is getting weirder and weirder and seemingly further and further away from the real problem....her knee.

 

I have chronic illness. It is complex because there isn't just one cause. So I've been peeling away the layers with the help of both allopathic and naturopathic doctors. This has included thyroid tests which resulted in thyroid pills (one layer), a blood test for my vitamin d levels which resulted in vitamin D supplementation (another layer) etc. I wouldn't expect or have faith in that sort of layered approach in what has been a more short term acute problem in a child.

[Harriet Vane]

Or should I just make an appt. with the PT (that was also mentioned by our family doctor when this whole thing started)...I might even be able to get that in before Christmas....I don't know though.

 

I am enthusiastic about both chiropractic care and I love-love-love physical therapy. I have had issues over the years with hips and knees and scoliosis-related spinal issues.

 

However.

 

I would NOT bother with a physical therapist until you have done the MRI and actually diagnosed the problem. Once you know specifically what is wrong, you can then treat it effectively. Guessing at the problem will take time and money--and time may mean the problem gets worse or simply doesn't heal.

 

Once you have a real diagnosis, then please do consider physical therapy. It can have absolutely fantastic results, and is a "natural" way to help the body heal itself.

[WishboneDawn]

double post

Edited December 16, 2011 by WishboneDawn

[WishboneDawn]

MRI stands for MAGNETIC resonance imaging. There is no ionizing radiation like there is for x-rays. http://en.wikipedia.org/wiki/Magnetic_resonance_imaging

 

The chiropractor sounds like a quack, frankly. If you don't want to go the MRI route, then I would up the ante to see an orthopedic doctor...but you're probably going to be told to get an MRI for diagnostic purposes. You could ask what the risks are of NOT getting an MRI, for instance, is there more likelihood of a misdiagnosis? How much greater is the risk for damage without knowing exactly what is going on, etc?

 

:iagree::iagree::iagree:

 

Go see someone who's trained to address the root issue.

I feel a bit like you're dealing with a roofing problem by going to electricians and plumbers for quotes. Go see the roofer!

[Laura in STL]

I would either look into getting that MRI, or asking if it could be plica tissue catching on the side of her knee.

There is also a distinct possibility she has a piece of cartilage loose on the back of her knee cap that is catching as well.

Really - an orthopedic surgeon is the person to go to.....

 

:iagree: I had the same symptoms- popping then pain that would come and go- and I had a MRI done. My ortho ended up removing plica tissue and shaving some loose cartilage off the back of my knee cap. It is much better now. The loose cartilage was from an injury, but the plica, I was told, was just something that some people have trouble with.

[WishboneDawn]

according to her, the reason that the diagnois is different each time is because she is peeling away layers...she is treating the most obvious symptom first, then the next and the next, until she unburies the real problem. But each symptom is getting weirder and weirder and seemingly further and further away from the real problem....her knee.

 

Very snarky here but I'm wondering if the layers she's referring to are actually layers of cash from your wallet?

[Laura in STL]

OK...if I am going to pick an orthopedist, what should I be looking for? There aren't any pediatric ones in our area, so that isn't an option....but is there anything in particular that I need to be aware of, or certain questions I should ask? Can this all wait until January when we return from our Christmas vacation? Or, I guess I could pick one and make an appointment in January, huh? Just thinking as I am typing. Thanks.

 

Look for someone who is board certified in orthopedics. Ask your primary care doc for names(if you value his/her judgement). Do you have any friends who have used someone? That's a good way to get a name, then you could follow up on that name with your doc. Also, our local homeschool group has a message board where people ask questions about health care rare references all the time. I don't know if you have anything like that in your community, but if so that's an option.

[EKS]

we aren't really wanting to expose her to radiation from the MRI unless we have too...

 

There is no radiation exposure with an MRI.

[ProudGrandma]

wow...there are so many possible things that could be wrong....I think we are going to get an MRI done as soon as possible.

 

thanks for all of the responses, I really do appreciate it.

[laundrycrisis]

Or should I just make an appt. with the PT (that was also mentioned by our family doctor when this whole thing started)...I might even be able to get that in before Christmas....I don't know though.

 

I would not start PT without a full ortho exam. And I don't think a good PT would want to touch the case without a doctor on board. When I had PT for my knee, I had an order from the doctor for exactly what to treat.

