MRI Scans and Knee Pain

I was recently told by two very experienced orthopedic surgeons in Santa Barbara that I need a RIGHT knee replacement “sooner than later”. I’ve led a very active lifestyle and what you do when you are younger catches up with us as we age. A right knee MRI scan determined this. I wanted to research the findings of the MRI scan and this is what I found.  

Knee pain is a common complaint that affects people of all ages. Knee pain may be the result of an injury, such as a ruptured ligament or torn cartilage. Medical conditions — including arthritis, gout, and infections — also can cause knee pain.

Many types of minor knee pain respond well to self-care measures. Physical therapy and knee braces also can help relieve pain. In some cases, however, your knee may require surgical repair.

The location and severity of knee pain may vary, depending on the cause of the problem. Signs and symptoms that sometimes accompany knee pain include:

• Swelling and stiffness
• Redness and warmth to the touch
• Weakness or instability
• Popping or crunching noises
• Inability to fully straighten the knee

https://www.mayoclinic.org/diseases-conditions/knee-pain/symptoms-causes/syc-20350849

 

 

 

 

 

 

 

 

 

 

 

 

 

 

The MRI Found Subchondral Fractures

Subchondral fractures, also known as subchondral bone fractures or stress fractures, refer to small cracks or breaks that occur in the subchondral bone. The subchondral bone is the layer of bone just beneath the cartilage in a joint. What Is Subchondral Bone? Subchondral bone is the layer of bone just below the cartilage in a joint. “Chondral” refers to cartilage, while the prefix sub means below. Subchondral bone serves as a shock absorber in weight-bearing joints like the knees These fractures can occur due to repetitive stress, trauma, or underlying conditions that weaken the bone. They commonly affect weight-bearing joints such as the knee, ankle, or hip. Subchondral fractures are often associated with conditions like osteochondritis dissecans, osteoarthritis, or osteoporosis. Symptoms of subchondral fractures may include localized pain, swelling, tenderness, stiffness, and limited range of motion in the affected joint. The pain is typically worsened with activity and may improve with rest. In some cases, subchondral fractures can lead to the detachment of a piece of cartilage and bone, causing loose bodies within the joint. Diagnosis of subchondral fractures usually involves a physical examination, medical history review, and imaging tests such as X-rays, MRI, or CT scans. Treatment options depend on the severity of the fracture and may include:

1. Rest and immobilization: Restricting weight-bearing activities and using crutches or braces to offload the joint and promote healing.
2. Pain management: Nonsteroidal anti-inflammatory drugs (NSAIDs) or pain relievers may be prescribed to manage pain and inflammation.
3. Physical therapy: Specific exercises and stretches can help improve joint mobility, strengthen surrounding muscles, and support healing.
4. Assistive devices: The use of orthotic inserts, braces, or assistive devices may be recommended to provide support and stability to the affected joint.
5. Surgical intervention: In severe cases, surgical procedures such as arthroscopy, bone grafting, or joint replacement may be necessary to repair or reconstruct the damaged joint.

An MRI finding of subchondral fractures in the right knee indicates the presence of fractures in the subchondral bone, which is the layer of bone just beneath the cartilage within the knee joint. Here’s an explanation of this MRI finding:

1. Subchondral fractures: Subchondral fractures refer to fractures that occur in the subchondral bone, which is the layer of bone immediately beneath the cartilage surface of a joint. These fractures can be small cracks or larger breaks within the bone.

2. Right knee: This indicates that the MRI finding is specific to the right knee joint.

Subchondral fractures in the right knee can occur due to various factors, including:

1. Acute trauma: A significant impact or direct force to the knee joint, such as from a fall, sports injury, or accident, can lead to subchondral fractures.

2. Repetitive stress: Repetitive stress or overuse of the knee joint, particularly in activities that involve repetitive pounding or loading of the joint, can contribute to the development of subchondral fractures over time.

Subchondral fractures in the knee can cause pain, swelling, and limitations in joint function. Treatment options depend on the severity, location, and extent of the fractures, as well as the individual’s symptoms and overall health. Conservative treatment measures may include rest, pain management, immobilization with a brace or cast, physical therapy, and modifications to activities or load-bearing. In more severe cases or cases with significant displacement, surgical interventions such as arthroscopy or open reduction and internal fixation may be necessary to address the fractures and promote healing.

 

   

The MRI Found a subchondral fracture of the medial tibia

An MRI finding of a subchondral fracture of the medial tibia indicates a specific type of fracture occurring within the bony surface of the tibia bone, specifically in the medial (inner) aspect. Here’s an explanation of this MRI finding:

1. Subchondral fracture: A subchondral fracture refers to a type of fracture that occurs just below the articular cartilage, specifically in the subchondral bone. The subchondral bone is the layer of bone immediately beneath the cartilage.

2. Medial tibia: The tibia, also known as the shinbone, is one of the long bones located in the lower leg. The medial tibia refers to the inner aspect of this bone.

