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Author Topic: New Here- MRI showed no meniscal tears, but I feel there is one!  (Read 1970 times)

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Offline cindjo

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New Here- MRI showed no meniscal tears, but I feel there is one!
« on: February 20, 2015, 05:47:34 PM »
Hi All-  I hope I am posting this in an appropriate place on this forum since I am new here! 
I am a 40 year old active female who has on and off again knee pain from playing racquetball.  In the past when me knee would act up,  I would Ice, elevate and rest it for a few days and off I would go.  Well, a little month and a half ago after a long weekend of racquetball tournaments I found my knee to be swollen (almost three times normal) and red, hot and painful.  Almost unable to walk on it.  I went to the dr. who was unable to do a physical examination due to the swelling but because of some tell-tale pops he suspected torn meniscus and ordered X-Ray and Ortho consult.  It took almost 2 weeks for the swelling to go down during which I was mostly walking with crutches, and I truly thought all the pain I was having was from the swelling, but after the swelling went down I was still having lots of pain.  Straight, flat walking is not painful, but stepping up or down is excruciating, and if I have been sitting and go to stand, my knee "catches" and it take a bit to straighten it out and that first step is pretty painful.  I cannot squat or lunge and stairs are the worst.  Ok-  so I have since had an MRI,  and was sent the results which showed no definite tear, but intrasubstance degenerating in the posterior horn on the lateral meniscus,  and patellofemoral DJD.  Unsure what these mean,  but the MRI report looked to say that it was negative for damage.  I have my follow up apt with the OS in 3 weeks-  so I am anxious to hear from anyone that might know if a meniscal tear could be missed or if the other things found could be the cause of the pain.   Very antsy as going for nearly 6 weeks unable to work out because of pain is very disconcerting for me-  I have played through various injuries in the past and it seems crazy to me that for the pain I am in that some sort of damage, tear, or rupture was not immediately apparent on the MRI.  Any thoughts would be appreciated!

Offline vickster

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Re: New Here- MRI showed no meniscal tears, but I feel there is one!
« Reply #1 on: February 20, 2015, 06:24:01 PM »
As someone with degenerative lateral tears, I am assuming that's what they mean. The meniscus us fraying or deteriorating, which happens with age (30 onwards) rather than a clear traumatic tear. If the meniscus is in that state, it takes little if anything  to cause damage

If it's causing you pain and mechanical issues, keyhole surgery to trim away the damaged bit is likely your only option if physiotherapy doesn't help. Unfortunately, the trimming of the meniscus usually leads to arthritis down the road. In the meantime, you'd be best to avoid any activity that aggravates it

There's a good meniscus primer and video in time information hub

I'm assuming patello femoral DJD means there's some evidence of damage to the articular cartilage on the bones in that compartment of the knee which might need a tidy up as could be the source of the catching with the knee bent? Google suggests DJD is degenerative joint disease, aka arthritis. Unfortunately, all of this is quite common ironically if active

Good luck :)
« Last Edit: February 20, 2015, 06:48:14 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 MDAL

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Re: New Here- MRI showed no meniscal tears, but I feel there is one!
« Reply #2 on: February 20, 2015, 08:19:00 PM »
Cindjo:

This is a very old story... MRIs skip in average 25% of meniscus tears that are indeed found in surgery... mostly because it's a cloudy image that relies on a lot of interpretation...

I could relate to the symptoms you describe and it was indeed a meniscus tear. But knees are tricky, could be many other things, it's hard to tell.

Aside this, we need to have in account that you don't need a lot of damage to have a lot of pain. The opposite is also true, people with a lot of damage can also live with very little pain.

It is an inflammatory condition... things that are wrong inside the joint emit signals that trigger the inflammatory process all around and make the nervous system go hysterical and make every step hurt... So in fact all you need is some little damage to trigger the pain (superficial chondromalacia for example) can be a torture for some, while the amount of actual damage could be minimum.


Offline cindjo

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Re: New Here- MRI showed no meniscal tears, but I feel there is one!
« Reply #3 on: February 20, 2015, 08:42:19 PM »
Thank you both for your insight,  that does help me!   I was feeling like because of the results of MRI I would not be a candidate for surgery-  while scary,  I had decided in my mind that it was what I needed to fix the problem so I could move on with my life with less pain!  It is just hard to wait so long for a consult to help me decifer the MRI results and help plan a course of action!  I guess I need more patience!  Thank you again for your time and input!

Offline vickster

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Re: New Here- MRI showed no meniscal tears, but I feel there is one!
« Reply #4 on: February 20, 2015, 11:50:24 PM »
Best to discuss surgery with the surgeon. It should really be a last resort in elective cases after conservative measures including physio, injections etc have failed. There are risks, and if the meniscus is degenerate as it seems, you will be at risk of more tears after surgery...which in turn will likely lead to more arthritis.

Don't rush into surgery, although if it's been 6 weeks and getting worse it might be needed. Make sure you are confident in the skills of the surgeon too as a knee specialist and have a good physio lined up for the post op rehab
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 MDAL

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Re: New Here- MRI showed no meniscal tears, but I feel there is one!
« Reply #5 on: February 21, 2015, 04:33:42 PM »
Yes, be careful with surgery and please read all the comments of people who did it.

It's like flipping a coin, some folks get better, some folks get worse, but even those who do get better, in the end will have far less cartilage and meniscus left and new tears may also come after the clean up...

If you have PRP in your area I would suggest attempting a few of those before rushing into surgery.