We will explore your knee symptoms and try to understand more about how your symptoms affect you, We may organise some investigations to fully understand your knee problem. We will then meet again and discuss with you what options for treatment are available.
Throughout your consultations we will endeavor to help you understand what choices of treatment are available and to make the most appropriate choice for you individually.
You will be invited to attend an outpatient consultation. You will meet with one of our specialist consultants who will talk through your knee problem. You will be asked some questions about other relevant medical conditions. Some Xrays may be obtained.
The aim of the initial consultation is to understand how your knee problem affects you and to make a provisional diagnosis as to the cause of your symptoms.
Often an MRI scan may be requested to increase the accuracy of the diagnostic evaluation. This is normally arranged at another visit, but you will be given options to try and make it at a convenient time.
We use a number of methods to investigate you knee problem. These investigations allow us to better understand the issue and what treatment options are available.
These are normally performed during your consultation, you will have the opportunity of discussing the radiographs with your specialist immediately after they have been performed. The Xray facilities at the Manor Hospital are modern high quality digital images. Xrays are a painless investigation using small doses of radiation to image the bony skeleton. The are extremely useful in the diagnosis and management of bone and joint disorders, particularly osteoarthritis.
Because Xrays only show up the bony skeleton often MRI scans are requested. These show much greater detail of anatomical structures in and around the knee including the articular cartilage (joint surfaces), menisci (sports cartilages), ligaments, muscles and tendons . A Magnetic Resonance Scan (MRI) uses a pulsed magnetic field to obtain detailed images of the anatomy of the joint, no radiation is used. The scans can take about 30 minutes and take place in the imaging suite at the Manor Hospital. They will book you in prior to your appointment and you will be given a safety checklist to complete prior to the scan to ensure there are no contra-indications to you undergoing a scan.
These are sometimes used to look at structures around the front of your knee (patella tendon and extensor mechanism). They are similar to the scans women have during pregnancy. Some jelly is applied to the area being scanned and then a probe is passed over the area. This emits sound waves that rebound of the structures in the knee. They are picked up by the probe and processed into an image. The scan is painless and has no side-effects. You will be able to see the images and the radiologist performing the scan will talk you through the images.
A bone scan is a method of looking at your bones to show conditions not seen using x-rays. It requires an injection of a small amount of radioactive fluid, which is then taken up by the bones. This scan is performed 3 hours after the injection.
These involve carefully controlled injections of Local anaesthetic and occasionally steroid into specific locations. This can be helpful in pinpointing problem areas. Sometimes the injections themselves can be effective treatments. The injections involve needles similar to the type used when blood samples are taken. Other than minor discomfort there are minimal risks. There is a very small risk of infection after an injection, the doctor will explain the process to you prior to performing the procedure.
After any relevant investigations we will see you again in clinic. We will talk you through the findings from investigations and together make a plan for the most appropriate initial treatment. We believe it is important for you to understand what the problem is with your knee and what treatment choices you have. This allows us to help determine what is the best management course to follow. We are currently developing a number of strategies to help us decide which treatment would be best suited to your requirements.
There are several routes for treatment:
- Advice (lifestyle advice, painkillers, anti-inflammatory drugs)
- Review of symptoms after a period of time.
- Specialist physiotherapy and rehabilitation
- Injection treatments (Steroid / visco-supplementation).
- Further specialist investigations
- Surgical interventions