joint pain

Never underestimate the importance of motion palpation

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Over the years I have personally witnessed time and time again a misdiagnosis.  The classic case is the individual with said "hip pain" and diagnosed with degenerative osteoarthritis of the hip as seen on an x-ray/MRI and the recommendation of complete hip replacement.  I have learned to never take that diagnosis at face value.  More often than I can count, after a complete physical examination I find the real culprit to be the lower spine, facet damage, bursitis or one of the sacroiliac joints.  Yes, they may indeed have some degenerative OA of the hip but if that's not causing the pain, then what good is it to perform a total hip replacement only to observe the patient when the surgery is complete and the pain remains!

This phenomenon can easily be related to any other joint in the body as well.  I'm always shocked after the exam when a patient remarks, "Why didn't my doctor do that?" and I say, "Do what?" "You felt around and moved me around in different positions until you found my problem, my doctor never touched me." Wow, just wow.

 I don't understand the omission of the physical exam by many doctors.  Getting a second opinion is always a good idea when something like spine surgery or a total joint replacement is recommended.  And with the advancements of today, options like stem cell therapy is proving to be a major game changer and making the spine surgery/joint replacement folks very nervous.  Don't get me wrong, joint replacement surgery will never go away as there are times when it is completely necessary.  But, necessary is becoming less and less common.

chronic knee-cap pain

Doug. 54 yrs.   Poor guy, he's in his 50's and excited about the recent snow in the mountains and getting excited about skiing at Steven's Pass.  Started doing some leg exercises and strength training and started getting really severe knee pain under the knee cap.  That was 2 weeks ago and not improving.  Admits he's had knee pain off and on for years but never this bad.

This side view of the knee cap revealed a dark line and a pointy part at the top of the cap.  Do you see it?  This is the beginning of advancing OA of the patellofemeral joint (the space under the knee cap)  What to do?  Stem cell injections of the space under the joint has been extremely well tolerated, and mostly painless procedure that will allow him to gradually over 5 months, regenerate his own knee.  He agreed with the procedure and we're scheduling him for Amniocyte injection next week.  Will keep you posted on Doug's results. :)

This side view of the knee cap revealed a dark line and a pointy part at the top of the cap.  Do you see it?  This is the beginning of advancing OA of the patellofemeral joint (the space under the knee cap)  What to do?  Stem cell injections of the space under the joint has been extremely well tolerated, and mostly painless procedure that will allow him to gradually over 5 months, regenerate his own knee.  He agreed with the procedure and we're scheduling him for Amniocyte injection next week.  Will keep you posted on Doug's results. :)