MRI Hip RT w/o contrast
Clinical history: Pain
An MRI of the right hip was performed utilizing axial fat saturated proton density, coronal inversion recovery, and sagittal fat saturated intermediate weighted sequences.
Findings:
There is no evidence of fracture or avascular necrosis. There is a small amount of fluid within the hip joint, likely physiologic.
There is bone marrow edema within the lateral aspect of the femoral head compatible with the femoracetabular impingement. There is associated increased signal within the anterosuperior labrum consistent with a nondiplaced tear. Note is also made of thickening of the ligamentum teres consistent with ligamentum teres syndrome.
The visualized musculature is unremarkable. The hamstring tendon origins and gluteal tendon insertions are unremarkable.
There is fluid within the obturator internus bursa consistent with obturator internus bursitis. There is no evidence for ilipsoas or greater trochanteric bursitis.
Limited evaluation of pelvic soft tissues demonstrates no abnormality.
Impression:
1. Thickening of the ligamentum teres consistent with ligamentum teres syndrome.
2. Findings compatible with femoracetabular impingement and an associated nondisplaced anteosuperior labral tear.
3. Obturator internus bursitis.
30 July, 2007
How quickly it wears off...
Well, about four weeks after the injection, the pain started to return. Here and there I would move and the hip would do a funky thing, or I'd start to limp on and off. And it's been downhill ever since.
I had an appt w/ Dr. Kelly on Friday, 27 July. He examined me and said that he thinks it's time for the surgery. I asked if I could wait until September for various reasons and he said so long as I can keep the strength up to what it is now, that should be fine. I am afraid of that as the hip is getting worse on a daily basis.
Ok, just got off the phone w/ Dr. Kelly's office and surgery is now scheduled for the 17th September. Fingers crossed I make it that long!
I had an appt w/ Dr. Kelly on Friday, 27 July. He examined me and said that he thinks it's time for the surgery. I asked if I could wait until September for various reasons and he said so long as I can keep the strength up to what it is now, that should be fine. I am afraid of that as the hip is getting worse on a daily basis.
Ok, just got off the phone w/ Dr. Kelly's office and surgery is now scheduled for the 17th September. Fingers crossed I make it that long!
meeting the ortho
I was able to get an appointment with Dr. Kelly on 22 December. I had to wait about four or five weeks if I recall correctly. I figured I was at least getting a two for one deal as he does hips and shoulders.
I brought my xrays and mri and report from the drs. I must say I was a complete wreck when I saw him. I couldn't walk without a limp and was in so much pain that I cried anytime he touched or moved me around for the exam. He felt that I needed to try some PT so get some strength back before we even considered surgery. I agreed, as going into surgery w/o any strength can lead to a very poor recovery.
I started PT for my hip first, eventually adding my shoulder to the routine. This began at the end of December. Dr. Kelly wanted to see me 4 mos later to give the PT some time to work. And I have to admit it definitely helped. It was slow going because of the state I was in, but eventually I got to the point of walking without a limp! This was a great improvement, though I was a long way off from walking distances or bike riding or going to the gym.
I went back to see Dr. Kelly at the beginning of May and he said to keep up the PT and if it plateaued to let him know and we'd do an injection. The bursitis was much better at this point, but I had been feeling more pain in the groin area, which did indicate the tear. In June I rang Dr. Kelly and spoke to Arianna, his PA. She was very helpful and said since I wasn't really improving anymore that I should do the injection, it would help diagnose where the pain was originating from and if surgery would be helpful. Because of varied types of pain and the unstable joint, no one was really sure what was the main cause of the pain at this point.
11 June I had the injection. It was incredible. The dr asks you to rate your pain in certain positions pre-injection and then post. It was like I had a whole new hip ~ the pain just disappeared! I was in heaven! I hadn't been able to walk like that for so long I had forgotten what it was like. I went to a concert the next week and was able to stand and dance a bit to the music! I kept the pain log for a week as directed, and then faxed it over to the dr's office. He rang me to review, and said since the pain had subsided, I should try to strengthen up the leg as much as possible. He said there could be a few outcomes, but pretty much in my case when the injection stopped working, surgery would be the next step. But I was going to use up as much of the good time I had!
I brought my xrays and mri and report from the drs. I must say I was a complete wreck when I saw him. I couldn't walk without a limp and was in so much pain that I cried anytime he touched or moved me around for the exam. He felt that I needed to try some PT so get some strength back before we even considered surgery. I agreed, as going into surgery w/o any strength can lead to a very poor recovery.
I started PT for my hip first, eventually adding my shoulder to the routine. This began at the end of December. Dr. Kelly wanted to see me 4 mos later to give the PT some time to work. And I have to admit it definitely helped. It was slow going because of the state I was in, but eventually I got to the point of walking without a limp! This was a great improvement, though I was a long way off from walking distances or bike riding or going to the gym.
