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Thread: MRI results...

  1. #1
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    MRI results... *finally!!*

    ... are in.
    Last edited by KimD; 06-30-2009 at 01:12 PM.

  2. #2
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    Ooookay... pretty much what I expected, plus some special added bonus features:


    The medial meniscus is intact.

    There is a vertical parrot beak tear noted through the anterior horn of the lateral meniscus. The mid-body and posterior horn of the lateral meniscus are intact.

    There is extensive surgical artifacts noted in the region of the anterior cruciate ligament compatible with the previous repair. No definite intact ligament or repair is seen. The posterior cruciate ligament is intact.

    The medial and fibular collateral ligament complexes are normal. The conjoint tendon is normal. The iliotibial band inserts normally in Gerdy tubercle.

    The extensor mechanism is within normal limits. Bone marrow signal is unremarkable. The articular cartilage in all three compartments is well maintained. The medial retinaculum is attenuated but appears to be intact. Some minimal joint fluid is noted.

    Impression:
    Previous ACL repair. However, no intact ACL or ACL graft is seen.
    Vertical parrot beak tear noted through the anterior horn of the lateral meniscus.

    ---

    Well, there we have it. Doctor is referring me to ortho which could take "months and months"... so I will begin exploring my options.

    Surgical artifacts... nice...! I assume this means staples and other goodies left over from my previous surgery? And what is retinaculum and its attenuated?

    So... I don't know where my ACL went, but it's surprising they can't even find it on the MRI. My doctor sits down, and says, "Well, I don't know what to make of this....but...." and I just started to laugh... it's just... gone.

    .
    Last edited by KimD; 06-30-2009 at 01:19 PM.

  3. #3
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    Time for some medical tourism to the USA to get her done?

    Why not post your MRI scans?
    My Shoulder Surgery Thread Click Here

    My ACL Graft Choice and Surgery Thread CLick here

  4. #4
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    Fred, it's looking like that might be the way I'll be going...

    I'd love to post the images, but I don't have them. I asked my doctor but SHE doesn't have them. They are at radiology at the hospital and I need to call over there and get a copy. Apparently, they don't send the pictures to the GP, only the report.

    When I get my hands on them, I'll post them. I'm REALLY interested to see what kind surgical junk (artifacts) are floating around in my knee....

  5. #5
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    Quote Originally Posted by KimD View Post
    Fred, it's looking like that might be the way I'll be going...
    I also hear India does nice work over there as well for a fraction of the cost of the US health care system....seriously. One of the local guides here got hurt and had to have pretty major surgery. He didn't have insurance and ended up going to India and getting it done. Might be worth looking into if you're looking to get your knee fixed.

  6. #6
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    Unhappy

    Quote Originally Posted by KimD View Post
    Fred, it's looking like that might be the way I'll be going...

    I'd love to post the images, but I don't have them. I asked my doctor but SHE doesn't have them. They are at radiology at the hospital and I need to call over there and get a copy. Apparently, they don't send the pictures to the GP, only the report.

    When I get my hands on them, I'll post them. I'm REALLY interested to see what kind surgical junk (artifacts) are floating around in my knee....
    I wouldn't be too worked up about the "artifact." There is probably a screw of some sort that was used to fix the graft during your first surgery. Any sort of metal will significantly distort the MRI image. The distortion is often described as artifact. It's not like there are remnants from your previous surgery floating around. The fact that no intact ACL graft fibers can be seen is more concerning. It sounds like you may have retorn your ACL. Bummer.

  7. #7
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    Here are a couple of images, for what they're worth... I don't know if I've chosen the best ones or not, but they're pretty cool anyhow.




  8. #8
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    Quote Originally Posted by KimD View Post
    They are at radiology at the hospital and I need to call over there and get a copy. Apparently, they don't send the pictures to the GP, only the report.
    WHAT? So who in the radiology department is a knee surgeon?


    Personally I have 2 experiences, 1 finger related and one knee, where the radiologist read my x-ray/MRI wrong. First was a trip to the ER for a severely swollen and bent finger, they took an x-ray, tech said "broken finger" and they splinted it and sent me to an ortho the next day. Ortho takes a look at the x-ray and says that hyper-extending my finger (bent back to almost my wrist) stretched the ligament and pulled a bone chunk away from the joint, and that the splint was making the pain worse.

    Second time was with my knee, I first had an x-ray to please my insurance, nothing looked promising. Then I had the MRI and the tech scared the shit out of me by saying nothing was left. The next week I went to the ortho and it turned out everything was stretched, but not not completely torn.

    Has your doctor at least seen the scan? IMHO you really can't be certain until they have, preferably the ortho. Techs are techs, they see thousands of scans from all over the body every year for various things. Doctors specialize in specific areas.
    Last edited by krp8128; 07-01-2009 at 07:45 AM.

  9. #9
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    I guess the ortho will look at the images, my GP does not.

  10. #10
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    Hmmm.

    Here's something I don't understand: I know as well as anyone with an ACL rupture that it is usually a big dramatic event -- my first one certainly was -- severe pain, swelling, crutches, etc.

    So how is it that my second rupture came along relatively unnoticed? The pain I have now is probably the meniscus tear. I can only assume that the direct repair failed somewhere along the way and the ligament just came apart as the sutures or staples or whatever was used pulled through slowly bit by bit, pretty much unnoticed by me... and I've just learned to live with the instability along the way.

    Does that sound like a reasonable assumption?


    (apologies for my endless questions and musings)

  11. #11
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    Quote Originally Posted by KimD View Post
    Here's something I don't understand: I know as well as anyone with an ACL rupture that it is usually a big dramatic event -- my first one certainly was -- severe pain, swelling, crutches, etc.

    So how is it that my second rupture came along relatively unnoticed? The pain I have now is probably the meniscus tear. I can only assume that the direct repair failed somewhere along the way and the ligament just came apart as the sutures or staples or whatever was used pulled through slowly bit by bit, pretty much unnoticed by me... and I've just learned to live with the instability along the way.

    Does that sound like a reasonable assumption?


    (apologies for my endless questions and musings)
    I would say that is less likely the cause of the failure. The screw fixation (assuming that's what was used) just holds things in place while the graft "incorporates" and essentially becomes part of you once again. The screws don't offer permanent fixation. That's one of the reasons you need to be careful during the first 4-6 months after surgery, regardless of how you are feeling. The healing process takes time. When and what type of ACL reconstruction did you have previously? It's hard to say why the first repair failed. Sometimes you have a good explanation with an obvious injury, but that is not always the case. Is your knee unstable? Is you exam consistent with the MRI report?

  12. #12
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    Jerlane, thanks... but the repair was 25 years ago, and I didn't have a graft of any kind, the ligament was simply sutured or stapled back together. There is a reason why they don't do it that way anymore... it just doesn't work.

  13. #13
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    Quote Originally Posted by KimD View Post
    Jerlane, thanks... but the repair was 25 years ago, and I didn't have a graft of any kind, the ligament was simply sutured or stapled back together. There is a reason why they don't do it that way anymore... it just doesn't work.
    Interesting. I guess that changes things a bit. I've never heard of anyone doing that, although I was in grade school back then. The upside to that is that a revision would be easier if you decide to go that route. I guess you have to decide if the ACL (or lack there of) is symptomatic enough to warrant a revision or should you simply have the knee scoped hoping that it's the meniscus that is causing all of your trouble. Good luck!

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