Can bursitis or a sprain be diagnosed without imaging?

Yes. They can do a physical exam and make a diagnosis.

They can, but expect them to push the X-ray pretty heavily—especially if it’s not bursitis, a sprain, or something else that can be detected through sight and feel with relative ease. The last time I refused an X-ray, the nurse insisted it was worth keeping my appointment. I saw the doctor for about two minutes before he said “if you’re not going to get the X-ray done, there’s nothing I can tell you.” It cost $150 to be told I had wasted my time coming (despite trying to cancel my appointment when I reached that conclusion myself).

@SavoirFaire that’s what I was afraid of, I hate to make an appointment to find that they can’t do anything except take my money.

Tell the office when you call, ask if there are alternative imaging like ultrasound.

@Rarebear What’s the treatment?

If the diagnosis doesn’t result in any treatment it’s a waste of her money and the dose of radiation (from an X-ray). If the treatment is the same for bursitis, pull, sprain, then it doesn’t matter. Like if stabilizing the knee will help for instance. Maybe some ibuprofen. I have no idea about bursitis treatment, I’m just guessing and generalizing.

I have pain in my hip for months now, and I can’t imagine the doctor can do anything for it so I haven’t gone to the doctor. Maybe I’m wrong. If it hurt constantly I probably eventually would go to rule out something awful like bone cancer, but admittedly I would probably wait longer than prudent. I always say I’ll die one day avoiding the doctor.

I go when I need to, but I have had near weekly (sometimes more) doctor appointments for the last year or two, and I really don’t like to add more if I don’t have to. It’s a lot of money. I had x-rays on this knee earlier this year, in fact.
@JLeslie something like that, your doctor can send you to physical therapy. I’ve had chronic hip pain for years, physical therapy is the best thing in the world.

I am not going to go into treatments or diagnosis here.

Yes. It’s possible to diagnose those two things without an X-ray. The X-ray would be to rule out other cause of symptoms rather than confirm the diagnosis. Now, if you lived in a slightly less litigious country, possibly with socialised health care, then you might be able to go to the docs with your knee pain and not need imaging on the first visit…

I love the doctor bashing on this site. Makes me all warm and fuzzy.

While it is absolutely true that @Rarebear‘s first response is correct – and I’m not about to bash the doc on his own ground – it may be difficult in the USA to find a doctor who will accept a non-imaged diagnosis, if only because of non-medical issues: insurance and lawyers.

That is, it might be difficult to convince an insurance company without an image that the diagnosis is accurate, and the practice’s own legal adviser may not want to allow the doctor to make a positive diagnosis without an image. If the diagnosis is in any way incorrect, the doctor is then subject to potentially heavy legal liability.

@Rarebear Who says we’re bashing the doctors? Maybe we’re just critiquing the system.

It was a joke. Relax.

Thanks, all. I’m going to keep icing it and give it another day or two and then I’ll at least call and see what they think.