[angela in ohio]

Orthopedic surgeon. Look for one who is board certified. He will order tests. That's how you can be sure of the diagnosis. Don't be afraid of them...they are necessary to treat your dd properly.

 

To me it sounds like it could be meniscal, could be chondromalacia of the patella, could be Osgood-Schlatters. Only an exam plus the proper tests (either x-rays or an MRI) will tell you for sure.

 

PS. Your other practitioner is not qualified to treat this. You are wasting your time and money.

 

I agree with all of this.

 

Get her in as soon as possible. Being in pain really stinks.

 

I use chiropractic care, and it is wonderful for my neck pains. But my dd with spine problems sees an orthopedist, not the chiro.

[southcarolinamom]

Okay....not at all snarky, I promise, but my DH would say "don't chase zebras when the horse is standing in front of you"....your DD has a knee issue, not an iodine storage issue, not a thyroid issue and not likely Type I diabetes -those are zebras....the horse, her KNEE - take her to an orthopedist and let them figure out what is wrong. The orthopod could very well tell you, hey, it's really not her knee, she needs to see XYZ because this is what I highly suspect....but right now the chiro is chasing zebras and wasting your time, and possibly causing more damage to a knee that might very well be easily taken care of if whatever is wrong is addressed in a timely manner!

 

I agree! I work for orthopaedic surgeons. Listen to them. :D

[Momof3littles]

I would not start PT without a full ortho exam. And I don't think a good PT would want to touch the case without a doctor on board. When I had PT for my knee, I had an order from the doctor for exactly what to treat.

PTs in most states can operate under direct access. They can do the eval and then screen for whether the patient needs to be referred back to the MD for imaging, etc. and they very frequently do. IME, most PTs err on the side of caution with referring back or referring for imaging if they feel they need more info or it is beyond their scope. That's part of what the evaluation procedure is. Some insurances require a referral, but in the vast majority of states it is legal for a PT to practice without an "order" from a doc.

 

I think seeing the PT first can be a viable option (provided that isn't an issue with OP's insurance), or it would also be appropriate to see an orthopod first.

[SueinNC]

we aren't really wanting to expose her to radiation from the MRI unless we have too...not to mention that the test will have to come out of pocket becasue of our deductible is high. But you see, this is my problem...I honestly don't know what to do. UGH!!!

 

“MRI” stands for “magnetic resonance imaging,” and it uses magnetic and radio waves to produce images -- not radiation. So, you would not be exposing her to radiation. But, they are costly without insurance. But, it might be worth the expense.

 

oops, I see that another poster has already mentioned this.

Edited December 16, 2011 by Caledonia Academy

[YLVD]

:iagree: I would go to the orthopedist.

 

I agree

 

I would not waste time with anything else. She needs to see a doctor, someone that can fix this. I had a similar injury and ended up needing physical therapy for it. The doctor had to refer me to the PT. If we hadn't discovered it or I had waited, it would have really impeded my life and could have led to lifelong issues. Again, don't wait on this.

[YLVD]

so then what did you have to do to fix the problem??

 

My daughter is not an athlete, she is not a dancer, she doesn't do anything outside of the normal running and playing of a child. So, I don't understand why she even has this problem.

 

I had the injury and I was neither. This is why you should talk to a doctor about this.

[YLVD]

Orthopedic surgeon. Look for one who is board certified. He will order tests. That's how you can be sure of the diagnosis. Don't be afraid of them...they are necessary to treat your dd properly.

 

To me it sounds like it could be meniscal, could be chondromalacia of the patella, could be Osgood-Schlatters. Only an exam plus the proper tests (either x-rays or an MRI) will tell you for sure.

 

PS. Your other practitioner is not qualified to treat this. You are wasting your time and money.

 

:iagree:

 

My daughter has Osgood-Schlatters.

[teamturner]

I had a meniscal tear in my left knee about 8 years ago. It is my understanding that it is a particular cartilage that is like a rubber band around the knee. When it has a tear it can flap around and cause pain if it is laying incorrectly or in my dh's case, caught in the joint. My pain was only sometimes when I would bend up and down on it or turn a certain way. But only sometimes. I let it go for about 6 months and then I danced the night away at my brother's wedding and the pain became severe and constant.

