Author Topic: Accuracy of MRIs (Read 8352 times)

rhea · « **on:** August 26, 2002, 06:43:47 PM »

Hi Everyone
I have not been impressed by mris. I spent 75 mins in that tiny tube getting my ear drums blasted out only to provide my GP with an excuse not to reffer me. It seems like the last 2 OSs I have seen (and my GP) think that mris are 100% completely accurate. From the stories I have heard here, I think that is poodle poop. Anyways, here is a study by AAOS done on the accuracy of MRIs for meniscal tears, plica problems, patellofemoral issues, ACL and OCD lesions and discoid meniscus. What do you guys think of this? How many of you have had MRIs giving false results?

(((Hugs)) 'n healing

rhea

HERE IS THE ARTICLE

Incidence of Pediatric Knee Pathology: A Correlation of Clinical, Arthroscopic and Magnetic Resonance Imaging Findings
Paper No. 16

Thursday February 22, 1996
8:30 AM

Congress Center Rooms 264-265

James S. Marsh, MD, New Haven, CT
John Daigneault, MD, New Haven, CT

One hundred twenty-seven children who failed conservative treatment for knee pain had preoperative magnetic resonance imaging (MRI) scan and subsequent knee arthroscopy. The preoperative clinical findings were correlated with the radiologist's MRI interpretation and compared to the arthroscopic findings. The MRIs were blindly read by a sports medicine physician. Operative findings included meniscal tear (48 patients), plica (47), OCD (42), patellofemoral problems (44), discoid meniscus (

, ACL tear (2). MRI accuracy for meniscal tears was 85% (radiologist), 92% (sports physician), 100% for ACL and OCD lesions. Plica diagnosis was missed frequently by MRI. The authors correlate the presence of medial patellar plica and OCD lesions, and note the accuracy and predictive value of the MRI to be less than expected. There were surprisingly few false positive MRI scans.

--------------------------------------------------------------------------------

Moderator: Vernon T. Tolo, MD, Los Angeles, CA

PEDIATRICS

http://www.aaos.org/wordhtml/anmeet96/sciprog/016.htm

Iona_-Uk · « **Reply #1 on:** August 26, 2002, 10:55:04 PM »

Hi Rhea

I am not overly impressed with MRI's myself!.

An incident where I was referrd for a wrist MRI came back negative, when I had a wrist arthroscpy however, I was told I had severe cartilidge tears and congential holes in them as well, the MRI had not picked this up.

I had to wait 14 months for the surgery when if I had been scoped rather than MRI-ed, it would have provided a better end result for me.

Iona

Tizzy953 · « **Reply #2 on:** August 27, 2002, 06:19:12 AM »

Hi Rhea,
I have had a few MRI's and I have to agree with you. I didn't have a ligament that developed in my shoulder. The MRI didn't show that. The surgeon, when he went in, was expecting stretched ligaments, instead the ligament wasn't even there. More recently I had an MRI on my knee and it showed and OCD lesion in the trochlear region of my knee. The surgeon was expecting to get a biopsy for the carticel procedure but instead found no lesion and a relatively clean area. So I don't trust the MRI's at all.

Good luck,
KJF

Heather M. · « **Reply #3 on:** August 27, 2002, 07:34:24 AM »

I have to join the chorus of disappointed MRI patients...I've had four on my knees, and only one showed any problems. Unfortunately, I've had serious problems that were later documented in each case (usually by surgery). My favorite is the most recent--I have a lump or cyst or something in the back of my good knee. It hurts, swells, etc. My PT, OS and three separate physicians all palpated the area and agreed there was a lump. One day later the MRI came up perfectly clean, and yet the lump was quite irritated and definitely there to be felt. Go figure.

I was hoping shoulder MRI's were a little better. Since I'm going to be doing a lot of stuff that's hard on my shoulder in an effort to baby my knee (biking, swimming), my doctor wants to find out what's going on--it sounds like I have gravel in there when I rotate the shoulder, I can't reach into the back seat of my car any more, and it hurts if I try to do anything like weights or holding my arm out. Sleeping on it is out of the question, and crutches were torture. Tentative diagnosis is torn rotator cuff and/or torn labrum (more darn cartilage!!) My OS is hopeful that the damage will show up on MRI...I'm not so sure.

