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Author Topic: How to Read my MRI... do I have ACL tear?  (Read 6243 times)

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Offline chiguina

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How to Read my MRI... do I have ACL tear?
« on: December 24, 2010, 07:00:51 PM »
Is anyone out there skilled at reading MRIs or have a good resource to help figure out how to read them? 

I had a ski accident on Sunday and hurt my knee (loud pop).  The strange thing is that I have not had a lot of pain in my knee when I am just sitting down.  However, I do feel pretty unstable standing and it hurts to pivot.   
Had my MRI yesterday and was given a CD of ALL the scans, but.... don't get the radiology report until Monday or Tuesday.  This is killing me - I just want to know what's going on.  I've been trying to look at normal & abnormal MRIs on line and then compare it with my scans.  I think I may have an ACL tear and maybe a couple other small tears ????  Help. 

Thanks!  Shawna

Offline soozles

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Re: How to Read my MRI... do I have ACL tear?
« Reply #1 on: December 25, 2010, 05:04:32 AM »
Unfortunately, if you're not skilled in reading MRI's and don't know what you're looking for, it can be incredibly difficult to look at on your own, and all the nuances between T1 and T2 and the signal intensity just make it all the more confusing. It would also be next to impossible to try to explain it online. Your best bet is to just wait until the report comes out, and then if you're really curious, ask your OS to show you on the scans at your next visit. Although, if you really have a torn ACL, the physical exam with the anterior drawer test is pretty accurate when it comes to diagnosing a torn ACL.
May 2005: Torn PCL, misdiagnosed as chondromalacia
April 2010: pain worse, lots of instability
Nov. 23, 2010: PCL reconstruction
progress here: http://pclrecovery.blogspot.com/

Offline Snowy

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Re: How to Read my MRI... do I have ACL tear?
« Reply #2 on: December 25, 2010, 08:13:03 PM »
I was in the same situation as you (right down to the skiing accident) and ended up Googling MRI images of torn and intact ACLs. While I had no way of being completely sure, my scan did look much more like the torn ligaments than the intact ones. Depending on the images this may or may not work, but it at least helped me feel like I was doing something while I waited for the report.

I second the comment about the physical tests - the emergency doc, my family doctor and my PT all diagnosed my tear correctly with these before I had the MRI.
Mar 11: R Biceps femoris tear (skiing)
Jul 10: ACLr (hamstring autograft)
Mar 10: L ACL rupture (skiing)
Feb 06: L partial ACL tear (kickboxing)
Dec 03: R bone edema (motorbike)
Jan 01: R patellar chip (motorbike)
May 93: R ACL sprain (hockey)
Ongoing: bilateral PFS and OA

Offline chiguina

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Re: How to Read my MRI... do I have ACL tear?
« Reply #3 on: December 26, 2010, 04:40:58 AM »
Thanks to both of you.  It's just so frustrating to wait.  Looks to me like an ACL tear b/c I see no "black line" there, whereas I can see it for the PCL.  Plus, I feel pretty unstable - like when I straighten my leg it hyperextends.  But, I'm not sure if it is a T1 or T2 MRI. 

Offline chiguina

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Re: How to Read my MRI... do I have ACL tear?
« Reply #4 on: December 26, 2010, 04:45:07 AM »
I had ACL repair 10 yrs ago using hamstring.  If I do need ACL repair, what are people using these days? 

What do you suggest? 

Offline soozles

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Re: How to Read my MRI... do I have ACL tear?
« Reply #5 on: December 26, 2010, 05:37:12 AM »
Thanks to both of you.  It's just so frustrating to wait.  Looks to me like an ACL tear b/c I see no "black line" there, whereas I can see it for the PCL.  Plus, I feel pretty unstable - like when I straighten my leg it hyperextends.  But, I'm not sure if it is a T1 or T2 MRI. 

Just for information sake, T1 and T2 relates to something... I forget exactly what because I just came back from a birthday party that involved quite a lot of wine. But T2 is usually better at seeing abnormal signals, tears, bruises, fat, etc. whereas T1 is better for looking at the normal anatomy. The MRI does both, and the radiologist reads both to see what's going on. Anyways, MRI's are big confusing machines and trying to interpret on your own is not likely going to be very fruitful. But if you have nothing else to do, and you're just looking for one particular thing, then you may be able to kinda guess by looking at other images, but I wouldn't put much faith into that kind of reading. When I got my MRI images, I already knew the results so then it was easier to see where the tear was, but I don't know if i would have been able to pick it out on my own.
May 2005: Torn PCL, misdiagnosed as chondromalacia
April 2010: pain worse, lots of instability
Nov. 23, 2010: PCL reconstruction
progress here: http://pclrecovery.blogspot.com/

Offline Snowy

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Re: How to Read my MRI... do I have ACL tear?
« Reply #6 on: December 26, 2010, 07:57:20 AM »
These days you have a choice of four main options: hamstring or patellar tendon autograft, allograft (donor graft) or LARS (synthetic graft). There are pros and cons for all four options, and the end decision will lie with your own preference and your surgeon's recommendation. There's a ton of info about all four on the information hub, but here's a really quick and dirty summary of the pros and cons.

Patellar tendon graft: generally considered to be the strongest, and has a faster healing time due to bone-on-bone fixation. Higher risk of long term problems at the donor site, and not a good choice for anyone with existing patellar tracking problems or pain.

Hamstring: strength of the final graft is also good, and less donor site morbidity. Offers a longer graft than the patellar tendon. Difficult to regain full hamstring strength and function, although studies show that it does get there eventually.

Allograft: no donor site morbidity or short-term healing. Takes longer for the graft to gain full strength, and there's a small risk of infection.

LARS: much faster healing time and return to activity. No long-term data on how the grafts react over time (previous generations of synthetic grafts have not done well, though early signs are that LARS are doing better) and the need for larger bone tunnels makes revision harder if the graft fails.

As you can see, there are strong pros and cons for every type of graft. My surgeon recommended hamstring for me, which I think was a good choice. Existing patellar issues ruled out the patellar tendon graft, I didn't want the longer healing time associated with an allograft, and although LARS was really tempting I wasn't comfortable with the lack of long-term data.

If you do need a reconstruction (and I do hope you don't), talk to your surgeon about options first and foremost. It's a tough decision, but also a very personal one.
Mar 11: R Biceps femoris tear (skiing)
Jul 10: ACLr (hamstring autograft)
Mar 10: L ACL rupture (skiing)
Feb 06: L partial ACL tear (kickboxing)
Dec 03: R bone edema (motorbike)
Jan 01: R patellar chip (motorbike)
May 93: R ACL sprain (hockey)
Ongoing: bilateral PFS and OA















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