I went back to see Dr. Kelly at the beginning of May and he said to keep up the PT and if it plateaued to let him know and we'd do an injection. The bursitis was much better at this point, but I had been feeling more pain in the groin area, which did indicate the tear. In June I rang Dr. Kelly and spoke to Arianna, his PA. She was very helpful and said since I wasn't really improving anymore that I should do the injection, it would help diagnose where the pain was originating from and if surgery would be helpful. Because of varied types of pain and the unstable joint, no one was really sure what was the main cause of the pain at this point.
11 June I had the injection. It was incredible. The dr asks you to rate your pain in certain positions pre-injection and then post. It was like I had a whole new hip ~ the pain just disappeared! I was in heaven! I hadn't been able to walk like that for so long I had forgotten what it was like. I went to a concert the next week and was able to stand and dance a bit to the music! I kept the pain log for a week as directed, and then faxed it over to the dr's office. He rang me to review, and said since the pain had subsided, I should try to strengthen up the leg as much as possible. He said there could be a few outcomes, but pretty much in my case when the injection stopped working, surgery would be the next step. But I was going to use up as much of the good time I had!
Background
OK, so I guess I should give some background as to how I got here though that seems to be the big question. How did I get here? I never had an accident or injury to my hip. I do not do heavy duty sports either. So how is it my hip decided to fall apart on me?
Well, my brief medical history is as follow:
age 14 - diagnosed with bilateral chondromalacia in my knees
age 18 - right wrist started to hurt, A LOT! went to 7 dr's in 3 years, most of whom had no clue and one who even told me to call him instead of my mother when it hurt, b/c he was convinced it was in my head.
age 20 - met the hand surgeon of my dreams. (yes this was more important than any other average man!) his team diagnosed me straight away and i was off to have surgery in two weeks time. surgery was relatively successful, until...
age 23 - my right hand/wrist developed chondromalacia so i had to have surgery no. 2 to fix that. then at
age 25 - my left wrist was so jealous that it decided to want surgery too, actually this was surgery no. 3
age 30 - my right hand/ thumb and other bits decided to become a crazy mess of instability so i needed surgery no. 4
Now, in between all of these joyous surgeries, I was diagnosed with fibromyaglia syndrome whilst living in London when i was 22. I love, LOVE, L O V E London, but the weather over there puts me through the ringer. turns out low pressure and high humidity are one of my FMS triggers. I was in PT over there and when I came back to NY. My hand surgeon would not operate until I was stable with that and doing better. He sent me to a rheumatologist, who turned out to be not the brightest or most enlightened or even open to anything other than drugs.
OK, so moving along, my hips have been annoying me for ages, but not to the point where I couldn't really walk or exercise or bike ride. The would hurt, I would shift around, and relatively soon they would be quiet.
That was until last summer...
Ah, last summer. The right hip especially started to pop and click and do all sorts of wonky things on a much more regular basis. I was used to the occasional hip sublexation/dislocation that had been happening for a while, but this pain became all too frequent. It was hurting mostly on my outer hip, which I would later learn was trochanter bursitis.
I had a trip booked to London for a week in October. I decided I would wait to make an appt. to see a dr for the hip after the trip. I wanted to enjoy myself and not worry about appointments or diagnosis or anything of the sort. After all of the medical issues I've had, you start to put of the inevitable.
Big oops by me. I arrived on a Saturday am and left a week later on Sunday. During this time I walked a lot! I usually walk a lot, but in London somehow it always seems to double, especially now that the tubes are horrid. One day I went riding in Hyde Park, something I'd been longing to do. That made all the muscles in my legs ache for a couple of days so I was actually walking funny. I guess one shouldn't do an hours ride when one hasn't been on a horse for a bit! Still my hip wasn't doing hurting too much (I did keep lidoderm patches on it so that was probably masking the pain).
Saturday my friend and I went to do a walking tour in lovely Hampstead. Now, if you've not been, Hampstead is a very, very hilly village. So here we are on the walking tour, going from one lovely old place to another, and on one incline, POP! There goes the right hip. I seriously don't know how I was still standing from the pain. My friend was quite happy to turn back, but I am a bit stubborn (to put it mildly) and refused to let my last night in London be ruined by my crap body, so on we went. All I can say is thanks be to G-d for all the pubs in Hampstead that we stopped at on our tour! Afterwards, I hobbled onto the tube, then to the rail to go out to my friends house where I was staying. I was just hanging in there, and sitting on the train helped a bit, but then I had about a mile walk to his house. That was the longest walk of my life. To this day I do not know how I made it. I was able to take about 3 steps at a time. Stop, whimper, talk myself into moving again, and then another 3 steps. Longest mile of my life! I was a wreck when I got back and literally had to pull myself up the stairs to bed. At this point I'm thinking - yeah, really should have made that dr appointment already! Daft me.
