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Did foot surgery. Having pain with elevated D-dimer level. Should I request for MRI?

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Orthopaedic Surgeon
Practicing since : 1998
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My 10 year old son recently had foot surgery, and has been no weight bearing for 4 weeks now. He developed pain on his left side and then shoulder PCP sent him for ultrasound of legs which was clear but blood work came back with elevated D-dimer level, believe it was .58? X-rays were also done and were clear too. He is still having pain though. Should I request an MRI?
Posted Thu, 24 Oct 2013 in Bones, Muscles and Joints
 
 
Answered by Dr. Vaibhav Gandhi 2 hours later
Brief Answer:
Yes, you could request a MRI

Detailed Answer:
Hello,

As per your history, reports and age of patient there is possibility of infection of bone, due to injury or collection of haematoma.
Yes I will to go for MRI and rule out any residual abnormality.

Till time give rest to leg and if required give splint to leg should be given.
You also can repeat blood investigation as parameters can change fast in children.
Due to chairi malformation there can be depressed immunity so you can suspect
Infection.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Wishing you good health.

Take care
Above answer was peer-reviewed by
 
Follow-up: Did foot surgery. Having pain with elevated D-dimer level. Should I request for MRI? 7 hours later
What if PCP says no? Do I press for one? With the PDD/NOS my son presents unusual with his pain at times, a stranger or someone less familiar with him, can think he is fine. I' ve learned very well how to read my child and he is not fine .
 
 
Answered by Dr. Vaibhav Gandhi 5 minutes later
Brief Answer:
Yes do insist him

Detailed Answer:
Hello,

If he is not very sure of his clinical findings then you can insist him.

Take care.
Above answer was peer-reviewed by
 
Follow-up: Did foot surgery. Having pain with elevated D-dimer level. Should I request for MRI? 7 minutes later
Okay. Thank you very much for your (professional) help, this has been very scary. My sons foot surgery was due to a congetial bone malformation, his bones were fusing together in his foot. Does that relate to the Chiari and palate?
 
 
Answered by Dr. Vaibhav Gandhi 5 minutes later
Brief Answer:
Yes these are related

Detailed Answer:
Hello again,

Chiari and cleft palate are formation defects and so is defect in formation of bone.
So these are related to genetic dysfunction.

Take care.
Above answer was peer-reviewed by
 
Follow-up: Did foot surgery. Having pain with elevated D-dimer level. Should I request for MRI? 14 minutes later
Does that still mean possible bone infection then?
 
 
Answered by Dr. Vaibhav Gandhi 13 hours later
Brief Answer:
LESS PROBABLE

Detailed Answer:
Hello again,

Probability of infection is reduced. You can discuss with the surgeon who can completely rule out infection through a clinical exam.

Take care
Above answer was peer-reviewed by
 
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