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Trevonte Citizen injury considered serious [Sep 23 - *may* return this year]

CanesFan448 said:
I'm an orthopedic radiologist. A full tear is very difficult to miss and swelling/inflammation has nothing to do with it. But unfortunately there is no perfection in anything, let alone medicine. If an ACL is getting missed, it's probably in some rural town with a general radiologist, but that's not happening with D1 athletes/facilities. The practice comes in looking at partial tears which the decision for surgery comes down to the orthopedist physical exam.

It's the pain and swelling that make it hard for the surgeon to make the physical diagnosis. But that doc is right that pain can limit how the athlete is positioned in the scanner and lead to them moving which hurts the images.

The vast majority of times we get the patient already knowing the ACL is torn and it's just for confirmation (so the surgeon can charge for the knife) and to look for associated injuries (menisci, LCL, MCL) that can complicate surgery and recovery.

I've met Andrews a couple times. Nice guy. He also did my Tommy John.
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Wow. But you are wrong per amateurs who had an ACL or anal-ectomy and based on that experience are writing AMA peer reviewed articles on the subject
 
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HurricaneinLA said:
How is this one? They have come a long way.
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That's a hot rod, even has a detachable table, which Seimens used to not have. It's weird that it looks like it's stuffed into an alcove or something. At first I thought it was in a mobile trailer, maybe a modular or something.
 
CanesFan448 said:
I'm an orthopedic radiologist. A full tear is very difficult to miss and swelling/inflammation has nothing to do with it. But unfortunately there is no perfection in anything, let alone medicine. If an ACL is getting missed, it's probably in some rural town with a general radiologist, but that's not happening with D1 athletes/facilities. The practice comes in looking at partial tears which the decision for surgery comes down to the orthopedist physical exam.

It's the pain and swelling that make it hard for the surgeon to make the physical diagnosis. But that doc is right that pain can limit how the athlete is positioned in the scanner and lead to them moving which hurts the images.

The vast majority of times we get the patient already knowing the ACL is torn and it's just for confirmation (so the surgeon can charge for the knife) and to look for associated injuries (menisci, LCL, MCL) that can complicate surgery and recovery.

I've met Andrews a couple times. Nice guy. He also did my Tommy John.
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I figured an MSK Rad would chime in eventually.
 
ddann said:
So to summarize:

1) Citizen is out for the season even before the season begins?

And

2) Chaney is set to miss half the season (again)?

Is that where we’re at now?
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Chaney won’t miss half the season. We play 4 games then a bye before ACC play vs UNC in game 5, week 6. That’s October 8th. He should be fine by then, at worst. Maybe even before. That’s 1/3 of the season, and it’s also none of the ACC schedule.
 
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OrangeBowlMagic said:
Chaney won’t miss half the season. We play 4 games then a bye before ACC play vs UNC in game 5, week 6. That’s October 8th. He should be fine by then, at worst. Maybe even before. That’s 1/3 of the season, and it’s also none of the ACC schedule.
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My first post yesterday i said “half the season” then edited a little bit later. The original text I was sent said “6-8 wk’s”. Glancing at it I thought games. When I saw Mtsu the light went on it wasn’t half the year and they meant weeks, I literally had posted thats the absolute earliest he‘d return lol. That could possibly be why some are thinking half the year. Even though that could happen , you never know how something will heal but 6-8 weeks is the ball park.
 
K.O.M.A. said:
That's a hot rod, even has a detachable table, which Seimens used to not have. It's weird that it looks like it's stuffed into an alcove or something. At first I thought it was in a mobile trailer, maybe a modular or something.
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That is at the UCLA MPTF center in Valencia. They several different ones over there and had my 38th and 39th MRIs done in that one. They have come a long way. The first ones were like the Frankenstein MRI machines They always ask have you had and MRI done before. It is great that you know so much about them. Always meet these technicians but most are always busy.
 
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CorniceCane said:
Or they read it on the internet!
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CanesFan448 said:
I'm an orthopedic radiologist. A full tear is very difficult to miss and swelling/inflammation has nothing to do with it. But unfortunately there is no perfection in anything, let alone medicine. If an ACL is getting missed, it's probably in some rural town with a general radiologist, but that's not happening with D1 athletes/facilities. The practice comes in looking at partial tears which the decision for surgery comes down to the orthopedist physical exam.

It's the pain and swelling that make it hard for the surgeon to make the physical diagnosis. But that doc is right that pain can limit how the athlete is positioned in the scanner and lead to them moving which hurts the images.

The vast majority of times we get the patient already knowing the ACL is torn and it's just for confirmation (so the surgeon can charge for the knife) and to look for associated injuries (menisci, LCL, MCL) that can complicate surgery and recovery.

I've met Andrews a couple times. Nice guy. He also did my Tommy John.
Click to expand...
The guy that did my knee in the 90s Dr. Stephen O'Brien HSS in NYC said he can't be sure until he puts the cameras in. Granted he said right away you tore your ACL and prob your meniscus just from pulling on my knee but can't be sure until he puts the cameras in and he was right.

Go Canes!
 
pacusmc said:
I don’t know the percentage but there are plenty of acl injuries that have a negative anterior draw test. But if it is positive then the accuracy is above 90 percent.
I had a complete ACL tear when I was 22 years old while playing soccer. The orthopedic surgeon that I saw told me he needed an MRI to make sure I was OK. After the MRI he sent me to therapy for about a month prior to the surgery because he wanted to make sure my muscles were strong. When I got to therapy the therapist Examined my knee and said are you sure this is a torn ACL?

I got a second opinion from another surgeon and he showed me the images and both ends of my ACL looked like floor mops.

Imo relying on a negative anterior draw test or a Lachlan’s test to determine severity of knee injuries is a mistake.

We’ve seen players show up to college and get mri’s and find out they’ve been playing with acl and labrum tears.

I don’t know what protocols are established at UM or at any college program for a player to get an MRI. But I imagine that getting an mri for every player that tweaks a knee can get expensive.
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So all this technnicial ACL, Meniscal tears, PCL, MRI, SOB, FU2, etc -

So this means the knee bone isn't properly connected to the leg bone, and swelling may or may not affect a proper diagnosis, and that's even if the peek at it during examination has the knee bent in the right angle - or the doc is looking at it from the right angle - and if the foot is facing backwards - it can mean the player is out for maybe weeks?
 
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Samson Doyo said:
The guy that did my knee in the 90s Dr. Stephen O'Brien HSS in NYC said he can't be sure until he puts the cameras in. Granted he said right away you tore your ACL and prob your meniscus just from pulling on my knee but can't be sure until he puts the cameras in and he was right.

Go Canes!
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Ultimately yes, you never know for sure until the surgeon goes in and looks. I’m sure HSS had a great MRI in the 90s but MRI has only been used clinically since the 80s. The MRI and images we get now are vastly greater than then. Sensitivity and specificity for internal derangement of the knee is greater than 90% now.
 
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