Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
What Does The Following MRI Scan Report Indicate?
Question: So i had normal lab values, normal mri, normal bone scan now my surgeon wants to do a ganglion block to R/O nerve damage before doing s revision. Im 8 months post my Partial Knee replacement it does not move smoothly the metal feels as if it pulls and scrubs me and the pain and swelling continues. Seems to be no answers. The last surguery was a proximal patella realignment and also unaware when he git it a big chuck of loose cartlidge floating around. This was after a CT and mri prior to surgery. My question is could i still have cartlidge loosening that is unidentified with mri from the metal. Is something missing? Can i upload a photo to identify if have swellinh or fluid. Ive had it drained many many times.
Brief Answer:
Cartilage injury less likely
Detailed Answer:
Hi there.
Welcome to Healthcare Magic.
Thanks for the query.
I have read your query and understood your problem. Usually MRI scan can show loosening of prosthesis, signs of infection, osteochondral injuries and cartilage damage.
Since you are having fluid collection, there could be arthritis of the remaining cartilage in the knee. If you are experiencing hindrance in moving the knee freely, then there could be malalignment of the prosthesis due to improper surgical technique.
Your Doctor wants to rule out nerve injury near the prosthesis which can get irritated and cause muscle spasm nearby.
It is best to get the aspirated fluid tested for infection by a culture and sensitivity testing and also get a blood CRP test to rule out infection.
Your non-operated knee compartment could also be arthritic which can cause similar problems.
Cartilage loosening will usually show up on bone scan and MRI. So it is less likely to be there if the scans were normal.
Yes, Kindly do upload a photo so that I can be in a better position to look for signs of inflammation and any malalignment. If you can get a standing photo of both your knees it would be helpful as well. Also your latest X-ray or MRI scan would help.
I hope I have answered your query.
I will be available to answer your follow up query.
Regards,
Dr. Aashish Raghu
Cartilage injury less likely
Detailed Answer:
Hi there.
Welcome to Healthcare Magic.
Thanks for the query.
I have read your query and understood your problem. Usually MRI scan can show loosening of prosthesis, signs of infection, osteochondral injuries and cartilage damage.
Since you are having fluid collection, there could be arthritis of the remaining cartilage in the knee. If you are experiencing hindrance in moving the knee freely, then there could be malalignment of the prosthesis due to improper surgical technique.
Your Doctor wants to rule out nerve injury near the prosthesis which can get irritated and cause muscle spasm nearby.
It is best to get the aspirated fluid tested for infection by a culture and sensitivity testing and also get a blood CRP test to rule out infection.
Your non-operated knee compartment could also be arthritic which can cause similar problems.
Cartilage loosening will usually show up on bone scan and MRI. So it is less likely to be there if the scans were normal.
Yes, Kindly do upload a photo so that I can be in a better position to look for signs of inflammation and any malalignment. If you can get a standing photo of both your knees it would be helpful as well. Also your latest X-ray or MRI scan would help.
I hope I have answered your query.
I will be available to answer your follow up query.
Regards,
Dr. Aashish Raghu
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Sedrate was 4 WBC 7.7 CRP less than 5 so all normal, i have tenderness over the prosthetic knee cap and bone tender below the knee in top of the tibia and rubbing sendation lateral. Since the day i stood up on it had felt not gliding smooth. When i turn my knee out layersl bent it feels like metal hitting
Brief Answer:
Wrong alignment of prosthesis
Detailed Answer:
Hi there.
There appears to be mild signs of inflammation due to the redness. Your Laboratory reports do not indicate infection. Kindly get the aspirated fluid tested for infection anyway.
The knee prosthesis may have been fixed in the wrong alignment which is why you are having the symptoms.
Kindly discuss with your Doctor about this.
Avoid flexing the knee excessively, apply hot water bottle to the painful region, keep the limb elevated/
I hope I have answered your query.
I will be available to answer your follow up query.
