Monday, August 17, 2015

MRI Results Followup

Meniscus is good. PCL is normal. ACL is completely torn. Lateral meniscus looks okay. Still a good amount of fluid in there which is creating the tightness disallowing me to bend it completely.  I need to work on getting the motion back.

Not everyone needs to have surgery. There are three groups of people. Some live their entire life not knowing the ACL was torn at one point. Another group of people can walk but can't trust it during sports. The third group of people have a knee that buckles when they walk and need to have surgery. I feel like I fall in this third group but I haven't really tested it out much since the injury.

It's to my favor that the meniscus is not damaged.

The biggest risk for the surgery is the stiffness.  Near normal range of motion is preferred prior to that.  The plan is now to start PT and work on the motion.

So that's where I am now. In need of finding a qualified physical therapist close to me. I need to start putting some weight on it.

Here's the actual analysis of the MRI:

EXAMINATION: Right knee MRI without contrast
CLINICAL INFORMATION: Jumped and landed awkwardly on 7/30/2015; felt pop and the knee buckled; persistant pain and swelling; difficulty with weightbearing; no improvement with conservative treatment; evaluate for anterior cruciate ligament tear.
TECHNIQUE: A routine right MRI exam was obtained.
COMPARISON: None.
FINDINGS: The body and posterior horn of the medial meniscus demonstrate a poorly defined globular region of mild/moderate increased internal proton density and T2 signal intensity. There is no associated disruption of the overlying meniscal articular surfaces. The anterior horn of the medial meniscus is unremarkable.
The lateral meniscus is normal in configuration and patterns of signal intensity.
The anterior cruciate ligament demonstrates moderately severe diffuse abnormal irregular oval thickening, diffuse moderately severe increased T2 signal intensity and a severe irregular wavy configuration.
The posterior cruciate ligament, the medial and lateral collateral ligaments, the iliotibial band, the biceps femoris tendon, the popliteus tendon, the infrapatellar ligament and the visualized region of the quadriceps tendon are intact.
There is a large right knee joint effusion. There is no definitely evidence of intracapsular loose bodies. There is a moderate medial synovial plica.
There is apartially fused secondary ossification center at the superior-lateral margin of the patella. The overlying articular cartliage is intact.
There is slight impaction of the central osteochondral surface of the lateral femoral condyle associated with moderately severe underlying subchondral intraosseous inflammation/edema.
There is mild/moderate poorly define increases subchondral intramedullary T2 signal intensity involving the posterior half the tibial plateau, lateral greater than medial. There is no assicated significant depression of the overly osteochondral surface.
All three compartments of the right knee joint are well-maintained. The visualized osseous structures are otherwise normal in configuration and patters of signal intensity for the patient's age.
There is mild to severe superficial and deep soft tissue inflammation/edema overlying all regions of the right knee. The visualized soft tissues are otherwise unremarkable.
IMPRESSION:
1. There is a large right knee joint effusion.
2. There is evidence of an acute, complete tear of the anterior cruciate ligament.
3. While the body and posterior horn of the medial meniscus demonstrate evidence of mild internal degeneration, there is no evidence of an associated linerar medial meniscal tear.
4. There is a slightly impacted osteochondral fracture involving the central region of the lateral femoral condyles associated with moderately severe underlying subchondral intraosseous inflammation/edema.
5. There is a mild/moderate diffuse osseous contusion involving the posterior half of the tibial plateau, lateral greater than medial. There is no associated significant depression of the overlying osteochondral surface.
6. There is a moderate medial synovial plica.
7. There is evidence of a developmental bipartite patella.
8. There is a mild to severe superficial and deep soft tissue inflammation/edema overlying all regions of the right knee.

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