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Questions on MRI....

Posted by Sue R on 11/21/00 at 15:09 (033250)

I met with my orthopedic surgeon today regarding my mri, which was negative. 'Plantar tissues are maintained without evidence for significant thickening'. Why don't I have thickening of the fascia? It seems like I should be able to see a problem to have this much discomfort. Do you see this often? I have pain in the 'hot spots' so why don't I SEE the problem?

We talked briefly about shock therapy. I'm considering this but waiting to see if insurance will cover. Do you think this could help me even if we can't SEE anything wrong on mri, x-rays, nerve tests, etc??

I'm confused!

Thanks,
Sue R

Re: Questions on MRI....

Dr. Zuckerman on 11/21/00 at 18:45 (033258)

Hi,

It would be better to see the areas that are thickened on an MRI. If the pain is in the area of the insertional and all other conditions such as stress fracture. Posterior Tibial Tendon dysfunction and the joint surfacs of the ankle and subtalar joint are ok then ESWT could be an answer.

If your problem is chronic and you have tried alot of treatment then you must consider ESWT as an option. I can't think of any other treatment except surgyery What does your doctor tell you about your feet. Did you give you his thoughts on what to do.?/

Re: Questions on MRI....

Dr. Zuckerman on 11/21/00 at 18:47 (033259)

Make sure that posterior tibial dysfunction has been ruled out by mri and physical examination. Have you heard anything about insurance coverage for ESWT. So far I haven't found any company willing to pay. Medicare has to lead the way to get the others to start paying.

Re: Questions on MRI....

Sue R on 11/21/00 at 21:01 (033268)

He says to continue conservative treatment and it may just take a while longer. He really doesn't believe in surgery as an option and neither do I at this point. It just seems odd that I don't have obvious signs on the mri of this condition. My pain is right along the fascia and not really anywhere else. Everything else has also checked out ok. I know I'm not dreaming up this pain!

Have you seen this before? Could my tears be so microscopic that you can't detect them on an mri?

Sue R

Re: Questions on MRI....

Sue R on 11/21/00 at 21:03 (033269)

My doctor is starting the shock treatments in December. He said they are looking into insurance now and will let me know. It may take awhile. I think I'll hold off until I hear from insurance.

Re: Questions on MRI....

Dr. Zuckerman on 11/21/00 at 22:34 (033275)

Good luck I hope that you find relief with ESWT . I have many patients that have have been reliefed from pain . Please let us know how you make out..

Let's hope that you get a pain free foot for Christmas

Re: Questions on MRI....

Kay S on 11/23/00 at 11:48 (033364)

Dr.Z--In case you didn't see his post, Graham said that he went to the place in Il. and the doctor (SR. although Jr. does the ESWT treatments)said that about 70% of their patients are getting insurance coverage. I called yesterday to see what code they use and to ask questions about how they get it paid, but so far no one called me back. I will try again. I also called my own insurance to see if they could tell me if they paid it or not, and was told that I would have to submit the bill and then they would have a 'meeting' (or whatever they do at insurance companies) to decide if they would pay it or not. (I am not planning on them paying but it doesn't hurt to find out) Apparently BC/BS is the one most likely to get paid--this is according to Dr. W. at the clinic. This should be interesting and I will keep you informed. I feel like a detective!

Re: Questions on MRI....

Tracey A on 1/07/01 at 15:15 (036081)

I had a MRI that was negative and my doctor has given up on me. he refuses to talk or see me. I'm going to a new doctor. The pain is there and it hurts, I know my body and I'm not getting any better. My advice is ask your doctor every question and get the answers. If not see a new doctor. Make yourself heard......

Re: Questions on MRI....

Dr. Zuckerman on 11/21/00 at 18:45 (033258)

Hi,

It would be better to see the areas that are thickened on an MRI. If the pain is in the area of the insertional and all other conditions such as stress fracture. Posterior Tibial Tendon dysfunction and the joint surfacs of the ankle and subtalar joint are ok then ESWT could be an answer.

If your problem is chronic and you have tried alot of treatment then you must consider ESWT as an option. I can't think of any other treatment except surgyery What does your doctor tell you about your feet. Did you give you his thoughts on what to do.?/

Re: Questions on MRI....

Dr. Zuckerman on 11/21/00 at 18:47 (033259)

Make sure that posterior tibial dysfunction has been ruled out by mri and physical examination. Have you heard anything about insurance coverage for ESWT. So far I haven't found any company willing to pay. Medicare has to lead the way to get the others to start paying.

Re: Questions on MRI....

Sue R on 11/21/00 at 21:01 (033268)

He says to continue conservative treatment and it may just take a while longer. He really doesn't believe in surgery as an option and neither do I at this point. It just seems odd that I don't have obvious signs on the mri of this condition. My pain is right along the fascia and not really anywhere else. Everything else has also checked out ok. I know I'm not dreaming up this pain!

Have you seen this before? Could my tears be so microscopic that you can't detect them on an mri?

Sue R

Re: Questions on MRI....

Sue R on 11/21/00 at 21:03 (033269)

My doctor is starting the shock treatments in December. He said they are looking into insurance now and will let me know. It may take awhile. I think I'll hold off until I hear from insurance.

Re: Questions on MRI....

Dr. Zuckerman on 11/21/00 at 22:34 (033275)

Good luck I hope that you find relief with ESWT . I have many patients that have have been reliefed from pain . Please let us know how you make out..

Let's hope that you get a pain free foot for Christmas

Re: Questions on MRI....

Kay S on 11/23/00 at 11:48 (033364)

Dr.Z--In case you didn't see his post, Graham said that he went to the place in Il. and the doctor (SR. although Jr. does the ESWT treatments)said that about 70% of their patients are getting insurance coverage. I called yesterday to see what code they use and to ask questions about how they get it paid, but so far no one called me back. I will try again. I also called my own insurance to see if they could tell me if they paid it or not, and was told that I would have to submit the bill and then they would have a 'meeting' (or whatever they do at insurance companies) to decide if they would pay it or not. (I am not planning on them paying but it doesn't hurt to find out) Apparently BC/BS is the one most likely to get paid--this is according to Dr. W. at the clinic. This should be interesting and I will keep you informed. I feel like a detective!

Re: Questions on MRI....

Tracey A on 1/07/01 at 15:15 (036081)

I had a MRI that was negative and my doctor has given up on me. he refuses to talk or see me. I'm going to a new doctor. The pain is there and it hurts, I know my body and I'm not getting any better. My advice is ask your doctor every question and get the answers. If not see a new doctor. Make yourself heard......