Regards,
Dr. Aashish Raghu
Wrong alignment of prosthesis
Detailed Answer:
Hi there.
There appears to be mild signs of inflammation due to the redness. Your Laboratory reports do not indicate infection. Kindly get the aspirated fluid tested for infection anyway.
The knee prosthesis may have been fixed in the wrong alignment which is why you are having the symptoms.
Kindly discuss with your Doctor about this.
Avoid flexing the knee excessively, apply hot water bottle to the painful region, keep the limb elevated/
I hope I have answered your query.
I will be available to answer your follow up query.
Regards,
Dr. Aashish Raghu
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Thats what i keep saying after the nerve block nect is revision surgery. Is that a recommendation? I just need another opinion i understand it can be a tough surgery
Brief Answer:
Nerve block provides pain relief and chance to assess prosthesis function
Detailed Answer:
Hi there.
Nerve blocks are a form of analgesia which will offer pain relief, once the nerve in question is blocked with local anaesthetic injection.
Also your Doctor can assess the range of movements at the knee and ascertain if the restriction in movement is due to a mal-aligned prosthesis and if it needs revision.
This can help your Doctor find the cause of the pain and restriction of movement. Revision surgery or physiotherapy may be indicated accordingly.
I hope I have answered your query.
Regards,
Dr. Aashish Raghu
Nerve block provides pain relief and chance to assess prosthesis function
Detailed Answer:
Hi there.
Nerve blocks are a form of analgesia which will offer pain relief, once the nerve in question is blocked with local anaesthetic injection.
Also your Doctor can assess the range of movements at the knee and ascertain if the restriction in movement is due to a mal-aligned prosthesis and if it needs revision.
This can help your Doctor find the cause of the pain and restriction of movement. Revision surgery or physiotherapy may be indicated accordingly.
I hope I have answered your query.
Regards,
Dr. Aashish Raghu
Above answer was peer-reviewed by :
Dr. Prasad
Thank you
Brief Answer:
Kindly follow up
Detailed Answer:
Hi there.
Kindly follow up with me on your progress so that I can help you understand anything you need to know in this regard and the necessary precautions to be taken. You are free to contact me any time.
Wishing you a speedy recovery.
Regards,
Dr. Aashish Raghu
Kindly follow up
Detailed Answer:
Hi there.
Kindly follow up with me on your progress so that I can help you understand anything you need to know in this regard and the necessary precautions to be taken. You are free to contact me any time.
Wishing you a speedy recovery.
Regards,
Dr. Aashish Raghu
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Saw the surgeon for cortisone shot to help with pain until nerve block injection is scheduled. I have uploadrd my mri and bone scan which limited reports in some respect but R/O infection
Brief Answer:
Good News of No osteomyelitis or bone infection
Detailed Answer:
Hi there.
I have reviewed your MRI Scan and Bone scan reports. Fortunately no osteomyelitis or bone infection is noted.
The cortisone shot shall help with the inflammation and pain till you get the nerve block anaesthetic. Also keep a hot bag on the knee and keep the limb elevated.
Do follow up with me on your future progress.
Regards,
Dr. Aashish Raghu
Good News of No osteomyelitis or bone infection
Detailed Answer:
Hi there.
I have reviewed your MRI Scan and Bone scan reports. Fortunately no osteomyelitis or bone infection is noted.
The cortisone shot shall help with the inflammation and pain till you get the nerve block anaesthetic. Also keep a hot bag on the knee and keep the limb elevated.
Do follow up with me on your future progress.
Regards,
Dr. Aashish Raghu
Above answer was peer-reviewed by :
Dr. Prasad
Besides the liagments etc the scans are unspecified correct? Would any of this show mailagnment issues? I am better but hardware feeling out XXXXXXX laterally has not changed yhe injection yesterday was medial instead of lateral as before. Just trying to get a understanding. Would loosening on the patella implant be found on these reports. I feel a pulling up sensation over the patella in lifting my knee .
