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Author Topic: MRI Results and Your Diagnosis Anyone???  (Read 1778 times)

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Offline ladue22

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MRI Results and Your Diagnosis Anyone???
« on: September 01, 2006, 11:27:15 PM »
One year after torn meniscus debridement surgery 25 percent of the meniscus was taken out on both knees and I continued to have excruciating pain which built up over time... the County finally did another MRI with dye contrast in August and here are the results. Finally a diagnosis.....

What do you think would be the best treatment for me. I cannot walk, stand or walk properly and I have lost 20 pounds due to the increase in pain over the last two months.... and I live with non stop knee and back pain. Pain medications, rest, ice, cortizone shots, and physical therapy have not illeviated the pain and now I have an idea of what is wrong with me... here are my MRI with dye contrast results. I thought it was osteoarthritis but it was not.... and these are my MRI results.

Right knee:  Evaluation of the medial meniscus shows an anterior horn, which appears partially extruded.  The body of the posterior horn of the medial meniscus is visualized.  Within this fragment, there is a linear area of increased signal, which corresponds to a small tear. 
There is increased signal in several fibers of the anterior cruciate ligament, consistent with a partial tear.  In the promimal aspect of the posterior curciate ligament, there is thickening of the fibers, which fills with contrast suggestive of a small partial tear.  Just inferior to the posterolateral tibial plateau, there is a small 1 cm lesion with linear are of increased signal on STIR sequences which may represent a small contusion.

Impression:  Partial tear of the anterior cuciate ligament.  Likely small partial tear of posterior cuciate ligament.   Possible trabecular fracture involving the posterolateral tibial plateau.  Small tear in the remaining posterior horn of the medial meniscus.

The injection of local anesthetic provided pain relief which suggests the knee as the source of pain, while she continued to have pain in her left knee despite local anesthetic injection and imaging of the hips and eventual lumbar spine could be undertaken to rule out a source of referred pain.  The patient mentioned that she has low back pain as well.

Left Knee:  Evaluation of the posterior horn of the medial meniscus shows increased signal reaching the articular surface, consistent with a small non-displaced tear.  On the coranl STIR sequence a linear increased signal was seen under the medial tibial plateau which could be an artifact but it could also represent a microtrabecular fracture (bone bruise).

Impression:  Small horizontal tear of the posterior horn of the medial meniscus, which also appreciated on previous MRI.
Please note that the patient continued to report pain after local anesthesia injection, which raises the possibility of referred pain.  Further imaging of pelvis and lumbar spine are suggested to rule out a possible source of referred pain.

Can anyone explain some of this to me... and what will be the treatment to get rid of the chronic knee and now back pain. Would the right knee be taken care of first or would the left and what will the orthopeadist tell me they plan to do to help stop my excruciating knee pain and tears..can they fix both knees are the same time... what types of things will they suggest and what will work.....
Thank you sincerely for your much needed advice....
Liza in Los Angeles.