OK so we saw the Ortho Doc, and I beyond confused. Think I will be seeking a 2nd opinion. MRI report reads: Prominent marrow edema within the left L4 pedicle, slight marrow edema in the right pedicle of L4. This marrow edema left greater than right shows no bone expansion or destruction or adjacent soft tissue mass and there is no evidence of L4 spondylosis. The edema is considered benign and most likely represents a stress response.
At L5-S1 the findings are unremarkable except that there may be subtle or early bilateral spondylolysis.
Ortho Doc, says there is a stress response at L4 (he showed it to me on MRI). He recommends a brace for 6-8 weeks and physical therapy thereafter with a plan to return to the field in 3 months.
He seems to think her pain has nothing to do with the stress fracture and possibly comes from getting hit by the pitch. he also disputes that there is any abnormality at L5.
None of this is making much sense to me right now. Stick
I am not a doctor, but saying there may be early bilateral spondy sounds like enough reason to pursue a second opinion. As I understand it, the most common area of injury is L5 - S1. And maybe you have a situation where the hit by pitch injury actually exacerbated the fracture and now you've found it, so possibly ortho doc is seeing the soft tissue injury in L4 and discounting what's happening in L5?
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Did you he give you a reason for disputing the findings of abnormality at L5? And is this a sports med ortho?
Did you he give you a reason for disputing the findings of abnormality at L5? And is this a sports med ortho?
Thanks Dial would this be better than MRI?, or would another future MRI be good to compare progress?Stick,
Sorry to hear the diagnosis. Get the second opinion if you feel uncomfortable. Ask for the bone scan as well. Ours did both on the same day. That might be considered a SPECT?? Still trying to get all the medical jargon down.
But your daughter IS IN PAIN. Man, this is frustrating.said 6% of the population has this finding not significant without edema
So sorry to hear this situation stick - it hits sooo close to my heart - even after all the years gone by.
My 2 cents =>
Don't go see another doctor. Trust the one who has seen the most pitchers & football linemen in their sports injury Ortho doctor career (which sounds like the one ya got the diagnosis from). We had exactly the same scenario where our younger sports orthopedic doctor, who cared for the UW Madison pitchers and football team directly, said we should go see the almighty "senior" ortho surgeon in the UW medical system hierarchy. Well this nationally renowned senior ortho surgeon was just a bad distraction and he recommended surgery too (talking specifically to pars break now). I think some "senior & out of the focus of pitchers injuries" experts get very distracted from the peculiarities of a young body pitchers pars injury.
There are no shortcuts in the recovery to this. Ya have to accept and move forward to the next step of the process. The faster you move to the next stage of this the better.