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Sports injury clinics
Sports injury clinics
Having just been sent by my GP for an X-ray on my ankle for a suspected stress fracture (begining to get the idea the old bastard in the sky's got something against me acheiving my goal!!), I was told that the X-ray was inconclusive. The GP suggested the only way to know would be to have an ultrasound scan but apparantly the NHS is not willing to afford me this. I was told to visit a private sports clinic for a consultation. I'm poor at the best of times and the thought of this no-doubt massive expenditure is putting me in a bit of a pickle!!. Has anyone else had a similar experience?, or can offer me some advice?, it would be grately appreciated!, cheers, Rob.
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Worthers Original
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- Joined: Sun 22 Feb, 2004 5:48 pm
- Location: London
I'd cause a bit of a fuss with your doctor. If the x-ray is inconclusive then how are you expected to get treatment to alleviate the pain you are suffering. Your doctor says you need an ultrasound so he should organise it, it's not just OAPs potentionally needing hip ops that should get them. What good would it be to go to a sports clinic, if you need an ultrasound then you need an ultrasound. Having said that, doctors are quick to rely on expensive tests rather than relying on better diagnostic skills which an experienced sports injury person would have.
The alternative is that he treats you for the stress fracture and you trust to luck that that is the problem.
What are people doing though getting all these injuries? Whatever it is it probably needs to be addressed. The numbers with "shin splints", for example, is pretty suprising. Is it that people, inexperienced with regular exercise, are starting too hard regimes and literaly running before they can walk?
The alternative is that he treats you for the stress fracture and you trust to luck that that is the problem.
What are people doing though getting all these injuries? Whatever it is it probably needs to be addressed. The numbers with "shin splints", for example, is pretty suprising. Is it that people, inexperienced with regular exercise, are starting too hard regimes and literaly running before they can walk?
Am going to stick up a little bit for doctors (esp GPs, and I don't do that often!)
There is no way a GP would be able to get an ultrasound for a ?stress fracture of ankle, due to the way radiology departments work - your X-ray would have been reported by a Radiologist, not the GP. X-rays would either show the fracture or not. If not, then radiology would not authorise a test for a diagnosis they have excluded.
If you still have trouble with your ankle you need orthopaedic/physio referral - I can't understand why he would say you need an ultrasound, not exactly commonplace in fracture management, yet not offer referral to ortho.
I personally would be very reluctant to pay for such investigations etc. when you haven't been offered standard treatment.
If the GP has told you that he feels stress fracture is still a serious differential diagnosis, and is unwilling to offer any real help himself, I think the easiest short term option is (damn my tongue) get yourself to A+E, and thus get a 2nd opinion. Most A+E departments now have attached fracture clinics so you would get to see an orthopod.
Please I hope no-one shouts at me for suggesting this course of action, but I feel to absolve responsibility for a patient like this is quite unacceptable.
Hope you get some help/symptomatic relief soon,
Adrian
There is no way a GP would be able to get an ultrasound for a ?stress fracture of ankle, due to the way radiology departments work - your X-ray would have been reported by a Radiologist, not the GP. X-rays would either show the fracture or not. If not, then radiology would not authorise a test for a diagnosis they have excluded.
If you still have trouble with your ankle you need orthopaedic/physio referral - I can't understand why he would say you need an ultrasound, not exactly commonplace in fracture management, yet not offer referral to ortho.
I personally would be very reluctant to pay for such investigations etc. when you haven't been offered standard treatment.
If the GP has told you that he feels stress fracture is still a serious differential diagnosis, and is unwilling to offer any real help himself, I think the easiest short term option is (damn my tongue) get yourself to A+E, and thus get a 2nd opinion. Most A+E departments now have attached fracture clinics so you would get to see an orthopod.
Please I hope no-one shouts at me for suggesting this course of action, but I feel to absolve responsibility for a patient like this is quite unacceptable.
Hope you get some help/symptomatic relief soon,
Adrian
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Doc
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I totally agree, I avoid GPs in the main, A&E is my usual port of call in the rare instance Ive needed medical help for my body. My Mind? thats a whole new thread 
Get yourself to A&E but my only tip is to not mention you've been to your GP, because they could just request the Xray report, or refer you back to the GP. Say you just did the injury/re injured it, and play on it a bit so they get you to the fracture clinic.
