Thoughts on MRI Results
My eleven-year-old daughter, who is 5’1” and weighs 110 lbs, has been experiencing unexpected knee pain for almost a year now, without any clear cause. Initially, we consulted an orthopedic specialist, who assured us that she was fine and advised against activities that caused pain. Fast forward six months, and her condition hasn’t improved; she continues to limp frequently and experiences severe pain in her knees, as well as in her femur and tibia, particularly at night. We decided to revisit the orthopedic doctor, who again claimed that she was fine. Frustrated, I insisted on an MRI. The results revealed advanced Osgood-Schlatter disease, which finally provided us with a diagnosis. However, six months later, my daughter is still in discomfort. We've also started looking into a possible breathing issue that occurs at night and conducted some blood tests, revealing an ALP level of 519 and vitamin D level of 21.7. Just a week after, her ALP level rose to 626 following an isoenzyme test, confirming the elevation is linked to her bones. She has a scheduled bone scan tomorrow. Out of curiosity, I retrieved her MRI images from January and submitted them to ChatGPT for analysis. It indicated the presence of lesions in her knee but found no evidence of Osgood-Schlatter disease. I'm interested to hear if anyone else has insights or information regarding this situation, as I'm trying to gather knowledge to alleviate my concerns.
Answers (1)
6/30/2025, 1:40:43 AM
OpenHealth AI
It's understandable that you're feeling concerned for your daughter, especially since she has been in pain for such an extended period and has had difficulty getting a clear diagnosis. Let's break down the situation based on the information provided and outline some next steps.
Main Points:
- Your daughter has been diagnosed with advanced Osgood-Schlatter disease, which can cause knee pain but is generally self-limiting, especially in growing children.
- The elevated alkaline phosphatase (ALP) levels and vitamin D deficiency indicate potential bone metabolism issues.
- You are seeking further clarity on the MRI findings and potential next steps.
Explanation:
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Osgood-Schlatter Disease: This condition is common in adolescents and often results from repetitive stress or overuse during growth spurts. While it usually resolves over time, persistent symptoms may require more attention, especially if she is experiencing severe pain and limping.
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Elevated ALP Levels: High levels of alkaline phosphatase in the blood can indicate bone growth or turnover, and when coupled with symptoms and imaging results, may point to underlying issues that require further investigation.
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MRI Findings: Discordance between the suspected diagnosis and MRI results can happen. Lesions could indicate other conditions, and the analysis of these images by a professional radiologist is essential for accurate interpretation.
Next Steps:
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Bone Scan: Attend the scheduled bone scan, as it can provide valuable information on bone health, inflammation, or other abnormalities that may not be evident on the MRI.
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Addressing Vitamin D Deficiency: Focus on ensuring your daughter increases her vitamin D intake through diet (foods like fatty fish, fortified dairy products) and safe sun exposure, or consider a supplement. Low vitamin D can impact bone health, possibly contributing to her symptoms. Discuss appropriate dosage with a healthcare provider.
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Pain Management: Implement supportive measures such as:
- Resting the affected knee and avoiding activities that provoke pain.
- Ice therapy after activity to reduce swelling and discomfort.
- Consider discussing with a healthcare provider about options for pain relief, such as NSAIDs (ibuprofen) if not contraindicated.
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Follow-Up on MRI and Symptoms: Request a thorough review of the MRI findings by a pediatric orthopedic specialist or a rheumatologist, especially considering her ongoing discomfort and the possible implications of the lesions.
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Track Symptoms: Keep a detailed diary of her symptoms, including daily pain levels, limping frequency, and any changes in sleep or breathing patterns. This information will be useful for her healthcare team in assessing her condition over time.
If you have additional concerns or see changes in her condition, please don’t hesitate to seek further medical advice. It’s important to advocate for your daughter’s health and ensure she receives the care she needs. Your attention to these details will help clarify her situation and guide appropriate treatment.
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