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Dr. David
Dr. David, Board Certified MD
Category: Medical
Satisfied Customers: 46937
Experience:  Board Certified Physician
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I wrenched my leg getting into my car which was awkwardly parked,

Resolved Question:

I wrenched my leg getting into my car which was awkwardly parked, since which I have had physiotherapy which was unable to pinpoint or assist the problem also a scan on my hip, pelvis and lower back. The result said nothing wrong with my hip or pelvis but the last couple of vertebrae on my lower back have squashed down a bit. My Doctor says that maybe my lower back is trapping some nerve ends that maybe the problem. I believe the scan report but do not believe it is my lower back causing the problem. I believe it is a pure and simple leg injury, so where should I go from here. My age is 81 years.
Submitted: 2 years ago.
Category: Medical
Expert:  Dr. David replied 2 years ago.
Dr. David :

This is Dr. David

Dr. David :

was your MRI scan of your lumbar and sacral spine done with contrast?

Dr. David :

where exactly in your leg is the pain?

Dr. David :

hello?

Customer:

I have no idea if my scan was done with contrast.

Dr. David :

hello?

Customer:

At first the worst pain was at the top of my leg where my leg meets my body and still is the worst but it also caused aches down as far as my knee on the inside and outside of my leg. By the time I finished physiotherapy aches and pains had also started below my knee, down my shin and the outside of my leg.

Dr. David :

some of those aches in your lower leg an and down the shin can be from physical therapy exercising muscles and causing soreness.

Dr. David :

physical therapy can exercise muscles in your leg which have not been used in sometime and this can cause aches and soreness pains.

Dr. David :

but this can take some time to resolve and get better.

Dr. David :

when did you finish physical therapy?

Customer:

Six weeks ago

Dr. David :

have the pains gotten better or worse since then?

Customer:

The same

Dr. David :

how severe is the pain?

Dr. David :

on a scale from 0-10?

Customer:

Five

Dr. David :

I would get copies of your MRI scan results.

Dr. David :

i would be happy to review them with you.

Dr. David :

it may not have been done with contrast.

Dr. David :

IV contrast is when they inject gadolinium into your veins during the MRI scan

Dr. David :

and this lights up your blood vessels in the area.

Dr. David :

and helps the radiologist see better.

Dr. David :

if the MRI scans of the hip and lower back were not done with IV gadolinium contrast during the MRI scan, the scan could have missed areas of nerve impingement

Dr. David :

if you have squashed down vertebral bodies in your lower lumbar spine, this could definitely be pinching nerves coming out of the neuro foramen in your lumbar spine causing leg pain down one leg.

Dr. David :

if you believe you still have a leg injury, you might need an MRI scan of your knee or lower leg as well.

Dr. David :

it doesn't sound like you have had a knee MRI scan.

Dr. David :

there are many nerves which travel past the knee as well.

Dr. David :

it sounds like your pain radiates down into your leg and this makes me think that your pain is due to pinched nerves from your lower back

Dr. David :

does your pain radiate into and down your leg.

Customer:

I had no injections before the scan

Dr. David :

I see.

Dr. David :

it sounds like the MRI scans were not done with IV contrast.

Dr. David :

the injections would have been set up before the scan and then injected during the middle of the MRI scanning process.

Dr. David :

also if you had an open MRI scan, the images are not as clear as a closed MRI scanner.

Dr. David :

the image quality is really important to be able to see small nerves.

Dr. David :

closed MRI scanners with IV contrast are much better image quality.

Dr. David :

they even have now 3 tesla high magnet strengthen high resolution closed MRI scanners which have even better image quality.

Dr. David :

most closed MRI scanners are 1.5 tesla MRI scanners.

Dr. David :

was your MRI scans an open MRI ?

Customer:

there is no problem while sitting or sleeping but when pressure is put on the leg to walk I get pain for the first couple of steps then it reduces to a slight ache

Customer:

no idea if it was an open scan

Dr. David :

I see.

Dr. David :

an open MRI scanner is open on the sides to help patients with claustraphobia

Dr. David :

a closed MRI scanner is a long closed torpedo type tube your whole body goes into.

Customer:

Mine was a closed scan

Dr. David :

your symptoms could be due to pinched nerves in your lower back which gets better when you get started with walking.

Dr. David :

the spine bones can change position slightly to affect pain in your legs.

Dr. David :

I would ask your doctors to refer you to see a spine specialist to review the MRI scan of your lumbar spine.

Dr. David :

and see if it should be repeated with IV contrast.

Dr. David :

and see if a procedure like kyphoplasty to help open up your collapsed vertebral bodies can help take pressure off of the nerves.

Customer:

Do you think I should ask my Doctor for a leg scan? Would seeing a Premier League Football Doctor who deals with leg injuries all the time prove a good idea.

Dr. David :

you can ask your doctor for a knee or leg MRI scan.

Dr. David :

your injury most likely is different from typical sports or football or rugby type injuries.

Dr. David :

and you are different age group than those patients seen by premier league football players.

Dr. David :

I would ask your doctor to get a copy of your spine MRI scan.

Dr. David :

I would be happy to review it with you.

Customer:

Thank you very much for your comments Doctor. Have a great Christmas!

Dr. David :

let me know if you have other questions.

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