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Author Topic: Need MRI Translation/Recommendations  (Read 8342 times)

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Offline OhMyAkenKnee

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Need MRI Translation/Recommendations
« on: January 09, 2005, 03:48:06 AM »
My Knee History:
1998 - Injured knee playing basketball (had not played for 5 years, then played hard for three consecutive Sundays and left knee got progressively worse).
1999 - MRI diagnosed a torn lateral meniscus, scheduled orthoscopic.
1999 - Left knee scope showed no meniscus problems at all, Dr said I had cartilage of a teenager, but he removed a plica band with a laser.
1999-2000 Healing went ok and the pain was gone, started mountain biking and felt great, tried playing basketball again and the pain was back, very similar to the first time.  I had swelling around the outside of my knee and it hurt to bend with weight on it.  Twisting it really hurt and it always felt like it was going to lock while walking and did lock up a few times.  
2000-Present I lived with this pain on and off, depending if I re-aggravated playing ball with the kids or just moving it wrong with weight on it.  It seemed I always re-aggravated it when I had weight on it and twisted it.  My knee has really bothered me the most in the last few months, with constant pain while it is in use, like bending, walking, standing, etc.  The only form of exercise that does not bother my knee is mountain biking.  I guess this is because I do not have all my weight on it and my feet are always clipped into the pedals, not allowing my feet to turn, so there was no twisting.  Also, while biking, my knees are always in a bent position, which I believe is best for that joint.

Anyway, I got an MRI a few days ago on my left knee and had it read by a Radiologist at Mercy Hospital.  I would like some help translating this, if anyone has time to help out.
Here are the results of the MRI:
1.There is mild to moderate size joint effusion.
2.Degenerative changes are seen within the knee with mildly irregular cartilage thinning and mild degenerative bone spur formation seen.
3.There are small focal defects along the articular cartilage of the medial and lateral femoral condyles best seen in the coronal images.
4.There is a small area of heterogeneous abnormal signal consistent with bone edema involving the anterior aspect of the lateral femoral condyle.  This is most consistent with mild bone contusion.
5.There is a well-defined small degenerative supracondylar cyst seen along the mid proximal posterior aspect of the tibia adjacent to the insertion site of the posterior cruciate ligament.
6.Anterior cruciate ligament, posterior cruciate ligament, medial collateral ligament, and lateral collateral ligament complex are intact.
7.Mild heterogeneous degenerative changes are seen within the lateral and medial menisci.  
8.No discrete meniscal tears seen.
MRI Impression:
1.Degenerative changes with cartilage thinning and mild bone spur formation seen throughout the knee.  Small defects within the articular cartilage of the medial and lateral femoral condyles.
2.Small to moderate size joint effusion.
3. Small area of edema most consistent with bone contusion involving the anterior aspect of the lateral femoral condyle.

I am new to this site, but have found it the most help on the internet and I hope someone has time to give me any feedback at all.
I am supposed to go meet with a surgeon next to discuss how my knee will be treated from here, but I don&#8217;t know who is good in my area.
All Dr.s are not the same and I want the best.
If anyone can also recommend a good knee surgeon in Maine, I would appreciate it.
Thanks to all that help &#8211; K. Brooks.  ???
KB in PAIN

Offline knight_of_knee

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Re: Need MRI Translation/Recommendations
« Reply #1 on: January 09, 2005, 08:09:50 AM »
1.There is mild to moderate size joint effusion.

Joint effusion is swelling that occurs inside the joint cavity... swelling caused by excess synovial fluid (as opposed to edema which is caused by serous fluid).

2.Degenerative changes are seen within the knee with mildly irregular cartilage thinning and mild degenerative bone spur formation seen.

It sounds like your knee has sustained damage over time and not from an acute injury...  irregular cartilage thinning, I think, would mean that your knee is not sustaining damage uniformly.  
Bone spurs happen because your body is trying to create a larger surface area to distribute weight bearing.  

3.There are small focal defects along the articular cartilage of the medial and lateral femoral condyles best seen in the coronal images.


The articular cartilage of the medial and lateral femoral condyles means that the cartilage covering the end of both the inner and outer sides of the femur (where the knee joint forms) is damaged...  by focal defects, I would assume that you have very specific spots of damage rather than a general breaking down of cartilage.  Coronal images are those that divide the body or body part into front and back.



4.There is a small area of heterogeneous abnormal signal consistent with bone edema involving the anterior aspect of the lateral femoral condyle.  This is most consistent with mild bone contusion.

You have bone edema (bone swelling/bruise?) on the front part of the outer(away from the body)  femur surface that makes up part of the knee joint. (femur is the bone from knee to hip)  The abnormal signal (its on my MRI's too) I think refers to the image produced by the MRI machine and how the body reflects back magnetic waves (or something).  Heterogenous abnormal signal probably means that the abnormal film parts aren't uniform... meaning perhaps different degrees of bruising.

