Undiagnosed leg pain

[T40ORA]

I can't lift my left leg (knee to chest type lift) without significant pain, and even then there is limited movement. If I jar my leg (slip or kick something) it hurts like hell. The pain seems to be in the psoas area up the leg, inner head of the quad above the knee. I do have some lower back pain too.

I've seen a physio and a rheumatoid consultant, had an xray and an ultrasound, and seen a neurologist how sparked me with electric current and stuck needles in my leg to monitor the nerves.

All tests are clear, and the physio and consultant don't know what is going on. The consultant said "Hmm. Really interesting. You are an enigma. We will get to the bottom of it. Eventually." Not words to inspire hope!

I had a hip replacement in that leg 2.5 years ago, but the xray shows that the joint is sound and seems to be causing no trouble.

I'm off to see a chiropractor tomorrow for an initial consultation, but I seem to be running out of options.

Any ideas what it might be?

[The_Doc]

http://www.ncbi.nlm.nih.gov/pubmed/17541541

if I'm right I'd like a statue of me putting up in your local village.

no not really, but just keen to try and help. I have seen patients with this, but it's quite hard to diagnose

Have a look at the line drawing on page 2 of this pdf: http://dorrhipnav.com/pdf/hip-05sugicalreleaseilio...

Edited by The_Doc on Sunday 15th December 22:01

[mrpurple]

The_Doc said:

http://www.ncbi.nlm.nih.gov/pubmed/17541541

if I'm right I'd like a statue of me putting up in your local village.

no not really, but just keen to try and help. I have seen patients with this, but it's quite hard to diagnose

Have a look at the line drawing on page 2 of this pdf: http://dorrhipnav.com/pdf/hip-05sugicalreleaseilio...

Edited by The_Doc on Sunday 15th December 22:01

Wow....I don't know about the OP but if you are right in my case you can have a statue put up wherever you want........I have never found these articles despite many years of researching my problems.......many thanks for posting these links

Hope the OP don't mind me hijacking his thread but need to add... my THR was 3 yrs ago. 2 years ago I had another operation to release my sciatic nerve trapped in my groin however I was still left with 2 major problems:

1 - the permanent hip / groin pain (which I did not have pre THR).

2 - calf / thigh seizures / locking. Which I did have pre THR but has just (4 weeks ago) been resolved after stenting of my blocked iliac artery.

However 1 is still present 24 hrs a day / 7 days a week. I assumed this may be due to necrosis and the fact that the, previously undiagnosed, blocked artery had deprived the wounds and operated areas of blood / oxygen.

Like the OP I have all sorts of treatments, injections, therapies, scans, electromyography studies, pain management etc and have been told there is nothing more that can be done for me and just learn to live with it........once again apologies to OP for the hijack.

Edited by mrpurple on Sunday 15th December 22:52

[T40ORA]

Bloody hell Doc! Thank you.

Those links are going to be forwarded to the rheumatoid consultant I saw recently and possibly the orthopaedic consultant who performed the hip replacement. I don't fancy more surgery but this looks like the cause of my problems.

[T40ORA]

MrPurple help yourself. I hope that this possible diagnosis will be of help to you. The word necrosis makes me shudder soi hope that it is not to late for you to gain some benefit.

I am hopeful thati may not need surgery as I did not suffer this pain immediately after surgery but it had got progressively worse. However if surgery is what it takes then so be it.

Once again thanks Doc and good luck MrPurple.

PS apologies for typos as (a) I am using a phone screen 'keyboard', and (b) I've hada few glasses of wine!

[mrpurple]

T40ORA said:

Bloody hell Doc! Thank you.

Those links are going to be forwarded to the rheumatoid consultant I saw recently and possibly the orthopaedic consultant who performed the hip replacement. I don't fancy more surgery but this looks like the cause of my problems.

Good luck with contacting your ortho consultant.. I have no wish to offend our resident Doc but I found mine not very open to diagnostic suggestions. I wrote to him in Feb 2011 asking if I had a blocked artery (even attached a description of claudication pointing out my identical symptoms)which he promptly dismissed without even the most basic of tests....No prizes for guessing why I needed stents in my iliac artery, found & inserted 2.5 years later by a different hospital after I asked for a transfer.

