MRI Scan for Proof of Hernia or Diastasis Recti?

[linniecat]

I am a 52 year-old mother of four.  My oldest is 31 years old, my youngest are 11 year-old twins.  Ever since I have had my twins, I have had discomfort in my lower abdominal muscles.  Now I have been told by a plastic surgeon that my abdominal muscles have separated by at least three fingers.  (That's understandable, as my twins were born big and healthy!  My girl weighed 8 pounds and my boy weighed 6 lbs. 8 ozs!)   For years, I have wanted to have a tummy tuck, but was afraid to undergo major surgery for only cosmetic reasons.  However, for the last 5 months, I have had pain in my lower groin on both sides.  I thought that I had a hernia on each side, because years ago, my family doctor told me that I had a weak spot that could develop into a hernia.  I truly believed that I had hernias because I have all of the symptoms.  Some of which are throbbing pain when I stand or walk, but lying down and applying ice packs help.)  However, when I have gone to two general surgeons, they cannot feel a bulge for either hernia, no matter how hard I strain. They think that I have strained my muscles.  But I feel there is something more involved.  I wake up at night with a throbbing pain in the femoral canal or possibly a hip flexor.  Crossing my legs seems to pinch something that sets off this pain.  Would a MRI scan show a hernia or tissue damage?  Would it show a problem in the femoral canal or hip flexors?  What can I do to track down the source of this pain?  The plastic surgeon seemed to believe that abdominalplasty could possibly alleviate this problem as my muscles are not meeting in the middle but are coming in at the sides.  The separation is quite pronounced.  Could diastasis recti be the true source of my pain?

[GwannieJannie]

You exactly describe my condition and the repairs that have been recommended by plastic and general surgeons. I have had this 7 month pregnant bulge coming on for ten years, my last baby was 40 years ago and I am 74 years old. I'm in otherwise great health but so hate my bulge and the problems that go with it. Should age be an issue? Should I be grateful it's nothing worse, like a terrible disease? I would sooo like a flat tum again for the rest of my life. Is it a risk at my age or might the cure be worse than the "disease" These are the questions I ask myself. You sound so pleased with the result. I just might do it.

[FortMillMommy]

Hi. I just read your post. I definitely think diastatis Recti is the source of your pain.  You can get your insurance company to pay for the Diastasis Recti, but you would have to pay for the tummy tuck portion yourself.  I had the surgery in October 2009. I had two surgeons: a general surgeon and a plastic surgeon.  The general surgeon did the repair (which was covered by insurance). The plastic surgeon did the tummy tuck.

This is how the procedure goes: The plastic surgeon makes the bikini incision and lifts the skin.  The general surgeon added mesh (to hold things in) and stitched my muscles back together.  I can actually feel the stitches thru my ab walls, because I'm very thin.  But it's not bad or anything.  Then the plastic surgeon pulls the skin down, makes a new belly button (if necessary), cuts the excess skin off and stitch you up.

I feel so much better now. I no longer have back pain or lower belly pain. Not to mention...my tummy is flat again! :)

You have muscle separation, it is NOT going to be better and you can potentially make it worse if you apply stress or strain to your belly.  You should definitely consider at least getting the repair done.

[linniecat]

Hello!  Thank you so much for your response!  I tried to send a comment to you just a few minutes ago; but I don't think it actually went through.  So like you said in your email to me, I apologize if this is a repeat!

Recently I have had another test.  It was an ultrasound of the femoral triangle (with bearing down as well) but it showed no hernia.  

For the past few weeks I have been seeing a chiropractor, who believes that the pain may be from a muscle, tendon, ligament, or gland in that area.  She has been treating me with ultrasound therapy and other physical therapy.  I am feeling better, as long as I take it easy.  

However, I am going to check into some of the things that you suggested.  With all the research that I have tried to do on my own, I have not thought of the possiblility of a labral tear.  So I will try to find more information about that.  Also, I still suspect that the throbbing is caused from a hernia.  As with your experience, I have read about many cases where inguinal hernias have been overlooked.  Since the ultrasound showed nothing abnormal, I'm not sure if any further tests will show anything either.  A radiologist told me that an MRI would not be the right test for my problem.  He suggested a CT Scan next, but I'm reluctant to undergo more tests that have some risks and more expense.  But, in time, I may go to see an Orthopedic MD as you suggested.  Please feel free to give me more input.

  

[atsweet4]

I did not receive confirmation of my reply.  Apologize if this a repeat.
I am the mother ot triplets and one more.  I was misdiagnosed for 10 years for what was an inguinal hernia.  Told it was ovaries, endometriosis, psoas,etc.  I finally got a referral to a well respected MD for hernia repair.  I waited 5 hours for my appointment, and after the very detailed MRI, no hernia was detected.  I didn't believe it.  I found another surgeon who ordered an ultrasound (bearing down etc.)  They found the hernia.  No bulge was ever detected by palpating etc.   I had the repair in October 2008.

Regarding the hip flexor pain, have you investigated the possibility of a labral tear?  Again, this was misdiagnosed and I was even told I was a hypochondriac and "hormonal" by practitioners over the years.  There are several treatments for this injury, including debridement (cleanup), repair, and various forms of partial or total joint replacement.  I had the repair with osteoplasty (bone reshaping).  I am not "all better"  so I am not a huge advocate of any particular treatment, but was grateful to see the MRI showed something, noteable a partially detached torn labrum.  I would recomment seeing an orthopedic MD with a hip specialty.  A good PT can also help with the diagnosis, along with the MRI Arthrogram.   Hope you are soon pain free!

ATSWEET4