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What Do These X-ray Findings Indicate?
Question: Please direct question to Dr. XXXXXXX Tayal.
As mentioned earlier, she had taken 1.5 month of near bed rest. After bed rest, though she was not feeling much pain, she started feeling more pain these days. The pain increase more once she does any physical activity that includes doing regular day to day work. Our surgeon suggested to take x-ray( which i had attached in email), he also asked us to try out INJ Forteo for 3-6 months before going for surgery. He also asked to take Ultracet instead of Hifenac-P. Sometimes, she is getting pain while in idle. Not sure, whether we are going in right direction. Could you please tell us
1. Is this related to any bone fracture
2. Though she is not having fever or swelling or reddishness, the pain is accumulated near to thigh bone. Do you think is this related to any infection.
Also please guide us the next steps.
As mentioned earlier, she had taken 1.5 month of near bed rest. After bed rest, though she was not feeling much pain, she started feeling more pain these days. The pain increase more once she does any physical activity that includes doing regular day to day work. Our surgeon suggested to take x-ray( which i had attached in email), he also asked us to try out INJ Forteo for 3-6 months before going for surgery. He also asked to take Ultracet instead of Hifenac-P. Sometimes, she is getting pain while in idle. Not sure, whether we are going in right direction. Could you please tell us
1. Is this related to any bone fracture
2. Though she is not having fever or swelling or reddishness, the pain is accumulated near to thigh bone. Do you think is this related to any infection.
Also please guide us the next steps.
Brief Answer:
No fracture is seen. Possibility of infection is there.
Detailed Answer:
Hello,
Thanks for posting your query.
I have seen the attached X-rays. There is no sign of fracture in the X-rays. The implant is well placed and seems to be fixed. However there is a slight thinning of the bone cortex in the upper part of the thigh- upper end of the X-ray. This can be suggestive of an infection in the area. It is best to get another X-ray of the upper part of the thigh with hip joint done to find in detail about any possible infection in the area. It can cause the thigh pain that she is having.
Inj. Forteo is a good option to treat osteoporosis. She can continue taking ultracet till then for pain relief.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Wishing you good health.
Regards.
Dr. Praveen Tayal.
For future query, you can directly approach me through my profile URL XXXX
No fracture is seen. Possibility of infection is there.
Detailed Answer:
Hello,
Thanks for posting your query.
I have seen the attached X-rays. There is no sign of fracture in the X-rays. The implant is well placed and seems to be fixed. However there is a slight thinning of the bone cortex in the upper part of the thigh- upper end of the X-ray. This can be suggestive of an infection in the area. It is best to get another X-ray of the upper part of the thigh with hip joint done to find in detail about any possible infection in the area. It can cause the thigh pain that she is having.
Inj. Forteo is a good option to treat osteoporosis. She can continue taking ultracet till then for pain relief.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Wishing you good health.
Regards.
Dr. Praveen Tayal.
For future query, you can directly approach me through my profile URL XXXX
Above answer was peer-reviewed by :
Dr. Prasad
Thank you doctor for prompt response.
Do you suggest to go with x-ray or any other tests? also, if there is any infection what would be the treatment?
Do you suggest to go with x-ray or any other tests? also, if there is any infection what would be the treatment?
Brief Answer:
X-ray is first basic investigation.
Detailed Answer:
Hello.
Thanks for writing again.
An X-ray is the first test. In case some abnormality is seen then CT scan and other blood tests like TLC and CRP will be helpful. Broad spectrum antibiotics are the mainstay of the treatment in case of infection.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Regards.
X-ray is first basic investigation.
Detailed Answer:
Hello.
Thanks for writing again.
An X-ray is the first test. In case some abnormality is seen then CT scan and other blood tests like TLC and CRP will be helpful. Broad spectrum antibiotics are the mainstay of the treatment in case of infection.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Regards.
Above answer was peer-reviewed by :
Dr. Prasad
Hello Doctor,
Please find attached x-ray covering the upper part of knee till thigh bone. Please let us know your opinion.
Thanks
XXXX
Please find attached x-ray covering the upper part of knee till thigh bone. Please let us know your opinion.
Thanks
XXXX
Brief Answer:
Chronic infection needs to be ruled out.