Maybe I'll just leave my poor shoulder alone after all....anyone have experience with shoulder MRI? I know this is the KNEEguru page, but I thought I'd check.

Heather

rightkneeinjured · « **Reply #4 on:** August 27, 2002, 08:34:31 AM »

I recently took an MRI and I will get the results tomorrow.. but from these discussions i understand MRI's are not that useful.. moreover i reinjured after taking MRI, so i guess it is a total waste in my case

anyways let you know what it says..

Shazinoz · « **Reply #5 on:** August 27, 2002, 08:55:03 AM »

I too join the ranks of useless MRI's I had one a few weeks ago after bending my knee (ACL reoc'd 2x last time 1998) and my knee exploding (literally). The MRI showed absolutely nothing at all (My GP says he doesn't know how my OS could say that my ACL etc was fine by this MRI as it was so bad (Interference from screw and staples and poorly done) that you couldn't even see the ACL.
My GP sent me for a bone scan as a HUGE lump has come up on medial side of tibia from knee to about 5+cm below. The Bone scan showed lots (but the radiologist thinks it is probably (don't you just love that word) from my recent (recent ? yeah 4 yrs ago) surgeries . But these changes didn't show on a bone scan 13 months before. But the radiologists answer is it is a different kind of Bone Scan (SPECT

) and the results are still true. My GP on the other hand says this is $%#&% and it is from this recent injury and I have partially torn my ACL graft out of the bone at each end (fractured it a bit from the bone) and that I have stretched the graft AGAIN (it is now 1/2 as wide and 2x as long). I am not allowed to put ANY stress on my ACL therefore I am to be in an immobiliser (ROM brace) locked between 15 to 45 degrees as between these there is no stress on the ACL I am also supposed to be non weightbearing but as I had my right shoulder reconstructed last August this is TOTALLY out of the question. So I use 1 crutch with left arm when I am doing a lot and most of the time no crutches and just try to limit my walking.

rhea · « **Reply #6 on:** August 28, 2002, 05:13:43 AM »

Well this is certainly interesting!! Here my GP and last 2 OS are talking like the MRI is 100% accurate, completely fool proof, absolutely no chance of it being inaccurate! I'd like to take all you people with me back to my GP and last 2 OSs and we could BLAST them. Let them know our experiences with this so called modern "advance" in technology. Advance smanche.....in my case this mri has just provided my Drs with an excuse not to help me. Forgive me for this bitterness, but I am having a rough night and haven't ranted for at least a fortnight. A pox on all of those uncaring, don't give a poodle poop, surgeons!!

Would anyone mind if I printed off all of your responses? I'd like to add them to my knee file and use them as ammo if I need to at my next GP appt for painkillers.

Thank you again for your replies everyone!!

(((hugs))) n' healing to you all.

rhea

Shazinoz · « **Reply #7 on:** August 28, 2002, 02:12:07 PM »

feel free to print my responses and if you want more ammo then i can fire anytime

Linds · « **Reply #8 on:** August 28, 2002, 03:19:40 PM »

Hey Rhea you know about me and MRI's but I just thought I would share...only because I love testing out hte new forum. I had three MRI's in which nothing was out of place...or different then a perfectly healthy knee. I however after have had a scope in 97 and LR and subsequent scope in April of this year have been diagnosed with CMP and Patella Femoral Syndrome. But in my not proffesional opinion the MRI is farely useless at diagnosing alignment/mechanical problem, unless it is one of those ones they take while you are moving because your leg is just plain straight....my knees are perfectly aligned when my leg is straight! Ohwell....Hope all is well
Linds

Iona_-Uk · « **Reply #9 on:** August 29, 2002, 09:14:53 PM »

No problem printing mine off Rhea, give those dr's what for Rhea!

iona

ellynno · « **Reply #10 on:** August 31, 2002, 09:41:14 PM »

