Torn Meniscus, Not Sure About the Dr...?

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02-22-2018, 11:18 AM
C.O. Jones

Torn Meniscus, Not Sure About the Dr...?

I'm curious to see other people's experiences with tearing their meniscus. I've read a bunch of stuff on here and other sites about it, but wanted to know how other people's treatment progressed.

I hit a patch of ice at the apex of my turn in early January, skis washed out and I loaded the tails with my butt basically on my skis, in addition to a bit of a twisting rotation. Felt like someone cracked a walnut inside my knee. Not a pop, but more of a grinding / cracking feeling. It was decently swollen shortly thereafter and lasted for about a week with lots of ice and elevation.

ER said I still had stability in my knee, didn't think it was ACL. This is a nurse, 24 hours after the fall. X-Ray shows no bone damage. Then I went to my general practitioner, who repeated the diagnostic - good overall stability, seems like a meniscus tear. He doesn't want me to get an MRI, which I find odd but he sells me on the idea. This is approx 4 weeks after the accident.

During this time, I can't bend the leg more than about 3 inches off the ground. I don't have enough flexion in my knee to walk up stairs. I can put weight on it and walk, but any bend outside of the 3 inches it allows is excruciating, almost worse than the accident. No clicking / not locked straight.

I'm now 6 weeks out, with no improvement in range of motion. I called the dr. yesterday and basically demanded a handoff to the orthopedist and an MRI. He's making me come back to see him once more to "build a case for the insurance company to cover the MRI". He says any motion that doesn't hurt is okay, but given the lack of an MRI i'm concerned that if it's something else, maybe I'm damaging other things.

Has anyone else been told to wait on the MRI? It just seems strange to me, and I'm not confident he's looking after my best interests. Maybe he is - but I'm curious as to other people's experiences. Also, anyone else tear their meniscus and have this limited of a range of motion / similar symptoms? Everything I read seems to be "hurts when bent past 70-80-90 degrees".
02-22-2018, 11:31 AM
I've seen black diamonds!

Don't accept an orthopedic diagnoses from your GP. MRI or not, go see a specialist.
02-22-2018, 11:42 AM
splat

You're young. You got the rest of your life to learn to use a cane.

If you don't keep up their asses, they're on to the next victim. I just spent a week fighting for an mri.
02-22-2018, 06:48 PM
Kinnikinnick

Go to orthopedic surgeon. Get MRI. Try PT unless the surgeon puts you in the 90% chance of successful repair. Get multiple opinions from Orthos.

See the other meniscus thread for some stories, including mine in progress.

I had what wasn’t even as obvious or debilitating injury as yours seems to be. I ignored, pushed through, did PT, eventually got MRI and diagnosis. I did the repair surgery some 8-9 months later. Sort of wished that I’d done it sooner - may give you a better prognosis.

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02-22-2018, 09:19 PM
jerlane

Quote:

Originally Posted by C.O. Jones

I'm curious to see other people's experiences with tearing their meniscus. I've read a bunch of stuff on here and other sites about it, but wanted to know how other people's treatment progressed.

I hit a patch of ice at the apex of my turn in early January, skis washed out and I loaded the tails with my butt basically on my skis, in addition to a bit of a twisting rotation. Felt like someone cracked a walnut inside my knee. Not a pop, but more of a grinding / cracking feeling. It was decently swollen shortly thereafter and lasted for about a week with lots of ice and elevation.

ER said I still had stability in my knee, didn't think it was ACL. This is a nurse, 24 hours after the fall. X-Ray shows no bone damage. Then I went to my general practitioner, who repeated the diagnostic - good overall stability, seems like a meniscus tear. He doesn't want me to get an MRI, which I find odd but he sells me on the idea. This is approx 4 weeks after the accident.

During this time, I can't bend the leg more than about 3 inches off the ground. I don't have enough flexion in my knee to walk up stairs. I can put weight on it and walk, but any bend outside of the 3 inches it allows is excruciating, almost worse than the accident. No clicking / not locked straight.

