Today I met with Mr N (my consultant) to discuss the results of the MRI Arthrogram. I was really hoping that he would be able to clearly see where the pain was coming from, but unfortunately that didn’t happen.
My MRI-A results show an impingement on the femoral head (cam shaped). It was expected that a labral tear would also be seen as this is a known source of pain with FAI, but one couldn’t be seen.
As it is not possible to identify the source of pain, Mr N said that he doesn’t know how to stop it hurting. Exploratory open surgery MAY reveal something that didn’t show up on the MRI-A, but this is not guaranteed. He said I need to think about whether I am willing to go through the operation and recovery with the possibility that I could be the same afterwards. I’m not sure how I feel about that at the moment.
As nothing was apparent on the MRI-A (apart from the impingement), it was suggested that this could, although unlikely, be a tissue or tendon issue outside of the joint, and that the impingement has nothing to do with the pain. To test this, I will be having a local anaesthetic injected into the joint… if the pain or catching stops, Mr N can conclude that the problem is from within the hip and that open surgery is worthwhile (though still with the caveat that he may not be able to fix me).
The MRI-A contrast dye irritated my hip, so this is a good indicator that the pain is coming from within the joint and not from tissue outside. Still, we’re going to do the local anaesthetic test to make sure.
After that I need to decide whether to go ahead and have open surgery. It’s a daunting prospect given that it may not improve things.
16 September 2009
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Hi! I just randomly came across your blog. I am 16-days post-op for FAI resulting from a cam lesion. I had surgery to repair a labral tear 2 years ago, got back into running and cycling, and then started to have problems again. This time there was no labral tear apparent in the MRI but a cam lesion was found from a CT scan. Once they went in there, they found a bone spur on the socket that had developed directly across from the cam lesion which was pinching tissue plus some other stuff causing me pain (scar tissue, floating pieces of bone, etc) that they did not see from the MRI. Both of my hip surgeries were done arthroscopically. Only a handful of doctors perform this surgery arthroscopically. It is a much quicker recovery time than the open surgery. My first surgery was 6 months recovery (longer because I had a psoas release) and this surgery should be 3-4 months recovery. I have heard that the open surgery could be over a year recovery time. I had both surgeries at Hospital of Special Surgery by Dr. Bryan Kelly. Maybe call his office to see if they can recommend someone in the UK.
ReplyDeleteBest of luck!
Sandy
Hi Paul,
ReplyDeleteSorry to hear your scan didn't show what you wanted it to, but keep in mind that just because it doesn't show on there, doesn't mean there isn't a tear.
Also, I'd be very concerned that your doc is willing to do open surgery with no 'real' need?? It is major major stuff and I would look for a second opinion with someone who can do it via scope.
Hi Paul, I'm 30 as well and I recently had pain in my hip for a few weeks not agony but not nice either. My chiro sent me for an MRI (not an MRI-A so no contrast). The results are similar to yours - a mild FAI cam impingement with a blunted labrum but no tear. I could go see a specialist about it, Melbourne, Australia apparently has two of the best specialists in the world ( www.hiparthroscopy.com.au ) so I would be in good hands, but at this stage I will just see how it goes because they will probably tell me the same thing your guy did. I am concerned about long-term scenarios such as Arthritis or full hip replacements. Thanks for the info though, and I've got your blog on my rss feed.
ReplyDeleteI want to share my story here to see if it helps. I'm in the U.S. I am 44 now and was having hip problems in my late 20s. I would have general hip pain, and sometimes my leg would buckle. I had xrays done in the early 90s and was diagnosed with hip dysplasia and osteoarthritis. Over the years I would have bouts of hip pain that would last about 2 weeks and go away. About a year and a half ago, I almost fell down the stairs carrying a heavy table and that started continuous, chronic, and acute pain in my hip, knee with shooting pains down my leg and into my ankle. I've been living with this since 1/08. In addition to conventional medicine, which seemed to immediately want to go the hip replacement route which I disagreed with, I started investigating alternative medicine -- accupuncture, physical therapy, massage therapy, magnets, elimination diet, supplements, biofeedback, chiropracty. I tried these with varying levels of success but the pain never really went away. I've been to four different orthopods, looking for one I feel comfortable with. I started seeing one a couple weeks ago, and he was conservative which I liked. He was he one who recommended the MRI arthogram which I had today to see if the pain was a labral tear or something else. He's not a real believer in arthroscopy. In any case, two days ago, I went to see another alternative med doctor who did applied kinesiology. In one session, he fixed the shooting pains and eliminated much of the pain I was having. I can't explain what he did, but I wish I had found him a year and a half ago. It would have saved me a lot of pain. The moral of my story is that we should all recognize the different disciplines have different lenses and their answer may not be the "real" answer to our problems. If you haven't considered other therapies, I would really recommend looking into them before going to a surgical solution. If your problems are soft-tissue related, surgery will not fix that and you'll be cut open for naught. Personally, I am trying to take advantage of what's available to me, both conventional and alternative therapies, so I can figure out the right thing to do for me.