HeY! This is my very first post! I'm so glad to have found this site, but I feel so sorry for all of you who have had so much misery with knees.
I have had pain, achy swelling and hot spots in my left knee for 3 years off and on. I've had two MRIs--one just last week. The first one, done in 1999, showed nothing. My family doctor sent me to a physical therapist who decided I had a trapped nerve, and charged my insurance company a lot of money to have me do some really lame (no pun) exercises.
My knee did seem to improve, but started in again last fall. It seemed like my whole leg would swell, and hurt from my hip to my ankle. I went to a Rheumatologist--I don't have to have a referral to see specialists--because I've had other symptoms which could be arthritis or fibromyalgia or WHAT? He sent me to a GP who sent me for another MRI. I love doctors-- they spend your money. It's so much easier than maybe trying to diagnose by, say, touching the patient! My husband knows some people who own an imaging center, and they sent me the radiologist's report. The MRI showed no meniscus tears, no bony changes, a little swelling AND a "small to moderate popliteal cyst." A few days later, the doctor's office called me and said "there were no abnormalities"!!! So does everyone have cysts in their knees? I was so mad. The doctor wouldn't even take the time to explain what a popliteal cyst is! Of course, the doctor doesn't know I have a copy of the report. I have been searching everywhere to find out what it means to have a "politeal", "Baker's" or mensical cyst. All I know is I have had to stop exercising, which I have done for over 20 years, and never know what is going to make my knee go beserko. The doctor offered to give me a cortisone shot in my knee (even though there's nothing supposedly wrong with it) or I could go to an orthopedic specialist. I suspect that what she really wants me to do is shut up and go away.
I live in rural Florida where everything is a long trip.
So is this congenital, or what? Any insight would be greatly appreciated. Thanks for listening!

ellynno · « **Reply #11 on:** September 01, 2002, 06:21:57 PM »

The way health care care works in the US is this: if you have insurance, no one will even tell you how much things cost because they over-bill the insurance company in order to get every last dollar the insurance may cover. Good luck if you want to pay cash. If you don't have insurance and you qualify as being low-income, you have to get into the government's system, which is okay because you don't have to pay for anything but is bad because you have to go where they will take you as a patient.
In my case, I have a $1000 deductible which I haven't met so I have to pay for the MRI. I called a couple of different places to get an "estimate" for an MRI on one knee. One place was going to charge me $2,045. The place my husband found said $900. My husband is a veterinarian so I understand well the costs involved in operating a medical facility. But how could there be such a difference in the price of the same procedure?
An MRI is just a test. No test is perfect. I think the frustration we are feeling is because MRIs are built up to be the key to every diagnosis. Plus they cost so much!!! Then you still don't know???
But what else can you do? I still don't know what's wrong with my knee. Did the MRI miss something (twice) ? This has really affected my life because I can't walk right. It makes my other hip hurt. Then I really get crabby. I'm 51 years old and I don't think that's old. I get so sick of hearing about "falling apart" and how "gettting on" sucks for everyone.
But you poor thing! You have a very strange lump! Something everyone can see! By anyone's standards this is not right.
I had a big lumpy swollen thing on my little finger way back in 1979. I went to the doctor who decided it was a "ganglion". He sent me to a hand surgeon who cut open my finger (boy was he happy to have a little finger to cut open) and guess what? There was no ganglion, which is when the synovial fluid leaks out of the joint. I had something torn, which he sewed down, but he said that wasn't the cause of the lump.
For a year I had a purple, sore, stiff little finger that ached in the cold and didn't move right. Then the lump came back. I went back to the doctor, who wanted to cut open my finger AGAIN. I walked out the door and never went back.
Fingers, knees, who knows.
Good luck. (And thanks for listening to my ranting.)

Heather M. · « **Reply #12 on:** September 01, 2002, 08:09:59 PM »

Hey Nouse,

Thought I would reply to a couple of things--I've had four MRIs, and the ONLY thing that was ever picked up was my meniscal cyst and the tear causing it. It was SOOOO big, it was impossible to miss. But if I were you, I'd wait and see what the private OS says--you may not need an MRI with that big old lump on your knee. My MRI's have ranged from $1200-$2200, depending on the facility.