When an MRI identifies a subchondral fracture of the medial tibia, it means that a fracture line or break is present within the subchondral bone of the inner aspect of the tibia.

Subchondral fractures of the medial tibia can occur due to various factors, including:

1. Acute trauma: A significant impact or direct force to the lower leg, such as from a fall, sports injury, or accident, can lead to a subchondral fracture of the medial tibia.

2. Stress fracture: Repetitive stress or overuse of the lower leg, particularly in activities that involve repetitive pounding or loading of the bone, can contribute to the development of stress fractures over time. Stress fractures are hairline cracks that can occur due to cumulative microtrauma.

Treatment options for a subchondral fracture of the medial tibia depend on several factors, including the location, size, stability, and displacement of the fracture, as well as the individual’s symptoms and overall health. Treatment may include conservative measures such as rest, immobilization with a brace or cast, pain management, and modified weight-bearing activities. In more severe cases or cases with significant displacement, surgical intervention, such as internal fixation or external bracing, may be necessary to stabilize the fracture and promote healing.

 

                   

 

 

 

 

 

 

 

 

 

The MRI Found a subchondral fracture of the femoral condyle

An MRI finding of a subchondral fracture of the femoral condyle indicates a specific type of fracture occurring within the bony surface of the femur (thighbone) at the area known as the condyle. Here’s an explanation of this MRI finding:

1. Subchondral fracture: A subchondral fracture refers to a type of fracture that occurs just below the articular cartilage, specifically in the subchondral bone. The subchondral bone is the layer of bone immediately beneath the cartilage.

2. Femoral condyle: The femoral condyles are the rounded, knuckle-like structures at the lower end of the femur that articulates with the tibia (shinbone) to form the knee joint. They play a crucial role in knee joint stability and movement.

When an MRI identifies a subchondral fracture of the femoral condyle, it means that a fracture line or break is present within the subchondral bone of the femoral condyle.

Subchondral fractures of the femoral condyle can occur due to various factors, including:

1. Acute trauma: A significant impact or direct force to the knee joint, such as from a fall, sports injury, or accident, can lead to a subchondral fracture of the femoral condyle.

2. Repetitive stress: Repeated stress or overuse of the knee joint, particularly in athletes or individuals engaged in activities involving repetitive motions or high-impact forces, can contribute to the development of subchondral fractures over time.

Treatment options for a subchondral fracture of the femoral condyle depend on several factors, including the location, size, stability, and displacement of the fracture, as well as the individual’s symptoms and overall health. Treatment may include conservative measures such as rest, immobilization with a brace or cast, pain management, and physical therapy. In more severe cases or cases with significant displacement, surgical intervention, such as internal fixation or arthroscopic procedures, may be necessary to stabilize the fracture and promote healing.

               

 

 

 

 

 

 

 

 

 

 

 

The MRI Found a subchrondral edema

An MRI finding of subchondral edema in the right knee indicates the presence of fluid accumulation in the subchondral bone, which is the layer of bone just beneath the cartilage within the knee joint. Here’s an explanation of this MRI finding:

1. Subchondral edema: Edema refers to the buildup of excess fluid. Subchondral edema specifically refers to fluid accumulation within the subchondral bone, which is located beneath the cartilage.

2. Right knee: This indicates that the MRI finding is specific to the right knee joint.

Subchondral edema can be associated with various conditions and injuries, including:

1. Trauma: Direct impact or injury to the knee joint, such as a fracture, can lead to subchondral edema as part of the healing process.

2. Osteoarthritis: Subchondral edema is commonly observed in individuals with osteoarthritis, a degenerative joint disease characterized by cartilage breakdown and inflammation.

3. Stress fractures: Repetitive stress or overload on the knee joint, such as from intense physical activity or certain sports, can cause microfractures in the subchondral bone, leading to edema.

4. Bone marrow lesions: These are areas of abnormal bone tissue that can develop in various conditions, such as osteoarthritis or other joint disorders, and are associated with subchondral edema.

The presence of subchondral edema indicates an underlying issue within the knee joint. Treatment options will depend on the underlying cause and may include rest, pain management, physical therapy, anti-inflammatory medications, joint injections, and in some cases, surgical interventions.

 

 

 

 

 

 

 

 

 

 

 

 

The MRI Found a recurrent horizontal longitudinal tear of the medial posterior horn and body with associated flaps.

An MRI finding of a recurrent horizontal longitudinal tear of the medial posterior horn and body with associated flaps indicates a specific type of injury to the meniscus, which is a C-shaped cartilage structure located in the knee joint. Here’s an explanation of this MRI finding:

1. Meniscus: The meniscus is a tough and rubbery cartilage structure in the knee joint that acts as a cushion, providing stability and shock absorption.

2. Recurrent horizontal longitudinal tear: This refers to a tear in the meniscus that is recurrent, meaning it has happened more than once, and is oriented horizontally along the length of the meniscus. Longitudinal tears run parallel to the fibers of the meniscus.