Back in NY I ring some dr's that my main dr recommended. I had to go to the darling rheumatologist that I had written off a few years ago (long story) b/c she was the only one I could seem to get an appt with in the near future. My logic was at least I would be able to have the xrays and mri's started and then hopefully I would know what type of dr I needed to locate. The x-rays were fine, perfectly normal, the MRI not so much. After finally getting the radiologist's report she said I had an FAI, labral tear, bursitis, and some other random things. (btw, my right shoulder had been bad too so she did an xray of that which was fine, but not an mri, something about insurance not doing two mri's at a time). The rheumatologist told me to go see an orthopedist. I asked her for more details, as all of these words were like a foreign language to me, but trying to get an explanation out of her was like trying to find water in the Sahara desert during a drought. The only good thing she did was send me in Dr. Kelly's direction.
Well, my brief medical history is as follow:
age 14 - diagnosed with bilateral chondromalacia in my knees
age 18 - right wrist started to hurt, A LOT! went to 7 dr's in 3 years, most of whom had no clue and one who even told me to call him instead of my mother when it hurt, b/c he was convinced it was in my head.
age 20 - met the hand surgeon of my dreams. (yes this was more important than any other average man!) his team diagnosed me straight away and i was off to have surgery in two weeks time. surgery was relatively successful, until...
age 23 - my right hand/wrist developed chondromalacia so i had to have surgery no. 2 to fix that. then at
age 25 - my left wrist was so jealous that it decided to want surgery too, actually this was surgery no. 3
age 30 - my right hand/ thumb and other bits decided to become a crazy mess of instability so i needed surgery no. 4
Now, in between all of these joyous surgeries, I was diagnosed with fibromyaglia syndrome whilst living in London when i was 22. I love, LOVE, L O V E London, but the weather over there puts me through the ringer. turns out low pressure and high humidity are one of my FMS triggers. I was in PT over there and when I came back to NY. My hand surgeon would not operate until I was stable with that and doing better. He sent me to a rheumatologist, who turned out to be not the brightest or most enlightened or even open to anything other than drugs.
OK, so moving along, my hips have been annoying me for ages, but not to the point where I couldn't really walk or exercise or bike ride. The would hurt, I would shift around, and relatively soon they would be quiet.
That was until last summer...
Ah, last summer. The right hip especially started to pop and click and do all sorts of wonky things on a much more regular basis. I was used to the occasional hip sublexation/dislocation that had been happening for a while, but this pain became all too frequent. It was hurting mostly on my outer hip, which I would later learn was trochanter bursitis.
I had a trip booked to London for a week in October. I decided I would wait to make an appt. to see a dr for the hip after the trip. I wanted to enjoy myself and not worry about appointments or diagnosis or anything of the sort. After all of the medical issues I've had, you start to put of the inevitable.
Big oops by me. I arrived on a Saturday am and left a week later on Sunday. During this time I walked a lot! I usually walk a lot, but in London somehow it always seems to double, especially now that the tubes are horrid. One day I went riding in Hyde Park, something I'd been longing to do. That made all the muscles in my legs ache for a couple of days so I was actually walking funny. I guess one shouldn't do an hours ride when one hasn't been on a horse for a bit! Still my hip wasn't doing hurting too much (I did keep lidoderm patches on it so that was probably masking the pain).
Saturday my friend and I went to do a walking tour in lovely Hampstead. Now, if you've not been, Hampstead is a very, very hilly village. So here we are on the walking tour, going from one lovely old place to another, and on one incline, POP! There goes the right hip. I seriously don't know how I was still standing from the pain. My friend was quite happy to turn back, but I am a bit stubborn (to put it mildly) and refused to let my last night in London be ruined by my crap body, so on we went. All I can say is thanks be to G-d for all the pubs in Hampstead that we stopped at on our tour! Afterwards, I hobbled onto the tube, then to the rail to go out to my friends house where I was staying. I was just hanging in there, and sitting on the train helped a bit, but then I had about a mile walk to his house. That was the longest walk of my life. To this day I do not know how I made it. I was able to take about 3 steps at a time. Stop, whimper, talk myself into moving again, and then another 3 steps. Longest mile of my life! I was a wreck when I got back and literally had to pull myself up the stairs to bed. At this point I'm thinking - yeah, really should have made that dr appointment already! Daft me.
Back in NY I ring some dr's that my main dr recommended. I had to go to the darling rheumatologist that I had written off a few years ago (long story) b/c she was the only one I could seem to get an appt with in the near future. My logic was at least I would be able to have the xrays and mri's started and then hopefully I would know what type of dr I needed to locate. The x-rays were fine, perfectly normal, the MRI not so much. After finally getting the radiologist's report she said I had an FAI, labral tear, bursitis, and some other random things. (btw, my right shoulder had been bad too so she did an xray of that which was fine, but not an mri, something about insurance not doing two mri's at a time). The rheumatologist told me to go see an orthopedist. I asked her for more details, as all of these words were like a foreign language to me, but trying to get an explanation out of her was like trying to find water in the Sahara desert during a drought. The only good thing she did was send me in Dr. Kelly's direction.
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