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Author Topic: Why didn't the osteophyte show up on the MRI?  (Read 2781 times)

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Offline Tahugo

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Why didn't the osteophyte show up on the MRI?
« on: May 03, 2006, 12:13:25 PM »
The MRI (I had this done privately) said I had a posterior horn tear of the miniscus and joint effusion, but that the lateral miniscus and cruciates were intact, no bone bruising, collateral ligament damage or other abnormality.

Through the NHS I had an arthroscopy -- the post op picture the OS drew showed I had an osteophyte on the inside of the patella that had worn a groove in the cartlidge down to the bone. So the OS did a partial meniscetemy and debridement.

This is on the NHS and it wasn't the Head Surgeon, nor his assistant, but another surgeon that was learning as its a teaching hospital.  They didn't tell me a student would be doing the surgery -- I was told it would be the assistant.  The Asst was there, but the report shows that he "assisted".   The student OS told me that there was quite a lot of bleeding and that "it was really tight in there" -- they put in a couple of stitches and I have bruising all down outside of my leg.

Why didn't the osteophyte show up on the MRI ?  Is it possible that the OS slipped with his little tool and cut a groove in my cartlidge down to the bone? 

Perhaps this sounds paranoid, but it comes from not feeling like you have any control over who does the surgery when you rely on the NHS>

Please answer me.  Thank you.

Tahug

Offline patpalloon

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Re: Why didn't the osteophyte show up on the MRI?
« Reply #1 on: May 03, 2006, 12:30:02 PM »
Hi Tahug,

sorry to hear of your woes on the NHS. How long is it since your injury? Osteophytes take some time to develop after an injury, some months I would guess. MRIs are mainly for showing up the soft tissues in the knee like the cartilage, menisci and ligaments. A plain x-ray would be the best thing to show osteophytes. Presumably you have had the knee x-rayed at some time? Ask why wasn't the osteophyte picked up then.

hope this helps,

Robin
LEFT KNEE: ACL and medial meniscal tear Sept 05.
Arthroscopy Jan 06.
Hamstring ACLR Apr 06.

RIGHT KNEE: meniscal tear 2008. Partial meniscectomy 2008 and again 2009.

knee deep in Goo

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Re: Why didn't the osteophyte show up on the MRI?
« Reply #2 on: May 03, 2006, 12:34:42 PM »
xrays would show it.. and really they cant see fully what is going inside the knee until they scope. it..   you should ask .. how your cartlidge is..  soft..? weak.?. shreded ?.. bone on bone ?    The osteophytes can chew up your meniscus

Offline blackbeltgirl

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Re: Why didn't the osteophyte show up on the MRI?
« Reply #3 on: May 03, 2006, 01:10:50 PM »
an osteophyte is a bone spur - generally the body's attempt to repair itself.  The presence of osteohpytes indicates damage to the articular cartilage.  If it was on the back of your patella, the only way it would have been seen pre-op is if you had sunrise/merchant view x-rays.  For these x-rays, your knees are bent and the film is "in your lap", so they can see the patella, the trochlear groove, and their positioning.  An osteophyte on the back of the patella is less likely to damage the menisci, since it's not that likely to come in contact with them.  And it could absolutely do more damage to the trochlear groove (the groove your kneecap runs through), as every time you bend your knee this spur would be running through the cartilage. 

MRIs show soft tissue - ligaments and tendons.  They are not intended to check for bone damage, and an osteophyte is effectively bone.  MRIs also do a very poor job of showing articular cartilage, so there are often surprises in the condition of cartilage during athrscopies.  Bruising is not uncommon after surgery.  Some of it depends on the surgery, the surgeon, how it all goes, etc.  Some of it depends on the patient, and your body's responses.

I wouldn't panic about your care.  Just keep asking questions, and make sure you put all your effort into rehab, to get the knee in the best shape possible.

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 Tahugo

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Re: Why didn't the osteophyte show up on the MRI?
« Reply #4 on: May 03, 2006, 05:36:01 PM »
Tahug

Thanks for the replies.  When I had an xray -- a student did it and it did not come back clear (NHS teaching hospital again) -- but the OS said that regardless it wasn't clear, he could see that there was a lot of wear and tear.  No mention of an osteophyte, though.

In early December 05, I came down on a metal plate on my knee.  It hurt like hell.  But it wasn't for another two months that the pain walking set in -- I couldn't walk without limping.  So perhaps that was the injury that sourced the osteophyte.  Besides that I seem to have a weakness towards meniscal tears(Jan 05 I had a partial medial men'tmy on the other knee)

Thanks all for the advice regarding putting my energy into rehab, etc. 

Tahugo

Offline heather k from wales

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Re: Why didn't the osteophyte show up on the MRI?
« Reply #5 on: May 03, 2006, 08:12:00 PM »
Im sure the surgeon would have been closely supervised by the OS.  I had an operation on my wrist 7 weeks ago, I sat up watching the complete operation.
The OS did half the work and another surgeon did the other half.  The OS did the tricky bits whilst his assistant harvested the bone graft etc...
On my notes the assistant surgeon is down as having done the operation with the OS as assistant.
Please dont worry who did the operation, Im sure you would have been in good hands.

Take care,

Heather ;)
91 Mangled Right knee on trials motorbike
94 Meniscus Repair
95 ACL/LCLrec,notchplasty,bone graft
01 90% Menisectomy
02 Scope
03 ACLrec,LAD
OA,osteophytes
04 Ch'plasty, ACLdeb,Suprapatella mbr ex, haematoma
04 Scope
March 06 Scaphoid op/bone graft
Nov 07 Thyroid Cancer ops x 2, radiation