Will be watching your future replies with great interest....best wishes

[T40ORA]

OK mrpurple. I have been thinking of how to approach my original consultant. I had an initial assessment with a chiropractor, late Friday evening, who actually suggested that my symptoms were due to this tendon being impinged in some way; not so much by the (mis) alignment of the new joint or any hardware in there, but by my pelvis being out of whack due to my leg being longer after the THR.

So the Doc's suggestion really does make sense to me and there is supporting evidence.

My THR was done privately and, although I have no experience in these things, I would assume that my Health Insurance Company would support me if my original ortho consultant were difficult.

I might be being naive here, but looking on the positive it seems there is a way forward. And I will post updates after Christmas.

You must be really annoyed that your suggestions were ignored and I am really sorry that you ended up with so much unnecessary grief.

[The_Doc]

T40ORA said:

Bloody hell Doc! Thank you.

Those links are going to be forwarded to the rheumatoid consultant I saw recently and possibly the orthopaedic consultant who performed the hip replacement. I don't fancy more surgery but this looks like the cause of my problems.

The rheumatologist won't know what to do with this information. They just don't deal with anatomical/structural problems. It's all cells and brainy complicated stuff in their discipline.

Unlike mine, where it's all saws.

Anyhow, hope this helps. To quote Pulp Fiction, Let's not start sucking each other's di*ks quite yet. Perhaps I have found the problem, bit early to say...

[T40ORA]

The_Doc said:

T40ORA said:

Bloody hell Doc! Thank you.

Those links are going to be forwarded to the rheumatoid consultant I saw recently and possibly the orthopaedic consultant who performed the hip replacement. I don't fancy more surgery but this looks like the cause of my problems.

The rheumatologist won't know what to do with this information. They just don't deal with anatomical/structural problems. It's all cells and brainy complicated stuff in their discipline.

Unlike mine, where it's all saws.

Anyhow, hope this helps. To quote Pulp Fiction, Let's not start sucking each other's di*ks quite yet. Perhaps I have found the problem, bit early to say...

Haha! Point taken. At least I have a possible solution. And as you might have seen from my post above, I went to see a local Chiro late on Friday for an initial meeting (just a chat about symptoms) and he immediately pointed to the iliopsoas tendon being impinged in some way which does support your view as a knife man.

I have no experience of using a chiro, and this guy is practicing something called micro-manipulation which is a newish technique (I haven't had time yet to research it)but as he immediately pointed to a possible cause which nobody had so far, and you come up with the same view.

My original ortho guy was very good, has a great reputation and would hopefully be open to discussing any possible adjustments such as the surgical intervention mentioned in those links. He also recognised that I did not fit his usual profile as a recipient of his attention, being younger, fitter, more active and wanting to retain that level of activity.

But once again, thank you - it is a route to investigate with supporting links. So possibly bypassing the rheumatoid man, seeing what happens with the chiro, then possibly contact my surgeon would be the planned course of action.

[mrpurple]

T40ORA said:

My original ortho guy was very good, has a great reputation and would hopefully be open to discussing any possible adjustments such as the surgical intervention mentioned in those links. He also recognised that I did not fit his usual profile as a recipient of his attention, being younger, fitter, more active and wanting to retain that level of activity.

My Ortho also has a great reputation and even I can see on the Xrays / scans that I have a perfect hip now but he seemed to lose interest post THR,

I also did not fit usual profile, had THR at 51 and was playing semi pro footy aged 46.

Think the Doc may have eluded to part of the problem in that consultants are specialists in their own particular areas of expertise but get a bit bogged down with issues outside this.

look forward to hearing about your successful resolution post Xmas

[T40ORA]

mrpurple said:

My Ortho also has a great reputation and even I can see on the Xrays / scans that I have a perfect hip now but he seemed to lose interest post THR,

I also did not fit usual profile, had THR at 51 and was playing semi pro footy aged 46.

Think the Doc may have eluded to part of the problem in that consultants are specialists in their own particular areas of expertise but get a bit bogged down with issues outside this.

look forward to hearing about your successful resolution post Xmas

Similar to me; THR at 51, no football but running, cycling, gym work - pretty fit.

