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Author Topic: patella articular cartilage, medial meniscus tear and burista  (Read 4768 times)

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Offline cookiecrumbs

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I got my MRI  report back today and this is what it says Ď areas of high signal within the articular cartilage on the lateral facet of the patella. The surface of the cartilage was difficult to assess but there is though to be some irregularity present. There is a small vertical longitudinal tear in the central portion of the medial meniscusí

Words like Ďareas of high signal and irregularityí scare me, mostly because I donít know what that means. My Family Doc mentioned inflammation. I hope thatís all it is. I think the cartilage tear wasnít a recent occurrence. I have never had any swelling or pain and I have full range of motion in the joint with no pain. A few weeks ago while out running the joint caught a couple of times. It was uirstaa very fast and brief sensation and didnít give much pain. Running causes less pain than cycling.

So what does high signal and irregularity mean? Is it just inflammation? Can I get arthritis in the patella from this? Is treatment just rest? Will the tear in the medial meniscus repair itself or is the blood supply poor in the central meniscus? If surgery trims away some cartilage will this lead to arthritis? I have heard about injecting blood into the joint to help it heal. Is this possible?

I also have fluid and a small bursta in the left knee. My family doc. said this is an overuse injury and will heal with rest.

Yep its sounds like I am falling to pieces. But I can walk with no pain and I only get brief sensations of an ache in the knees during the day.

Offline Lottiefox

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Re: patella articular cartilage, medial meniscus tear and burista
« Reply #1 on: July 23, 2010, 03:10:44 PM »
High signal refers to how the radiologist spots any unexpected changes on the images. So, things like tears, cartilage lesions etc stand out with a different resonance or signal depth than a healthy portion of the joint. At least, thats how I understand it.

You have wear on the lateral side of your patella - this is a symptom not a diagnosis. Before you worry about the future you need to explore why its happening. I too have lateral patella wear - because I over pronate badly, my kneecaps sit laterally and my inner quad muscles are not balanced with my outer ones. I also have some mild misalignment in my lower limbs where my femurs rotate inwards slightly but not enough to warrant a surgical derotation at present. Combine these factors and my kneecaps have spent 40 years not moving properly and the outer edge has worn out. I used to run and never had pain on running. But suddenly pain set in for normla day to day stuff and hence I went for scans and OS appointments etc.

You need to ask your referring doc why this wear is happening for you and see what is suggested. MRI scans won't show anything to do with your kneecap tracking - ideally you need proper CT scans of the patella moving and X-rays of the patella and lower limbs. Arthritis is loss of cartilage that becomes inflammed. So, if you lose cartilage then yes, you may get arthritis. But it seems you may have caught this early and therefore have a great chance of stopping further degeneration. Surgery can smooth the cartilage if it is in the early stages of wear and tear and stop catching, scraping etc but if its deep wear and tear there often isn't much for them to smooth. Again, it sounds like you are not at this stage, although you need clarification.

You sound like you've got an early warning in place and with the right treatment now and diagnosis you can get a good handle on things,

Lottie  :)
Bilateral patella OA since 2009, no surgeries.
Euflexxa working well x3 to current
Right forefoot CRPS post fusion surgery 2011
Refusing to let the ailing parts stop me....

Offline crankerchick

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Re: patella articular cartilage, medial meniscus tear and burista
« Reply #2 on: July 23, 2010, 03:36:31 PM »
Lottie has provided you great info. I just want to reiterate what she said about the patella wear being a symptom, not a diagnosis. This is very important to understand. Procedures that attempt to smooth the cartilage aren't "fixes" they are just band aids (and depending on who you ask, not very good band aids for behind the patella). Something is causing the patella to engage the trochlear groove too much laterally, resulting in the wearing. A knee specialist, preferably one with interest and experience with patello-femoral issues, is needed to get to the root cause of the problem and suggest the best course of treatment right the ship.

Conservative treatments include rest, ice, and elevation and usually physical therapy to strengthen the whole leg and hopefully help get the kneecap to stay in it's proper place within the trochlear groove. Sometimes this combination is enough to get the symptoms under control. But if there is a structural anomaly in the knee, physical therapy of course won't fix that, but you may still be able to get the symptoms under control with exercise, otherwise surgery would be discussed. But again, it is imperative that the surgical approach be the one that addresses the root problems.
Mar '07 - plica excision
Oct '09 - femoral + tibial derotational osteotomy & TTT
Aug '10 - hardware removal
"You control your leg. Don't let it control you." -Smart trainer
"Get your a$$ in gear and go for it! Nothing will happen until you make it!" -Smart doctor