Bruce B. Fry, DO
Specialty: Orthopedic Surgery
- orthopedic surgery
- physical medicine/rehabilitation
Location and Office HoursKnoxville Orthopaedic Clinic
260 Ft Sanders W Blvd Bldg 6
Knoxville, TN 37922
- BlueCross BlueShield
- BlueCross BlueShield of Tennessee
- First Health
- Great-West Healthcare Cigna
- United Healthcare
Why is it hard to diagnose knee problems?
Scott Martin, MD, Orthopedic Surgery, answeredDiagnosing knee problems can be complicated, in part because of the large number of possible causes of knee pain. Patients are not always able to pinpoint the exact location of their pain, and injuries may not be clearly visible on imaging tests. In some situations, a physical examination and the information you provide are sufficient. But most diagnoses require at least an x-ray, and in some cases the doctor may recommend more advanced imaging and laboratory tests to determine the cause and extent of damage. But be aware that even expensive tests such as magnetic resonance imaging (MRI) may not be conclusive or even useful. While MRI may reveal an abnormality, it may not be the source of the pain. Studies show that MRI can be too sensitive and often reveals abnormalities in patients who have no pain.
What are musculoskeletal problems?
The musculoskeletal system is a type of organ system that allows for movement and stability of the body and consists of bones, muscles, joints, tendons, cartilage, ligaments, bursae (fluid-filled sacs), and other connective tissue. Complications arise when individual parts of this bodily system are injured can range from minor discomfort to serious medical conditions. Symptoms of musculoskeletal disorders (MSDs) can be acute or chronic and may include inflammation, swelling, pain, fatigue, weakness, joint noises and stiffness, limited range of motion, and lack of coordination.
The skeletal system serves many important functions, including providing structure, shape, form, support, and protection for the body. The skeletal system also allows for bodily movement, produces blood for the body, and stores minerals. The skeletal system consists of 206 bones that form a rigid framework as well as protect soft tissues and vital organs of the body. For example, the brain is protected by the skull which surrounds it and the heart and lungs are enclosed in the sternum and rib cage.
Bodily movement is made possible by the interaction of the muscular and skeletal systems. For this reason, they are often grouped together as the musculoskeletal system. Muscles are connected to bones by tendons. Bones are connected to each other by ligaments. Where bones meet one another is called a joint. Muscles that cause movement of a joint are connected to two different bones. The muscles contract and relax to cause movement. An example would be the contraction of the biceps and a relaxation of the triceps. This produces a bend at the elbow. The contraction of the triceps and relaxation of the biceps produces the effect of straightening the arm.
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How are hip problems diagnosed?
Scott Martin, MD, Orthopedic Surgery, answeredDuring a hip examination, the doctor will ask you questions about pain and other symptoms. Be sure to describe sensations in the entire leg: a hip problem may cause pain in the front, side, or back of your hip, in the groin, and even in the knee. Mention any physical labor or sports you participate in and falls or injuries you have experienced. Even if you landed on your knees rather than your hip, you may have jolted your hips.
The doctor will watch you walk to observe unevenness or changes in your gait. Hip pain or muscle weakness can change how you walk. Speak up if any portion of your stride hurts. The doctor may examine your shoes for signs of abnormal wear. He or she will observe how far you can flex your knee toward your chest and extend your leg out behind you, and how readily you can move your leg out to the side (abduction) and across your midline (adduction). As you lie on your back, the doctor will measure how far you can rotate your hip externally (letting the knee fall toward the outside of your body) and internally (letting your knee turn toward your midline). As you move or try to resist pressure applied by the doctor during different maneuvers, the doctor will assess pain, muscle strength and restrictions, and any grinding or snapping in the joint.
Along with the hip exam, the doctor will examine the position of your pelvis, compare your leg lengths, test nerve function in your legs, and check your feet and ankles for swelling that might indicate impaired circulation. He may ask you to simulate putting on socks with a figure of four position of the leg. Lack of motion in the hip may indicate degenerative hip disease. He or she will also examine your spine for curvatures or conditions (such as a pinching of the sciatic nerve) that can cause hip pain.
In addition, the doctor is likely to use x-rays, magnetic resonance imaging (MRI), or an MRI arthrogram (an imaging technique in which an iodine-based dye is used to enhance the resolution of the MRI) to diagnose hip problems.
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