Accuracy of MRIs

[ellynno]

Noueuse---OOPS!! Yes those WERE your liks.    They were very good! Lynne

[Heather M.]

Well, I got my MRI results.  Not really good news....the back of my kneecap has damaged cartilage that is cracked and hanging in shreds in some places.  Chondromalacia, basically, as the result of poor tracking.  We already knew this, but the radiologist compared the new films to the two previous ones and determined that things are getting a bit worse.  Plus my OS believes I actually have a flap of articular cartilage that's getting dislodged and stuck when I bend and straighten.  He says he's satisfied with the results as they explain why my knee hurts and is swelling.

The truly unfortunate thing is this--my OS advised me that the recommended treatment for this, once PT had failed, was patellar shaving and lateral release!  I informed him that I'm not a big fan of this surgery, and he said he wasn't really advocating it for me right now.  So I'm stuck.  If the other knee gets strong enough, my OS recommended a scope to shave the patella and clean out any loose bodies.  But we know that will just be treating symptoms, not the underlying problem--bad tracking!

Knees stink.  But I guess I can't complain toooo much about MRIs right now.

Anyway, that's the news here.  Not a huge help, but nice to know I'm not hallucinating.

Heather

[Lori]

I don't think MRI's are very accurate at all...and my OS still confused about whats going on (even though its obvious) wants me to get one next week. ALthough what my PT and I think is wrong would never show up on an MRI. Not to mention my OS is hesitant about doing one b/c the screws in my knee will just make it impossible to read and will blur most of it he said. SO is there really no point to having it done??? He seems to think so since his thick skull can't figure out the obvious of whats wrong and most certainly won't listen to me. He had me do more PT BEFORE he got me an MRI b/c he claims an MRI will be to blurred to see anything cause of the screws in my knee. SO then whats the point??? To sit in a tube forever having my eardrums blown out to get a blurred image of absolutely nothing??? This makes me upset an angry b/c its just a waste of more of my money....although if it comes out negative he will feel theres absolutely nothing wrong with me......but the accuracy on an mri is BS and the image is worth crap when you have probs with ur kneecap and alignment!!! Phew! Felt good to get all of that out!!!  
Lori

[ellynno]

The arthritis in my knee showed up on an x-ray but not the MRI.  The previous x-rays were done with me lying down. The rheumatologist took views with me standing up. Isn't there some procedure where the patient (victim) moves around? So the MOTION that causes the problems can be studied? That's what you need, Lori. With x-rays and MRIs the damage shows up but not the process. Then it's just guessing and statistics.

Getting an MRI with screws in your knee? I don't know about that! I can just see your leg vibrating all over the place!   Lynne

[medsport]

Rhea,
I had an MRI that was very accurate in showing
large complex medial meniscus tears and a
Baker's cyst.  
My understanding is that MRI does a good job
of detecting meniscus problems especially
large tears.  MRI is not as successful at
detecting articular cartilage problems--the
slippery stuff on the end of bones.  
For example, I had arthroscopic surgery for
the medical meniscus tears and the surgeon
detected much more arthritis than was anticipated.
The meniscus issues were exactly as expected per MRI.

The surgeon actually gave me pictures that showed
bone spurs and articular damage.  Neither x-rays or
MRI pre-op indiciated complexity of my problem.
So, MRI can be helpful in some cases.

[jerry6664]

well, after reading the posts, i guess my new o.s. who said, 'you don't need an mri because i'm BETTER than any mri' wasn't far off base.  this is a great board and i'm lucky i found it.  thanks to all!
 jerry

[Linds]

I just wanted to say, that I think the point rhea was trying to make here...was that the MRI is not the end all be all..just because it doesn't show anything doesn't mean it is all in our heads, and it is difficult for much of the diagnostic imaging available to us today to pin point tracking problems, because the pictures are static and most tracking problems happen in motion.
Take care and Hugs and Healing
Everyone
Linds

[Robin W.]

On September 6, 2002 I fell and fractured my patella.  It broke completely in half horizontally and the two halves of my knee cap separated by about two inches.  In addition, the bottom half fractured into a number of other sections. Post operatively, my surgeon stated that the lower half looked like a road map due to the number of fratures it contained.  The upper half remained intact. Although I did not tear ligaments, did have severe soft tissue damage.

I had surgery that same day, which included two screws to hold the two halves together and wire to hold the bottom pieces together. The surgeon stated that he  had to clean out a lot of "bone fragments" from areas around the edges of the break that were "a bit pulverized."

