Need a proper diagnosis

[Kamphaengcat]

Hi all, hope someone can maybe point me in the right direction...my father in law (in Thailand) has had a severe bad back for the past 10 months or so, it has progressively got worse despite visiting several doctors and receiving countless drugs, he has been told by his current doctor he has a fractured back and was prescribed a back brace to wear plus some medication. The last couple of days he's started to forget who people are and is not very lucid. My wife and I are in the UK so what we can do is limited, we really need a proper diagnosis of my father in law's condition. Is there anyone out there who can recommend a hospital or doctor in Kamphaeng phet province?..already been to the government hospital : (

[scubascuba3]

Drugs don't really help and my UK back consultant said back braces don't do much, so it sounds he needs to see a specialist, an MRI is usually needed. Maybe someone can suggest a specialist 

[Salerno]

No doubt @Sheryl can point you in the right direction. A veritable font of knowledge in all things medical.

 

Edited December 10, 2020 by Salerno
Typo

[RotBenz8888]

What was the diagnosis "Fractured back" based on, MRI, x-ray, or just a "clinical diagnosis" ? 

 

Progressively worsening backpain might be due to various serious issues which could cause secondary vertebral compression including  malignancy, subacute osteomyelitis, 

multiple myeloma. 

 

If MRl hasn't been done, I would insist on having one done. 

Edited December 11, 2020 by RotBenz8888

[Sheryl]

There isn't a better  option in Kampaeng Phet province itself.  The nearest place would be Pitsanoluk where there is a university teaching hospital (Naresuan) as well as a large regional government hospital.

http://www.med.nu.ac.th/fom/th/

http://www.budhosp.go.th/home/

 

He should get all his records from the hospital he went to including Xray film and bring with him. If he can get a referral letter then treatment will be covered under the government scheme.

 

The fracture may well have been evident on clinical exam and Xray but the larger question is, assuming no history of trauma, what caused the fracture.  The combination of a (reportedly) fractured vertebra and onset of mental changes is worrisome and may indicate a malignant process (i.e. a cancer that has metastasized to bone and brain)

 

 

[Mops59]

Just one question to be answered. What is the cause of the fracture. Normal X-ray can already show bone cancer. MRI or CT scan maybe. But maybe it got worse and spread to the brains.

[Kamphaengcat]

Thankyou all for your helpful replies. Sheryl, I was thinking this myself about it being more sinister, the fractured back was diagnosed by x ray , no MRI has been performed as yet. I'll get onto the hospitals you mentioned and we'll take it from there. Again, many thanks for everyone's advice.

[Sheryl]

3 minutes ago, Kamphaengcat said:

Thankyou all for your helpful replies. Sheryl, I was thinking this myself about it being more sinister, the fractured back was diagnosed by x ray , no MRI has been performed as yet. I'll get onto the hospitals you mentioned and we'll take it from there. Again, many thanks for everyone's advice.

 

Fractured vertebrae can be diagnosed by Xray.

 

Possible that  the hospital is aware that it might be due to bone mets but saw no point in mentioning it or investigating further.

[Boomer6969]

On 12/11/2020 at 1:16 AM, Kamphaengcat said:

The last couple of days he's started to forget who people are and is not very lucid. 

Why do you associate this condition with he's bad back? The only link between these two problems may be old age.