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  #1  
Old 05-02-2012, 10:45 PM
HotDogWater HotDogWater is offline
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Please translate this MRI report

We've gotten the MRI report, but don't see the ortho guy for a week. Can someone please tell us what this means?

"There is a mild lateral patella tilt with mild patella alta. There is mild edema identified within Hoffa"s fat pad immediately adjacent to the lateral patellar facet concerning for anterolateral fat impingement. There is mild edema seen superficial and slightly inferior to the lateral patellar retinaculum at its patellar attachment. The patellar and femoral trochlea anticular cartilage are maintained.

There is partial fusion of the proximal tibial physis.

The medial meniscus and medial joint compartment articular cartilage are maintained.

The lateral meniscus and lateral joint compartment articular cartilage are maintained.

Ligaments and tendons are intact.

There is a minimal joint effusion without discrete loose body formation identified.

IMPRESSION:
1. Mild edema identified within Hoffa"s fat pad immediately adjacent to the lateral patellar facet concerning for anterolateral fat impingement possibly secondary to the altered patellar tracking.
2. No discrete meniscal, ligament or tendon tear.
3. Mininal joint effusion."
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  #2  
Old 05-02-2012, 10:56 PM
VOW VOW is offline
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IANAD, but the kneecap seems to be slightly out of place, there is some swelling, but nothing major is busted up.


~VOW
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  #3  
Old 05-02-2012, 11:02 PM
aruvqan aruvqan is offline
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The fat pad is slightly swollen, and is slightly protruding into a space where it is not normally present [impingement translates to intruding into a space where it is not normally found.] So far nothing is seriously out of whack, but it can obviously get worse. It can be painful.

Something obviously needs to be done soonish because the kneecap is getting out of whack.

This link about injuries to the Hoffa's Fat Pad may help. Probably the doc will try physiotherapy first, with NSAIDs and wrapping to support the knee while healing. If that doesn't work, then possible surgery. Typically if the injury is not that serious and you get to it fast enough you can avoid the knife.
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Old 05-02-2012, 11:34 PM
Colibri Colibri is online now
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Medical advice is best suited to IMHO.

Colibri
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  #5  
Old 05-03-2012, 05:29 AM
isaiahrobinson isaiahrobinson is offline
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I'm no doctor but I've read my own MRIs before, and you can get a basic read of it yourself if you know a few of the terms: the "patella" is the kneecap. "Edema" means bruising. "Meniscus" would be called cartilage in layman's terms, essentially it's just another type of cartilage. "Hoffa's fat pad" is literally just a little pad of fat underneath the kneecap. The "physis" is the bit at the end of a bone. The "femur" is the big thigh bone and the "tibia" is one of the two big bones running down the shin. "Joint effusion" means more fluid in the joint than usual.

So as it sounds to me:

1. The kneecap is tilting slightly.
2. The fat pad and a couple of other small structures are showing mild bruising, possibly caused by the tilting of the kneecap.
3. All the cartilage, tendons and ligaments are appearing normal on the scan.
4. There's slightly more fluid in the joint than usual.
5. The end of the shin bone looks "partially fused" - I don't know what that means but it doesn't sound too serious given they haven't mentioned it in the "impression" at the end.

So as VOW said, it sounds to my non-medical ears like the basic situation is that the kneecap is tracking slightly wrong causing a bit of bruising. I had that suspected before and apparently the first course of action is usually to try and solve it with exercises and taping the kneecap in place to force it to track better. (Bear in mind the MRI scans don't always show everything, and that the guys reading it can often get it wrong because they haven't had a chance to examine you, so it's fairly common for ortho's to draw a different conclusion when they read the scan themselves.)

Last edited by isaiahrobinson; 05-03-2012 at 05:34 AM..
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Old 05-03-2012, 05:44 AM
isaiahrobinson isaiahrobinson is offline
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Just another note on the terminology: words like "lateral", "anterolateral", "medial", "proximal", "superficial" and "inferior" are all just spatial descriptions. Superficial means above and inferior means below, for instance. They're useful to allow doctors to locate the parts of the knee the MRI is talking about, or which direction something is moving, but for your purposes in reading the MRI you can basically ignore them.