I'm now 6 weeks out, with no improvement in range of motion. I called the dr. yesterday and basically demanded a handoff to the orthopedist and an MRI. He's making me come back to see him once more to "build a case for the insurance company to cover the MRI". He says any motion that doesn't hurt is okay, but given the lack of an MRI i'm concerned that if it's something else, maybe I'm damaging other things.

Has anyone else been told to wait on the MRI? It just seems strange to me, and I'm not confident he's looking after my best interests. Maybe he is - but I'm curious as to other people's experiences. Also, anyone else tear their meniscus and have this limited of a range of motion / similar symptoms? Everything I read seems to be "hurts when bent past 70-80-90 degrees".

Your lack of motion is very concerning. Get in to an Orthopod and get an MRI. After that get a new pcp that isn’t an idiot.

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02-23-2018, 01:02 AM
old goat

The ortho is more important than the MRI. Regardless of what the MRI says you're going to see an ortho, given no improvement in 6 weeks, unless the ortho wants you to have the MRI first.
02-23-2018, 12:10 PM
C.O. Jones

Quote:

Originally Posted by splat

You're young. You got the rest of your life to learn to use a cane.

Sticking with a shock-absorbing trekking pole to keep the mountain town vibe alive. Wouldn't mind leaving it behind, though.

I appreciate the reinforcement on my decision to stop listening to my PCP. Seeing him next week, and heading to Mansfield Orthopedics in early march.

On that note, anyone have this limited of a range of motion with just a meniscus tear? My knee isn't locked, I can bend it a little, but then there's a hard stop when my foot is three inches above the ground.
02-23-2018, 12:28 PM
jerlane

“Locked” doesn’t necessarily mean no range of motion. It can limited range of motion as well. I’ve seen patients with displaced bucked handle meniscus tears with full ROM.

There are other things that can limit motion, but a meniscus tear is probably highest on the list given your scenario.

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02-23-2018, 01:12 PM
bknyc

tore meniscus 6 weeks ago, surgery 4 weeks ago

I tore my lateral meniscus 6 weeks ago snowboarding. Hit a 30', landed on the knuckle and heard a loud pop from my right knee. Originally I thought it was my ACL because of the pop. There was some minor swelling later that evening, but no pain. My knee wasn't locking and my range of motion was fine.

As a ski/snowboard instructor, I know knee injuries are common, so I scheduled an appointment with an orthopedic surgeon 4-5 days later; I didn't bother with seeing my PCP. I had an x-ray prior to seeing the surgeon (insurance requires this). The doctor confirmed that my ACL was fine from the physical examination, but wanted an MRI because of the swelling and the popping noise I heard.

The MRI results showed that I had a radial tear in my lateral meniscus.

My options were surgery or just physical therapy. Knowing that I had a radial tear (these types of tears do not heal on their own), and researching that meniscus repairs are most successful if done within 3-6 weeks from the accident, I choose to immediately have the surgery. Delaying it would also risk making the tear worse.

The surgery took less than an hour. The surgeon discovered that I basically split the meniscus in half - the MRI images didn't show this, it was only possible through arthroscopic surgery. So I am glad that I choose to have it done. Aside from stitching the meniscus together (btw, no trim required, the tear was clean, no frayed edges), they also did a PRP injection and a microfracture procedure (bone marrow stem cells) to help stimulate the meniscus to heal better.

If i didn't know about knee injuries prior to the accident, I probably would have tried to muscle through this and most likely ended up destroying the meniscus completely.