 

I ended up having the surgery, which was no big deal at all. I wish I had done it sooner. I never did pinpoint exactly how I injured my knee in the first place. My dh did it in a workout class. He had stopped to tie his shoe, then got up fast and turn to lunge but his foot stayed in place and he gave himself a nice meniscal tear.

 

The knee MRI is not bad at all. They only put you in up to your thigh so your head is outside the machine. Then you don't have to worry about the feeling of claustrophobia. MRI's are excellent diagnostic tools.

[scrappyhappymama]

I am a BIG fan of chiropractic care. But we've moved around a lot, so I've seen many different chiropractors and just like in any field some are good and some are not so good. Honestly, I'd be running away quickly from the chiropractor you describe.

 

As a child, I had lots of issues with my knees popping and aching and hurting intermittently. My chiropractor was able to help me a lot. When my back was out of alignment, one leg was shorter than the other, which put stress on one of my knees. So periodic adjustments helped. He also discovered that I had a very low arch in my foot and proscribed orthotics for my shoes. This made a HUGE difference for me.

 

Since your daughter seems to be improving over time and is not in constant pain, I'd probably be inclined to find another, non-quacky chiropractor and get a second opinion there first. A GOOD chiropractor will admit when the problem lies outside their ability to help and will recommend you see an orthopedist or other relevant medical professional when needed. If the second opinion didn't yield a satisfactory diagnosis & treatment plan, then I'd probably go ahead and schedule the MRI.

[Lizzie in Ma]

First of all...sorry for the length of this, please be patient with me. about 3 months ago I took my dd11 to our family doctor becasue she had been complaining of a pain in her knee that she would describes as a "poping" and then pain. When asked to rank her pain it was often a 5-6...but on occasion it was higher or lower...and on one occasion it sent her to the ground in pain...but the pain would only last a minute or so. Our family doctor said it was a meniscus issue (which is the tissue between the 2 leg bones). The doctor told us to give her motrin 4x a day for a week to see if that helped. It did. Then she wanted us to have an MRI done to see what we need to do next.

 

We didn't want to go that route unless we needed to, and a really good friend of ours encouraged us to see their doctor...a chiropractic and acupuncturist. So we did. The first visit she had dd sit by her computer and she put a brass probe in her hand and the doctor touched dd's other hand with another probe. She touched various acupunture spots trying to diagnois her issue. She decided that it was a meniscus issue. She tested her strength in both her arms and legs...some movements dd had strength, other times not so much. The doctor then touched her with a heat "gun" (for lack of a better word) on her knee and ear (again acupuncture points). Then sent her home for a week.

 

When we returned, the pain was still there, but a little better. The doctor decided that she had some food allergies, so she treated those with the heat guns and then added some homeopathy too. Sent us home for another 2 weeks. When we come back, the pain was a little better, but still there, with an occasional really bad "pop". The doctor then decided that the problem might be the fact that iodine (which is naturally stored in the thyroid and ovaries) and in my dd it wasn't being stored in her ovaries...so the doctor treated her for that. Sent us home....

 

2 weeks later...(today) still has pain, and today the doctor asked us how much sugar dd eats. I told her not much because we limit that. No pop or sugar on any kind of regular basis...a special occasion yes...but once a month. DD has been eating fruit, yogurt and stuff like that...but not much candy type sugar. The doctor suggested that maybe we want to have a blood test for diabeties because type 1 will often show it's face during the pre-puberty time. She said that the pancres not working correctly can effect ligaments in the body.

 

I don't have any reason to NOT believe her, but this is seeming to be getting ridiculus too...I mean, each trip is a different reason for her knee problems, and yet the pain is less than before (just not gone yet). My husband and I aren't sure what to think. How many trips (and I have a co-pay each time, which is adding up) do we take before we seek another opinion? If you have any advice, opinions or thoughts for me, I would really appreciate it, especially if you have expereince with doctors like the doctor that we have been seeing. THANKS!!!

 

No advice but wanted to offer sympathy. It took 6 years of dr. visits to get our daughter, who grew more and more ill, with her Lyme. Oddly enough, the first specialists we were sent to were ortho people for the pain and swelling in her knees. Know we know that it was a classic presentation of it.

I hope and pray you get to the bottom of it, kids should not be in pain.

