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Author Topic: UPDATE: My MRI actually shows a bone bruise with osteophytes - anyone had this?  (Read 4279 times)

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Offline runner7

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UPDATE: See my new post at the bottom


Healthy cartilage?

(Click on the images to see them bigger.)

I was wondering if anyone here who has this issue or is adept at reading MRIs could tell me if the first image shows osteophytes (bone spurs)?  I am a 20 year old college distance runner, and my doctor diagnosed my condition as Chondromalaica with presence of osteophytes in both knees.  I have been looking at my MRI scans for a while on my own now, and just recently noticed the difference indicated by the red arrows in the first picture when compared to an MRI of a healthy knee.

All this time, I had been thinking Chondromalacia referred to degraded articular cartilage (behind the kneecap), however, I believe my articular cartilage appears rather healthy, and even thicker than the reference MRI I was comparing it to.  Can anyone confirm this?  It's indicated by the second image above.  Also, the pain that I get does not occur directly behind the kneecap, but rather below it and toward the inside of my knee, and only when bending my legs (as in going up or down stairs).  I believe this coincides with the location of the "osteophytes" on the MRI, as it looks like when the knee is bent about 30 degrees, the osteophytes will line up in the center, thus putting the most stress on them at that position.

However, I have to question the Chondromalacia diagnosis.  As far as I can tell, my cartilage is not thinner in any locations than the cartilage on the reference MRI.  Unless I'm missing something, I'm not so sure that I have this?  And two other reasons I'm not so sure that I have it:

  • My injury came on very suddenly after jumping into 3 speed workouts in one week after a long period of inactivity (due to being sick).  But from what I've read, Chondromalacia comes about with a gradual thinning of the cartilage and a gradual onset of pain, while bone spurs can come on fairly suddenly (not positive)?
  • I believe it is difficult for most people with Chondromalacia to bicycle.  However, even when I am in intense pain walking, I have no trouble cycling whatsoever.  I assume that with Chondromalacia, the worn cartilage would expose the femur and the fibula to each other, causing pain as they rub past each other.  However, with bone spurs, under a non impact movement, there will be no pain as the cartilage smoothly slides past.  (That's my theory anyway.)

And one last thing -- The osteophytes themselves seem to be covered with a layer of cartilage.  I'm not entirely sure what this means... anyone know?

Thank you!
« Last Edit: June 03, 2011, 05:51:43 AM by runner7 »

Offline Kimberly 77

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Re: Does my MRI show osteophytes (or Chondromalacia)?
« Reply #1 on: March 25, 2011, 03:29:29 PM »
I can't read your mri report but I can tell you that cartilage pain can come on suddenly. A week before this happening to me I was at a Huge Zoo and walked the thing 3 times and then went to another amusement park the next day, no pain in my knee at all. Then a week later sitting in the floor in my bedroom, I stood up using just my knee and something popped and then the pain came. I haven't been pain free since and that was a little over a year ago and 2 surgeries later. I have grade 3 defects.
Right leg amputee.
Osteoarthritis in left knee.
Medial femoral condyle defect, arthoscopy 8-2-10
Grade 3 defects, patella, medial femoral condyle, tibia scoped1-12-2011
Physical theraphy and awaiting microfrature 2-1-12

Offline runner7

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Re: Does my MRI show osteophytes (or Chondromalacia)?
« Reply #2 on: June 03, 2011, 05:47:31 AM »
Okay, so I was all ready to give in to arthroscopic surgery, and I went to see a good orthopedic surgeon.  He took one look at the MRI and said Chondromalacia was not the correct diagnosis (which I pretty much figured all along).  This also explains why the cortisone and Synvisc shots did absolutely nothing.

On that first image I posted above, he said that those white specks inside the bone represented a deep bone bruise, and he said this would eventually heal, although he said it could take anywhere from months to years.  I would agree with this.  He didn't say too much about the osteophytes (the black specks inside the cartilage), although he did comment that they were beneath the (healthy) cartilage so they would be very difficult to remove arthroscopically.

I do think my bone bruise will eventually heal, but I am actually concerned more about those osteophytes.  From what I've read online, they don't spontaneously go away.  And I am pretty sure they are the problem that is causing my pain, as I suppose they are impinging on some nerve in some way.

So now the question becomes... has anyone had osteophytes?  Did they ever go away for you?

« Last Edit: June 03, 2011, 05:52:58 AM by runner7 »

Offline runner7

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Just bumping this to see if anyone new to the forums has advice.

Offline mommyvix30

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Good Morning...I actually have almost the exact same thing in 07 I had arthorscopy for minscus tear and lateral release. Now around April I started having severe pain in the same knee with no injury. I had an MRI in May that showed bone bruise on the tibal plateau and the distal metaphysis the Ortho has no explination for why they are there since I did not fall on my knee or anything, I also have chondromalcia. But, basically they gave me a cortizone shot which didn't do anything and perscribed PT w/ a tens unit for home use which has also done nothing. The ortho wants me to have a bone scan to check the bruises to see if it is possibly bone cancer, even though he says since I'm only 30 I'm a little young for anything like that. My knee actually POPS and it's loud when it happens and when I walk my knee cap catches very weird feeling but since the MRI doesn't show a tear the OS is just kinda like eh I dunno. I def feel your pain and wish you the best of luck I am seeing 2 sep. OS hoping that one of them will figure it out. Neither has sugested another surgery yet. I go see my 1st OS today so well see what he has to say.
02/2007 - Lft knee pain started
05/2007 - arthoscopy bilateral minscus tear and later release
02/2011 - reoccuring lft knee pain
05/2011 - MRI - shows bone bruising, no tears
06/2011 - Bone Scan Result Normal
07/11/2011 - OS apointment
07/18/2011 - surgery left knee LRR, bone shave, and repair