Twin brother got a diagnosis, some slight sc

September 11, 2024 11:57 AM

You are not my doctor. I'm wondering if you could give me some advice on my next steps. My identical twin brother just got diagnosed with something called avascular necrosis in his left hip and he thinks he will get diagnosed in his right hip after an MRI and xray. My right hip just started slightly bothering me. Should I immediately book an appointment with a Ortho? Looking for some anecdotal advice some add'l details inside:

My bro and I are still fairly similar bodies -- i weigh a bit more but might run more (he bikes more). Our diet is similar but he takes ADHD medication and I don't .My first gut would be rest/go to a PT for a couple weeks to see if pain goes away, but my brother did that for months and it didn't get better. He suggested I go to the ortho. I have decent insurance so my appoints would be mostly copays. This is in a big US city.

posted by sandmanwv to Health & Fitness (5 answers total)

Best answer: If you have pain in your hip, a family history of similar issues and good insurance, there is no reason not to go to the Ortho. The worst case scenario is that you lose an hour of your time and they punt you to PT. (I wish I had pursued my hip pain, which ultimately resulted in a THR and a massive reduction in pain, sooner than I did.)
posted by eschatfische at 12:08 PM on September 11 [8 favorites]

I would. A lot of MSK stuff CAN be headed off with early treatment, but because of cost and life, most wait too long.
posted by atomicstone at 12:10 PM on September 11 [1 favorite]

From what I see studies do point to some rare genetic causes of avascular necrosis, particularly in the femoral head and hip. So why not get checked out? Also, why not see if you and your brother could participate in research?
posted by The 10th Regiment of Foot at 12:12 PM on September 11 [1 favorite]

Best answer: You don’t necessarily need to see an ortho to get avascular necrosis ruled out. When I first approached my PCP about my hip pain, avascular necrosis was one of the first things he wanted to rule out, so I had an xray that same day. (Don’t be surprised if the doc asks you A LOT of questions about alcohol and steroid consumption.) My xray did not indicate A.V. and based on that and other findings from the PCP’s clinical exam he referred me to a sports medicine specialist for evaluation of a different hip disorder that primarily affects athletes. (Sports medicine confirmed it with MRI, and then I went off to the orthopedic surgeon for a consult.) So if it’s faster to get into an appointment with your PCP I’d probably start there.
posted by stowaway at 12:14 PM on September 11 [2 favorites]

I have avascular necrosis in both of my kneecaps. I had chronic pain and some other symptoms (occasional swelling, clicking sensation etc) for many months/years before it was diagnosed as doctors and I had assumed were sports-related injuries from decades of soccer and running. It doesn't really show up well on an MRI or X-ray (apparently just looks like trauma, they asked if I had been in a car accident). Got officially diagnosed in the left knee during an arthroscopy (they did some extra procedures to stimulate blood vessel growth), then once they knew what to look for they confirmed it was bilateral via imaging and I had an similar procedure done on the right knee. Anyhow it can't hurt to get it checked out but just wanted to flag that in my case it wasn't diagnosed until a surgical procedure. My orthopedic surgeon was awesome and the first medical professional to detect it so yeah I'd probably try to get a referral to at least rule it out if I were you
posted by emd3737 at 4:45 PM on September 11 [1 favorite]