Yes, the Doc is probably right about the specialists. My bottom line is that I need to ski again!

[mrpurple]

After a phone chat with my GP I have an appointment with him on Saturday...probably give him time to do some research on the subject;)

[T40ORA]

Good luck.Please let me know how you get on.

[mrpurple]

T40ORA said:

Good luck.Please let me know how you get on.

Well I saw the GP - good news is my comprehensive blood tests have come back showing I am very healthy. Cholesterol a very good 3.3 which is good news on the vascular side.

As for the hip / leg pains - he has absolutely no idea what is causing it. All he could suggest was writing to the orthopedic consultant (the 1 that gave a 2nd opinion ruling out the need for a bursa operation that the original, hip replacement, consultant had wanted to perform)and ask him to re-look at the MRI scans / Xrays to see if he can identify any potential causes. Very doubtful this will provide any answers as he has already stated there is nothing more he can do but worth a try I suppose.

No need for a physio as the walking, exercises I am already doing should eventually build up the muscles adjacent to the scar and area of atrophy.

I should add the hip itself is absolutely perfect which makes things even more frustrating.

So in summary he was very sympathetic and understanding but has no more idea of the causes of my pain than I have.

[Gwagon111]

Have you had any jarring of the head and neck recently? It sounds bizarre, but I had a big 'off' in a kart, a few years back. I suffered some serious jip, in the areas you are describing. After a lot of dicking around, the root cause turned out to be a problem with one of the vertibrae in my neck .

[mrpurple]

Gwagon111 said:

Have you had any jarring of the head and neck recently? It sounds bizarre, but I had a big 'off' in a kart, a few years back. I suffered some serious jip, in the areas you are describing. After a lot of dicking around, the root cause turned out to be a problem with one of the vertibrae in my neck .

Do have a stiff neck as it happens...mentioned this numerous times to various people but has always been dismissed out of hand............ real irony from your posting - About 6 years ago I had a very big off coming out of cascades in a superkart (thought I was about to meet my maker :-))raced next day at Darley and never raced again.


ps before THR the consultant did say "I have concerns about the hip being the primary cause" but after a back MRI scan (not sure if it covered the neck) he discounted the back and went on to do the THR.

Edited by mrpurple on Saturday 21st December 12:48

[mph1977]

mrpurple said:

T40ORA said:

Bloody hell Doc! Thank you.

Those links are going to be forwarded to the rheumatoid consultant I saw recently and possibly the orthopaedic consultant who performed the hip replacement. I don't fancy more surgery but this looks like the cause of my problems.

Good luck with contacting your ortho consultant.. I have no wish to offend our resident Doc but I found mine not very open to diagnostic suggestions. I wrote to him in Feb 2011 asking if I had a blocked artery (even attached a description of claudication pointing out my identical symptoms)which he promptly dismissed without even the most basic of tests....No prizes for guessing why I needed stents in my iliac artery, found & inserted 2.5 years later by a different hospital after I asked for a transfer.

Will be watching your future replies with great interest....best wishes

http://www.xtranormal.com/watch/6752641/

[mrpurple]

mph1977 said:

http://www.xtranormal.com/watch/6752641/

can't open link?

[mph1977]

mrpurple said:

mph1977 said:

http://www.xtranormal.com/watch/6752641/

can't open link?

http://www.youtube.com/watch?v=q0S5EN7-RtI

[mrpurple]

mph1977 said:

mrpurple said:

mph1977 said:

http://www.xtranormal.com/watch/6752641/

can't open link?

http://www.youtube.com/watch?v=q0S5EN7-RtI

point taken......... original THR ortho has stated in a meeting with others and in writing:

"it is my fault the blocked artery did not get diagnosed as I did not re-raise the issue"

This after he dismissed, without a single test, my email in Feb 2011 asking "do I have a vascular disease" and attached a description of PAD symptoms stating "my symptoms are identical" - "I do not consider you have any signs of vascular disease" was his written reply. He then diagnosed bursitis, which was subsequently discounted by a 2nd ortho after I asked for a 2nd opinion and a transfer.

Pin the tail on the donkey with your eyes shut and then blame the donkey for getting it wrong comes to mind.... certainly no duty of candour shown