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Author Topic: ok, my turn... MRI and post-op help  (Read 2294 times)

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Offline kck11599

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ok, my turn... MRI and post-op help
« on: March 15, 2006, 07:24:42 PM »
Ok here is my story:

March 5, 2005 I was at a college hoops game as a spectator and was jumping around in the bleachers as we won the championships!!! Coming down out of the bleachers my knee hurt and I couldn't say why.  By the following day is was immensely swollen and decreased ROM.  I had an appt w/ PCP two days later so I just waited it out.  He thought lateral meniscus tear but with good blood flow it could heal on its own.

A month later no improvement so I went to sports med facility and they ordered PT.  MRI in May showed sprained MCL and ? MMT.  Actually 1st rad to read it said effusion with no pathology then I had another opinion.  3 months later, with almost no improvement I saw an OS.  Due to my age, 31, we decided on a partial menisectomy.  OS went in and ended up with plica, synovectomy and cleaned out behimd patella.  He left meniscus alone b/c it showed a small smooth tear and a patch of wrinkles.  Post-op seemed to be going well, but improvement faltered.

Surgery was 8-22-2005 and since then I have done NSAIDs, cortisone and repeated PT with sono/steroid therapy also.  I still have daily swelling, pain and ROM hasn't fully returned.  PTherapist is wonderful and always thought patellar tendonitis and meniscus.

I stopped wearing anything but sneakers - anything with a heel makes symptoms x10 worse and a month ago was told not to exercise at all until next appt and take Voltarin.  Nothing has improved.  I am heavy to begin with though active and feel like I have gained another 20 puonds which can't help -- losing weight would be ideal!

2nd MRI done and read by 2nd rad mentioned above.

--- ADDENDUM: 0 ---
Multiple sagittal, axial, and coronal images were reviewed in comparison to previous MRI dated 5/2/2005 which was performed prior to patient's left knee arthroscopy in August 2005.



The examination demonstrates upper limits of normal amount of fluid within the knee joint space.  I do not see signal alteration to indicate a discrete area of edema related to the marrow compartments of the distal femur or proximal tibia to indicate an area of osteochondral lesion, bone contusion, or avascular necrosis. 



I do not define a discrete medial or lateral meniscal tear.  I do suspect that there is some limited myxoid degeneration within the posterior horn of both the medial and lateral menisci.  There is no cruciate or collateral ligament tear identified.  The quadriceps and infrapatellar tendons are unremarkable.  I do not see abnormal fluid about the knee medially to indicate pes anserine bursitis.  There is no edema to suggest a tear of the medial collateral ligament complex.  The iliotibial band is of unremarkable contour and signal. 



On the transaxial planes there is artifact demonstrated from the popliteal artery.  There is demonstration of some signal changes at the level of the patellar articular facets in keeping with mild to moderate chondromalacia patella.  This I believe is particularly evident at the lateral aspect of the medial patellar facet near the patellar apex.  There is artifact, however, running through this region limiting assessment.  I see no evidence of patellar subluxation.  The contour and signal of the medial and lateral retinacula is unremarkable. 



I see no evidence of popliteal cyst.



Examination is reviewed in comparison to plain film radiography of the left knee dated 4/30/05.



IMPRESSION 

1. No definite medial or lateral meniscal tear identified.  Upper limits of normal amount of fluid within the knee joint space noted. 

2. No cruciate or collateral ligament tear identified.  Specifically, no evidence to suggest medial collateral ligament tear or edema or evidence of pes anserine bursitis.

3. Suspect moderate chondromalacic changes at the medial patellar facet laterally.


So yes, there were things found on the MRI, but nothing to really explain why I have swelling at medial side of patellar tendon.  OS is beginning to ? Hoffas impingement but rad didn't know that so maybe that's why it was not referred to??

I work at the hospital where both docs are can find pics in the research that show Hoffas MRi images that look just like mine, ie same signal abn in the same cuts etc.

I see my OS on Friday and have been trying to do my own research (which is how I founf this board).


My major ?'s are:

Was none on the chondromalacia seen on the 1st MRI and does that mean it has all gone downhill so quickly? 

and

What will it mean if it is Hoffas.  Everything I can find points to more surgery?


Any help would be appreciated.  Looking at some of your stories makes mine look petty, but the pain in real and is at least a nuisance on the best days!















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