|
hope this helps--orthopaedic consultation recommended
Work-up of hip pain for mets can include MRI and bone scan as well as PET/CT.PET/CTs which light up in the hip can reflect a lot of things besides mets. Often none of these need to be done if an expert orthopaedic surgeon consultation is obtained.
A good physical examination by an orthopaedic surgeon (not a rhematologist, physical medicine specialist or "chiropractic orthopaedist") could help determine if the pain is coming from your hip, is referred pain from your back, or is outside your hip (trochanteric bursitis).
Bursitis is treated with antiinflammatories or a local steroid injection when truly bothersome. A diagnostic injection with only local anaesthetic into the bursa can also be done by an orthopaedic surgeon to determine if that makes your pain go away--then you know it is not mets.
If you had a chemo regimen that included prednisone or were on steroid for some other condition for many years (eg asthma, lupus, etc) you may be at risk for avascular necrosis of the hip (loss of blood supply to the hip with collapse of the bone with time and early arthritis). This would show up on an MRI.
A bone biopsy is usually not needed and is usually avoided as it weakens your bone for three months or more, making the hip prone to fracture even if it turns out the bone of the hip was normal. Usually six to twelve weeks
on crutches is recommended after such a biopsy is taken.
Not to worry you--sounds like you are already doing enough of that.
Statistically, bursitis is common. Back pain referring to the hip is common.
Avascular necrosis is much less common. Mets are much less common than bursitis or referred back pain.
A good orthopaedic surgeon will also ask you questions which help determine the likelihood what you have is mets and therefore whether any tests need be ordered. If your hip pain gets better and worse it is VERY unlikely to be mets.
Again, a good orthopaedic surgeon should be able to help you sort this out.
Orthopaedic surgery is one of few fields in medicine in which there is not a medical and a surgical division (eg. nephrology and urology, gastroenterology and general surgery (GI), neurology and neurosurgery) so he/she ought to be able to help you out without your supposing surgery will always be recommended--most orthopaedic surgeons operate on the vast minority of their patients. They are generally much better than their non-surgical colleagues at injecting joints and bursae, diagnosing the musculoskeletal system, ordering the right CTs and MRIs and judging which things NEED surgery.
Information is the best defense against fear and worry!
Good luck,
Lani
PS where are you in California?
|
Bone biopsy for possible hip mets?
I am so glad we all have you here. 
Linear Mode
