Dr. Won’t Approve MRI. Suspects Bursitis

My right knee swelled up (softball size) suddenly five weeks ago. On the day that it swelled up I can’t recall any definitive injury. I had played golf and walked our dogs. I’m fairly active in that I play golf, pickleball, ride my bike and go to the gym on a regular basis.

The pain was significant and caused me to limp severely unable to put much weight on it. I probably should have been on crutches as walking was very difficult for at least three weeks. I needed to take pain meds to sleep.

I saw a doctor of orthopedics after a week and he suspects no structural damage and thinks it is bursitis. He approved an X-ray and PT, but will not give approval for an MRI.

Fast forward five weeks and my knee is still swollen and painful. It has started to improve a bit, but slowly after I reduced all physical activities to near nothing and tried to RICE as much as possible. The only activity that I had been doing was walking the dogs.

I start PT next week. X-rays were negative.

My concern is I thought that bursitis was a more chronic issue that got worse over time. This was an acute injury as I went from 0 to 10 on the pain scale when my knee swelled up initially. I pushed the Dr for an MRI but he will not approve because of his opinion of no structural damage.

Even after five weeks of RICE (two weeks of zero activity) the knee swelling is still significant. The knee feels unstable so I started wearing a compression wrap which has helped.

Thoughts?