My mother-in-law has knee pain for almost three years. Earlier, the pain was mild, and she was taking anti-inflammatory and pain killers under orthopedics care. Now, her pain is quite severe, and the pain killer does not provide any relief. We had Doppler study for her legs, and I have attached the report. Please explain the report and which specialty doctor we need to consult?
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I have viewed the prescription and the right lower limb arterial and venous Doppler scan reports (attachment removed to protect patient identity). The prescription mentions medications and injection given for severe pain and discomfort. The arterial Doppler for right lower limb is showing mild wall thickening of the vessel walls in the right leg and is acceptable for age. The arteries are otherwise showing triphasic blood flow and are normal.
The venous Doppler is showing a mild problem in the veins of the right leg, and at one area there is backflow of blood (going to the heart) below the knee posteriorly and is a condition called varicose veins. There is no incompetence of the larger junctions called saphenofemoral junction in the groin and saphenopopliteal junction at the knee. This can be discussed with a general surgeon or vascular surgeon doctor if available, and usually does not need any active treatment at this point. However, the patient can be told to avoid standing for long duration and keep a pillow under the ankle at night to improve the blood flow. Some doctors might suggest wearing compression stockings during the day.
For the severe knee problem, an MRI knee will be of help to see if there is fluid collection and effusion or bone and cartilage destruction or ligament and meniscus tear in the knee and if that is causing the problem. For MRI knee, you can discuss with the orthopedic specialist and then get the test done in a place close to you. The x-ray can be normal in some patients, and MRI knee will show the problem areas.
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