:grouphug:

[laundrycrisis]

PTs in most states can operate under direct access. They can do the eval and then screen for whether the patient needs to be referred back to the MD for imaging, etc. and they very frequently do. IME, most PTs err on the side of caution with referring back or referring for imaging if they feel they need more info or it is beyond their scope. That's part of what the evaluation procedure is. Some insurances require a referral, but in the vast majority of states it is legal for a PT to practice without an "order" from a doc.

 

I think seeing the PT first can be a viable option (provided that isn't an issue with OP's insurance), or it would also be appropriate to see an orthopod first.

 

Yes, but in this case, not knowing whether it is an actual injury or a dislocation, PT could make it worse. I know the PT clinic I went to would not do PT for anything until the person had been cleared by a doctor, even if it was non-medical PT. You still had to be cleared for it. It was on the paperwork I had to fill out - a form that said I had been medically cleared to begin therapy for the specific issue, signed by the doctor.

[Donna]

First of all...sorry for the length of this, please be patient with me. about 3 months ago I took my dd11 to our family doctor becasue she had been complaining of a pain in her knee that she would describes as a "poping" and then pain. When asked to rank her pain it was often a 5-6...but on occasion it was higher or lower...and on one occasion it sent her to the ground in pain...but the pain would only last a minute or so. Our family doctor said it was a meniscus issue (which is the tissue between the 2 leg bones). The doctor told us to give her motrin 4x a day for a week to see if that helped. It did. Then she wanted us to have an MRI done to see what we need to do next.

 

We didn't want to go that route unless we needed to, and a really good friend of ours encouraged us to see their doctor...a chiropractic and acupuncturist. So we did. The first visit she had dd sit by her computer and she put a brass probe in her hand and the doctor touched dd's other hand with another probe. She touched various acupunture spots trying to diagnois her issue. She decided that it was a meniscus issue. She tested her strength in both her arms and legs...some movements dd had strength, other times not so much. The doctor then touched her with a heat "gun" (for lack of a better word) on her knee and ear (again acupuncture points). Then sent her home for a week.

 

When we returned, the pain was still there, but a little better. The doctor decided that she had some food allergies, so she treated those with the heat guns and then added some homeopathy too. Sent us home for another 2 weeks. When we come back, the pain was a little better, but still there, with an occasional really bad "pop". The doctor then decided that the problem might be the fact that iodine (which is naturally stored in the thyroid and ovaries) and in my dd it wasn't being stored in her ovaries...so the doctor treated her for that. Sent us home....

 

2 weeks later...(today) still has pain, and today the doctor asked us how much sugar dd eats. I told her not much because we limit that. No pop or sugar on any kind of regular basis...a special occasion yes...but once a month. DD has been eating fruit, yogurt and stuff like that...but not much candy type sugar. The doctor suggested that maybe we want to have a blood test for diabeties because type 1 will often show it's face during the pre-puberty time. She said that the pancres not working correctly can effect ligaments in the body.

 

I don't have any reason to NOT believe her, but this is seeming to be getting ridiculus too...I mean, each trip is a different reason for her knee problems, and yet the pain is less than before (just not gone yet). My husband and I aren't sure what to think. How many trips (and I have a co-pay each time, which is adding up) do we take before we seek another opinion? If you have any advice, opinions or thoughts for me, I would really appreciate it, especially if you have expereince with doctors like the doctor that we have been seeing. THANKS!!!

 

Popping in the knee is most likely a meniscus tear and an MRI will show that and let them know if you need to go the surgical route. That doctor sounds like a quack.

[ProudGrandma]

I am amazed at all of the similar responses. I am trying to decide if I should first get an MRI done and THEN find an orthopedist....OR find an orthopedist and have that doctor send us for an MRI? I just discovered that we might have met our deductible with my son's brokem arm this summer, so maybe doing the MRI before Jan 1st would be wise....however, is it possible if we would do that BEFORE talking to an orthopedist we would have to redo the test becasue it wasn't done to their specs?.....or is this a pretty general test and it won't matter? Does that make sense?

 

Also, can all of this wait until January? We are scheduled to leave on a Chrsitmas vacation right after Christmas (for about 2 weeks)...I might be able to schedule an MRI before that, but I highly doubt I can be seen by an orthopedist before Christmas.

