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Author Topic: need help to understand MRI report  (Read 14126 times)

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Offline soccerbooty

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need help to understand MRI report
« on: March 27, 2006, 03:45:43 PM »
Hi all,

Im currentley in Australia from Canada where I have had an MRI for a knee injury that i sustained in July last year (9 months or so ago) Im not covered by a reciprical health care system and travel insurance only covers medical emergancies thus am paying for everything so thought I would see what you guys thought and getting some background information before visiting the doctor.

So the report follows, obviously im tossing up the advantages and disadvantages of getting any surgery done here (if thats what needed) while in Austaralia privatley versus waiting around for years to get anything done in Canada on our public system. Note: im in pain after doing anything even remotley physical, or even a bit of walking. basically any info on what this means to someone without medical knowledge, in the form of is surgery required, how is this normally treated, how long is recovery, any estimates on costs (is a major or minor surgery required). Thanks for your time

--------------------------

MRI left knee

Technique: sagittal and coronal PD and T2 (fat sat); and axial PD (fat sat)

Findings: The cruciate ligamate is intact, the medial meniscus in intact. A 10mm focus of mild chonral thinning with shallow underlying joint surface osteophyte involves the central weight bearing surface of the medial femoral condyle adjacent to the intercondylar notch. Associated with this is an oblique high-grade partial thickness chondral fissure which undercuts the chondral surface by approximatley 2mm. There are no subchondral bone changes. The MCL is intact.

the lateral meniscus, larteral compartment articular cartiladge and lateral supporting structures are intact. Within the patellofemoral compartment the is a 7mm focus of partial thickness chondral thinning and shallow fissuring over the medial patellar facet near junction with apex. the femoral trochlear cartilidge is preserved. The quadriceps and patellar tendons are intact. There is a normal volume of joint fluid. No bakers cyst of discrete loose body.

Comment:
1) mild focal chondral wear involves the central weight bearing surfcae of the medial femoral condyle adjacent to the intercondylar notch. This is associated woth an oblique chondral fissure wich undercuts the chondral surface by 2mm. No elevated chondral flap is evident.
2) Focal partial thickness chondral wear of medial patellar facet
3) No meniscal tear detected.
------------------------------------------

Thanks guys, any info is very much appreaciated.

Offline blackbeltgirl

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Re: need help to understand MRI report
« Reply #1 on: March 27, 2006, 05:56:06 PM »
You've damaged the articular cartilage in weight bearing areas of the joint.  This is the white stuff at the end of your bones, that allows them to slide smoothly over each other.  None of the damage is full thickness (down to bone), but it is in weight bearing areas, including the back of your knee cap.

A few things to keep in mind:
1) mri is notoriously bad for detecting articular cartilage damage.  Your damage may be more or less extensive than noted in the mri
2) you shoudl also have full leg, standing x-rays (ankle to hip).  This will show if the knee joint is properly aligned.  If it is not, surgery to correct the alignment would be required before doing anything to repair/replace the damaged cartilage.  They should also take what's called a skyline view, where your knees are bent and the film is in your lap.  This will show if the kneecap is sitting properly in the groove
3) surgery comes in all shapes and sizes, and is not always good.  They can clean out the knee - remove the bone spur and clean up any loose edges of cartilage.  This may provide some pain relief.  Most of the cartilage repair/replacement techniques require full thickness damage, meaning that you have worn away all of the cartilage.

Have you had a physical exam?  Did the doctor place his hand on your knee while you bent and straightened it?  Did he check for muscle strength?  YOu may benefit from physical therapy and anti-inflammatories as a starting point.  But until you know what's causing the damage, you shouldn't rush into surgery.  It also depends on your age.  If you're in your 20s or 30s, vs. your 40s, 50s, or 60s will determine how aggressove you want to be.

Good luck-
Jess
ACI was supposed to be 2/21/06.  On 6/29/06 Insurance co said have another scope, and if it still looks good, they'll ok the ACI.
Microfracture Dec 7, 2004
   3cm x 6cm lesion, LFC; 3cm x 1cm lesion, trochlear groove; lateral tibial plateau lesion
2nd degree black belt, tae kwon do (had to stop)

Offline soccerbooty

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Re: need help to understand MRI report
« Reply #2 on: March 27, 2006, 07:02:32 PM »
Thanks Jess,

To answer some questions and details that I have left out.

Im 22 years old, I sustained the injury playing the soccer in Canada (where I live) and made it worse playing longer than I should have. After injury I went to a walk-in clinic who did a physical examination and suspected that I fractured my knee cap, and to take time off work. (A screw around)

1 week later I went my doctor who examined the knee and said the muscles were weak and that i should go to physiotherapy to strengthen them.

Physiotherapy suggested that i get a patellar stabiliser knee brace as my knee cap was located out of place to the left, he suspected that I may have torn my meniscus, and that I had lost alot of muscle from my left quad and connecting muscles. During tests swaying my foot back and forth pivoting at my knee, my knee clicks many times. Additionally my left leg is hard to raise off the ground while laying flat on the floor. After 6 weeks of physio my knee continued to get progressively worse, the physio suggested that I take 2 weeks break to let it rest before coming back for more physio. After the 2 week break from physio I returned for another 4 weeks, and with no improvement went back to my doctor who gave me forms for an X-ray. I had X-rays taken (only of the knee, and of the knee under weight, not the ones you suggest) however had to leave on a pre-arranged trip to Australia before an appoitment with a speacilist could be made.

The whole process above took 6 months, im now in Australia however it has become worse again to the point it is stopping me from doing alot of day to day stuff, and hampering what work I can do.

Any more info would be much appreaciated, and once again jess for your help


   

Offline blackbeltgirl

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Re: need help to understand MRI report
« Reply #3 on: March 27, 2006, 07:49:41 PM »
I'd definitely see a specialist.  You don't know if your knee is properly aligned, or if the kneecap is sitting where it should.  You do know that your kneecap is not running through the groove properly (although that can sometimes be resolved with proper therapy, taping, and/or bracing).  It's probably worth seeing a sports medicine OS, who specializes in knees, to get some more information about your specific case and options.  Until you get a more complete diagnosis, you won't know a) if you need surgery; b) what surgery to have; c) how urgent it is.

Considering your age, I'd try to deal with this sooner rather than later, just so you don't end up with a lifetime of complications.
Jess
ACI was supposed to be 2/21/06.  On 6/29/06 Insurance co said have another scope, and if it still looks good, they'll ok the ACI.
Microfracture Dec 7, 2004
   3cm x 6cm lesion, LFC; 3cm x 1cm lesion, trochlear groove; lateral tibial plateau lesion
2nd degree black belt, tae kwon do (had to stop)















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