Last edited by isaiahrobinson; 05-03-2012 at 05:46 AM..
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  #7  
Old 05-03-2012, 05:48 AM
isaiahrobinson isaiahrobinson is offline
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"Patella retinaculum" is a band of connective tissue that attaches to the kneecap.

Last edited by isaiahrobinson; 05-03-2012 at 05:49 AM..
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  #8  
Old 05-03-2012, 06:55 AM
Antigen Antigen is offline
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Quote:
Originally Posted by isaiahrobinson View Post
I'm no doctor but I've read my own MRIs before, and you can get a basic read of it yourself if you know a few of the terms: the "patella" is the kneecap. "Edema" means bruising. "Meniscus" would be called cartilage in layman's terms, essentially it's just another type of cartilage. "Hoffa's fat pad" is literally just a little pad of fat underneath the kneecap. The "physis" is the bit at the end of a bone. The "femur" is the big thigh bone and the "tibia" is one of the two big bones running down the shin. "Joint effusion" means more fluid in the joint than usual.
Edema means swelling, not bruising.
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  #9  
Old 05-03-2012, 08:30 AM
Jackmannii Jackmannii is offline
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I'm not an orthopod, but the report sounds like an effusion of terminology that boils down to "nothing seriously out of whack, surgery not indicated for now".

Subject to confirmation of course by the ortho guy, who may or may not agree with what the radiologist said (clinicians often fancy themselves better able to read imaging studies better than the radiologist, although in my experience they are typically only good at spotting errors long after the fact).
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  #10  
Old 05-03-2012, 09:14 AM
Chessic Sense Chessic Sense is offline
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"The kneecap is kinda tilted sideways and a little higher than normal. There is mild swelling under the cap right by the side edge, so it could be hitting the fat there. There is mild swelling seen toward the skin and slightly below where a tendon connects to the cap. The cartilage there is OK, though.

There is partial fusion of the shin's growth plate.

Ligaments and tendons and cartilage all look fine.

There's only a little swelling and nothing's floating around broken in there.

IMPRESSION:
1. There's some swelling on the side of the kneecap where it got dislocated.
2. Nothing is torn.
3. The joint space itself is a little swollen."

Last edited by Chessic Sense; 05-03-2012 at 09:15 AM..
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  #11  
Old 05-03-2012, 10:15 AM
HotDogWater HotDogWater is offline
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I go to bed with confusion and wake up to information. Thanks Dopers!!
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  #12  
Old 05-03-2012, 12:28 PM
dngnb8 dngnb8 is offline
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Quote:
Originally Posted by HotDogWater View Post
I go to bed with confusion and wake up to information. Thanks Dopers!!
This is good. Some go to bed with dope and wake up with confusion.
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  #13  
Old 05-03-2012, 07:14 PM
isaiahrobinson isaiahrobinson is offline
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Quote:
Originally Posted by Jackmannii View Post
Subject to confirmation of course by the ortho guy, who may or may not agree with what the radiologist said (clinicians often fancy themselves better able to read imaging studies better than the radiologist, although in my experience they are typically only good at spotting errors long after the fact).
I had an MRI scan once which found a "tear in the meniscus" in the knee. I mentioned the report to one of the top consultants in my area before he'd read the scan himself and he basically cut me off, noting how frequently he finds the radiologists get it wrong. He was pretty scornful about them. He looked at the scan and said "that isn't a tear". He then examined me for 5 minutes and said, "it definitely isn't a tear". I was a bit sceptical of how certain he was but sure enough, it wasn't a tear and it healed on its own.

That's not necessarily a slight on radiologists; they have to look blind at a scan, without getting to examine the patient (or even see details about the patient's age, physiology or history, as far as I'm aware?), which can't make a diagnosis very easy. But this consultant spotted the radiologist's error (literally) instantly and it was clear from his demeanor that it happens a lot.
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