...to think MRI scans AREN'T just for "people who can't walk?"

[OneHandFlapping]

DS has a knee injury from playing football. It first occurred 6 weeks ago, and he was referred for physio. They could find nothing major wrong and discharged him.

Now something has snapped with an audible sound. He can hardly walk. His GP refused to refer him for an MRI scan, saying he would just have to give up football, and that MRIs are for people who can't walk. He has referred him for more physio.

Is this what the NHS has come to? That a sporty 19 year old boy is consigned to the sporting scrap heap - no football, no skiing, no squash? Ever?

Because the GP can't be arsed to diagnose the problem?

I'm not being unreasonable to expect more am I?

I'm with the others that say to ask for a second opinion, but be prepared for a long wait, and take the physio in the mean time

I did this it was my ACL. Get him referred or seen by a specialist- my knee would move 3" either way so my surgeon didn't even scan me. I had a repair done with a hamstring graft, but do this quickly, as the longer you leave it the more difficult it can be apparently.

True WooWoo but this kind of problem would not be referred to a Neuro physio, it will go to the musculoskeletal service and those physios will see sports injuries all the time. You will have both Neuro and MSK physios within a department (among others!)

Your local PCT probably runs a triage system for orthopaedic referrals whereby you must be referred into the specialist community physios / orthopaedic practitioners for assessment (a system known as ICATS). It is meant to lighten the load and reduce the number of unnecessary refs to Acute services (meaning, ideally shorter waiting times for those who do need the services of a hospital consultant) and enable those who don't to access appropriate treatment in the community, again often with shorter waiting times.
If the ICATS team feel it is not appropriate and your son needs a surgical opinion, they will fwd the ref to T&O at your local hospital.

ICATS are tri aging for all kinds if specialities, not just T&O.

Sorry if someone else already said this, I've not read all answers.

Yes, this is what the NHS has come to, sadly.

To echo, it's Bollocks.

DD has had 2 knee MRI's, one for a break a few years ago where they thought she had some ligament damage and another where she dislocated her knee a few months back and had one to check all was ok (she has hypermobility so dislocates a lot)

Over the last 4 years I think she's had about 7 or 8 for various body parts

You need to change your GP I think.

Dp & I are late forties...
I've had problems with my knees for years...last year after about 10 years I eventually got round to getting them seen to.
First an xray - no problems - GP tried to talk me out of an MRI on worst one. I insisted on it, was told it was old damage, couldn't be operated on and to see physio.
Went a couple of times to be told nothing really could be done...I had to live with them, take pain killers when they were bad on walking! (thankfully they haven't been too bad recently)
DP had problems with his knees too, he couldn't run on them. After a month went to GP, then physio, podiatrist etc, etc. Kept complaining, had an MRI, needed an operation and now they are fine! (whole thing took less than a year)
Get a second opinion. Insist on a scan and if it can be get it dealt with!

My local physio linked to my doctor's isn't just used to little old ladies, she's a highly experienced sports physio who also uses acupuncture and is fantastic. Don't write off your doctor's one!

My point is,NHS do not want to pay for MRI scans. Go private.if you have a sense of urgency.

my knee has been mri done - I can walk - because the x rays do not show up the cartilage damage clearly
I know exactly what I did
the mri is part of the watching brief to see when it will need surgery
(not yet thankfully)

consultant said that with his private hat on he'd slice, with his NHS hat on he'd make sure I stayed slim and fit
I'd have equal levels of pain after five years
I believe him

I keep my weight as light as I can as every pound I gain is an extra day a month in pain

My knee injury began in 2000, I went back in 2003 and was referred to the specialist which took 3 months. The MRI scan was done 3 months later. The results took 3 years to get to my GP .
Keyhole surgery done 3 months later. Result was" the original small tear was a bad one and the bones of the knee had developed arthritis .
Nothing to do with the 3 year delay".
Apart from now being a 'little old lady' my knee is fine

Thank you all so much for your opinions. I'm sorry I posted and ran - was on chauffeur duty.

I wish I'd gone with him to the appointment, but seeing as he's away at uni, and I work, it's not that easy.

I did go with him to his first set of physio at John Radcliffe hospital, and I have the highest opinion of the woman who treated him. She did check that all the ligaments - including the ACL were intact.

My suspicion (as lay person) is that he initially had a partial ACL tear, and that he now has a complete one - hence the audible snap.

After what you've all said, I'm inclined to send him back to get a private referral to an orthopaedic surgeon, and pay for an MRI scan and the interpretation. It won't be easy to afford it, but it sounds like he wouldn't be seen quickly even if his GP had been less of an arse.

