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What Do These Following MRI Findings Indicate?

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Posted on Thu, 16 Feb 2017
Question: Hi ... I had a surgery on my knee due to cartilage defects on november 2015 and till now after the surgery and I can't still run .... and I cant land on my right knee when i jump because its still going to be painful, some Doctors checked and cant seems to find the problem after the results of MRI test on after surgery, I want to know if there is anyway you guys can help me because I really wanna start walking properly and running


BEfore Sugery MRI results

configuration and location of the femoral tibial bone patella is not changed. Pathological hiperintensyvnyy MP signal to PDfs received bone marrow from the front boundary vidlyyiv medial femoral condyle at which vyznachastsya usurpation cortical layer articular cartilage potonshenyyz signs of integrity in thickness. Subchondral sclerosis of the bone marrow stemovoyi. VelykohoM1LKOVOI bones. On top of medial distal femur metadafizu ekzostoz to 0,8cm without peri focal articular cartilage changes (elbow, femoral condyle, tibia plateau) uniformly reduced thickness characteristics symalu modified circuit articular cartilage surface currents clear. The height of the joint space decreased slightly. The medial and lateral menisci triangular shape. Patolo?ichnyh change the structure of the lateral meniscus were found. The medial meniscus with signs of degenerative changes at the posterior horn front, rear cruciate: location, # of continuity HTensyv He ZM1HeNi signal. Collateral ligament, patellar ligament own: the location of continuity signal intensity is not changed. From patella holders received homogeneous, hipointensyvnyy signal mode PDfs. course, the contour of the intra not changed in suprapatelyarniy seminary small amount of free fluid. At the level of the medial femoral condyle and tibial bones, tendons between head of the gastrocnemius and medlalnoyi napivperetynchastoho M ulcers detected irregular cystic formation which is associated issuhlobovoyu cavity, with clear contours, size 41, 3x8,8x8,0mm Conclusion: MR signs of damage to the medial condyle osteohondralnoho femur, degenerative changes in the posterior horn of the medial meniscus and cartilage, synovitis, popliteal Baker right knee ekocrozu metadiafisu distal femur.







After surgery MRI results ....

In subhondralnyh parts of the medial femoral condyle determined Mr. bone marrow, increased signal at 72 and STIR, low on T1. The rest promry MP signal from the bone marrow of bones suhloboutvoryuyuchyh typical, relatively at worinyy. Coating thickness articular cartilage retained, the signal is not changed - vzaemorozmischennya bones in the joint and joint kon?ruentnist rhon preserved articular cavity is symmetric, height saved. The shape, size and position have not changed it kneecap natelo-femoralnyy gap in the medial part of the thigh and Petynakulom m'yay own ligament intact, harakternoro vidkosno odnoridnoro ripointensyvnoho signal in all PLAYBACK cruciate ligament have saved a typical course and natya fibers characteristic hinointensyvnoho signal in all sequences nerednya-bit heterogeneous due to degenerative changes neznawnh Kolateral ties 1ntakTH1-meniscus shape and size saved harakternoromointensyvnoho signal in all sequences breathes neodnorlyy the structure back pir medial meniscus due to degenerative changes in articular, articular bag and its twisting sposterihastsya synovial rLyna in moderation, uniform 72 not thickened synovium. Conclusion clinically significant traumatic knee injuries are not found in the right. Symptoms of moderate-patelo femoralnoho osteoarthritis. Subchondral bone marrow edema of the medial you sprout stehyovoyi bone moderate degenerative changes in the medial meniscus and anterior cruciate ligament medicament


pain when walking sometimes and when declining stair case I sometimes get almost twisted on my right leg like falling down
doctor
Answered by Dr. Mahaveer Patil (30 minutes later)
Brief Answer:
need another surgery

Detailed Answer:
Hi Mr. XXXXXXX

Thank you for posting the question.

