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Author Topic: MRI scans  (Read 1568 times)

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Offline gh05

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MRI scans
« on: February 18, 2013, 07:07:35 PM »
Just wondering what peoples opinions are on the reliability of MRI scans for detecting degeneration to the cartilage behind the kneecap.

Would a typical 1.5T MRI scanner pick up anything?   

I've had three different diagnosis now.  One doctor saying I have degeneration, one saying I don't and one sitting on the fence.  I've been sent for an Xray (for completeness apparently) but the results haven't come back yet.

The first doctor told me that an MRI wouldn't show changes and that an arthroscopy was the only way but not recommended (instead I should become quite inactive).  The second and third doctors told me to do what I like but one of them said that there was no point in an MRI because he didn't think there would be any damage showing.

I still just want to know what state my knee is really in...

Offline vickster

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Re: MRI scans
« Reply #1 on: February 18, 2013, 07:36:53 PM »
My first 1.5T MRI scan showed my meniscus tear, an osteochondral defect on my lateral femoral condyle (1.5cm2) and lots of femoral bone bruising.  This is what my OS told me, but I never saw the full report

When the knee was scoped 4 months after that (to deal with mechanical issues caused by the meniscus tear and possibly to microfracture the defect), I was found to have grade III on the lateral facet of my patella and grade 1-2 on the tibia.  People do seem to get diagnoses of patella cartilage degeneration on the basis of MRI.

Can you pay to be scanned on a higher specced scanner (or get a CT scan).  My OS told me the other week that bony issues do not show up as clearly on MR scans in his experience as on X Ray.  But we weren't looking specifically at the patella but more the other bones amd the joint space.

What are you hoping for as an outcome of confirming a diagnosis of cartilage damage to the patella - it is unfortunately very hard to fix (due to the shearing forces to the patella) and often modifying activity is the way to help the symptoms.  That said, my grade III was tidied up and when the knee was scoped again 9 months later, the patella was in good condition.

I personally wouldn't have a scope purely for the purpose of diagnosing something that isn't easy to repair
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline gh05

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Re: MRI scans
« Reply #2 on: February 19, 2013, 02:13:23 PM »
My first 1.5T MRI scan showed my meniscus tear, an osteochondral defect on my lateral femoral condyle (1.5cm2) and lots of femoral bone bruising.  This is what my OS told me, but I never saw the full report

When the knee was scoped 4 months after that (to deal with mechanical issues caused by the meniscus tear and possibly to microfracture the defect), I was found to have grade III on the lateral facet of my patella and grade 1-2 on the tibia.  People do seem to get diagnoses of patella cartilage degeneration on the basis of MRI.

Can you pay to be scanned on a higher specced scanner (or get a CT scan).  My OS told me the other week that bony issues do not show up as clearly on MR scans in his experience as on X Ray.  But we weren't looking specifically at the patella but more the other bones amd the joint space.

What are you hoping for as an outcome of confirming a diagnosis of cartilage damage to the patella - it is unfortunately very hard to fix (due to the shearing forces to the patella) and often modifying activity is the way to help the symptoms.  That said, my grade III was tidied up and when the knee was scoped again 9 months later, the patella was in good condition.

I personally wouldn't have a scope purely for the purpose of diagnosing something that isn't easy to repair

Thanks for the reply. 

I know how hard it is to fix but I'm keen to get a better idea of what the problem is so that I know just how much to reduce my activity levels - because I have been given such different diagnoses.  If like the one doctor said, i have very little cartilage damage then I'd want to get back into playing sport/running (obviously with a bit more care than in the past), but if i do have actual degeneration/de lamination of the joint then I want to be sensible to avoid having real problems in future.
 
I asked the one surgeon about MRI scanners and he said he only knew of 1.5T scanners in Wales (where I'm at) but I don't know about others - or even how i'd be referred for one now.  This is the surgeon who expected an MRI to show my cartilage as normal.  He doesn't believe crepitus is a sign of arthritis.. :-\

Offline vickster

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Re: MRI scans
« Reply #3 on: February 19, 2013, 02:59:29 PM »
I believe bupa has self pay scanning centres. Have a Google. If in S Wales I guess you could go to Bristol or N Wales, Chester or Liverpool for example

Here is a Tesla 3.0 scanner in Cheltenham - to have a knee scanned it says it  costs 228 with the rad report  http://www.gosalkneeclinic.co.uk/services/diagnostic-services/index.html
http://www.cobalthealth.co.uk/diagnostic-scans/patient-info/mri/pricing.aspx

Specialists have very different views on what exercise is good or bad for knees. You could perhaps pay to consult a sports physio or physician

Good luck
« Last Edit: February 19, 2013, 06:44:26 PM by Vickster »
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline kimb

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Re: MRI scans
« Reply #4 on: February 19, 2013, 04:23:59 PM »
They were able to correctly diagnose my chondromalacia with MRI, and it was confirmed when I had surgery. The MRI report was 100% what the surgeon found. I'm not sure if this is exactly what you were asking though, as I think chondromalacia is more the softening of the cartilage. They were able to tell on MRI to what degree (how thick) the chondromalacia was and everything. However, I did lose a chunk of cartilage off the back of the kneecap due to injury and while they saw that in the MRI, they did not know it came from the kneecap until they did the surgery.

Offline gh05

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Re: MRI scans
« Reply #5 on: February 21, 2013, 12:20:24 PM »
I believe bupa has self pay scanning centres. Have a Google. If in S Wales I guess you could go to Bristol or N Wales, Chester or Liverpool for example

Here is a Tesla 3.0 scanner in Cheltenham - to have a knee scanned it says it  costs 228 with the rad report  http://www.gosalkneeclinic.co.uk/services/diagnostic-services/index.html
http://www.cobalthealth.co.uk/diagnostic-scans/patient-info/mri/pricing.aspx

Specialists have very different views on what exercise is good or bad for knees. You could perhaps pay to consult a sports physio or physician

Good luck

Thanks very much for this.

For anyone who is interested, this study compares the accuray of 3T v 1.5T mri scans of the knee:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2704948/

Seems that the differences are not huge but can be significant.  Also, I read a study that concluded the accuracy of the scans are still only between 45 and 70% compared to what is found in an arthroscopy - so they can give a good indicator is something is obviously wrong but quite often miss things too.















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