The WAITING ROOM => GENERAL KNEE QUESTIONS and comments (good for new threads) => Topic started by: Lilspark on August 18, 2015, 03:41:43 AM

Title: MRI results negative, no closer to answers, now what?
Post by: Lilspark on August 18, 2015, 03:41:43 AM
My MRI results don't show that anything is wrong with my knee. I'm frustrated that I can be in so much pain and not be any closer to a diagnoses because nothing showed up on the MRI. Is there a business out there I can take my MRI imaging to for a second opinion? I don't think my doctor will take me seriously if all of my results are coming up negative. I have waves of pain even when just standing still. I don't know how I will be approved to see a specialist with negative results. Maybe it's something else, maybe they read it wrong? What should I do next? Should I just go back to physio and hope it gets better?
Title: Re: MRI results negative, no closer to answers, now what?
Post by: Vickster on August 18, 2015, 01:25:13 PM
What country are you in, as your access to healthcare will vary.  Can you not ask your doctor to refer you to a specialist, or your physio? I think you said your physio thought it is a meniscus tear, these can easily be missed on MRI. Is there anything showing up at all in the report? I would think your own medical team would know how best to proceed

What causes the pain in the knee, what is it like? Sharp, achy, dull, caused by certain movements? Did it come on after a trauma or more gradually, especially after an increase in activity? Where in the knee is it? Is there swelling, instability?

There are lots of causes of knee pain, some are inflammatory or mechanical rather than structural and thus won't show clearly on MRI
Title: Re: MRI results negative, no closer to answers, now what?
Post by: Lilspark on August 18, 2015, 03:27:00 PM
I'm located in Canada. My doctor thinking that it was a muscle issue was hesitant to refer me to an MRI, I am scheduled for another one at the end of December, due to the pain level I went to a private clinic and paid for this one that came up negative. The physiotherapists here cannot refer to a specialist, it has to go through a doctor. I may need to go to the hospital to speak with a doctor there to ask for a referral. My doctor wasn't me to pay for MLS laser therapy at his office, which I've already tried several rounds of and it is not helping.
Nothing at all is showing up on the MRI report. The pain came on over 2 and a half months ago after squatting down something in my knee popped with severe pain.
It aches (with twinges of sharp pain) when simply sitting, laying down, and even sleeping, the ache is coming from the inside back of the knee. When walking and standing I get sharp pains in the front of the knee and on the inside back of the knee. If I try to bend it past 90 degrees I get a very sharp pain in front of the knee in addition to the pain on the inside/ back. Going down stairs is very difficult, I do 2 feet on each stair or hop without bending the bad leg more than 90 degrees. I also get buckling. Strangely on the worst days the swelling goes down to my ankle even though there is no pain in my ankle.
Title: Re: MRI results negative, no closer to answers, now what?
Post by: Vickster on August 18, 2015, 04:25:36 PM
Who read the MRI? Here in the UK, they get read by a radiologist expert in doing so (you need all of the dozens of images and not just one) reported upon and then the report and images are past to the specialist

Can you pay to see a specialist privately rather than paying for treatment that isn't working?

I thought I had retorn my lateral meniscus but my physio is sure it's patello femoral and mechanical due to tight muscles, pain going down stairs and slopes, aching especially while sitting with the knee bent, pseudo locking and difficulty bending after the knee has been straight for a bit. 

Has your physio done the usual meniscus tests?  Do you have exercises to do? Are you icing and using heat?
Title: Re: MRI results negative, no closer to answers, now what?
Post by: Lilspark on August 27, 2015, 03:00:47 AM
I had an appointment today with a specialist who went over the history of my injury. She said the radiologist that read my MRI is one of the good ones. She thinks that I crushed my meniscus when I squatted down and had the pain with a short black out. I'm supposed to continue with physio for the next while and then if the pain is not getting better injections. Do the injections hurt, how do they work and how long do they last? Can you squish your meniscus and then have it form back into it's normal shape without having any evidence that you crushed it?
Title: Re: MRI results negative, no closer to answers, now what?
Post by: Vickster on August 27, 2015, 08:37:56 AM
Regarding the injections, what are they proposing to inject? Steroid? Platelet Rich Plasma? I've had a steroid jab into my knee, it didn't help but my meniscus was damaged so unsurprising.