As for costs, here's my little anecdote about the US healthcare system. I had my first surgery as a private patient, because my insurance only covered another physician (in their network) who told me if my knee hurt when I hiked and used exercise equipment, I shouldn't do it. For my surgery with my current OS, the bill for his time was $4500 and for the operating theater was another $3800. YIKES! But when I came back for another surgery I had different insurance, so I was covered this time. I saw that for the 2nd surgery, the amount billed was the same, but the amount my insurance reimbursed my doctor and the surgery center was a mere $450. That's reimbursement of .10 cents on the dollar--not a bad scam, eh?

They absolutely rip off private patients here, hope it's better in the UK.

Heather

PS My insurance coverage ends in December...looks like I'm sunk.

Heather M. · « **Reply #13 on:** September 01, 2002, 09:01:02 PM »

Actually, what our insurance system has done here is to make it necessary for doctors to have several layers of administrative bureaucracy to deal with the insurance companies. I doubt you could find a doctor today who even KNEW what his charges were...the admin handles that. My doctor, who works in a large practice with 4 other surgeons, has a full-time employee whose sole purpose is to type and file insurance claims. Another calls companies all day to get required pre-authorizations for surgical procedures...yet another handles the surgical scheduling, booking the anesthesiologist, nurses, rooms, etc. In a way, it's good that the doctors are focusing soley on medicine, but for surgeons in small practices I hate to think of what happens!

Stay with your endocrinologist, he sounds like he's worth his weight in gold. I feel the same way about my surgeon.

Heather

ellynno · « **Reply #14 on:** September 02, 2002, 12:36:23 AM »

I told you my husband is a veterinarian--the other day someone asked me if we took pet insurance. Insurance? I said yeah RIGHT. Be glad we don't. I chose the most recent doctor because one, she was close, and two, the office knows how to effectively file insurance claims. Pretty funny, huh. My mistake. She has proven herself to be a dud. She also wouldn't discuss the bloodwork I had done, even though it came back with an elevated value for a thyroid test. How hard is it to talk to a patient? Isn't that what doctors are supposed to do? I don't like being treated like a child or an idiot.
The bottom line is what you were saying, it's not easy to find a good doctor. It's downright unusual. Isn't that sad?
By the way, our insurance premiums are outrageous. Even with high deductibles. And now I sure hope I don't have to change companies (again) because I've gone to the doctor.

Noueuse, just lay your knee down here and I'll hit it with my Internal Medicine book (that I bought at a Barnes and Noble book store) which is HUGE and has proven to be way more useful than doctors.

ellynno · « **Reply #15 on:** September 02, 2002, 05:00:56 PM »

Our health care system is complcated. Doctors pay a lot for training for many years, and they expect to make a lot for what they do. Insurance is so expensive, many people can't possibly afford it. Those same people can't afford the medical treatments--really, nobody can--so everyone else pays for them with high costs and higher insurance. Plus, people expect insurance to pay for everything when probably it should just help with things like MRIs and hospital stays. And medicine. Drug companies make so much money!

I have been having trouble with my knee for about three years, but I've also been having other symptoms which have been making me unhappy. My mother had rheumatoid arthritis, my grandfather had gout, so I decided to consult with a rheumatologist. He asked me to get blood work done (they don't pull blood in his office!) so I went to an office here in town. I had the lab work done, even got the bill, but never heard from the doctor's office. They don't call unless something "shows up". I called and asked for a copy of the report which had my TSH as 6.57. Not really high, but elevated. Now keep in mind, I DON'T FEEL GOOD. I made another appointment, saw the doctor, who said I really don't want to start taking thyroid hormone because then I'll have to take it my whole life. So? What if I need it? She suggested they do the test again. I made another appointment for after the test results came in so that she would have to review them with me.
At this stage my knee was very swollen. I've had to cut my hours at my part-time job and stop exercising. The TSH was "normal". I asked, yes, but what was it? Four-point -something. Nothing to worry about. This is still on the high side of normal, right? She just stared at me and gave me some samples of prescription NSAIDS for my knee, which she barely looked at, but wrote me a script to get x-rays done.
I went back with the x-rays. She said the joint space was a little little bit smaller on one side, so probably it was a meniscus tear and that I needed to get an MRI. Which came back with nothing but a popliteal cyst. This is supposed to make the BACK of your knee hurt, which is the one place it doesn't hurt.
I have another appointment with the rheumatologist in three weeks. He's so busy it takes months to get to see him. I guess I'll just take my test results and get his opinion.
Keep in mind, my husband is a doctor. I worked while he went to school. I helped him study. I've been around medicine for over 20 years. At this point, I'm tired of trying to be the doctor and the patient. I'm not really a very rude or pushy person, either, and I try to be nice.
Maybe I'm just crazy. I am getting closer to crazy!!!
I'm going to go back and look at the photo of your knee.
And thanks for the input on the thyroid situation. I am going to follow up on that, too.