Detailed Answer:
I have seen the fresh X-ray. There is only a mild thinning of bone cortex that can be due to inactivity also. A small dot of bone cement is likely to be inside the bone cavity. This can also be the cause of pain in the thigh. To rule out chronic infection in the area, CRP levels can be evaluated.
Regards.
Chronic infection needs to be ruled out.
Detailed Answer:
I have seen the fresh X-ray. There is only a mild thinning of bone cortex that can be due to inactivity also. A small dot of bone cement is likely to be inside the bone cavity. This can also be the cause of pain in the thigh. To rule out chronic infection in the area, CRP levels can be evaluated.
Regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hello doctor,
Please find attached CRP and ESR reports and please suggest
Please find attached CRP and ESR reports and please suggest
Brief Answer:
ESR is raised.
Detailed Answer:
CRP is within normal limits. ESR is increased. This can be due to anemia or chronic bone infection. But since CRP is normal, an inflammatory process is less likely. In this situation, any treatment for infection cannot be started in the absence of a conclusive evidence.
It is best to continue with the pain killers and repeat ESR and CRP after 6 weeks to see the trends.
Regards.
ESR is raised.
Detailed Answer:
CRP is within normal limits. ESR is increased. This can be due to anemia or chronic bone infection. But since CRP is normal, an inflammatory process is less likely. In this situation, any treatment for infection cannot be started in the absence of a conclusive evidence.
It is best to continue with the pain killers and repeat ESR and CRP after 6 weeks to see the trends.
Regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks Doctor.
For past few days the pain is unbearable. She is feeling pain from thigh and is continuing till knee. Yesterday she felt something is pulling inside.
Our physician suggested to start anti biotic(augmentin-1gm, dalacin-c 300) and also suggested to take CT scan. Could you please suggest what we have to do now?
For past few days the pain is unbearable. She is feeling pain from thigh and is continuing till knee. Yesterday she felt something is pulling inside.
Our physician suggested to start anti biotic(augmentin-1gm, dalacin-c 300) and also suggested to take CT scan. Could you please suggest what we have to do now?
Brief Answer:
Start taking antibiotics.
Detailed Answer:
If the pain is severe then starting with antibiotics can help in pain improvement if it is due to a chronic infection.
CT scan will help in visualizing the bony abnormality more clearly. Do start with the antibiotics as suggested by your physician.
Regards.
Start taking antibiotics.
Detailed Answer:
If the pain is severe then starting with antibiotics can help in pain improvement if it is due to a chronic infection.
CT scan will help in visualizing the bony abnormality more clearly. Do start with the antibiotics as suggested by your physician.
Regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hello Doctor,
Today we went to near by hospital called Sparsh hospital. Doctor suggested to take PET scan. Because of higher cost, we are contemplating whether we really need this scan or not. Could you please suggest do we need PET scan, if not what is other scan can we get it done to see is the pain is due to infection or stress fracture or loosening of material.
Or do you suggest us to wait for few more days of antibiotic course before going for any further steps. Would you also please tell me how many days of antiboitic course is needed for result to reflect.
Thanks
XXXX
Today we went to near by hospital called Sparsh hospital. Doctor suggested to take PET scan. Because of higher cost, we are contemplating whether we really need this scan or not. Could you please suggest do we need PET scan, if not what is other scan can we get it done to see is the pain is due to infection or stress fracture or loosening of material.
Or do you suggest us to wait for few more days of antibiotic course before going for any further steps. Would you also please tell me how many days of antiboitic course is needed for result to reflect.
Thanks
XXXX
Brief Answer:
PET scan will be helpful.
Detailed Answer:
PET scan will help in identifying the exact site of infection or any tumor in the part scanned. It is a useful test and will help in pin pointing the diagnosis. Even after starting with the antibiotics it will take at least 2 weeks for a chronic infection to show some signs of improvement. It is better to confirm the diagnosis first and then plan the best line of treatment.
Regards.
PET scan will be helpful.
Detailed Answer:
PET scan will help in identifying the exact site of infection or any tumor in the part scanned. It is a useful test and will help in pin pointing the diagnosis. Even after starting with the antibiotics it will take at least 2 weeks for a chronic infection to show some signs of improvement. It is better to confirm the diagnosis first and then plan the best line of treatment.
Regards.
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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