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What Do These X-ray Findings Indicate?
Question: I had orthoscopic surgery done 6mo. ago for a laberal tear in my hip. Although I am able to stand now I still can not walk more then 20 feet without pain. An MRI shows moderate arthritis. Prior to the surgery the Dr. had said the arthritis wasn't anything that should bother me. I feel a slight burning in the groin and upper thigh and I can't lift my leg straight up from a laying down position or get into the drivers side of my car. I have to physically lift my left leg with my arms. This was happening before the surgery as well. Does the arthritis in the xray look like it could be causing this pain or are there other concerns I should look into? I am not on any medications.
Brief Answer:
Hip Arthritis
Detailed Answer:
Good evening
Thank you for writing on health care magic
Well, I have gone through your X Rays and the history. There is definite reduction in the joint space between the hip joints. Looks more of an Osteoarthritis.
But for him to refer you to a rheumatologist, we may have to look into other causes for the problem as you are still not too old to be having such sort of Arthritis. I would like to ask you a few more details to see if it is an inflammatory arthritis or the age related degenerative one:
1. Any other joints which are affected?
2. What has been the duration of the joint pain?
3. Is it better in the mornings or worse??
4. Anytime you have got the blood tests done???
5. ANy associated backache or neck pain?
Well, for the pain and burning you are having, it looks more of a nerve compression( Meralgic Paraesthesia). It can be due to compression of the nerve due to joint or due to Diabetes ( if you have that is).
Looking at your X ray , it does not look so bad which could be causing your symptoms. Most people with worse X rays manage the work with it. You should look into muscle inflammation as well. An MRI of the left side would be of utmost help as it will help to look for muscle inflammation and for the arthritis aspect as well
Hope the information was useful
Do let me know these queries
Regards
Dr naval
Hip Arthritis
Detailed Answer:
Good evening
Thank you for writing on health care magic
Well, I have gone through your X Rays and the history. There is definite reduction in the joint space between the hip joints. Looks more of an Osteoarthritis.
But for him to refer you to a rheumatologist, we may have to look into other causes for the problem as you are still not too old to be having such sort of Arthritis. I would like to ask you a few more details to see if it is an inflammatory arthritis or the age related degenerative one:
1. Any other joints which are affected?
2. What has been the duration of the joint pain?
3. Is it better in the mornings or worse??
4. Anytime you have got the blood tests done???
5. ANy associated backache or neck pain?
Well, for the pain and burning you are having, it looks more of a nerve compression( Meralgic Paraesthesia). It can be due to compression of the nerve due to joint or due to Diabetes ( if you have that is).
Looking at your X ray , it does not look so bad which could be causing your symptoms. Most people with worse X rays manage the work with it. You should look into muscle inflammation as well. An MRI of the left side would be of utmost help as it will help to look for muscle inflammation and for the arthritis aspect as well
Hope the information was useful
Do let me know these queries
Regards
Dr naval
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answers to your questions:
1. No other joints affected
2.Joint pain has been since Dec. 2014 Ortho surgery in May. The pain from the section of the tear deep in my groin is gone after surgery but there is a different pain more focused on the front of my thigh along with pain doing anything weight baring like walking in the hip. The inability to lift the leg has been since Dec. 2014.
3. Pain is slightly less in the morning and when I stay off it for extended amount of time but as soon as I begin walking it begins to hurt. The burning is on and off and seems seperate from the hip joint pain I get from walking.
4. I have not had any blood tests.
5. I do have lower back tightness but no pain. I stretch in the morning and that helps loosen it up. Ive never had my back checked for anything just assumed its from the weight gain. I dont recall if I had the tightness in my back, back in Dec. because it wasnt painful, just tight.
There is no diabetes. Blood pressure went up over time due to weight gain during the wait for surgery. Other then that blood tests are good. CRP was 2.0. Dr. said the arthritis is degenerative. Pre surgery he said it wasnt anything that should bother me. Post surgery he says its moderate. So Im wondering if Im still inflammed from surgery except its been 6mo. now.
My MRI results are as follows:
Interval progression of moderate left hip joint osteoarthrosis with increasing subchondral sclerosis and edema involving the left acetabulum. There is loss of the superior compartment joint space with full thickness cartilage loss and diffuse degenerative labral tearing. Stable appearance of the 7mm anterior para labral cyst. Large joint effusion. Moderate lower lumbar joint degenerative changes. Low grade tear of the bilateral hamstring origins. Mild diffuse atrophy involving the gluteus and thigh muscles.
The Dr. is referring me to pain management and weight loss. Both I plan to do naturally as Im sensitive to drugs and since this seems to be long term am not interested in taking pain meds for a lengthy time. My weight last Dec. was 180. I am now 225.
Thank you, I will request for neurologyst.
So my question is, any thoughts on the MRI? He disregarded the low grade tear of the bilateral hamstring origins saying thats just normal for me and explained the degenerative tear is just the thinning of the joint. I asked why I can't lift my leg and he said because you can't put a square block in a round peg. So I gather that means my joint isnt allowing me to move certain ways. He's a man of few words so it was hard to get an explanation and Im not a Dr. so don't always know the questions to ask. Thank you so much for your time!