The KNEEguru · « **Reply #16 on:** September 02, 2002, 05:54:04 PM »

NO single test is fully diagnostic when it comes to evaluating the knee. The more the interpreter of the test knows, the greater the likelihood of useful interpretation. Also some tests are dependent on the skills of the technician in determining the settings of the machinery, and this is especially so with MRI where there are various ways of enhancing the image.

MRI is a useful adjunct to other diagnostic tools - it is not able to fully show all knee problems, and it also needs a skilled person to understand the images which are produced. The way the MRI works is, in a very simplistic way, this - all your body cells carry a small charge, like a battery. In the MRI scanner the magnet aligns all the charges on the cells in the same direction, and then the magnetic field is released and they all return to normal. But the different body parts return to normal at different rates, and this creates a difference which can be measured by the instrumentation in the scanner. The scanner then 'cuts the 3D image' into thin slices and lays them side by side. Doctors are quite used to seeing and interpreting things in slices as body parts are often presented in slices during anatomy lessons! So the average doctor can have a stab at interpretation and seem pretty knowledgeable compared to the ordinary patient, but only an expert can distinguish signal from artefact, and put the findings truly into perspective. Knee MRI interpretation is a speciality in its own right! So sometimes it may be the fault of the type of body part that the problem is not revealed, sometimes the problem is in the lack of enhancement by the technician, sometimes the slices are not in the right plane, and sometimes the doctor misses things or mis-interprets others. But it is not ALL doom and gloom - in the right hands it is magic compared to the old X-ray days when only the bones were visible. Just remember that MRI findings have to be interpreted in the light of the other findings - and then you will understand the problem. Unfortunately some doctors do not appreciate that it is not all that highly specific, particularly with respect to meniscal tears.

KNEEguru

Ross · « **Reply #17 on:** September 04, 2002, 11:57:10 AM »

rhea, I had MRIs on both shoulders a while back, interesting experience that turned up two "torn" shoulder tendons. Interestingly enough when I'm loaded up with cortisone I can still lift engine blocks. Curious hey? With the aid of a bit of chemical horsepower the shoulder pain stops (understandable) but the tendons don't get any less torn, in fact abusing them should, one would have thought, result in more trauma.

MRI = Masks, Rattles & Eye of newt!

Total waste of time and money, pseudo-science gone spare!

opal · « **Reply #18 on:** September 04, 2002, 04:59:33 PM »

I too am disappointed in the whole MRI business. In the past year, 2 MRIs have not shown a damned thing wrong with my knee. Last year after my fall, it showed no problem on lateral meniscus but a torn medial meniscus. It showed no other problems, at all. Arthroscopy of that knee 4 weeks later showed torn lateral meniscus in 2 places and nothing medially! It also did not show chrondromalacia Grade IV or articular cartilege damage.

So, to recap, 2 scopes and a Fulkerson later, I'm finally on the road to recovery.

My daughter had MRI of her knee and it showed nothing; scope proved torn medial meniscus. Also had shoulder MRI and it said 'normal' findings; scope showed a labrum tear, adhesions and frayed rotator cuff...gee, do you see a pattern here?

ellynno · « **Reply #19 on:** September 04, 2002, 07:24:11 PM »

Thanks to you all for sharing your experiences, and to you, KneeGuru, for the technical knowledge. I have calmed down a bit, and am trying to have a more philosophical attitude toward the whole diagnostic process.

