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MRI for pulley injury (Read 1582 times)

AMorris

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MRI for pulley injury
September 28, 2020, 01:09:16 pm
So, the other day I pretty catastrophically popped the A2 on my left middle finger. Pretty shit. Question is, does anyone have experience with getting MRIs done on the NHS? I want to find out how bad it is (i.e. is it a full rupture or just a bad tear?) so that I can be realistic about what I need to do to recover and make sure this does not turn into a long term weakness. If it takes months to get one done then there's no point really, since that is a good chunk of my predicted recovery time.

Cheers in advance.

duncan

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#1 Re: MRI for pulley injury
September 28, 2020, 01:17:45 pm
You might consider an ultrasound scan: good for superficial soft tissue injuries with the added bonus of being able to visualise moving strutures. Nothing like as expensive as an MRI if you go privately.

Some physiotherapists have had extra training to do them eg Huffy.

SamT

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#2 Re: MRI for pulley injury
September 28, 2020, 01:40:26 pm
Recent advise from a physio (for a knee, but the principals the same) went along the lines of -

"MRI? what for. Unless you need surgery, the treatment/rehab will be exactly the same anyway.  MRI is only usually a precursor to surgery to allow the surgeon to see exactly what they'll be dealing with"

Given that its highly unlikely you're going to need surgery on it, then why bother? Just crack on with the normal A2 pully rehab regimes, and given time, you'll be back climbing again.

(caveat: I asked my physio about it since,  I expect just like you, I really wanted to know *exactly* what I'd done and to what extent, but her answer seemed to make sense.  I'm quite a way down the line with the knee know and the physio is working and I'm back climbing and gaining confidence it the knee again.)


AMorris

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#3 Re: MRI for pulley injury
September 28, 2020, 02:01:51 pm
You might consider an ultrasound scan: good for superficial soft tissue injuries with the added bonus of being able to visualise moving strutures. Nothing like as expensive as an MRI if you go privately.

This is a nice thought actually, one I had not had, thank you.

Recent advise from a physio (for a knee, but the principals the same) went along the lines of -

"MRI? what for. Unless you need surgery, the treatment/rehab will be exactly the same anyway.  MRI is only usually a precursor to surgery to allow the surgeon to see exactly what they'll be dealing with"

Given that its highly unlikely you're going to need surgery on it, then why bother? Just crack on with the normal A2 pully rehab regimes, and given time, you'll be back climbing again.

(caveat: I asked my physio about it since,  I expect just like you, I really wanted to know *exactly* what I'd done and to what extent, but her answer seemed to make sense.  I'm quite a way down the line with the knee know and the physio is working and I'm back climbing and gaining confidence it the knee again.)

Yeah that is reasonable, my main question is whether it is a grade 2 or grade 3. I suspect a grade 3, but you are right in that the recovery process is basically identical, and even the recovery time is not really that different in the grand scheme of things. I am 90% sure it is a rupture, rather than a partial tear, since it was sickeningly loud and has swollen and bruised (though not half as much as I expected) but it is very hard to know.

Cheers both, hopefully it wont take long until I am back at it, but after hang-boarding obsessively for 6 months the frustration is enormous!

abarro81

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#4 Re: MRI for pulley injury
September 28, 2020, 02:03:02 pm
As others have mentioned, ultrasound would be a good place to start. James @ Sheffield Climbing Clinic uses one if you're Sheffield based...
[Relevant aside - I saw Volker Schoffl in Germany recently about a chronic PIP joint issue, and ultrasound was his instant go-to tool]

bigironhorse

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#5 Re: MRI for pulley injury
September 28, 2020, 02:44:41 pm
If Sheffield based John Ostrovskis at The Clinic is a good guy and does ultrasound.

AMorris

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#6 Re: MRI for pulley injury
September 28, 2020, 02:52:37 pm
As others have mentioned, ultrasound would be a good place to start. James @ Sheffield Climbing Clinic uses one if you're Sheffield based...
[Relevant aside - I saw Volker Schoffl in Germany recently about a chronic PIP joint issue, and ultrasound was his instant go-to tool]

I will look into who near me can do that. I am Cardiff based as of 3 weeks ago, so there should be a few around.

mrjonathanr

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#7 Re: MRI for pulley injury
September 28, 2020, 06:40:25 pm
Jon O did ultrasound when I had a nasty tear in my knuckle hood- showed a lot of useful detail, really helpful technique.  From my research if you went down the MRI route think you’d be looking £300+ for a private consultation.

If you want to see a hand specialist, orthopod Mike Hayton does consultations for £220 in Manchester https://www.mikehayton.com/


Good luck.

 

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