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American Morning

President's Knees

Aired December 18, 2003 - 08:48   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.


SOLEDAD O'BRIEN, CNN ANCHOR: Dr. Sanjay Gupta is off today. In our medical segment this morning, checking out the commander in chief. President Bush is scheduled to have an MRI on both knees today at Walter Reed Army Medical Center. Mr. Bush has had to curtail his jogging because of knee pain.
And joining us this morning to talk about the procedure that he faces is Dr. Jordan Metzl. He is from the Hospital for Special Surgery here in New York.

Nice to see you, Dr. Metzl. Thanks for coming in.

DR. JORDAN METZL, HOSPITAL FOR SPECIAL SURGERY: Good morning. Nice to see you, too.

O'BRIEN: Getting an MRI is sort of the last of a series of steps. You wouldn't start immediately with an MRI if you have knee pain.

METZL: Not at all. Basically if you have the painful knee, the first thing to do is see your doctor, and they would look at you, examine your knee, sometimes get X-rays to look for arthritis, and if that doesn't work, you try some physical therapy. An MRI looks inside the knee and shows -- MRI stands for magnetic resonance imaging, and it looks inside the knee and shows the cartilage, the bones, the ligaments, and so it gives us a better idea.

O'BRIEN: So what are they hoping to find, and what should the MRI show them today?

METZL: Well, basically I think this MRI is being done, because it sounds like his knee's been bothering him for several months, and basically the MRI will not only show the bones, but it will if the miniscus, the cartilage between the bones, has a tear inside of it.

O'BRIEN: Will they be looking at the whole knee, or -- I know you've brought sort of this, sort of unattractive model of a knee, but if you grab that, tell me, what part of the knee will they be doing the MRI on?

METZL: I'm going to hold this up here. So this is a fake knee, not a real knee, and there are two bones, the femur and the tibia. The miniscus is the cartilage between them. And at a point right here, I'm to bend this knee down, and you can see this is the miniscus, and the MRI will actually -- the whole body goes into the MRI, up to your nose, but it will really focus on your knee, and it will look -- it takes about 45 minutes, and it will focus on the knee, and it will be able to tell us, or tell them, if the cartilage has a tear inside of it.

O'BRIEN: Would that be unusual for a man who is a pretty avid runner in his late 50s?

METZL: Running itself doesn't cause either arthritis or miniscus problems. More likely with President Bush, his father had a hip replacement, and so it sounds like arthritis may run in their family. And so arthritis tends to -- osteoarthritis, or wear and tear arthritis, tends to show up in family members. So his father had it; he may well be developing it, and this MRI will help in terms of finding that out.

O'BRIEN: Let's say they're able to find something out, whether there's a tear in the miniscus, or whether it looks like he actually has the family history of arthritis, what do you do with that information?

METZL: Well, it really depends on kind of putting together the whole picture, both kind of his physical examination, where his knee hurts, what the MRI shows, and it could range from everything from doing some physical therapy to injecting some medicine or taking different kinds of medicine all the way to in the extreme case, doing surgery to trim out a torn piece of cartilage inside the knee. So it really depends on what the MRI shows.

O'BRIEN: There's no way to repair the cartilage?

METZL: Not these days. Not for a small tear, in his age group. In kids we can, but not in his age group.

O'BRIEN: Do you think a doctor would advise him to stop running? He's a pretty, you know, avid runner.

METZL: Well, I've actually done 22 marathons, so I'm biased. But I think running is great for you. It really doesn't cause arthritis. But what I would say is he really needs to probably change the way he runs. In previous days, he could probably run all the time. Now he needs to kind of balance that with cross training.

O'BRIEN: Which it sounds like he's doing; he's moved on to the elliptical machine already.

Dr. Metzl, nice to have you, from the Hospital for Special Surgery. Got it right that time.

Thanks a lot, nice to see you.

METZL: Thank you.

TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com







Aired December 18, 2003 - 08:48   ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
SOLEDAD O'BRIEN, CNN ANCHOR: Dr. Sanjay Gupta is off today. In our medical segment this morning, checking out the commander in chief. President Bush is scheduled to have an MRI on both knees today at Walter Reed Army Medical Center. Mr. Bush has had to curtail his jogging because of knee pain.
And joining us this morning to talk about the procedure that he faces is Dr. Jordan Metzl. He is from the Hospital for Special Surgery here in New York.

Nice to see you, Dr. Metzl. Thanks for coming in.

DR. JORDAN METZL, HOSPITAL FOR SPECIAL SURGERY: Good morning. Nice to see you, too.

O'BRIEN: Getting an MRI is sort of the last of a series of steps. You wouldn't start immediately with an MRI if you have knee pain.

METZL: Not at all. Basically if you have the painful knee, the first thing to do is see your doctor, and they would look at you, examine your knee, sometimes get X-rays to look for arthritis, and if that doesn't work, you try some physical therapy. An MRI looks inside the knee and shows -- MRI stands for magnetic resonance imaging, and it looks inside the knee and shows the cartilage, the bones, the ligaments, and so it gives us a better idea.

O'BRIEN: So what are they hoping to find, and what should the MRI show them today?

METZL: Well, basically I think this MRI is being done, because it sounds like his knee's been bothering him for several months, and basically the MRI will not only show the bones, but it will if the miniscus, the cartilage between the bones, has a tear inside of it.

O'BRIEN: Will they be looking at the whole knee, or -- I know you've brought sort of this, sort of unattractive model of a knee, but if you grab that, tell me, what part of the knee will they be doing the MRI on?

METZL: I'm going to hold this up here. So this is a fake knee, not a real knee, and there are two bones, the femur and the tibia. The miniscus is the cartilage between them. And at a point right here, I'm to bend this knee down, and you can see this is the miniscus, and the MRI will actually -- the whole body goes into the MRI, up to your nose, but it will really focus on your knee, and it will look -- it takes about 45 minutes, and it will focus on the knee, and it will be able to tell us, or tell them, if the cartilage has a tear inside of it.

O'BRIEN: Would that be unusual for a man who is a pretty avid runner in his late 50s?

METZL: Running itself doesn't cause either arthritis or miniscus problems. More likely with President Bush, his father had a hip replacement, and so it sounds like arthritis may run in their family. And so arthritis tends to -- osteoarthritis, or wear and tear arthritis, tends to show up in family members. So his father had it; he may well be developing it, and this MRI will help in terms of finding that out.

O'BRIEN: Let's say they're able to find something out, whether there's a tear in the miniscus, or whether it looks like he actually has the family history of arthritis, what do you do with that information?

METZL: Well, it really depends on kind of putting together the whole picture, both kind of his physical examination, where his knee hurts, what the MRI shows, and it could range from everything from doing some physical therapy to injecting some medicine or taking different kinds of medicine all the way to in the extreme case, doing surgery to trim out a torn piece of cartilage inside the knee. So it really depends on what the MRI shows.

O'BRIEN: There's no way to repair the cartilage?

METZL: Not these days. Not for a small tear, in his age group. In kids we can, but not in his age group.

O'BRIEN: Do you think a doctor would advise him to stop running? He's a pretty, you know, avid runner.

METZL: Well, I've actually done 22 marathons, so I'm biased. But I think running is great for you. It really doesn't cause arthritis. But what I would say is he really needs to probably change the way he runs. In previous days, he could probably run all the time. Now he needs to kind of balance that with cross training.

O'BRIEN: Which it sounds like he's doing; he's moved on to the elliptical machine already.

Dr. Metzl, nice to have you, from the Hospital for Special Surgery. Got it right that time.

Thanks a lot, nice to see you.

METZL: Thank you.

TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com