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What Do The Following MRI And X-ray Reports Indicate?

Posted on Tue, 2 Feb 2016

Question: hi Doctor Aashish, I recently asked you a question related to my meniscus tear. I have recently gone thru an MRI and X-Ray for same. Based on MRI and X-Ray reports, do you think I should think about meniscus regeneration ?

I have instability in my knee. It comes and goes. not permanent. If I do some travel, knee swells and pain start at same place where lateral meniscus was excised. Also, this pain goes below leg.. on fibula bone.

I have pain squatting or climbing stairs, but not much now. I was a lot post surgery.

Should I apply warm packs now even if I have pain ?

I recently uploaded my reports on last question asked. Not sure if you will be able to see them. Please confirm and I can send by email if possible.

Please see below summary for same.

"Hello, I underwent arthroscopic knee surgery to remove lateral meniscus in my left knee on November 6th 2013, since then I haven't recovered from it. I was told that 30% of lateral meniscus was removed. I still have stiff muscles in my knee. I saw another doctor who asked me to go for physical therapy. I went for therapy in Fortis XXXXXXX where therapist told me that i have fibula dysfunction. I did exercises, but haven't recovered yet. any suggestion? also, I heard about Stone clinic in California, United States, where they can grow meniscus back. would that be feasible option?

Asked by Me , Sat, 5 Dec 2015

Doctor's reply

Brief Answer:
Kindly upload MRI films. Meniscus regeneration useful in large defects

Detailed Answer:
Hi there.

Thanks for the query.
Now please take a minute to answer the following questions please:

Do you have any instability?

Any pain on squatting or climbing stairs?

It your lateral meniscus has been excised surgically then the pain should not be there.

A proximal fibula dysfunction can be part of a posterolateral injury complex which can cause instability.

Stiff muscles can be treated by warm packs and physiotherapy usually.

Stone Clinic does provide cartilage regeneration services but it is useful only when there is moderate meniscus defect which will definitely benefit.

Also Dr. Venkatachalam from MJRC Clinic in XXXXXXX uses Stem cells to create meniscus cartilage and provides similar services.

Kindly upload your MRI films for me to be in a better position to comment on your problem and suggest the remedy.

I hope I have answered your query.

I will be available to answer your follow up queries.

Regards,

Dr. Aashish XXXXXXX

Answered by Dr. Aashish Raghu (33 minutes later)

Brief Answer:
Please upload full MRI Scans because of incomplete report. Do apply warm pa

Detailed Answer:
Hi XXXXXXX

Thanks for the query.

I have reviewed your reports once again.

It seems that the tear of the meniscus has not been dealt with during the surgery.

Since there is a large complex tear which is still unattended to, this could be the cause of your ongoing pain.

Feeling of instability could be due to the Proximal fibula dysfunction of Posterolateral corner injury, especially hurting when the knee twists while you make sudden turns.

I suggest you upload your MRI films for me if possible because it has not been quantified in the MRI Report of the tear is a superficial or deep tear. Deep tears can be repaired arthroscopically and solve the problem. I can also look for any issues with the posterolateral fibular ligaments to assess for a cause of instability.

Cartilage regeneration can be considered if repair isn't possible.

Please do apply the warm packs if it offers relief. Avoid flexing the knee. Avoid squatting, cross leg sitting as this puts the damaged meniscus under stress and can cause further damage or delayed healing and later arthritis can occur. You can wear a hinged short knee brace which will tackle the knee instability and reduce pain.

I hope I have answered your query.

I will be available to answer your follow up queries.

Regards,

Dr. Aashish Raghu

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Aashish Raghu (2 days later)

Hello Sir, I am not able to upload DICOM formatted files which I received in my CD from diagnostic center. How can I send it to you ? Please suggest.

Answered by Dr. Aashish Raghu (13 hours later)

Brief Answer:
Send to YYYY@YYYY with sub ATTN Dr Aashish Raghu

Detailed Answer:
Kindly discuss with HealthcareMagic team over phone or their email and send to YYYY@YYYY with sub mail as ATTN Dr Aashish Raghu. I'm sure they will help you with the same.

Thank you.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Aashish Raghu (3 days later)

Please see attached MRI dicom files.

Answered by Dr. Aashish Raghu (7 hours later)

Brief Answer:
I don't have a DICOM reader

Detailed Answer:
Hi there.

I'm sorry to inform that I do not have a DICOM reader. Kindly convert the images to jpeg and send it to my email.

Thanking you.

Regards,

Dr. Aashish Raghu

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Aashish Raghu (14 hours later)

Link sent to your email for Images/Reports.

Answered by Dr. Aashish Raghu (9 hours later)

Brief Answer:
Stem cells can be tried with or without repair

Detailed Answer:
Hi there.

I have just reviewed the scans. The lateral meniscus remnant can be subjected for stem cell or chondrocyte transfer after debriding the torn edges. You could consult the respective stem cell experts for the same.

Repair with stem cells shall hold some promise to getting you better.

Let me know if there's anything else I can help you with.

Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Arnab Banerjee