I've had a steroid jab for tennis elbow previously and that did help for a few months, I also had PRP for it subsequently which had no effect and actually that was very painful. I had surgery subsequently and the tendon was FUBAR, so again not surprising it was ineffective

I think pain levels will depend on the skill of the doctor injecting and also your own perception of pain, witn steroid they inject with a local anaesthetic so minimal soreness although it can be painful for a couple of days after if you have a flare reaction to the steroid

I can imagine that a meniscus would regain its shape if squashed, after all it's a shock absorber between bones, so I assume that it is subjected to such pressure regularly

It's possible you've bruised the bones,bone bruising can be very painful and can take a lot of months to heal , a year or more if severe

The fat pad is full of nerves too, perhaps that could also be a culprit, can suffer impingement
Title: Re: MRI results negative, no closer to answers, now what?
Post by: Char57 on August 28, 2015, 12:34:59 AM
I'm having the same problem as you at the minute. I damaged my knee 6 weeks ago and I'm still unable to straighten my leg and I still have a lot of pain and swelling. MRI has come back negative but I'm certain they have missed something. I'm going to my dr tomorrow to get referred for a second opinion as my current ortho won't re do the MRI. Fingers crossed it work out for you, trust your gut you know when something isn't right and make sure you find out what the problem is earlier rather than later, I know of people that have left their injuries because drs have said its nothing and because MRI's have come back negative, and then a couple of years down the line they've found that all along it was a meniscal tear or acl tear and now they have problems and/or arthritis in their knee for the rest of their life. You know your own body.
Title: Re: MRI results negative, no closer to answers, now what?
Post by: pinkywithap on September 03, 2015, 10:51:54 AM
You do know your own body, but it's almost impossible to get most doctors to listen unless the reports from radiology support your pain. Especially if you have a big file with other injuries, some of which came back inconclusive on reports.

How do you get a second opinion when your doctor refuses to admit the possibility of being wrong, and backs up their colleagues, and doesn't even administer clinical tests, preferring to rely on those reports?
Title: Re: MRI results negative, no closer to answers, now what?
Post by: Clarkey on September 03, 2015, 03:42:40 PM
If it is any consolation I started having right knee problems 12 years ago. I have had 4 MRI scans done over that time period with only 1 out of 4 actually coming up with a positive knee problem. I have had 2 exploratory scopes done the scope #1 was a fat pad trimming and medial plica excision. Scope #2 was anterior interval release surgery (AIR) excessive scarring caused from scope #1.

My MRI scan before scope #2 was the positive MRI result showing bone oedema inside the bone of the knee that could be early signs of osteoporosis and might need at worst a microfracture. Once my OS had a good look inside the knee it was excessive scarring from scope #1 pressing onto the patella tendon.

Soft tissue injuries and problems are often hard to spot on an MRI scan! After months of PT and a cortisone injection my right knee was not improving. I was pre-warned by my OS that I am taking a big risk as he may scope my right knee and find no problems that he can fix.

Of course surgery should always be the last option to take and a good OS will always take the conservative methods 1st before considering surgical intervention. Once you knee has been scoped it will never be 100% again which is logical but it better to take the risk if you in a lot of pain and discomfort and your knee is only 45% functional as an example then surgery would be worth risking.

I hope my explanation are clear and not too confusing, I just wanted to share my personal experiences that it is common and normal to have a negative MRI scan result but still can have a problem inside the knee that the MRI has missed out on.