5.There is a well-defined small degenerative supracondylar cyst seen along the mid proximal posterior aspect of the tibia adjacent to the insertion site of the posterior cruciate ligament.

Supracondylar cyst relates to a cyst (supra = above?) condyle which is the top part of your tibia (large weight bearing bone in lower leg) Supracondylar cysts are usually a sign of degeneration.

mid proximal posterior means middle back of the tibia on the end closest to the body (its in your knee not ankle)


6.Anterior cruciate ligament, posterior cruciate ligament, medial collateral ligament, and lateral collateral ligament complex are intact.

Your ligaments are in good shape.

7.Mild heterogeneous degenerative changes are seen within the lateral and medial menisci.  

Your menisci are showing hetero (unequal/unalike?) degeneration... so maybe they are slowing wearing out or getting damaged

8.No discrete meniscal tears seen.

Despite the degenerative changes in your menisci, the can't find any tears.

MRI Impression:
1.Degenerative changes with cartilage thinning and mild bone spur formation seen throughout the knee.  Small defects within the articular cartilage of the medial and lateral femoral condyles.

Sounds like perhaps you have osteoarthritis or might be developing it.

2.Small to moderate size joint effusion.

Small to moderate swelling inside the joint.

3. Small area of edema most consistent with bone contusion involving the anterior aspect of the lateral femoral condyle.

Swelling on the front outer portion of the top of the femur (the knee end of femur) that might be a bone bruise.

As far as I know, joint effusion isn't treated unless it becomes an excessive amount that hinders knee use.  The synovial fluid usually gets reabsorbed.

I hope this was helpful... I'm not a radiologist so take what I say with a grain of sand! :)

I can recomend a bad knee surgeon in Massachusetts but unfortunately not a good one in Maine.

Sid

Offline OhMyAkenKnee

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Re: Need MRI Translation/Recommendations
« Reply #2 on: January 09, 2005, 03:41:04 PM »
Sid,
Thanks for your interpretation.
This all mkes more sense to me now.
I want to have some level of comprehension before IO talk to the surgeon and what you gave me helps a lot.
Anyone eleses opinion is still welcomed.
K. Brooks. ;D
KB in PAIN

Offline knight_of_knee

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Re: Need MRI Translation/Recommendations
« Reply #3 on: January 09, 2005, 10:16:31 PM »
I just finished taking Anatomy and Physiology...

I complained all the way through the course saying "I'm not going to be a radiologist, why do I need to know this?"

Who knew it would come in handy so quickly!  :)

Sid




Offline dm

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Re: Need MRI Translation/Recommendations
« Reply #4 on: January 10, 2005, 06:55:36 AM »
You asked for an opinion, here's mine...
1.There is mild to moderate size joint effusion.
Joint swelling
2.Degenerative changes are seen within the knee with mildly irregular cartilage thinning and mild degenerative bone spur formation seen.
this is probably going to be arthritic type changes, no sudden accident here, I think.
3.There are small focal defects along the articular cartilage of the medial and lateral femoral condyles best seen in the coronal images.
this is small areas of damage to the rubbery gristle that covers the bone ends.
4.There is a small area of heterogeneous abnormal signal consistent with bone edema involving the anterior aspect of the lateral femoral condyle.  This is most consistent with mild bone contusion.
sounds like bone bruising to me.
5.There is a well-defined small degenerative supracondylar cyst seen along the mid proximal posterior aspect of the tibia adjacent to the insertion site of the posterior cruciate ligament.
there's a cyst on the big lower leg bone near the PCL
6.Anterior cruciate ligament, posterior cruciate ligament, medial collateral ligament, and lateral collateral ligament complex are intact.
ligaments are seen on the mri and intact
7.Mild heterogeneous degenerative changes are seen within the lateral and medial menisci.  
this is often a way to describe arthritic wear and tear or small meniscal tears that aren't obvious.
8.No discrete meniscal tears seen.
no obvious meniscal tears.
MRI Impression:
1.Degenerative changes with cartilage thinning and mild bone spur formation seen throughout the knee.  Small defects within the articular cartilage of the medial and lateral femoral condyles.
a lot of joint wear.
2.Small to moderate size joint effusion. swelling present
3. Small area of edema most consistent with bone contusion involving the anterior aspect of the lateral femoral condyle. bone bruise

The other poster beat me to answering you. I think we're pretty much saying the same thing.
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.

Offline OhMyAkenKnee

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Re: Need MRI Translation/Recommendations
« Reply #5 on: January 10, 2005, 05:48:49 PM »
Thanks for the fast opinion.
Good to see that both replies are consistant.
I will have a much better understanding when I go to discuss this with a specialist.
K.Brooks ;D
KB in PAIN