I want to rule out RA because it ruined my mother's life. After I go back to the rheumatologist, if my knee doesn't improve, I'll try an orthopedic doctor. From what the KneeGuru says, if I have to have another MRI, it would be better to go where they really know knees.

Another funny thing about my knee is that NOTHING I take, presciption or nonprescription seems to help the stiffness or swelling. I can ice it, elevate it and stay off of it but it just seems to recover in its own time. I can treat the pain but nothing else, which makes me wonder what is causing the pain.

I don't remember ever injuring this knee. I have always been pretty active but I would never call myself an athlete. I'm more of a walker than a runner. I have to stand up in the heat at work for several hours a day, but it's not really HARD work.

I go to the rheumatologist in two weeks. I hope my knee is good and swollen that day! (I'm kidding!) (But still, something that shows is easier to explain.)

KJ · « **Reply #20 on:** September 05, 2002, 12:10:58 AM »

I just hope that people looking for good information on their knee injuries and the relevant investigations are not put off by this biased trail of postings.
The big problem with knee boards is that they are used particularly by people who are generally dissatisfied either with their ongoing symptoms or their unhappiness with doctors.
MRIs are extremely useful investigations for many conditions, particularly ligament injuries.

Believe it or not the paragraph below is a URL for a full text British Medical Journal editorial article on MRI of the knee; you can try copying and pasting into the address book (or failing that www.bmj.com and the search MRI + knee)

http://bmj.com/cgi/content/full/325/7356/115?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=mri+%2B+knee&searchid=1031173398360_14616&stored_search=&FIRSTINDEX=0&resourcetype=1,2,3,4,10

Many people can be saved the risks and expense of an arthroscopy if MRIs are used correctly. On this board there seem to be people who moan when they are offered investigations and moan when they are not suggested. Doctors just can't win. What has to be recognised is that it is not always possible to identify the cause of every symptom. Sometimes in life we just have to get on with things
(and thats coming from someone who has had a lot of experience of extreme knee pain over the last 18m who is beginning to accept that there just might not be any solution)
Bulletin boards are great and a huge support but sometimes the tone of this one just degenerates into a mass whinge!

There, that's got that off my chest
KJ

iain · « **Reply #21 on:** September 05, 2002, 12:20:15 PM »

Thought I would type a post in favour for MRIs. After being under a so called experience knee surgeon but still having instability problems after fracturing my right patella my occupation paid for a MRI scan 5 months post-injury. It diagnosed that the fracture was still appreciated, severe articluar cartilage damage present and a PCL rupture at the femoral attachement - my OS at the time did not/could not reconginse the posterior draw that was visible in my leg and so afterwards I had firm evidence that more things were wrong that were above his skill level. Without the MRI the OS would of been for every ingnorant of this, so I changed OS straight away.

I think MRIs are an extremely valuable tool and shouldn't be discredited but all imaging (included X-rays) are only as good as the radiologist reading them.

So maybe all of you people still with the MRI prints should take them to a better radiologist to get a second opinion on the scans themselves - possbily cheaper than getting another set of scans done!

Luckily the MRI clinic that i went to (Brdgewater, Somerset UK) was superb!!!

Iain

ellynno · « **Reply #22 on:** September 05, 2002, 09:28:06 PM »

Of course we're biased! This is OUR perspective, our experiences and our frustrations!

As I've said before, I don't like being blown off, treated like a child or an idiot. I want to be told the truth. I can accept the truth. No, not everything CAN be fixed. Sometimes there isn't an answer. But I think a doctor should look at his or her patients, listen to what the patients say, and act interested in helping.

A person wants reasons, explanations, and solutions. It's just part of human nature.

I can also tell you that my husband has had both of his knees scoped, had the meniscus tears trimmed and has had a significant improvement in how his knees feel. He's also been able to keep bicycling and working standing up. He has arthritis in both knees and is well aware that nothing can change that.

Despite the fact that neither MRI has shown anything amiss in my knee, I am certainly glad that I didn't have to have surgery to determine the same. I hope it doesn't get to the point where I do have to have surgery before I get an answer to match my symptoms.

