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Hip and chest pain after a fall. Facing difficulty in walking. Diagnosed with arthritis. Effective cure?

Feb 2014
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Answered by

Orthopaedic Surgeon, Joint Replacement
Practicing since : 2004
Answered : 5930 Questions
i HAD a very serious high-impact fall 7 years ago and hurt hip and chest. Got insurance and 2.5 years ago an MRI. My doctor said nothing was wrong with both my MRI's. I was focused on the hip because I cannot walk well at all. I know I let a lot of time pass, but I did ask for both reports when leaving his office back in 2010.

I focused on the hip immediately. The report came back with a "contusion", but was not definite due to no contrast. This year I decided to tackle the hip issue. Just had another MRI/arthrogram done and the doctor told me that all it was is "arthritis". I finally looked at the MRI disc and I found a lot of white spots on the right femor head and surrounding tissue as opposed to only a few on the left femor and surrounding tissue.

My right leg is angled, very painful, very difficult to get into a car, and by the end of a busy day in extreme pain. That leg is also just about a half inch longer than the left.

All the doctor wants to do to "start" is do a short of cortisone as an out-patient.

My research on the internet (OH YIKES), indicates that I possibly broke my pelvis and ripped muscles from the back, gluts, groin and down right leg. It also said a CT scan should have been done.

Over the years, (about 4 years ago), it seems to have compromised my left hip. Sometimes when getting off a couch or chair, my hips lock and either throw me back down or I stand there in pain for about 5 minutes trying to ease into a standing position.

My white blood counts are extremely elevated and have been for many years, even before this accident. My platelets are on the lower side also. 190-220.

I am very frustrated. I have been seeing a rheumatologist for almost 8 years and I do not have any diagnose other than "ARTHRITIS". (I also do have reynaud's and my history going back to the age of 4 has all the indications of Lupus, although I test negative for it. The rhummy just recently told me that only 1-2% test negative. Although years ago, after 2 miscarriages within the first trimester, I tested negative for my third pregnancy. I miscarried in the middle of the night and took the fetus to the Dr. who was very rude and told me it was nto a fetus. I asked him to run the test. He said to call him in 3 days. The following day, he called and was a fetus).

I know I have really gone off subject here. But what is your opinion of the hip. I just want to know the truth. I have also read about osteonecrosis. Does the bloodwork coincide with some of the symptoms of the white spots, pain, length and angle (my foot will not go straight and veers off to the right side)?

Any suggestion would be very helpful. I had seen two other orthos who only x-rayed my hip and saw nothing wrong. If I try to align the right foot, I have to hold my arms out to balance me.
Posted Wed, 20 Mar 2013 in Bones, Muscles and Joints
Answered by Dr. Saurabh Gupta 1 hour later
Thanks for posting your query.

From description it seems you might having arthritis of hip secondary to Avascular necrosis(Osteonecrosis). The risk factor for developing this in your case might be the trauma to the hip.

The X-ray may be completely normal, or it may show severe damage to the hip joint. If the X-ray is normal, an MRI will be performed to look for early signs of hip osteonecrosis.

There are many things you can do to reduce the pain and stiffness in your hip joints, and to make day to day life easier. Self-help measures can help to reduce the stress on your joints and reduce the severity of your condition. Some of the main ones are listed below.
1.Try to maintain a healthy weight for your height. This may mean losing weight if you’re overweight because it puts more stress on your joints and can make arthritis worse.
2.Exercise regularly and keep moving. Exercise can help to keep your joints working well but it’s important to rest your joints as well. Doing a little exercise regularly may be helpful.
3.Use a walking stick to ease any stress on your hip joint.
4.Wear shoes with a soft, thick, cushioned sole. This will help to reduce any jarring.
5.Massage the muscles around your joints affected by arthritis to help ease pain.
6.Use a heat pad or an ice pack to help ease pain.

Consult your orthopaedic for-
Electrical stimulation. Electrical currents may encourage your body to grow new bone to replace the area damaged by avascular necrosis. Electrical stimulation can be used during surgery and applied directly to the damaged area. Or it can be administered through electrodes attached to your skin.

you may need to consider surgeries such as:
Core decompression.
Bone transplant (graft).
Bone reshaping (osteotomy).
Joint replacement.

Discuss these options with your orthopaedic surgeon.

Hope this will help you. Please do write back if you have any additional concerns.

Wishing you good health...

Dr Saurabh Gupta.
Orthopaedic Surgeon.
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