ReplyDeleteWhat was the specialty of the doc... I have been having this issue for 10mos
DeleteWhat was the specialty of the doc... I have been having this issue for 10mos
DeleteWhat was the specialty of the doc... I have been having this issue for 10mos
DeleteI'm reading your story and it sounds similiar to mine. I'm a 37 yo female in USA. starting having sharp pain in front of hip bone April 08 right before a hiking trip. At that time I was an active person - running, hiking, yoga, etc.
ReplyDeletepain progress to sciatic nerve down the leg, low back @ SI joints, inside of thigh, outside of thigh, soft tissue feels really tender. tried everything...chiro, accupuncture, physical therapy, water therapy, cortisone shots. have had nerve tests, MRI of spine and SI joints, bone scan, xray of hip - they show nothing!
I've been through a rhematologist, and a neurologist and now I"m seeing an orthopedic surgeon tuesday to see what he can find. I have not had the MRI arthrogram of the hip. my pain has gotten SO bad. I'm limping and even having difficulty driving. stairs are not an option. sitting a long time hurts and then when I stand...oh boy!
I cannot bend and stoop. getting comfortable to sleep is difficult. it feels like a deep aching and sometimes sharp shooting pain...moves around.
this is so discouraging. I just got married last year in October so this has been quite a challenge. the hiking trip where I first noticed this was the week of my engagement!
my precious hubby is supportive but unless you experience this daily for this long there is no way to understand. add to that working on a stressful job in a hospital. I don't know what I'll do if I have to be out for a surgery b/c we still have 2 mortgages b/c haven't sold his house yet.
I will check back to see how your surgery goes. hope everything goes really well.
Angie
Hi Paul - I'm a 38yo male who has just been diagnosed by Marcus Bankes ( london based ) for a cam lesion on my right hip. I reguarly play football and am active with other sports. In the past year i've been experiencing a mild ache in the hip with additional lower back pain. I've had MRI and CT scans which reveal cam lesions on both hips which i've been told are hereditary. My dad is about to have a full hip replacement and Mr.Bankes recommends i have the surgery to remove the cam lesion which will help prevent ( though not guarantee! ) a hip replacement later on in life.
ReplyDeleteIt feels like a gamble to have surgery as i'm not in huge discomfort though i'm told that the hip will eventually become arthritic and i should look at my dad's pedicament as an incentive to get it done!
Good luck with your surgery and look forward to hearing how it goes.
Mike ( London )
I'm sorry to here it didn't show anything. I am 13 years old and having the same problems... They can't find anything wrong with my hip either. It can be very frustrating especially because i am so young and can't really do much having already gone through physical therapy twice xrays and 4 MRIs including 2 with contrast. I hope everything goes well with you... and me
ReplyDeleteHas anyone had surgery for a labral hip tear and hip impingement with Dr. Robert Buly at HSS in NYC? I have been diagnosed with both and am considering surgery.
ReplyDeleteThanks
Yes i am 17 years old and i tore my labrum and i got sugrey to repair it. They re-attached my labrum and shaved the head of my femur bone down. The sugrey went really well, i am 3 months out from sugrey and recovery is going really good. I would recomend sugrey because my hip feels so much better.
DeleteI'm writing to see if anyone has had or heard of my situation:
ReplyDeleteI'm a distance runner. Went for 2+ years with a torn labrum in my right hip- tried so many things prior, but nothing helped. Got labral repair and psoas release in Nov. 2009- my hip has started feeling much better and just started mini jogs (5-10mins) only 2 weeks ago.