One cannot deny that many people on this discussion board have had less than the best medical experiences. We are unlucky in having less than perfect bodies. Or we've caused damage to good bodies. We are all here to learn from each other and offer support, encouragement, and yes, perhaps, even a little sympathy.

Keep on whinin' if it makes ya'all feel better!

Heather M. · « **Reply #23 on:** September 06, 2002, 02:41:59 AM »

Can you believe after all this fuss that I've consented to a FIFTH MRI (third for my right knee)? I could hardly believe it myself when I heard the words, "OK, if you think it would help," coming out of my mouth.

I saw my OS again today for follow up on the knee that's had surgery, and brought up again how much my good knee is hurting and how it's got a new pocket of swelling. He examined it pretty thoroughly and said the snapping and pain when he bends and twists is indicative of meniscal problem...he's confident that if it's so loud and obvious during the exam, it will really show up on the MRI. He swears that the previous time he examined the knee it wasn't nearly as noisy...I thought, what the heck, let's have another MRI.

At least this way even if nothing shows up I'll know I'm not crazy, because my OS said he was pretty sure the cartilage was torn (as my PT has been saying since April when I fell and injured the knee). Not that we can really do anything about the knee right now, but it will be good to know. I guess. Theoretically, anyway.

Heather

Shazinoz · « **Reply #24 on:** September 06, 2002, 04:06:26 AM »

Of course we are biased we are talking about OUR experiences of procedures, tests and doctors not what is supposed to happen and not what happend to our brothers, girlfriends, sisters, aunty . We are talking about US and what has happend to us. and yes we are the EXPERTS in this as it is US and has happened to US, we may be biased in the fact that sometimes nothing seems to go right and sometimes we seem to get the doctors with NO bedside manner (well actually no manners at all) and PT's who are the same. All we want is to be able to talk to others who understand what it is like to go through similar problems (ie. failed knee procedures) and hear and offer support to each other. People who have had NO problems witrh there knees or with there procedures are very very unlikely to be here ARE THEY as they don't have a reason to seek information and support. They are "Functioning" with working parts.
So I say to others. Keep winging and offering support this is one of the only places some of us have to get things off our chests regaring our knees, our treatment, our tests etc etc etc. and

to anyone who gets "upset" by this.

ellynno · « **Reply #25 on:** September 06, 2002, 06:51:06 PM »

Noueuse, it's been my experience that rashes are hard for doctors to diagnose--maybe they don't spend a lot of time on skin. We had a friend who was an ER doctor. He insisted that my son's rash was just poison ivy (something I've never gotten, it must be one of the few growing things I'm not allergic to). Well, it had gotten infected from his scratching at it. I took him to a pediatrician who said that what he had started out as poison ivy but turned into impetigo which is pretty contagious and will only go away with antibiotics!

Talking about your thyroid problems--I suspect that I have fibromyalgia. This is something that no test will prove, doesn't show any outward signs and most people have never heard of it. It makes you feel tired, your mucsles hurt for no real reason, and since it's a "syndrome" has about 100 symptoms that sufferers may or may not have.

When my knee hurts, it makes me feel bad all over. This is one reason why I want to find out what's wrong with my knee, because the other symptoms may be coming from the chronic pain and stiffness from my knee. Or maybe it's the other way around. Having two more-or-less normal MRIs makes me wonder if I don't have fibromyalgia in my knee worse than other places. But my knee swells up, which is unusual for fibromyalgia.

I did check out Rhea's links on knee cysts which were very informative! It would seem that what you have is a meniscal cyst. The popliteal cyst that my last MRI picked up may or may not be causing my knee trouble. I certainly can't feel anything behind my knee.

And Heather, good luck!

Heather M. · « **Reply #26 on:** September 06, 2002, 08:18:06 PM »

Hey Ellyno,

With respect to Fibromyalgia, while there are no medical tests per se that diagnose it, the common agreement among 'with it' medical professionals is that a series of trigger point tests can reliably indicate whether this syndrome is present.

When I was doing some research for my friend who doesn't have a computer, I found that there are a series of 'giveaway' symptoms. Try looking for the book "Reversing Fybromylagia" by Dr. Joel Elrod. It has background and some nutritional plans, exercises, and vitamin supplements this doctor believes is helpful--something like the chronic pain diet.

