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Bone fragment

Discussion in 'Ask your questions here' started by Unregistered, Mar 29, 2010.

  1. Unregistered

    Unregistered Guest


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    I have had pain and swelling in my left foot for a couple of months and an MRI scan has shown a bone fragment measuring 3.2 by 2 mm at the base of the 4th metatarsal causing imflammation to the surrounding tissue. Now I have to wait who knows how long to see an orthopaedic consultant.

    Any ideas of the kind of treatment for this? I can't really find anything on the web. I would assume it's not going to get better by itself.
     
  2. FootDoc

    FootDoc New Member

    MRI's may reveal abnormal findings, such as a bone fragment and indications of inflammation, but that does not necessarily mean that there is a cause and effect relationship. So, to state that the MRI revealed a bone segment which was the actual cause or even a factor in your inflammation may be entirely speculative, although, alternately, that might be a correct judgment call by the doctor attending the case. I have no idea of what the bone fragment is, where it came from, if it has anything to do with your complaint or if any treatment of it is required. But why aren't you asking this of the doctor who examined you and ordered the MRI? Does his/her function and responsibility to you stop there?
     
  3. Unregistered

    Unregistered Guest

    You have hit the nail on the head there as the reason I am posting here is due to frustration with the doctor!! It appears that I have been referred to the consultant and they seemingly have no further responsibility.
     
  4. FootDoc

    FootDoc New Member

    In the U.S. a consultant is a doctor who generally offers an opinion regarding another doctor's case. That consultant is SOMETIMES called upon to take over or participate in treatment, but not necessarily so. I assume from what I have learned on this forum that in the U.K. a consultant is a specialist to whom a GP transfers a patient for treatment if it is beyond the scope of the GP's practice. In either case, if a doctor transfers treatment of a patient to another doctor, his/her on-going responsibility for the patient ceases at the time the new doctor takes over unless the original doctor wishes to continue to work in tandem with the specialist or new doctor. But certainly the doctor who orders a test where adverse findings are made needs either to turn evaluation and treatment over to another doctor or act appropriately in regard to the test and the patient's condition.
     
  5. Unregistered

    Unregistered Guest

    Yes you are correct in your assumption that in the UK a GP may order tests and then if the findings warrant it, he/she will refer the patient to a consultant specialising in that field. It is my understanding that once referred the GP would not expect to give the patient further information about their condition, probably because he/she would not be qualified to know the answer. The hospital has to give the patient an appointment with the consultant within 18 weeks of the referral letter being sent so you can see that there is a long time for the patient to wait and wonder what is happening next!!!

    I actually received my appointment today and perhaps should be grateful it was only 7 weeks away but since I have been living with this pain for 2 and a half months now I am going to pay £200 to see the consultant privately and can do that in 2 weeks time. However I am told that if I do need treatment from the NHS (which I will as I cannot afford to pay for any necessary surgery) I cannot jump the queue. I am not sure if that means I wouldn't be put on the waiting list until after I would have had my NHS appointment. Either way, just be glad you do not have to put up the UK health system!

    I believe that the bone fragment is what is causing my problem since the top of my foot is swollen and painful with localised pain and tenderness on top and underneath the 4th metatarsal head. Sorry I didn't explain that better in my original post. Thank you for your comments.
     
  6. FootDoc

    FootDoc New Member

    Not so fast. If you don't have the money to pay for necessary surgery, you probably don't have enough money to pay for insurance to pay for the surgery as you would need if you didn't have the NHS to put up with. So maybe an 18 week wait is better than never. The major problem as I see it with the NHS is that the government is both the payer and the provider of medical services, and the doctors get paid just as much to treat as to not treat. Medicare in the U.S. for those 65 and over actually works quite well, only because the doctors are independent contractors so to speak, and are merely paid by the government on a fee for service basis for the most part, but not employed by them. Sure, the government calls the shots as to what is covered and how much is paid, but so do the private insurers, and THEY have a much more direct profit motive in not paying and not covering. Doctors in the U.S. have gotten use over the last 30 years or so to having the insurers, whether private or government setting the remuneration rates for doctors and what is and what is not covered. So whether the government does it or the private sector insurance does it, doctors work more and get paid less either way, unless their at least under 65 patient population is wealthy enough to paid directly without insurance.
     
    Last edited: Mar 31, 2010
  7. Unregistered

    Unregistered Guest

    Well I would imagine that insurance cover is paid on a monthly basis which I guess would be easier to afford than a one-off payment into the thousands for surgery! But I take your point and accept the grass always looks greener on the other side but it is immensely frustrating when foot pain is limiting my ability to do my job and live my life in general and the whole process of getting any improvement is so painfully slow.
     
  8. FootDoc

    FootDoc New Member

    Not if you had routinely banked the monthly amount that you have been saving because your medical care, such as it is, is paid for.
     
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