It has only been 6 weeks and I only just began physical therapy yesterday, but I am trying to get a picture of what I can expect down the road.  

I am 44, but in the best physical shape of my life. I am somewhat athletic (run, spin, weight train) and I am wondering how this injury will impact me.  I am also wondering how long the excruciating pain from physical therapy and the awful pain at night will last.  

In addition, my job is about 75 % travel around the United States and it involves carrying presentation supplies and equipment with me.  I am trying to find out when I can expect to begin traveling again (not just getting on and off the plane, but also carrying my supplies).

If you have had a similar experience, please let me know what your recovery has been like -- I am feeling a bit overwhelmed right now!!

[ruby2zdy]

I just had both knees MRI'd.  I've had a lot of MRI's in the past and thought they were 100% diagnostic, pretty much.  But in these last MRI's, for some reason on the films there's no indication of which knee is which!!!    

The radiologist's report said I have seriously torn lateral meniscus in right knee and less seriously torn lat. men. in left knee.  Also the right lat. collat. lig. looks "weird" (I don't think that was the radiologist's word) -- like a string of beads.  And in my left knee I also have some kinda ACL tear and chondromalacia.  I have the most pain in the right knee.  I can also feel, now that I know that things are going on w/my meniscii, more pain in the medial menisc. in the R knee than in the lateral.  Nobody mentioned the medial on the MRI.  I asked the doc to print me the radiologist's rpt but he said the printer wasn't working.  Yeah.  

I looked at the films, or at least some of the pics, and they were so dark and kinda blurry I wonder how they can even interpret them.  I thought the machines were supposed to be getting better.  I remember a couple of  MRI's I had done in the early/middle 90's -- extremely clear.

Unfortunately, the only way to find out what's going on is to go under the anesthesia and let them scope you and I'm really not anxious to do that.  OTOH -- if it could help ...  

I too haven't been able to do anything aerobic, at least not on a regular basis, for several years and am gaining weight, which is exactly what bad meniscii need, right?  

And as long as I'm ranting, why do we even have pain nerves?    Think about it: when we evolved, back in the cave days, what good did it do for the poor bloke out with the hunting party if a mammoth gave him a hairline fracture?  Since it hurt too much to walk, he got left out there to die in the elements (or in a mammoth revenge stampede) even though, without pain, he could have walked back to the cave, and would have healed over time.  I say, do away with pain nerves.  So what if our meniscii are wearing away?  So what if we get arthritis walking on knees with bad or missing meniscii?  If we have no pain, we can still function until our knee joints just won't bear us up any longer.  Vote for me: NO PAIN, MORE GAIN!!!  

[katie]

On the "not showing cartilage" thing - I am led to believe, by a housemate who lectures in magnetic resonance imaging, that it depends on exactly how the imaging is done, there are various ways to probe things and they will show up differences in different density things differently.

In other words, if someone suspects you have a meniscal defect and schedules you for a scan that will show that well, it won't show arthritis properly.

It's something to do with the excitation frequences put into the water molecules, but at that point the explaination stopped containing any recognisable words.

[Tanya]

I have to agree with everyone on the accuracy of MRI's being not too good. i have only had two, but nothing is showing in my left knee. I have been in extreme pain for the past ten months and since nothing shows both OS's have just put me in PT. I know there is something wrong, my left knee hurts way more than my right ever did and I had arthroscopic surgery to repair a tear in the meniscus on that knee.  I am under a workman's comp claim and am afraid they are just going to release me and tell me to keep up my exercises. Then, someday it will get worse.
Does anyone know of anyother tests that could be done to review the knee?  
Thanks , Tanya

[ellynno]

Dear Tanya:

Have you had x-rays of your knee? The first one I had just showed joint narrowing, so the doctor sent me for an MRI which came back normal. I went to another doctor, who took some different x-rays that showed a small area of arthritis. If I'd had better x-rays, I'd have saved myself $600.

I'm not convinced the arthritis alone was causing all of my symptoms--a lot of swelling, stiffness, and pain in my whole leg. I was slightly hypothyroid, and have started feeling much better since I've been on thyroid medication. Hypothyroidism is way under-diagnosed, and happens more often to women. It can cause joint problems among lots of other things.

I hope you find out what's wrong with your knee. You must be so bummed. I had to cut back on my exercising when my knee got so bad. After almost a year, I'm really out of shape. I'm afraid, even though it feels better, that I'll hurt it again.

X-rays are cheap. They can only show bony-type problems, but can be more acurate than MRIs.

Good luck. Lynne.