My good friend with fibromyalgia suffered for years before finally finding a doctor who listened and understood what was going on. She does an arthritis exercise regimen and a diabetic diet (absolutely NO sugar that's not in natural form, like fruit). She's been living symptom free for years now, though she does take maintenance medications. Her plan may not work for everyone, but the first step was finding a doctor and pain clinic to help her try things out.

Good luck.

Heather

Tania · « **Reply #27 on:** September 07, 2002, 10:38:15 AM »

Hi Rhea

I agree that MRIS are not accurate. I've had 2 almost 3 years apart. The first showed nothing , the recent one showed deep scar trauma from the fall almost 3 years ago and fluid build up in the fat pad. The docs think you're mad when you have constant aching and pain in the knee and nothing dramatic (as they say it) shows up on the MRI.
Catch ya . Tania.

KJ · « **Reply #28 on:** September 07, 2002, 05:26:05 PM »

Noueuse
If you are having a knee MRI you don't need to worry about feeling closed in. Even though there is a large long tube, only your leg needs to go in so your head is out in the open.
I have had one on my neck in the past and know what you mean, I am not claustrophobic but being in a tunnel for so long with the enormous banging and crashing of an MRI around you is enough to make anyone feel panicky.
KJ

ellynno · « **Reply #29 on:** September 07, 2002, 07:45:38 PM »

Both knee MRIs I've had were the open style, aimed at my knee. You have to be very still which is uncomfortable (it hurt my back a little) but not intolerable. The machine makes all sorts of interesting noises at different frequencies and in different patterns. Mine took about 45 minutes. I am a bit claustrophobic, I don't think I'd like to have my head done, but the knee was easy.

Heather, thank you for the fibromyalgia info. I'll see if I can find the book you named. I have a good friend who has it also, and I've done some research on the condition. I went to the rheumatologist orginally to find out if my symptoms were maybe from fibro, or, since my mother had rheumatoid arthritis, maybe from that. He touched the "tender points" that are supposed to hurt if you have fibromyalgia, and only a couple of them did. I was having a very good day that day, however.

It seems as though my pains come from muscles, not joints. But I can't reallly tell. Today, my knee doesn't hurt, nor is it swollen. For the most part, I feel pretty darn good. But my neck and shoulders are stiff and my right elbow is really sore!! This happens; the pain moves around. My knee is a little different, because it swells up and gets warm in spots.

I might be able to give up sugar, but not coffee! And no matter what's wrong with you, they tell you "no caffeine" which I don't want to hear. Coffee always makes me feel better, and it helps Tylenol work, too.

I am actually Lynne. That name was taken, so I used "Ellynno" which is a friend's nickname for me. It comes from
El Lynno--he was trying to learn Spanish and was making a joke. My husband is El Marko. And so on. HA!

ellynno · « **Reply #30 on:** September 07, 2002, 08:23:05 PM »

Noueuse---OOPS!! Yes those WERE your liks.

They were very good! Lynne

Heather M. · « **Reply #31 on:** September 13, 2002, 12:42:03 AM »

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 · « **Reply #32 on:** September 24, 2002, 09:07:31 PM »

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 · « **Reply #33 on:** September 24, 2002, 10:27:09 PM »

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 · « **Reply #34 on:** October 13, 2002, 09:34:44 PM »

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 · « **Reply #35 on:** October 14, 2002, 08:13:24 AM »

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 · « **Reply #36 on:** October 16, 2002, 01:27:50 AM »

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. · « **Reply #37 on:** October 17, 2002, 05:36:37 PM »

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 · « **Reply #38 on:** December 10, 2002, 01:03:41 AM »

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 · « **Reply #39 on:** January 08, 2003, 06:24:52 PM »

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 · « **Reply #40 on:** January 14, 2003, 04:53:46 PM »

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 · « **Reply #41 on:** January 16, 2003, 12:51:04 AM »

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.

Author Topic: Accuracy of MRIs (Read 8352 times)

Iona_-Uk

Iona_-Uk

iain

medsport