If you are experiencing joint pain, muscle pain, or other musculoskeletal problems, it is worth consulting an orthopaedic traumatologist. However, before seeing a specialist, you may feel hesitant and have many questions. Questions often arise during the visit, but sometimes we forget to ask them. So, I will answer the most frequently asked general questions!
WHICH DOCTOR SHOULD I REGISTER WITH?
Most orthopaedic traumatologists specialize in a particular area; some focus on joint replacement, others on arthroscopy, and still others on foot surgery. Any specialist can perform the initial examination, but certain pathologies are best diagnosed and most effectively treated by specialists in that specific field. In many medical institutions, the doctor's areas of interest are indicated during registration, so you should pay attention to these. If you register with a doctor who does not deal with your specific pathology, there is no need to worry; we always try to refer patients to our colleagues who can best help you.
WHAT QUESTIONS CAN I EXPECT?
If you are complaining of pain, it is important to know not just where it hurts. For us, as orthopaedic traumatologists, it is very important to know how long the pain has lasted, where it spreads, whether it is related to movement, and whether it hurts at rest. Perhaps you notice what activity intensifies the pain or what helps reduce it?
As with any doctor's visit, including an orthopaedic traumatologist, it is important, if you take medication regularly, to know its name, dosage, and how often you take it. It is especially important for us, when planning surgery, to know if you are taking commonly referred to "blood-thinning" medications. It is also important to know why they are being taken so that we know when it is safe to stop them before surgery and when to resume them.
WHAT DOES THE EXAMINATION LOOK LIKE?
First, we always examine the problematic area for visible changes and perform various tests by manipulating it with our hands. We check active and passive joint movements and painful points.
A visit to an orthopaedic traumatologist is hardly imaginable without imaging tests. The most common are X-rays. Usually, they can be done during the same visit. For feet, X-rays are taken from three different projections, X-rays with weight-bearing (i.e., standing), and ankle X-rays. Foot or ankle pain can also be caused by changes in the leg axis and problems with other joints, in which case X-rays of other areas are also performed.
WHAT OTHER TESTS MAY BE NEEDED?
Sometimes X-rays alone are not enough, so we perform other, more detailed tests. To better evaluate bone structures, we perform a computed tomography (CT) scan. This test is quite quick, only a few minutes. When evaluating it, we see the examined area in various projections with small slices. This test can be imagined as many X-rays, so the radiation exposure during a CT scan is higher, which is why we try not to repeat it often unless there are necessary indications.
To assess soft tissues, such as ligaments or articular cartilage, we perform a magnetic resonance imaging (MRI) scan. Unlike computed tomography, this test does not involve radiation exposure, as it works with magnetic rays. Therefore, before this test, it is important to remove all metal objects and jewellery, and it is important for the doctor to know if you have a pacemaker or other implants in your body.
Another test that can be used is an ultrasound examination. It is also used to assess soft tissues, but its visibility is poorer, superficial structures are seen better, so it may not be sufficient.
WHAT IS IMPORTANT TO KNOW ABOUT THESE TESTS?
These tests are usually not performed during the orthopaedist's visit. You need to register for them after a specialist consultation and then come for a follow-up consultation once they are done. Regarding CT and MRI scans, if these tests are not performed at the same institution as the orthopaedic traumatologist's consultation, do not forget to ask for the test images to be saved on a USB drive or disc. To properly evaluate the pathology, and especially when planning surgery, it is very important for us to see the images, not just the radiologist's description.
ARE INTERVENTIONS POSSIBLE DURING THE VISIT?
One of the interventions that can be performed during the visit is joint injections. Anti-inflammatory drugs, analgesics, or other substances can be injected. Also, if a joint infection is suspected or for other indications, diagnostic punctures can be performed, and the fluid obtained from the joint can be examined.
HOW TO PREPARE FOR SURGERY?
We always try to explain everything during the visit, but the essential things are not to eat or drink on the day of the operation. Most often, we ask you to bring pre-operative blood tests, an electrocardiogram, and your usual medications. Operations are often planned several months in advance, so a lot can change during that time, which is why it is very important to inform the doctor. If you can no longer come for the operation, have fallen ill, or have started taking new medications, especially blood thinners, it is important for us to know!
DISCUSSION OF THE TREATMENT PLAN
We will offer you treatment options; sometimes we can choose between conservative treatment or surgery, as well as between different types of surgery. It is very important for you, as the patient, to understand what each treatment option entails and what to expect from it. The final decision is yours alone! So, during the consultation, do not be afraid to ask questions, and if you feel you need more time to think, do not rush into decisions. You can always come for a follow-up consultation and then finally decide which treatment is most suitable for you.
Do you have questions? Write to me, and together we will try to find the most suitable solution for your problems!
Karolina
