Need help with MRI report...

In My Humble Opinion (IMHO)
#1

Hello and thanks for reading this. I had an MRI done and the report came back with more than I can digest properly. I did read it in many times and still am getting lost in it. Any help would be great. The doctor is on vacation so I am on limbo until he comes back. Any help with this would be great.

Impression:

  1. Status post osteochondral implant repair of the extension surface of the lateral femoral condyle. 0.2 em depression along the anterior border of the graft.
    Minimally displaced old fracture site extending superiorly into the metaphysis.
  2. Small anterior horn of the lateral meniscus either related to resection or
    degenerative change.
  3. Degenerative joint disease.
  4. Chronic partial tear of the anterior cruciate ligament with borderline passive joint line subluxation.
  5. Interval resolution of the post traumatic changes in the medial compartment.

There has been surgical repair of an osteochondral lesion on the extension surface of the lateral femoral condyle using an osteochondral implant. The donor site is unknown.
There is diffuse moderate chondral thinning over the implant. There is a 0.2 em step off along the anterior border of the implant. Normal reactive marrow changes are seen within the condyle related to this. There is a minimally displaced chronic fracture seen involving the lateral femoral condyle. This extends superiorly from the operative site into the metaphysis.
The anterior horn of the lateral meniscus is small and slightly irregular. This could be consistent with resection or degenerative tear.
There is diffuse moderate patellofemoral chondromalacia involving both facets of the patella.
There may be a small chondral flap on the lateral facet in the midpole region. There is mild chondral thinning seen in the lateral compartment in addition to the more pronounced thinning overlying the plug. The medial compartment is normal. There is mild lateral compartment osteophytosis with less pronounced changes elsewhere.
Moderate grade II degenerative signal is seen in the posterior horn of the medial
memscus.
The anterior cruciate ligament exhibits abnormal intrasubstance signal and has a wavy configuration. The appearance is consistent with a chronic partial tear. This is a new finding. There is associated borderline passive joint line subluxation with the knee compressed in the knee coil. The posterior cruciate and collateral ligaments are intact.
There is a small joint effusion with an intact joint capsule.
There is soft tissue contusion seen in the subcutaneous fat anteriorly presumably related to recent injury. Peri-articular bone and soft tissues are otherwise unremarkable.

#2

I have no idea what any of this means, but I just want to say that it’s a pretty piss-poor doctor that would dump a highly technical analysis like this on you with no explanation, and then skip town so that you couldn’t even call him. Especially if there’s a potentially scary medical issue on the line.

Nobody should be blind-sided by a report like this. You should have been called into the office or MRI clinic where some professional would sit down and walk through the analysis with you.

#3

This is why I discourage patients from reviewing their own results without having someone competent to interpret it for them. But some patients insist on having their results right away, regardless of whether or not their doc can fit them in to discuss it. (I make no judgement about the particulars of your situation, which are unknown to me.)

And Knee MRIs are rarely emergencies.

My two bits (I am NOT an orthopedist, but I do work with a LOT of knees).

  1. you had your knee fixed a while back with a bone graft, and that fact is still visible. An old fracture there is still a bit off and doesn’t appear (at least on MRI) to have healed fully. (this may or may not be a problem.)

  2. Your lateral meniscus is either a bit worn down by time or was affected somewhat by the old surgery.

  3. You’ve got some wear and tear to your knee (DJD is pretty common with time, especially with time and trauma.)

  4. Your ACL is a bit frayed and partly torn through, and your joint MAY be a bit loose as a result. This change is new from your last MRI.

  5. Since your previous MRI, the medial part of your knee (the part closest to your other knee) looks like it’s gotten better.

Other language implies some wear and tear of the cartilage of the kneecap and of the lateral part of the knee surface, the lateral part has some small bone spurs forming (not unusual for someone with DJD in the knee), your medial meniscus is a bit worn, you’ve got a bit of extra fluid in the joint (not unusual for someone with a history of knee trouble), and it looks like you sustained a bruise under the skin to the front of your knee, which does not appear to affect the knee structures themselves.

What this really means for you is dependent on your clinical history and what your knee looks like on an actual examination; don’t overread anything from the MRI without fitting it into that proper context.

I would describe nothing here as a finding that would “blindside” someone. I assume you know you’ve had knee trouble before, and despite your previous surgery, your knee continues to be less than brand new.

Good luck with it, hope the MRI provides useful info and that a treatment plan can be put forth to improve things.

#4

Patty- I thank you for the response. Yes I thought that this was odd to not have talked to me about the results. I never leave a client holding on like this was done to me. I am going to talk to the doctor this week and get the scoop on what it all means now and the future. Thanks again.

#5

Qsdgop the Mercotan- I really want to thank you for your response to my post. Yes my knee is less than brand new but I was fully functional after the first two operations. Not being able to walk for seven months and some heavy rehab I made it back to working construction. Being hit head on in a work truck messed it up again. The past operation has left me still with bad pain and the inability to go back to work let alone what was my life. I am 45 and need to get better. Again I thank you for your help.