[email protected]
Title: Re: MRI results negative, no closer to answers, now what?
Post by: Lilspark on September 07, 2015, 03:47:59 AM
Sorry for the late reply, my cat passed away this week while having a dental a the vet. My heart is shattered over the whole situation, and I'm still having a terrible time with it. I thought it was interesting that you mentioned osteoporosis. I am a 38 year old woman, at the age of 25 I had a positive bone density scan for osteoporosis. I had been taking depo provera for 7 years and the black box warning came out, so my family doctor sent me for a bone density scan. I was diagnosed with osteoporosis (-2.8 t score). I had taken different medication (fosamax, actonel, calcium, vit D) at 31 my bone density was back up to a safe range. I used to be a runner all the way up to half marathons, but had no knee issues. I had a car accident back in 2006 that hurt my neck and back enough to make me stop running completely. I wonder if the osteoporosis caused any issues with my knee. It is aching very bad tonight unfortunately, I will wait until December for my "free" MRI in hopes of an answer.
Title: Re: MRI results negative, no closer to answers, now what?
Post by: Clarkey on September 07, 2015, 04:20:26 PM
Hi Lilspark,

I am sorry to hear the sad news about your cat passing away during a routine dental procedure and understandable that you are going to feel upset. I have a black and white short haired cat called Ellie she will be 9 years old in November and have had her shortly after my 1st scope back in November 2009. It was a good to have her as company while recovering from the surgery, she seemed very concerned and was around me when I had my 2nd scope last year July. Cats and dogs seem to sense when you not yourself and Ellie often slept beside me while recovering from both scopes.

Osteoporosis can happen at any age and not far behind you in age difference aged 37 in December. I was also aged 25 when my right knee started to become more of a problem. MRI scans I am not too keen on as it hardly ever shows up with a negative scan that positive as soon as my right knee was scoped.

It could be Osteoporosis, I also get days when my right knee becomes sore and aches a lot with the weather very much in control of the pain levels! We are soon coming into autumn and winter months that not a great time for anyone with a chronic knee condition.

Finding out what will happen next week Wednesday when I see my OS again for a final decision! I was surprised and stunned when his registrar mentioned doing an osteotomy as I have pain and discomfort at the bottom of the right knee and a plate and screws was mentioned! Want to hear what my OS thinks needs to be done next week when he is in clinic. 

It's a long time to wait for an MRI maybe ask to be put on a cancellation list so you can have your MRI done soon! December is a far too long wait! Good luck.

[email protected]
Title: Re: MRI results negative, no closer to answers, now what?
Post by: Orla2708 on September 29, 2015, 11:35:08 AM
Sorry you are not getting any answers.

I had a fall over 12 months ago & twisted my knee & after RICE, Intense Physio I was referred for MRI which showed no major injury just early degenerative osteoarthritis so I had my 1st cortisone shot. This kept the pain at bay for 2 months but the pain came back. I then had 2nd MRI, no changes, so more Physio & another injection. This still didn't cure the pain & it got worse so in July my BUPA consultant performed an arthroscopy hoping to complete any repairs that needed carrying out. Once inside he found a cartilage defect 25mm by 8mm that had not shown up anywhere on the MRI. To correct this I had an osteochondral graft carried out on 19/9  & I am just over a week into the 8-10 week rehabilitation.

 I thought I was imagining the pain as the MRI was showing nothing but it turned out that there was something significantly wrong with my knee so don't be fobbed off & persevere while you are still in pain.

Hope you get some answers soon.
Title: Re: MRI results negative, no closer to answers, now what?
Post by: Clarkey on September 29, 2015, 01:04:34 PM
Hi Orla,

I can fully understand and know what you are experiencing as I am going through a similar pattern that you are finding yourself in right now! April 2015 I have an MRI scan. I was prepared and expecting to have a positive MRI scan when I got the results back from my OS. It was negative that was surprising as I am now in more pain and discomfort than I was pre-op to scope #1 & #2!

I have had 3 cortisone injections so far in my right knee 1 back pre op to scope #1 and then had one post op to scope #1, I then had one in May 2015 post op to scope #2. Now my OS wants to maybe do another cortisone injection around the patella tendon as he thinks it might be patella tendonitis or runners knee. I am not so convinced and think he just playing it safe and being too much on the conservative side of treatments at this stage of my never ending right knee problems.

Before I had my 1st scope my right knee MRI was negative and visually knee looked ok and then was decided that a diagnostic arthroscopy is the only way to really find out why I am feeling pain and discomfort in my right knee. Once my OS was had his camera inside he found my medial plica and fat pad was inflamed causing the sharp catching pain so removed my plica and trimmed my fat pad.

