what should you do?..
well, wait for the Orthopaedics clinic's appointment and stop lifting heavy weights when in pain..
meanwhile take plenty of rest and put the knee on a pillow when you are lying on a bed or on a sofa..
Rest: means no lifting heavy weight and no unnecessary trips..
however you should do some minor knee exercises for few minutes to prevent the knee from going stiff.. the type of exercises that you can do while lying on the bed..
Elevation: is to put a pillow or two under the knee when you lie on the bed.. the aim is to bring the knee higher above the level of your chest/heart.. this helps with the initial swelling..
there is this tendency to refer knee injury cases to see an Orthopaedics surgeon/doctor too early.., however ideally, a GP (or a family doctor) should refer a case of simple knee injury to an Orthopaedics clinic when the swelling is reduced or resolved (usually after the first 2-4 months)..
yes, you can see an Orthopaedics doctor/surgeon early in the first week of the injury, but detailed knee physical examinations and the MRI of the knee would not be useful because of the swelling in the first 2-4 months..
there is no real value to refer a knee injury to an Orthopaedics clinic early, to have an MRI early or to prepare a knee surgery urgently - except when there are some life-threatening or limb threatening circumstances, such as certain bone fractures, free-floating knee dislocations, large gaping wound over the knee joint, vascular injuries and/or nerve injuries..
in such emergency cases, the GP (US) or the Family Doctor (UK) should refer the case to the ER or to the A&E (accidents and emergency - UK) department for early emergency surgery and for a possible emergency MRI..
it is normal to delay the MRI and to delay the referral to an Orthopaedics clinic for non-emergency knee injuries; this is how we usually operate whether you are in a private or in a public hospital, and whether you are a sport-athlete&celebrity or a simple average joe..
X-rays are useful to detect bone fractures but they are not very useful for other types of knee injuries..
Ultrasound is sometimes used to exclude life-threatening and/or limb threatening emergency types of knee injuries.. however, an MRI is far more accurate than X rays and ultrasounds, and it provides the best image possible of the knee.. but unlike ultrasound and x rays, MRI machines are very demanding, they consume a lot of power, they need regular often expensive maintenance, they require trained operators and trained radiologists to interpret the results.. and they often break-down a lot..
the MRI machine is basically a large powerful magnet.. so powerful, they can move the hydrogen atoms in the water and in the fat inside the human body.. and with "great powers comes greater responsibility", and MRI machines must only used to fulfil a specific purpose or a specific role..
i know, it is hard for non-medical people to understand why we do things in certain ways.. and i know that most patients cannot wait until their injuries are fixed as soon as possible.. but these things take time, and they cannot be rushed..
every medical student is taught how to examine and properly assess a knee injury - this includes how to detect meniscus injuries, how to detect PCL or ACL injuries and how to assess the collateral ligaments of the knee.. full knee examination is a lengthy process that could take about 5 minutes to finish for one knee..
and these knee examinations need to be detailed because insurance claims, sport/occupational injury claims and documentations are dependent on our initial findings..
however, if the knee is swollen, it would be difficult and almost impossible to examine and to properly assess the knee even by Orthopaedics specialists/doctors who have done these examinations thousands of times before..
so the usual procedure is to wait until the swelling is resolved (after 2-4 months)..
when the swelling is gone, only then we can BEGIN to properly assess the knee.. and this knee examination is usually conducted by an Orthopaedics doctors/surgeons/specialist.. and if the knee examination reveals an injury to the meniscus, ligaments, tendons and/or muscle, only then we can proceed with the MRI..
we do not simply order an MRI of the knee just because the patient had a knee injury.. the MRI is ordered when an abnormal finding is detected in knee physical examinations..
the MRI should determine the type of surgery is needed to fix certain injuries..
if certain injuries is minimal, the surgery can be minimally invasive (arthroscopy) which is basically inserting tubes into the knee with small cameras and small mechanical hands to fix the damage.. but it can be an open surgery (arthrotomy) which involves creating a large opening over the knee, if the damage is extensive..
- smaller surgeries heal better and faster than larger surgeries..
to determine the type of repair surgery needed, we need the 'very latest' MRI image of the knee - which is another reason why we can delay MRI appointment after seeing an Orthopaedics doctor/surgeon/specialist..
if we have done an early MRI within the first few weeks of the injury, it may fulfil our curiosity, but we cannot do much about the diagnosis..
for example, we cannot operate (perform a surgery) on a swollen knee because it creates a whole new sets of problems.. surgeries on a swollen knee often yield worse results than in non-swollen knees.. because the active inflammation in a swollen knee can have negative effect on repair-surgeries.. and to explain why inflammation can be bad for healing, i have to cover an entire chapter in books about pathology that first year medical students struggle to understand..
in short, we would still need to wait 2-4 months until the knee swelling is gone; and we may still need another MRI to determine what type of knee surgeries it needs..
i have mentioned few exceptions: such as open wounds over the knee joint, large internal wound inside the knee (knee effusion), injured blood vessels and bone fractures.. in such examples, early MRIs, early surgery and early intervention are warranted.. but otherwise.. it is perfectly normal (whether you are in a private or a public hospital) to delay MRI and Orthopaedics appointment.. 2-4 months..
all the best..
PS.. it is midnight where i am.. i think a dosed-off few times while writing this long assay..