Author: Foot Doc
Date: 5/31/2008 5:03 pm PDT
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DISCLAIMER:
THE FOLLOWING IS OFFERED GRATIS AS GENERAL INFORMATION ONLY, AND, AS SUCH, MAY NOT BE APPLICABLE TO THE SPECIFIC QUESTIONER AND/OR HIS/HER PROBLEM. IT IS CLEARLY NOT BASED ON ACTUAL KNOWLEDGE AND/OR EXAMINATION OF THE QUESTIONER OR HIS/HER MEDICAL HISTORY, AND IT CAN NOT AND SHOULD NOT BE RELIED UPON AS DEFINITIVE MEDICAL OPINION OR ADVICE. ONLY THROUGH HANDS- ON PHYSICAL CONTACT WITH THE ACTUAL PATIENT CAN ACCURATE MEDICAL DIAGNOSIS BE ESTABLISHED AND SPECIFIC ADVICE BE GIVEN. NO DOCTOR/PATIENT RELATIONSHIP IS CREATED OR ESTABLISHED OR MAY BE INFERRED. THE QUESTIONER AND/OR READER IS INSTRUCTED TO CONSULT HIS OR HER OWN DOCTOR BEFORE PROCEEDING WITH ANY SUGGESTIONS CONTAINED HEREIN, AND TO ACT ONLY UPON HIS/HER OWN DOCTOR’S ORDERS AND RECOMMENDATIONS. BY THE READING OF MY POSTING WHICH FOLLOWS, THE READER STIPULATES AND CONFIRMS THAT HE/SHE FULLY UNDERSTANDS THIS DISCLAIMER AND HOLDS HARMLESS THIS WRITER. IF THIS IS NOT FULLY AGREEABLE TO YOU, THE READER, AND/OR YOU HAVE NOT ATTAINED THE AGE OF 18 YEARS, YOU HEREBY ARE ADMONISHED TO READ NO FURTHER.
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In my opinion your MRI and CAT reports represent the typical shot-gun, often unfocused impressions which, because of their impressive language, tend to make, especially the patient and often the doctor think that they supercede old fashioned diagnositic ability. It seems often the case that the radiologist tends to attempt to justify his/her value by citing any and all abnormalities seen, whether or not they bear significantly on the patient's complaints. For that reason, I generally read my own tests in addition to receiving the narrative from the radiologist, as I know exactly what I am looking to rule in or out and don't have to bother with extraneous information which often simply muddies the waters. I note in particular that you mentioned that your doctor suspected a problem with the medial (tibial) sesamoid. The MRI report finds problems with the laterial (fibular) sesamoid, while the CAT report states that that same sesamoid is fine. Seems to substantiate the waste of money that these tests often wind up being. Many are preformed because the doctor may not possess the necessary diagnostic skills, and/or because the patient both expects and is impressed by such tests. But all that being said, I see no information regarding the alternative diagnosis of a possible nerve entrapment. I can't tell you what your diagnosis is, but I'd bet dollars to donuts that with a good old-fashioned physical examination, I could give you one.
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