As everything in life theres a system and sometimes it needs playing. Look after number one at the end of the day...oh and take a book as the waiting could be awhile!
Get yourself to A&E but my only tip is to not mention you've been to your GP, because they could just request the Xray report, or refer you back to the GP. Say you just did the injury/re injured it, and play on it a bit so they get you to the fracture clinic.
As everything in life theres a system and sometimes it needs playing. Look after number one at the end of the day...oh and take a book as the waiting could be awhile!
It's always difficult to make definite comments without knowing the full facts, but ultrasound for a stress fracture is not the usual route of investigation - if the X-ray doesn't show much, a bone scan is the usual next step. Your GP may have said the X-ray was inconclusive because there was no definite fracture seen but that doesn't mean it isn't there.
There is absolutely no reason why you can't get sorted out on the NHS, and you GP should be able to get you referred to ortho (there'll be one locally with an interest in feet/ankles or sports stuff) or arrange a bone scan himself. Make a nusciance of yourself.
I just hate to warn you - your old X-rays will be linked into any new ones you get from the GP, so they'll know you have had the problem for a bit. And you need to be aware you could be seen by a moron in A&E as easily as in a GP surgery....
There is absolutely no reason why you can't get sorted out on the NHS, and you GP should be able to get you referred to ortho (there'll be one locally with an interest in feet/ankles or sports stuff) or arrange a bone scan himself. Make a nusciance of yourself.
I just hate to warn you - your old X-rays will be linked into any new ones you get from the GP, so they'll know you have had the problem for a bit. And you need to be aware you could be seen by a moron in A&E as easily as in a GP surgery....
Ruth - are you trying to imply that emergency docs + GPs are morons!! 
- surely you must be a physician! (Tongue firmly in cheek)
Got to class as a poor state of affairs when a GP is recommending going private over NHS ortho referral. That said, I know if I asked for an ultrasound or bone scan at the hospitals I've been at radiology would stick my head on a spike in the waiting room just to teach a lesson to the other juniors.
BERTAVFC - would you mind letting us know how you get on? I'm quite curious now. Also, please let us know which book you take with you, and how far you get through it?!
Adrian
- surely you must be a physician! (Tongue firmly in cheek)Got to class as a poor state of affairs when a GP is recommending going private over NHS ortho referral. That said, I know if I asked for an ultrasound or bone scan at the hospitals I've been at radiology would stick my head on a spike in the waiting room just to teach a lesson to the other juniors.
BERTAVFC - would you mind letting us know how you get on? I'm quite curious now. Also, please let us know which book you take with you, and how far you get through it?!
Adrian
Wash your mouth out with soap and water! How dare you insult me like that?? I'm a woman happiest with a knife in my hand and a hammer for backup Having said that, I did PACES on Monday (the shame, but it's a means to an end).
I am merely pointing out that you can meet morons in A&E as easily in a GP surgery. In fact, I'm sure Doc will confirm that you can meet medical morons, so so easily!
No, I have a vested interest - I'm in A&E at present and we really hate longstanding problems turning up when we are busy, but I did arrange for a very similar case 2 days ago to go to ortho and get a bone scan as the X-ray was inconclusive, so the advice here is pretty sound for getting sorted out.
I think it's a disgrace that your GP won't get you sorted out on the NHS. Completely agree with Adrian on this, and there is absolutely no reason for it. Sure he's not trying to protect his budget or referrals rate?
Having said that, I did PACES on Monday (the shame, but it's a means to an end).I am merely pointing out that you can meet morons in A&E as easily in a GP surgery. In fact, I'm sure Doc will confirm that you can meet medical morons, so so easily!
No, I have a vested interest - I'm in A&E at present and we really hate longstanding problems turning up when we are busy, but I did arrange for a very similar case 2 days ago to go to ortho and get a bone scan as the X-ray was inconclusive, so the advice here is pretty sound for getting sorted out.
I think it's a disgrace that your GP won't get you sorted out on the NHS. Completely agree with Adrian on this, and there is absolutely no reason for it. Sure he's not trying to protect his budget or referrals rate?
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Doc
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