radiologist Archives - DOC

#860 Radiologist and Orthopedic doctor disagree on my stress fracture diagnosis

Just this morning, during the live Stress Fracture Masterclass I had an interesting question.

The story went like this. An athlete who is a State ranked high school cross country and track, had to suddenly stop running due to intense pain that started about 15 days ago.

He went and saw a doctor. He got x-rays. He got an MRI, had a physical exam where the orthopedic doctor poked around and tried to figure out what was going on. The Orthopedist gave on diagnosis, but the Radiologist suggested a different diagnosis.

This is where the trouble comes in.

So, the runner was told a couple of different things, 1) a stress reaction, or 2) stress fracture, possibly of A) the third metatarsal or B) intermediate cuneiform bone, at the base of the third metatarsal.

Confused yet?

So was this runner!

What do you do if you think you have a stress fracture, you see an orthopedic doctor and the radiologist who reads your images s disagrees about your diagnosis.

Well, that’s what we’re talking about today on the Doc On The Run Podcast.

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#608 The benefit of your radiologist being clueless

The radiologist reading your MRI knows nothing about your problem.

The only clues a radiologist gets about your injury are described in the clinical history section of the MRI order from your doctor.

I just got off a call with a runner who had gotten an MRI order from his doctor. He had a long history of injury but the only description on the MRI order was “Concern for fracture.”

This runner had more than just a concern for a possible fracture.

But because there was such a limited description for the radiologist, the injured runner was understandably irritated and frustrated that the radiologist didn’t have the full information.

I will admit that I also get very upset about this when I’m looking for something obscure that the radiologist is likely to miss, unless it’s on their radar.

But there is an up-side to everything!

Today on the Doc On The Run podcast, we’re talking about the benefit of your radiologist being clueless.

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#374 Can you see Raynauds Phenomenon on an MRI in a runner?

Raynaud’s Phenomenon is an interesting condition in which spasms of small blood vessels cause changes in the skin color of the hands and feet. Raynaud’s phenomenon can also cause pain in the feet. Foot pain is also very common in runners.

Raynauds is one of those conditions that isn’t typically diagnosed with a blood test or and x-ray. The diagnosis is typically made “clinically” meaning the doctor hears your story, listens to your history and decides you probably have the condition, because nothing else fits.

The question is whether or not a runner who gets an MRI because of foot pain, might have something show up on the MRI images that can indicate Raynaud’s is contributing to the runner’s trouble.

Today on the Doc On The Run Podcast, we’re talking about wether or not you can see see Raynaud’s Phenomenon on an MRI in a runner.

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