1. No other joints affected
2.Joint pain has been since Dec. 2014 Ortho surgery in May. The pain from the section of the tear deep in my groin is gone after surgery but there is a different pain more focused on the front of my thigh along with pain doing anything weight baring like walking in the hip. The inability to lift the leg has been since Dec. 2014.
3. Pain is slightly less in the morning and when I stay off it for extended amount of time but as soon as I begin walking it begins to hurt. The burning is on and off and seems seperate from the hip joint pain I get from walking.
4. I have not had any blood tests.
5. I do have lower back tightness but no pain. I stretch in the morning and that helps loosen it up. Ive never had my back checked for anything just assumed its from the weight gain. I dont recall if I had the tightness in my back, back in Dec. because it wasnt painful, just tight.
There is no diabetes. Blood pressure went up over time due to weight gain during the wait for surgery. Other then that blood tests are good. CRP was 2.0. Dr. said the arthritis is degenerative. Pre surgery he said it wasnt anything that should bother me. Post surgery he says its moderate. So Im wondering if Im still inflammed from surgery except its been 6mo. now.
My MRI results are as follows:
Interval progression of moderate left hip joint osteoarthrosis with increasing subchondral sclerosis and edema involving the left acetabulum. There is loss of the superior compartment joint space with full thickness cartilage loss and diffuse degenerative labral tearing. Stable appearance of the 7mm anterior para labral cyst. Large joint effusion. Moderate lower lumbar joint degenerative changes. Low grade tear of the bilateral hamstring origins. Mild diffuse atrophy involving the gluteus and thigh muscles.
The Dr. is referring me to pain management and weight loss. Both I plan to do naturally as Im sensitive to drugs and since this seems to be long term am not interested in taking pain meds for a lengthy time. My weight last Dec. was 180. I am now 225.
Thank you, I will request for neurologyst.
So my question is, any thoughts on the MRI? He disregarded the low grade tear of the bilateral hamstring origins saying thats just normal for me and explained the degenerative tear is just the thinning of the joint. I asked why I can't lift my leg and he said because you can't put a square block in a round peg. So I gather that means my joint isnt allowing me to move certain ways. He's a man of few words so it was hard to get an explanation and Im not a Dr. so don't always know the questions to ask. Thank you so much for your time!
Brief Answer:
LEft leg weakness
Detailed Answer:
Good evening
Sorry for the delayed reply
Had a long 24 hour duty
I have gone through your history and the reply. The MRI is suggestive of a degenerative disease but there is significant effusion as well around the joint which is probably restricting to mobility and causing inability to move. Weight loss and pain management are needed but they are not gonna help for acute stages. Probably your weight has increased quite some( 180--225) which is putting more pressure on the hips and causing restriction.
But I still feel the effusion has to be taken care of first with priority causing it is causing atrophy of the muscles surrounding the area. The tear will not cause so many symptoms, especially the labrum one.
The only thing i am worried is...if the effusion developed before or after the repair?
But the best way to approach would be an ultrasound guided aspiration of the fluid and maybe an intra articular injection into it. That would relieve the compression it is causing on your joint and allow for mobility. Or else the muscles will keep getting atrophied
But just rule out muscle involvement ( CPK levels and LDH levels to be sure it is not a focal myositis.
I am not too sure how waiting period in your condition would help. We are more on aggressive modes, so we prefer to attack it at the earliest. Some prefer waiting and seeing if it resolves by itself
I hope the information was useful
Do let me know for more queries
REgards
Dr Naval
LEft leg weakness
Detailed Answer:
Good evening
Sorry for the delayed reply
Had a long 24 hour duty
I have gone through your history and the reply. The MRI is suggestive of a degenerative disease but there is significant effusion as well around the joint which is probably restricting to mobility and causing inability to move. Weight loss and pain management are needed but they are not gonna help for acute stages. Probably your weight has increased quite some( 180--225) which is putting more pressure on the hips and causing restriction.
But I still feel the effusion has to be taken care of first with priority causing it is causing atrophy of the muscles surrounding the area. The tear will not cause so many symptoms, especially the labrum one.
The only thing i am worried is...if the effusion developed before or after the repair?
But the best way to approach would be an ultrasound guided aspiration of the fluid and maybe an intra articular injection into it. That would relieve the compression it is causing on your joint and allow for mobility. Or else the muscles will keep getting atrophied
But just rule out muscle involvement ( CPK levels and LDH levels to be sure it is not a focal myositis.
I am not too sure how waiting period in your condition would help. We are more on aggressive modes, so we prefer to attack it at the earliest. Some prefer waiting and seeing if it resolves by itself
I hope the information was useful
Do let me know for more queries
REgards
Dr Naval
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.
Above answer was peer-reviewed by :
Dr. Yogesh D
Answered by
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