#855 Doctor missed fracture on my X-rays - DOC

#855 Doctor missed fracture on my X-rays

My doctor missed a fracture on my x-rays. What should I do about that? Well, that’s a great question and that’s what we’re talking about today on the Doc On The Run Podcast.



Last night, I was doing a consultation with an athlete who had a fracture and what happened was, is that she kicked some furniture, she went to urgent care, they took x-rays, they looked at her foot, her foot was swollen, it was really painful. She couldn’t walk on it, it was black and blue.

What she said was, I was sure it was broken because I’ve had other fractures and I actually know what a fracture feels like and I know it was broken. So, she was a little concerned that they told her that it wasn’t broken. So, she called me for a second opinion and we did that last night.

This was the day after her fracture when we got on the call And she had a bunch of questions. I told her, “Look, first of all, it’s really normal. Doctors miss these all the time. I go to conferences, and I actually teach physicians how to not miss subtle fracture patterns in athletes, and it is easy to miss them.”

The first thing is, is that you have to remember if you go to urgent care, you go to the emergency room, well, those doctors actually don’t spend all day looking at fractures. They look at them some, but they don’t look at them all day. They do other things. They’re treating heart attacks and strokes, and pneumonia, all kinds of things that I don’t treat.

The first thing is that when you go to the doctor, number one rule is get the images. Do not leave without your image disk or actual plain film images of your x-rays. Don’t do that. Just earlier today, a guy called me. He actually has pain, he can’t run and I said, “I can see you for a second opinion today but do you have the x-rays?” He called them and they said, “We can’t give you the disc here, we can mail it to you, it’s going to take two weeks.” Who wants to wait two weeks for the x-rays?  So, when you’re there, if you request a copy of the images, they will give them to you. But do not forget that, that’s rule number one.

Rule number two, never rely on one opinion, particularly if you have a timeline like you have a race to do or if you don’t get better quickly. So, any doctor can be wrong. I can be wrong, anybody can be wrong. And so, if you get an x-ray, and they say there’s nothing wrong with it, that your foot’s fine, get a second opinion, you should always get a second opinion. And then if you’re trying to train, you’re trying to get back to activity and you still feel like you’re not improving as quickly as they told you that you should, well then you should get a third opinion.

When you get the third opinion, don’t just rely on the original x-rays. One of the tricks with x-rays is if you have an injury here, if you rotate the x-rays, you can’t see it anymore, it disappears if you rotate it as little as five degrees, sometimes subtle fractures like lateral process fractures disappear entirely. So, if you had x-rays, you saw a couple of doctors, you weren’t getting better and it was your ankle or one of your broken toes, well, what I would do is I would do one of three things. I would either get a second set of x-rays that are different, or I would get a CT-scan that really looks at it completely or I would look at it with ultrasound. But I would not rely on those images that  people already missed.

If you want to understand some more of these details related to fractures and runners, I created something for you. It’s a stress fracture masterclass. You can get it for free at www.docontherun.com/stressfracturemasterclass. So, go sign up and I’ll see you in the training.