On the Bench

1

Abby (Read 438 times)

    My Vit D is 48 - with "good" being over 34. My PTH intact, Mg, Phosphorus, Ca and ionized Ca are all normal - although my ionized Ca was 5.5(ref 4.8 - 5.6) - they checked all that stuff in May as screening for the last stress fracture. My PCP does not believe this is metabolic - says my last DEXA was too good for me to "suddenly" have osteo. She thinks that since all my fractures have been in the R leg - we need to look at the R leg. She is going to check out some stuff and get back to me. MRI: "There are band-like areas of increased STIR signal within the distal femoral bone marrow extending from the diaphysis into the metaphysis. These are most pronounced anteromedially, abutting the inner surface of the cortex. There is also less pronounced hyperintensity posterolaterally. In addition, there is curvilinear hyperintense signal outlining the anteromedial periosteum. The appearance is compatible with a stress fracture of the distal diaphysis......note is made of a small knee joint effusion." X-Ray: "...very localized area of smooth periosteal thickening which extends for a distance of about 1.5cm What is your take on the fracture site? I don't like that it goes to the metaphysis. I'm back to thinking that this had something to do with my fall - that is the area that I hit and I think the knee effusion was a result of that as well....and if it was, why didn't I have any symtoms for 10 days after the fall? I also have a "small bone island" in the proximal shaft - but I take it that is a normal site to have that. With the tibial fractures, it was extremely annoying and frustrating, but this is different, and I just have a "bad feeling" about it.

    Life is not measured by the number of breaths we take, but by the number of moments that take our breath away...(unkown)




    Go With The Flow
    Thyroid Support Group

      Hi Chenille, Great news on all the labs! (My Vit D was 19. Oops! But my dexa was good and the biopsy didnt show any problems. I am taking supplements now, but we dont think that caused the fracture.) I agree you probably dont have osteoporosis. But there could be a different metabolic bone problem going on - something that could affect the way your bone deals with stress. But I think its very, very unlikely. I hate to admit it, but reading the MRI report, I am totally in over my head. I feel like most advice I would be giving is really going with my gut feel, rather than my experience. So dont take what I say too seriously. Dont know what it means that it goes into the metaphysis. That just explains where the fracture is. Dont know if it is significant that it crosses the growth plate. I also dont know what a "small bone island" signifies. I dont think the knee effusion is significant. That could be from the fall. Or just there. If your knee isnt bugging you, dont worry about it IMHO. I agree its unlikely that you are all of a sudden having trouble from your fall 10 days ago. (Are you feeling sick? Fever? Fatigue? Etc?) I might try to see someone who is in primary care sports med. I wish I had better advice for you and could be more helpful!
        Abby - it does help. It just helps mulling things over with someone who understands the context. My PCP is in over her head too, she brought up Mayo again. She is checking with some other docs, but doesn't know what to order next. I think osteo is very unlikely, but I think we need to do redo DEXA at 1 year. DH says I just want to run again - and I do - but I don't have any desire to do that right now just because I don't feel well enough - I can't put my finger on it - I am tired, I feel like I have a low grade fever most of the time, and believe it or not, this time, I don't think it is my thyroid - my levels weren't off enough to explain me feeling this way. If the 24hr NTx comes back normal - I think it might be time to start looking at autoimmune stuff. I don't think they ever found out what caused your fracture either. I seem to recall that you were not doing a lot of running at the time. Did you have a bone biopsy? I hope that's not in my future. bone island thanks again - you hang in there too

        Life is not measured by the number of breaths we take, but by the number of moments that take our breath away...(unkown)




        Go With The Flow
        Thyroid Support Group

          One thing I am slightly worried about is could you have osteomyelitis which is a fancy way of saying a bone infection? They tend to show up a bit after you fall and hurt yourself. (I dont know what they look like on imaging.) And are accompanied by constitutional symptoms (generally feeling sick). So if you have been feeling tired with that low-grade fever for the last 5-10 days (or couple days), I might ask your doc about that. I think its pretty unlikely though. I wasnt doing a ton of running and I hadnt increased miles. The femoral neck (hip area) is a weird place for a first stress fx, usually showing up in anorexic runners, etc. It also tends to be a sight where you can get tumors, though we never thought that was the case. We have less of an idea why it hasnt healed yet. When my surgeon was putting in the nail she did a biopsy from the area. She said she only wanted to do it if I opted for surgery. As expected, it was totally normal. (Thank goodness!) No idea how painful it is without the hardware. Its fast, usually done under general, and while I am sure its not a walk in the park, I dont think its too awful. Of course, my vote is for no biopsy if it isnt needed. Wink
            I forgot to add: my surgery was May 9th. So about 7 months ago. And I agree - it is really sad when you know what bone pain feels like. Cry


            Along for the Ride

              I just came back to see who is still here ... I am sorry you two are having such trouble. My best wishes and healing vibes for both of you!

              Your living is determined not so much by what life brings to you as by the attitude you bring to life; not so much by what happens to you as by the way your mind looks at what happens.

              Out of suffering have emerged the strongest souls; the most massive characters are seared with scars.

               

                thanks, Runnergabe, good vibes appreciated. I now have an internal hip click - deep, muffled but audible, and pain on the inside of my groin - low grade ache. Have you noticed that whenever I try to pick up, and find something positive to focus on, another "issue" rears it's ugly head. Sad I think the orthotics contributed to this. I think my pronation was compensating for issues in my hip/pelvis, and correcting the pronation put strain on areas that couldn't handle it. I think that's why I had so much trouble finding the right shoes after the last stress fracture. Of course, none of that really matters, but I am not going to get another set of orthotics. MTA: "We're discovering that cycling may contribute to bone loss in both men and women because it's not a weight-bearing activity. So cyclists should crosstrain for bone health. Weight training and jumping (like rope skipping) are helpful." Nice..... No

                Life is not measured by the number of breaths we take, but by the number of moments that take our breath away...(unkown)




                Go With The Flow
                Thyroid Support Group