3. Medial posterior horn and body: The medial aspect of the meniscus is the inner side of the knee joint, while the posterior horn and body refer to specific regions of the meniscus. The tear is located in these areas.

4. Associated flaps: Flaps are portions of the torn meniscus that can become folded or displaced within the joint. In this case, the tear has resulted in flaps of the meniscus that are potentially causing additional symptoms or complications.

When the MRI identifies a recurrent horizontal longitudinal tear of the medial posterior horn and body with associated flaps, it indicates a tear that has occurred multiple times in the inner region of the meniscus. These types of tears can be caused by trauma, degeneration, or repetitive stress on the knee joint.

The management of meniscal tears depends on several factors, including the location, size, symptoms, and overall knee condition. Treatment options may range from conservative measures such as rest, physical therapy, and anti-inflammatory medications to more invasive interventions like arthroscopic surgery, where the torn meniscus may be repaired or trimmed.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

The MRI Found a medial collateral ligamentous sprain

This ligament keeps your shin bone (tibia) in place. The MCL is usually injured by pressure or stress on the outside part of the knee. A block to the outside part of the knee during football is a common way for this ligament to be injured. An MCL injury can be a stretch, partial tear, or complete tear of the ligament.

An MRI finding of a medial collateral ligamentous sprain indicates an injury to the medial collateral ligament (MCL) of a joint. The MCL is a band of tissue that runs along the inner side of the joint, providing stability and preventing excessive sideways movement. Here’s an explanation of this MRI finding:

1. Medial collateral ligament (MCL): The MCL is a ligament located on the inner side of a joint. In this case, the MRI identified a sprain, which indicates an injury to the MCL.

2. Sprain: A sprain refers to damage or stretching of ligaments due to excessive force or trauma applied to the joint. In the case of an MCL sprain, it typically occurs as a result of valgus stress, which means the joint is forced into a sideways or inward direction.

MRI is a diagnostic imaging technique that uses magnetic fields and radio waves to create detailed images of the body’s structures. It is useful for visualizing soft tissues like ligaments. When an MRI identifies a medial collateral ligamentous sprain, it means that the ligament has sustained an injury that is detectable through this imaging modality.

The severity of the sprain can vary, ranging from mild stretching or partial tearing to complete rupture of the ligament. Treatment for an MCL sprain depends on the severity and may include rest, ice, compression, elevation (RICE), bracing, physical therapy, and, in severe cases, surgical intervention. The specific treatment plan will be determined by the healthcare professional based on the individual’s condition and the extent of the ligament injury.

 

 

 

 

 

 

 

 

 

 

 Plus a visible low-grade partial thickness tearing with the thickened proximal ligament

A visible low-grade partial thickness tearing with a thickened proximal ligament typically refers to a specific finding in a diagnostic imaging report, such as an MRI or ultrasound, related to a ligament injury. Let’s break down the components:

1. Partial thickness tearing: This indicates that the ligament, a strong band of connective tissue that connects bones and provides stability to a joint, has sustained damage. “Partial thickness” means that the tearing does not extend fully through the ligament. It suggests that some of the ligament fibers have been disrupted or torn, but not completely.

2. Low-grade: The term “low-grade” implies that the severity of the tearing is relatively mild. It suggests that the ligament injury is not severe or complete but still warrants attention.

3. Thickened proximal ligament: The proximal ligament refers to the part of the ligament closer to its origin or attachment point. “Thickened” suggests that the ligament appears thicker than normal in that region. This thickening can be a response to injury or inflammation, and it may be an attempt by the body to stabilize the joint.

In summary, a visible low-grade partial-thickness tearing with a thickened proximal ligament indicates a ligament injury that is not severe but shows some tearing and thickening in the region closer to its attachment point. It suggests an injury that should be monitored and may require appropriate management, such as rest, physical therapy, or other interventions to promote healing and prevent further damage.

 

 

 

 

 

 

 

 

 

 

 

The MRI Found the medial meniscal w partial meniscectomy

Partial meniscectomy involves partial removal of the meniscus. This can vary from minor trimming of the damaged part of the meniscus to the removal of the rip from the meniscocapsular junction. Meniscus tears are the most common knee injury.

 

 

 

 

 

 

 

 

 

 

 

 

*Disclaimer: This information is not intended to be a substitute for professional medical advice. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider. Please consult your healthcare provider with any questions or concerns you may have regarding your condition. The information provided is for educational purposes only and is not intended as a diagnosis, treatment, or prescription of any kind. The decision to use, or not to use, any information is the sole responsibility of the reader. These statements are not expressions of legal opinion relative to the scope of practice, medical diagnosis, or medical advice, nor do they represent an endorsement of any product, company, or specific massage therapy technique, modality, or approach. All trademarks, registered trademarks, brand names, registered brand names, logos, and company logos referenced in this post are the property of their owners.