Edited December 16, 2011 by NEprairemom

[JudoMom]

I am amazed at all of the similar responses. I am trying to decide if I should first get an MRI done and THEN find an orthopedist....OR find an orthopedist and have that doctor send us for an MRI? I just discovered that we might have met our deductible with my son's brokem arm this summer, so maybe doing the MRI before Jan 1st would be wise....however, is it possible if we would do that BEFORE talking to an orthopedist we would have to redo the test becasue it wasn't done to their specs?.....or is this a pretty general test and it won't matter? Does that make sense?

 

Also, can all of this wait until January? We are scheduled to leave on a Chrsitmas vacation right after Christmas (for about 2 weeks)...I might be able to schedule an MRI before that, but I highly doubt I can be seen by an orthopedist before Christmas.

 

I would get the MRI ordered by your family doctor. The report should be able to just be sent to the ortho if you need one.

[laundrycrisis]

I am amazed at all of the similar responses. I am trying to decide if I should first get an MRI done and THEN find an orthopedist....OR find an orthopedist and have that doctor send us for an MRI? I just discovered that we might have met our deductible with my son's brokem arm this summer, so maybe doing the MRI before Jan 1st would be wise....however, is it possible if we would do that BEFORE talking to an orthopedist we would have to redo the test becasue it wasn't done to their specs?.....or is this a pretty general test and it won't matter? Does that make sense?

 

Also, can all of this wait until January? We are scheduled to leave on a Chrsitmas vacation right after Christmas (for about 2 weeks)...I might be able to schedule an MRI before that, but I highly doubt I can be seen by an orthopedist before Christmas.

 

1. Get her an appointment with an ortho.

2. The ortho will likely order the MRI, especially if you have already done an x-ray (the ortho may want a copy of that) and are specifically saying you are ready to have an MRI done - no more guessing.

3. If PT is what is needed, the ortho will order that.

[choirfarm]

I am amazed at all of the similar responses. I am trying to decide if I should first get an MRI done and THEN find an orthopedist....OR find an orthopedist and have that doctor send us for an MRI? I just discovered that we might have met our deductible with my son's brokem arm this summer, so maybe doing the MRI before Jan 1st would be wise....however, is it possible if we would do that BEFORE talking to an orthopedist we would have to redo the test becasue it wasn't done to their specs?.....or is this a pretty general test and it won't matter? Does that make sense?

 

Also, can all of this wait until January? We are scheduled to leave on a Chrsitmas vacation right after Christmas (for about 2 weeks)...I might be able to schedule an MRI before that, but I highly doubt I can be seen by an orthopedist before Christmas.

 

Since you have met your deductible, I highly suggest that you get the MRI. Have your family doctor as for it as that will be faster and will save you some steps. You can take it in there when you see the orthopod. I also doubt that you could get in with an orthopod. My dh is booked until almost Feb, but you could try. CALL NOW. A lot of people schedule things when they are off for Christmas vacation. That is hubby's busiest time. He generally takes off for Christmas in January.:)

[Mrs Mungo]

I have an ACL tear from tripping over my vacuum and landing on my knee. It is too tiny to bother with surgery, and it only bothers me if I run more than a few miles. I had an MRI before seeing the PT, but I never saw an orthopedist. Your family doc could order an MRI and refer you to a PT or orthopedist, depending upon what the MRI shows.

Edited December 16, 2011 by Mrs Mungo

[Jan in SC]

In SC a physician must write a prescription for PT.

 

If you have met your deductible, then get the MRI. I would call the ortho first, and try to gt an appointment. Most offices have doctors that specialize in pediatrics, even if they don't list it. If your son broke his arm, you must have an ortho.

 

If you can see the ortho before the MRI, I would. My son has knees that partially dislocate when bending. They make popping noises and cause lots of pain. The ortho might diagnose something that doesn't need an MRI. My ds' treatment is PT, for now.

 

If you haven't met your deductible, everything can wait, but I would call and get an appointment before you leave, as it could be a month wait.

[Donna]

I would get the MRI ordered by your family doctor. The report should be able to just be sent to the ortho if you need one.

 

:iagree: Most of the orthos I have seen have wanted the testing done before they see my child anyway unless they were ordering a different test themselves. The ortho will probably want to see the films himself, though rather than just reading the radiologist's report.