HOWEVER, 3 weeks ago my other (left) hip started hurting in the SAME way as my right did prior to surgery. Haven't yet had an MRI, but know for sure that the left tore just due to symptoms.
My left hip is getting worse everyday. I know physical therapy won't help b/c have been doing it since December and the left started hurting while still doing it. If torn, considering getting the left fixed ASAP b/c I don't want my entire left side to get messed up like what happened to the right... Any thoughts or words of wisdom?
Hi,
ReplyDeleteMy brother is diagnosed with Femoroacetabular impingement, mixed. arthroscopic surgery has been suggested and they have set a date in December.
Has anyone had this operation? And if so, in your estimation, was it successful / a good decision? I am extremely skeptical as this is a relatively new finding and procedure. From personal experience, recovery time often can be significantly worse - and in some cases, impossible - than doctors lead us to believe. My father had a hip replacement 6 years ago, from which he still has not recovered. My younger brother had a wrist surgery, from which he has not recovered and remains with the original pain. All consulted “leading surgeons” in their respective fields, Hospital of Special Surgery in NYC, surgeons of professional athletes, etc. I do not find much on the web and have not found anyone who has gone through this. Only a few success stories published by the arthroscopic clinics or association of arthroscopic surgeons….
Thank you,
There is a very active blog on Active.com
ReplyDelete-The forum is called : Hip Arthroscopy & Labral Tear
I would totally recommend joining and reading all the info. The members are inviting and have tons of info.
I'm having the surgery on Thursday. There is tons of patients who have benefited greatly from this surgery. Stay postive! Check out the forum and speak to the others for questions/support.
Take care!
I'm a 34 yr old very active female. I work as a personal trainer and am a student paramedic. My hip pain started this April, i noticed it after doing hill sprints with a client. It has now progressed and totally slowed down my activity levels. I cant sit at uni and i cant sit at home, stairs are difficult too. I think this is what i have although i cant be sure but all symtoms are the same. Very disheartened and dicouraged.
ReplyDeleteHi All, I am a 38 yr old female & was diagnosed with hip impingement and a labral tear earlier this year. Diagnosis was based on history, examination, MRI-A and Acrobot CT. I had arthroscopic surgery to treat this a few weeks ago now which involved femoral osteoplasty (reshaping) and labral debridement. My symptoms are already enormously improved although obviously its a bit sore post op. I would suggest that anyone struggling with this diagnosis should see someone who specialises in hip disorder (as opposed to a general orthopaedic surgeon) & who is EXPERIENCED in hip arthroscopy. There are many out there who lack the necessary skill to fix you but might just have a go, or write you off!!!
ReplyDeleteHello...I'm a 30 year old female. Starting experiencing groin/hip flexor pain after going for a 9 mile run. I was in the process of training for a half marathon, I thought it was just due to my increase in training. I had pulled my groin a few times before from sprints or from doing a lot of cardio kickboxing classes. Took a week off, ran again and once again same pain. Saw a sports med person for a free eval, she thought it was just a bad groin strain, said no half marathon or triathalon that I had coming up. Got sent to PT after seeing primary care physican, no help...few months later went to orthopedic, did xrays and mri...only thing that came up was a crossover sign on the xray. Doc wasn't too concerned, said we would try an injection of cortisone...made it worse. Sent me back to PT, no improvement,,,back to orthopedic again, finally looked at xray again, said he thought it could be FAI, he sends me to a hip specialist. Dr. Birmingham in Milwaukee through the Medical College. Dr. B orders new xrays and a new MRI and schedules an injection into the hip joint to see if that is where the pain is coming from. Xray and MRI come back, shows that Yes I have an impingement and labral damage. and injection stopped the pain, so I was a good candidate for surgery...Finally after 10 months I had a diagnosis.
ReplyDeleteI had surgery on June 14, 2011. I'm now 4 weeks post-op. I woke up from surgery and knew right away that I didn't have the pain that I did anymore. However, there was one complication with surgery, he couldn't fix a torn ligament that was deep inside my hip joint due to no way of accessing it,-don't have technology yet for that. Recovery has been good, making progress, but it's very very slow. Still on crutches and wearing a bizarre hip brace. Had to sleep with ski foam boats for 2 weeks to keep my legs from moving at night. I have a CPM machine to use 4 hours a day, and a Game Ready Ice machine to reduce swelling.
