KNEEtalk

The WAITING ROOM => GENERAL KNEE QUESTIONS and comments (good for new threads) => Topic started by: Patience : ) on September 16, 2005, 02:05:09 AM

Title: MRI shows nothing but Arthiscopic does ...
Post by: Patience : ) on September 16, 2005, 02:05:09 AM
Has anyone had an MRI that showed nothing but later you decided to get a scope done because you were still having same problems (Chrondomalacia - suppose) and were glad you did because in fact it did show that something else was wrong or it was able to help you?  Please let me know ... Im nervous, my cortisone shot has worn off and Im considering getting the scope done but am afraid, is it worth it?

Thanks so much for any thing you can let me know regarding this!
Title: Re: MRI shows nothing but Arthiscopic does ...
Post by: blackbeltgirl on September 16, 2005, 02:48:47 AM
It happens all the time.  MRIs are not 100% accurate, or complete.  And they do a poor job of showing articular cartilage.  So while the MRI shows that all the tendons, ligaments, and menisci are intact, it won't tell your OS that you have a focal lesion in the articular cartilage, or the size, or how deep it is.  That's why so many patients go into surgery for relatively minor surgery, like a torn meniscus, and wake up with microfracture to correct focal lesions.

HOWEVER - before insisting on a scope, get a 2nd or 3rd or 4th opinion.  Different doctors can look at the same MRI films and find different information, injuries, etc.  And there are a number of injuries that can be diagnosed, at least partially, by physical exam.  Insisting in surgery with a surgeon who has been unable to diagnose your problem sounds like asking for trouble.  Get a copy of your medical records, a copy of any x-rays and your MRI, and make an appointment with another knee OS.

Jess
Title: Re: MRI shows nothing but Arthiscopic does ...
Post by: j_smi001 on September 16, 2005, 03:01:18 PM
I had an MRI in 2000 that showed only a tilt on the patella.  During the scope both the medial and suprapattela plicas were inflamed and catching and so were removed despite the MRI reading saying no obvious plica determined.  I had both knees scoped at the same time and have had two good years on them and the recovery from the LR and plica removals was OK.  Hope this helps.
Title: Re: MRI shows nothing but Arthiscopic does ...
Post by: Nettan on September 17, 2005, 01:24:49 PM
I have also had Mri showing nothing, then I had both meniscus tear and a growth like a band in my knee when doing scope. So you can't relay on them 100%.
Good luck to you !!

HUGS NETTAN  8)
Title: Re: MRI shows nothing but Arthiscopic does ...
Post by: guardmom810 on September 17, 2005, 07:27:21 PM
Hi,

I had an MRI and it showed the same thing your did.  It was done in April 2005.  I had the scope and it showed I have damage to the medial condyle.  At the time of the scope the os did drilling and "cleaned up the area".  Now I am getting ready to go back and have the OAKS procedure.  I am still not sure what that is.  I am trying to get more infomation. 

Get a 2nd opinion.

Good luck.

guardmom
Title: Re: MRI shows nothing but Arthiscopic does ...
Post by: brattkids on September 18, 2005, 01:39:58 PM
I also had a MRI that showed nothing and when I had my scope they found damage on both the medial and lateral femoral chondyles.

Guardmom, I have had two OATS- one autograft this is where they take a cartilage plug from a non weight bearing portion of your knee and place it in the defect spot. I have also had allograft OATS- this is where they take cadaver plugs and fill in the bad area in your knee.

If you have any questions please dont hesitate to ask!!

Paulette
Title: Re: MRI shows nothing but Arthiscopic does ...
Post by: Psflash on September 19, 2005, 02:11:44 AM
Last summer, my knee was continually locking as a result of an injuring I acquired when I was 12 (17 years ago).  I sought treatment from an OS who ordered an MRI and determined that I had a complete tear of the ACL.  His only answer was an allograft ACL (for which I sough an Patellar Tendon Autograph, as I am active and for the physical demands of my career).  I sought a 2nd opinion, in which the new OS told me that my ACL was loose, but functional - The MRI "missed it" and that my problem was related to a loose/mal-tracking kneecap.  After several months of therapy and the condition getting worse (and me repeatedly complaining about what felt like a marble next to/under my kneecap when the knee would lock up - and the new OS dismissing it as inflammed cartilage) -  he finally agreed to perform an arthroscopy.  As soon as he inserted the scope, he found a marble sized piece of bone/cartilage in the location where I was complaining.  Her removed that, shaved 3/4 of the damaged cartilage from under my kneecap (which I feel was caused by the "marbel" and not the kneecap tracking, and there was a 2cm x 3cm hold in the lateral femoral condyle (where the marbel originated).  I later went to a new OS in NYC for the damaged lateral condyle, and he noted that the "marbel" actually showed up on the MRI.
So my experience with an MRI is such that:
1) It can be wrong, escpecially with an ACL diagnosis if the "slices" are not taken correctly.  The radiologist noted that I had a complete tear of the ACL, when it was in fact intact (just stretched).
2) The radiologist may have missed something (such as a marbel sized piece of jagged bone wedged under my kneecap) which can be clearly seen on the MRI film.
3) Even the best OS may not pick up on a problem via an MRI, as they generally dedicate their training to Orthopedic surgery, not radiology ---- even when you complain about a specific pain in a specific place and they don't take the time to re-examine the MRI.

If you are still weary of a diagnostic arthroscopy (which is a piece of cake in my experience), have another radiologist look at your MRI films.  What could it hurt?  Another point to keep in mind is that your condition may have worsened since the last MRI - possible consider speaking to your OS about another MRI (if insurance would cover same).