What Do These Following MRI And X-rays Findings Indicate?

Posted on Sun, 11 Dec 2016

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Sun, 11 Dec 2016 Answered on

Mon, 2 Jan 2017 Last reviewed on

Question : Good day doctor

Patient XXXX was involved in an accident, 17 Nov, 2016 with injuries including broken left fibula. An MRI was performed Fri, 09 Dec, 2016 for detailed assessment of injury to knee region.

3 X-Rays from the first 2 weeks of fibula following injury uploaded to Google Drive:
1. https://drive.google.com/open?id=0B90glucIcidFa3p2TDgyWlVFSjA (17 Nov)
2. https://drive.google.com/open?id=0B90glucIcidFVUlWTFBvQkIyTFk (25 Nov)
3. https://drive.google.com/open?id=0B90glucIcidFTDRqR0RPX2pJSTA (02 Dec)

MRI from 9 Dec uploaded to Google Drive:
4. https://drive.google.com/open?id=0B90glucIcidFLS1ReUo2Ym9EQVE (09 Dec), with Hospital assessment.

Google Drive DICOM folders have both ZIP, plus the extracted DICOM files to choose from for download.

Patient feedback:

* Foot and knee are swollen.
* Mild bearable discomfort.
* Range of motion ~20-30 degrees.

1. Does your evaluation of the MRI concur with Hospital findings (if not, what is omitted and / or additional comments)?
2. What does the MRI translate to, in simple terms, to the patient?
3. What are the possible paths / timelines to recovery (surgery, physiotherapy, nutrition, exercises)?

XXXX

Answered by Dr. Aashish Raghu (-5 hours later)

Brief Answer:
Only 3 images received. Please contact Healthcare Magic team to upload other images.

Detailed Answer:
Hi XXXX.

Thanks for the query.

I have viewed 3 of images which were provided to me by the Healthcare Magic team. You can send remaining reports at YYYY@YYYY and address it to my name: Dr Aashish Raghu.

I was able to see the fracture of the posterolateral region of the proximal tibia, head and neck of fibula and shaft of fibula.

The MRI findings in the Hospital assessment is true except for the fact that there is also a fracture of the shaft of the fibula at the proximal third and middle third junction which may have not been visualised in the MRI scan due to far proximity of the fracture from the knee, if they had only done the knee MRI.

I would advocate the use of a thigh to groin cast to heal the tibia and proximal fibula fracture. Surgery may also be done by the use of buttress plate and screws.

The recovery time to walking with full weight bearing could take about 3 to 4 months till the fracture heals well.
Physiotherapy is required to treat the ACL ligament sprain.

MRI shows the incomplete fracture lines in the upper part of the bones of the leg (tibia and fibula) as well as sprain of one of the key knee ligaments(ACL) and a ruptured cyst at the back of the knee, such is usually seen in knees with arthritis.

Baker's cyst has ruptured, which may be another reason for the pain and swelling in the leg and must be watched carefully to prevent complications like Compartment syndrome.

Do perform limb elevation, active movement of the foot and ankle, application of ice.

I hope I have answered your query.

I will be available to answer your follow up queries.

Thanks and regards.

Dr. Aashish Raghu

Above answer was peer-reviewed by : Dr. Vaishalee Punj