Its' very frustrating with the process of recovery, I'm almost a year done since my first symptoms started. and won't be able to run for another 2 months. I'm very much hoping I can fully recover and not have any problems with my another hip in the future.!
I was told i have hip dysplacia 14 yrs ago as i was in terrible pain and could berly walk and was sent for ex rays and was diagnosed with this. since then I have had a ganz ostemy on my right hip which the surgeon reconstructed my hip and used screws to hold everything together.I was 10 months recovering. This surgery did not work I was still suffering with pains in my groin and my both hips and when the pain was really bad it would go down my leg and down to my ankle.
ReplyDeleteI have had cordezone injections put into my hip bones which did not work so they tried putting them into the side of my hips which did not work either. I av tried painkillers, anti-inflametrys, etc and the pain always stays the same.
every now and again the pain gets so bad that its unbearable and my leg just goes from under me. 3 weeks ago the hospital finally gave me an MRI-I after 14 yrs which was very sore when they put the needle in my groin . I rang to see the consultant as i was in extreme pain and seen him last wk and he gave me the results of the MRI-I and it showed that with the hip dysplacia i av that i have no labral at all on both hips. They have decided now that there going to take some cardilage from my hips and form a labral for me. They are trying this procedure to avoid replacing them as there is no sign of artiritis.
I have tried to google information on people with no labral and nothing comes up, the only info i'm getting is on damage or tears. I am just 40 yrs of age and have no quality of life.
Anyone with hip pains for whatever reason it is i sympatise as its a terrible thing to go through.
Hi. I'm 23 years old and have been having hip problems for well over 3years. I have had X-rays, MRI scan without contrast and spoken to loads of hip specialists. I was told my my doctors that they suspect that I have a labral tear in my hips and that I need surgery. I went to have an MRI with contrast today and got as far as the drawing the spot on my hip before freaking out and refusing anything else (in am beyond terrified of needles) I think the problem was they took so long to come in the room and do the injection part and I was left waiting for a good 15minutes worrying on the bed about it. Plus the doctors started shouting at me for being scared which didn't help me! Is there a way of checking for labral tears with injecting contrast dye? They are speaking to my specialist to see if it necessary and if they can do something else as I'm so scared of needles.
ReplyDeleteHope you all had a better time then me, does it hurt when they inject the dye? They were going to numb it first with an injection......just freaking out at the thought of it really.
Previous to the above comment....is there a way of checking for Labral tears without injecting contrast dye?
ReplyDeleteI just did the Contrast dye MRI and the thought is much worse then the actually process... I am a big sissy when it comes to shots, Its an awkward feeling and there is mild discomfort but its tolerable and if it can give you answers and maybe lead you on a path of fixing your constant pain wouldn't you want to just get it over with?
ReplyDeleteTo previous commenter: yes, you can have a 3T MRI rather than an MR arthrogram (MRI with contrast) done to check for labral tears and FAI. 3T MRIs are still somewhat hard to find because they're a newer and more expensive technology so you'd probably have to find a hospital that typically uses it for hip patients (like the Hospital for Special Surgery) or specifically request it from your doctor. From the patient's view, it's no different than a regular MRI without contrast. It's becoming more popular for hips because no shots are needed and the patient doesn't experience an increase in pain for days later which is common with the MRA.
ReplyDeleteDr. Carl Wierks treats femoral acetabular impingement (hip impingement) with hip arthroscopy. He reviews labral tear, femoral abnormalities, hip joint motion, and labrum separation and arthroscopic labrum repair. Includes FAI animation.
ReplyDelete616.738.4420 or visit http://hollandboneandjoint.com for treatment worth the travel!
Is there anyone of you members who can privately contact me and tell me how you were finally helped please? I have severe pain and cant find assistance. My MRI showed the impingement without a labral tear and I was told by the ortho "it shouldnt hurt this much" and to just go to pain management. Other than that I dont know what to do. it would be great if someone could email me jessicarosefield@gmail.com
ReplyDelete