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Author Topic: X-ray (no fracture) vs. MRI (w/fracture)  (Read 3873 times)

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Offline sashazur

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X-ray (no fracture) vs. MRI (w/fracture)
« on: October 28, 2004, 12:55:29 AM »
I confused about conflicting information I'm getting from my orthopedist (who did an x-ray) and the report from the radiologist who examined my MRI.

Here's the background:

I ruptured my left knee ACL on October 3.

About 5 days after my injury I had an x-ray, and it didn't show any bone problems according to my orthopedist.

About 2 weeks after that, I got an MRI. My orthopedists office told me that the MRI showed a torn ACL but no meniscus problems.

A few days later, I actually got a copy of the MRI report (from my PT), and when I read it, I saw that (in addition to the info about ACL and meniscus) it said I had a "non-displaced small fracture involving the posterior margin of the medial tibial plateau measuring approx. 20x5x6mm".

Naturally, I called my orthopedists office and asked for an explanation of why they had not mentioned the fracture, and whether it contraindicated physical therapy, etc.

The doctor's response was (paraphrased): "In this case when th MRI report says there's a fracture, it doesn't mean what you would think of as a fracture.  It really means a bone bruise rather than a fracture. And the x-ray didn't show any fracture. So don't worry about it".

That wasn't an entirely satisfactory response!

So, I showed the MRI report to a friend of mine who's a radiologist. Obviously she hasn't seen my x-ray or MRI, but she told me that in general, the type of fracture described is more likely to show up on an MRI than on an x-ray (and also that this is a fairly common type of fracture with ACL injuries, and that usually it gets better on its own).

So... who do I believe? My orthopedist is supposed to be the best guy in town. Does not knowing the answer 100% really make any difference?
Tore ACL October 2004, no surgery so far, just PT.

Offline dm

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Re: X-ray (no fracture) vs. MRI (w/fracture)
« Reply #1 on: October 28, 2004, 06:19:26 AM »
I dont know if this helps any, but I broke my forearm bone with an impacted fracture, it was very hard to see unless you knew what to look for, because the pieces were compressed together.

Maybe this can happen with tibial plateau fractures? Perhaps the doctor isn't as good at reading xrays as he  thinks he is? Perhaps a radiologist would see what the dr didn't. If your doc is like most, he'll have the xray taken right there in the office and read it himself instead of having you sent elsewhere for the xray.

Perhaps if you signed out the xray from the doc and had your radiologist friend look at it, you'd feel better?
multiple arthroscopies 2/00,3/01,6/01,1/03, 12/07,10/10. chondromalacia, severe medial joint space narrowing following 3 partial menisectomies, chronic pain problems, kneecap problems, OCD lesion, failed mfx.