I have gone through your medical history in detail.I have noted the important findings in both the MRIs and presently,i feel that pain and instability in your knee is typically due to an injury to anterior cruciate ligament.

I am sorry,but you will need another knee surgery for Anterior cruciate ligament reconstruction.

Once this ligament is reconstructed ,the twisting instability and the pain will reduce to significant extent.

However,some pain may still remain even after the surgery due to the cartilage and meniscal degeneration.

The surgery should be done by arthoscopic means (through a camera ).

Aggressive physiotherapy and knee strengthening exercises after surgery will help building up the strength around the knee.

I hope the answer was useful.

Feel free to ask me any follow up queries that you may have.

Thank you.
Kind regards.

Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Mahaveer Patil (3 hours later)
another doctor wrote me this, how true is this or what do you think ?

The results of two MRI show somewhat different areas of concern.

The earlier MRI mainly showed a defect in medial femoral condyle which which seems to have been filled up by cartilage repair .Some edema in underlying bone still persists and may be causing the pain to an extent.

The new MRI shows changes of moderate patello femoral arthritis and that may be responsible for your present pain.

Greater stress is placed on patello femoral compartment when using stairs and that may be responsible for the problem while using stairs.

Therefore though surgery seems to have worked the newer degenerative changes may be causing symptoms.

Therefore you may be helped to some extent by using supplements like glucosamine and rosehip extract.

There is no curative treatment of osteoarthritis as degeneration cannot be reversed.

Having regular exercise to strengthen the muscles controlling motion about knee namely quadriceps, hamstrings would also help.

Feel free to ask any follow up questions .

If not , do remember to rate my answer as this is the only way we get assessed and paid for our work and time on this website.



As per the newton's law " every action has equal and opposite reaction".Therefore when you run on a hard surface like a road the knees are subjected to a much greater stress because every time your foot hits the road the hard surface rather than dissipating that force sends that force back through your knee.On the other hand the treadmill absorbs a part of the force on every impact.

Your knee is not in it's prime.It shows changes of ostaoarthritis which is also known as degenerative joint disease.You have to accept that fact and modify your activity accordingly.

If you do not do that your knee is going to have a shorter natural life than it should have otherwise.

I understand that this may not be what you expected to hear from me but I have to tell you complete truth and be ethical in my answer.I hope you would not hold that against me while rating the answer.
doctor
Answered by Dr. Mahaveer Patil (8 minutes later)
Brief Answer:
Query answered

Detailed Answer:
Hi Mr XXXXXXX

I do agree with the above answers given by my colleagues.

"However,some pain may still remain even after the surgery due to the cartilage and meniscal degeneration"- This is what i mentioned in my original answer. This in other words means degenerative joint disease or arthritis.

As far as i see,this explains only "pain" part of your symptoms.
The "instability" part feels important to me that is why i have stressed more on this in my answer.

If instability is left untreated,the arthritis will deteriorate very fast and thats why it needs to be adressed first.

Thank you.
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
Answered by
Dr.
Dr. Mahaveer Patil

Orthopaedic Surgeon

Practicing since :2002

Answered : 1209 Questions

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What Do These Following MRI Findings Indicate?

Brief Answer: need another surgery Detailed Answer: Hi Mr. XXXXXXX Thank you for posting the question. I have gone through your medical history in detail.I have noted the important findings in both the MRIs and presently,i feel that pain and instability in your knee is typically due to an injury to anterior cruciate ligament. I am sorry,but you will need another knee surgery for Anterior cruciate ligament reconstruction. Once this ligament is reconstructed ,the twisting instability and the pain will reduce to significant extent. However,some pain may still remain even after the surgery due to the cartilage and meniscal degeneration. The surgery should be done by arthoscopic means (through a camera ). Aggressive physiotherapy and knee strengthening exercises after surgery will help building up the strength around the knee. I hope the answer was useful. Feel free to ask me any follow up queries that you may have. Thank you. Kind regards.