One then thinks that we are going potty and are imagining the knee pain as you clearly pointed out already! You knew all along that your knee was not right that been proved to be right as you have a substantial amount of cartilage damage! I cannot walk that far as I get intense pain around the bottom of my right knee by the tibia and now seeing my OS for a private consultation. I will ask him politely if he could please do an diagnostic arthroscopy. I am in more pain then I was prior to scopes 1 & 2.

My concerns as with your knee problems is that the longer I leave it untreated the more damage I will impact on my right knee that can never be reversed again! This happened despite having a negative scan and does annoy me when OS's are not keen to scope our knee if we are in great pain and discomfort on a daily basis and then fix it when it too late.

I am 70% certain that when my OS does finally agree to do a diagnostic arthroscopy he will straight away see why I am limping around and feeling pain at the bottom of my right knee. It not that hard to make a decision if a patient is in greater pain and discomfort then then they was before their 2 previous scopes.

I am sorry that the damage to your knee has progressed so far that it no going to be a bigger fix then your OS 1st anticipated! I hope he/she can get your knee back to some normality again. I am over 14 months post op after scope #2 to remove excessive scar tissue and had to have AIR surgery and now worse off!

[email protected]
Title: Re: MRI results negative, no closer to answers, now what?
Post by: Lilspark on December 20, 2015, 08:31:55 PM
My next MRI is next week. This pain has been going on for over 6 months now. The first MRI came back negative, but for the first 15 minutes of that MRI I had spasms and could not get my knee to stay still no mater how hard I tried. This MRI is at a different hospital, different machine and different doctors. If this comes back negative I do not know what to do, physio is no longer helping and trudging through the snow is difficult and painful. Can a nerve be causing this? I've lost any muscle I had on my legs due to not being able to bear much weight (can't do squats, stairs up and down are painful). I'm hopeful this next MRI will show something, If it doesn't should I be requesting a scope? The pain is constant in the front, bottom right quadrant of the left knee. It hurts whether I'm sitting, standing or laying down, there is no comfortable position.
Title: Re: MRI results negative, no closer to answers, now what?
Post by: LeonGruber on December 22, 2015, 04:23:03 AM
 ;D ;D
Title: Re: MRI results negative, no closer to answers, now what?
Post by: Lilspark on December 31, 2015, 12:41:41 AM
Another negative MRI, it doesn't show any issues with my knee. I'm frustrated with this pain. My doctor did state that it sounds like plica and now that the meniscus has been ruled out this could be the issue. How is plica diagnosed and does it ever show on an MRI?
Title: Re: MRI results negative, no closer to answers, now what? (MRI pics)
Post by: Lilspark on January 01, 2016, 11:36:25 PM
I am attaching the pictures from the first MRI of the sequence where the plica could be. I do not have a copy of the second MRI to compare. The MRI results do not address plica, is this something I should followup with to ask the MRI to be checked for plica?
Title: Re: MRI results negative, no closer to answers, now what?
Post by: Gishy on January 02, 2016, 01:48:03 PM
Are those the only images you have? Can you post the sagital/coronal images too? The 3 images I can see there only cover a tiny portion of your knee - maybe they aren't loading properly for me.

My Knee MRI came back negative but out of interest I taught myself how to interpret the results. There is a lot that can go on in there and some of the signs are incredibly subtle while others (like mine) are blindingly obvious.

Start by doing a Google image search for "healthy knee MRI" and compare to yours. Then go to YouTube and watch some videos on how to read a knee MRI - there are a couple of very good introductory videos aimed at patients and med students. Once you have a grip on what kind of things can go wrong, go back to that image search and start again.

I believe my MRI was misread partially because of what my referring doctor wrote on the request form and partially because the time stamp on my images was 7:30pm and the radiologist wanted to go home.

Best of luck.
Title: Re: MRI results negative, no closer to answers, now what?
Post by: Lilspark on January 02, 2016, 10:46:09 PM
I finally figured out how to upload an album to flickr- I've screen shot the whole MRI and here is the link to the photos:[email protected]/GARHF0