So, get an MRI...and if you can get your meniscus repaired, do it. Even though repairs aren't 100% successful, it's better than getting a meniscectomy even though the rehab time is much longer (6 months for me). You won't know any of this until the MRI shows what kind of tear you have, and just waiting means you're jeopardizing the chances of your meniscus healing, and possibly damaging the cartilage between your knee.
03-08-2018, 03:51 PM
C.O. Jones

Two thumbs up for the gimp central advice. MRI shows a torn ACL, no meniscus damage. Score 1 for crowdsourced advice over the (two!) medical professionals who were very confident that the physical manipulation tests they indicated a tear of the meniscus.

Long story short, get the fk'n MRI.
03-08-2018, 05:18 PM
jerlane

Bummer about your ACL. Good luck with everything.

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03-08-2018, 11:41 PM
old goat

Quote:

Originally Posted by C.O. Jones

Two thumbs up for the gimp central advice. MRI shows a torn ACL, no meniscus damage. Score 1 for crowdsourced advice over the (two!) medical professionals who were very confident that the physical manipulation tests they indicated a tear of the meniscus.

Long story short, get the fk'n MRI.

I still feel it's more important to see the specialist than to get the xray--let the specialist decide if the xray is necessary. That said, a lot of specialists want to see the xray first so you have no choice; I think that this is one of the problems with American medicine--both doctors and patients put too much importance on the xray and not enough importance on listening to what the patient has to say and on the physical examination. There are two things wrong with this--a lot of unnecessary xrays (not in this case of course) and too often it's the xray that gets treated and not the patient.
03-09-2018, 06:55 AM
C.O. Jones

Quote:

Originally Posted by old goat

I still feel it's more important to see the specialist than to get the xray--let the specialist decide if the xray is necessary. That said, a lot of specialists want to see the xray first so you have no choice; I think that this is one of the problems with American medicine--both doctors and patients put too much importance on the xray and not enough importance on listening to what the patient has to say and on the physical examination. There are two things wrong with this--a lot of unnecessary xrays (not in this case of course) and too often it's the xray that gets treated and not the patient.

Considering I told both the doctors I saw that there was a moment where I was in the "phantom foot" position during my fall, and they both looked at me cluelessly, I'd have to agree.

It's tough because they both emphatically stated that the physical assessment pointed strongly to a meniscus. As a patient, it's a tough spot to figure out when to push and when to listen to them.
03-09-2018, 03:27 PM
old goat

Quote:

Originally Posted by C.O. Jones

Considering I told both the doctors I saw that there was a moment where I was in the "phantom foot" position during my fall, and they both looked at me cluelessly, I'd have to agree.

It's tough because they both emphatically stated that the physical assessment pointed strongly to a meniscus. As a patient, it's a tough spot to figure out when to push and when to listen to them.

Very true. As a general rule though, family docs and internists--especially internists--can't really be trusted when it comes to physical diagnosis, ie diagnosing hernias, orthopedic injuries, rashes, etc--anything that represents a disorder of anatomy. They have a shaky concept of anatomy since they don't see it live and haven't seen it dead in a very long time. One way to test, if an xray is involved--if the doc is reading an xray report they're not an expert on the subject. If they're reading the actual xray they probably are.

I don't generally agree with self referring to specialists. Primary docs aren't totally clueless and they generally will know what specialists scan help you the best, but if what the primary doc isn't making sense to you by all means insist on seeing a specialist. When to seek a second opinion from a second specialist--for any reasonably large elective operation, especially if the specialist tells you there is more than one reasonable option (or if your reading tells you that), or if you just don't like or feel comfortable with the specialist. And if a specialist is reluctant to refer you for a second opinion in an elective situation that's a red flag for me. My policy was to refer second opinions to someone I thought most likely to disagree with me; that was easy since there was only one other vascular surgeon in my dept and he almost always disagreed with me. (We're friends though.)
03-16-2018, 05:56 PM
splat

ACL recovery is a piece of cake. My meniscus story (two surgeries, I retore it five months after he sewed up a bucket handle tear, left medial) is I was crippled and saved by stem cells. Do some PRP on your knee, CO. You'll never regret it.