I have had MRI scans (also on knee) but I'm pretty sure the GP didn't order it but the orthopaedic surgeon or rheumatologist I can't remember. BUt I agree a very good physio is likely to be just as good and can now refer on I beleive.

Here GPs cannot refer for MRI scans.
Referrals to orthopaedics go via a physiotherapy pathway - an 'extended scope practitioner' aka specialist physio can refer for MRI or other suitable test before the patient then sees an orthopaedic surgeon who decides whether the problem is amenable to surgery.

Knee injuries easily take 6 weeks to 3 months to improve - and it sounds like your DS had a secondary injury on top of the first one.
Yes, he should avoid high impact sports, particularly those with fast direction changes until he is improved. Physiotherapy is absolutely vital to that recovery.

I don't really see how your GP 'couldn't be arsed'??

Having said that, if you are not happy with your DS's management, seek a second opinion. Or get an MRI scan done privately - locally the going rate is about £800 AFAIK.

And as to what the NHS is coming to - close to crumbling around our heads .

Get a second opinion. I have had 2 MRI's due to knee problems from a car accident - they are worth every penny. It's pointless gettting physio when the problem has not been properly diagnosed. I was in so much pain I would throw up, once the scan was done and a course of treatment was decided on, the recovery was much quicker. I wasted a year going through various physio treatments prior to the MRI and they left me sore, exhausted and feeling no better. Waste of money too!

I've snapped my ACL (well tore it beyond repair) and I agree it sounds similar. It took three years to get it properly repaired. I agree with others who said that soft tissue sports injuries are generally neglected on the NHS. In my case I could walk and even run after the initial healing but I couldn't play my sport. I moved things along by paying privately for the first appointment with consultant who referred me for an MRI on the NHS, only had to wait about six weeks then. I waited a long time for the op though, and my knee is still buggered although I can play again just about. Good luck to your son, knees are awkward things.

My ACL snapped like that when it ruptured. By chance, I had an appointment with my ortho surgeon the next day for the other knee. Said, 'Oh, yesterday I was XC skiing and had a bit of an accident.' So I told him what happened, I hopped onto the couch and in seconds he could feel the ACL was totally blown.

A physio can feel it, too.

I would definitely not let this injury go!

The thing that annoyed me about the GP was the way she casually told him he'd have to give up football.

In one thoughtlessly cruel sentence, she has basically ruined his life. Not that he was a professional player or anything like, but he lived for the times he could play.

What happened to that Rate My GP website? Is that still around? Or was it deem libellous?

Would it not be more constructive to voice your complaints with the practice? Either informally or by making a formal complaint? If that is what your 19 year old son wants to do.

It is impossible to know what exactly was said during the consultation and whether "You need to lay off the football for a while" was interpreted as "You'll never play football again".
Either way, it does not sound as if communication worked particularly well, so even that simple fact should be fed back to the surgery and that individual dr.

I don't know whether 'Rate my GP' is any good, but these sites have always struck me as somewhat underhanded tbh.

It's all right Pacific. I've calmed down a bit. DS said she wasn't an idiot. Anyway, he's going back to ask for a private referral - rather against his own judgement, which is more wait and see.

My step mum had a pyruvate MRI recently, cost loads, hundreds with tests iirc, then it'll be the cost of the consultant going over the results etc. Be prepared to pay a lot OP.

Go back to the gp and ask to be referred again. If there's no joy then take out up with ether practice manager our ask for a second opinion.

Or go to a and e as it is an injury after accident, especially if he can't walk.

Private-daft auto correct!

My GP was fuming at the length of time that my referral was going to take. They are virtually bound,and gagged. I had to rely on the NHS for further treatment (due to finances) and it was 3 years before I received any care,by which time it was too late.
As your son is so young,I'd invest as much as you can possibly afford in private treatment,to ensure his future health.

As has been said above, your GP almost certainly can't refer for an MRI scan or direct to an orthopaedic surgeon. Going to a different GP or the practice manager won't change this. The CCG (and PCT before that) will have set up a system where all referrals go to physio first and the physio refers if they think it is necessary. The GP may not necessarily agree with this system but you and they are stuck with it (if you want it different, we all have to pay a lot more taxes to fund it - this does not tend to win votes at elections which is why we have more and more rationing in the NHS)

If you want to go direct to a surgeon, it will almost certainly need to be private.

Of course the GP is BU. I laughed when I read the post which said s/he "flatly doesn't believe a GP would say something like that"! I could fill a book with all the ridiculous, insensitive, inaccurate things Dr's have said to me in the past 2 years. That's not to say some haven't been fantastic. I would actually change GPs in the first instance, that will transform the situation if you get a good one.