Brief Answer:
Loosening would show on a Bone scan. Standing X-ray or CT Scanogram for mal
Detailed Answer:
Hi there.
Usually loosening would show up well on a Bone scan. Your Report has no mention of such a finding.
The injection can be given medial or lateral and has no difference either way. The effect of the steroid shot would take a few days to show.
The pulling sensation could be due to rubbing of the implants. Malalignment can be assessed clinically by your Surgeon and also on constructing your Mechanical axis by doing an entire standing lower limb X-ray or CT scanogram and also assessment of Patellar Q angle which is important in your case. If there is axis deviation of the components or the limb regions, then malalignment can be noted.
I hope I have answered your query.
I will be available to answer your follow up queries.
Regards,
Dr. Aashish Raghu
Loosening would show on a Bone scan. Standing X-ray or CT Scanogram for mal
Detailed Answer:
Hi there.
Usually loosening would show up well on a Bone scan. Your Report has no mention of such a finding.
The injection can be given medial or lateral and has no difference either way. The effect of the steroid shot would take a few days to show.
The pulling sensation could be due to rubbing of the implants. Malalignment can be assessed clinically by your Surgeon and also on constructing your Mechanical axis by doing an entire standing lower limb X-ray or CT scanogram and also assessment of Patellar Q angle which is important in your case. If there is axis deviation of the components or the limb regions, then malalignment can be noted.
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. Prasad
Thinking if mailalignment i had a muscle realignment didnt show much on the ct but after taping thr tibia snd patella it lined up. Had many weeks of therapy with no improvement. He did Ct begore the surgery to R/O bone alignment. For 8 eeeks it worked seemed pretty close to normal then i got fluid build up snd aspirated snd back like it was. Im on my 4 th surgery and not intersted in more. I do think its either malaligment or somejow my body is not excepting it. It is with certain movement from a lateral aspect. Is it possible for cy or diagnostic test to show what happens in a rotation mode? There is a soft area ir tender area identified at the bone where the IT band attaches. I just dont want to go through it all again eith uncertaincy. I want it fixed for the last time. My hisband can freel a grind of the metal when hand placed over the side as it bends as i do.
Is it basicay trial and error and since it was a makiplasty is it tge same tool used to do revision?
Is it basicay trial and error and since it was a makiplasty is it tge same tool used to do revision?
Brief Answer:
Ligament laxity, Wear and tear reaction to the Polythelene plastic
Detailed Answer:
Hi there.
There other cause could be ligament laxity. This causes the implant components to malalign due to weakness of the surrounding supporting structures. Another cause can be reaction to the plastic component due to wear and tear.
Both these problems require revision surgery like Synovectomy for Wear and tear reaction and change to stable prosthesis in ligament laxity due to possible Medial collateral ligament injury during surgery.
Usually dynamic CT, sequential Xrays can demonstrate loosening and malalignment.
Kindly discuss about this with your Surgeon.
I hope I have answered your query.
Regards,
Dr. Aashish Raghu
Ligament laxity, Wear and tear reaction to the Polythelene plastic
Detailed Answer:
Hi there.
There other cause could be ligament laxity. This causes the implant components to malalign due to weakness of the surrounding supporting structures. Another cause can be reaction to the plastic component due to wear and tear.
Both these problems require revision surgery like Synovectomy for Wear and tear reaction and change to stable prosthesis in ligament laxity due to possible Medial collateral ligament injury during surgery.
Usually dynamic CT, sequential Xrays can demonstrate loosening and malalignment.
Kindly discuss about this with your Surgeon.
I hope I have answered your query.
Regards,
Dr. Aashish Raghu
Above answer was peer-reviewed by :
Dr. Prasad
Yes its very hard to explain it doesnt slide right when diagnostics are normal. I live an active life snd it just seems foreign nothing normal and its just not moving right. I appreciate your time .
Thank you just want to walk not limp, run after my 14 month on grandbaby and be normal!
Thank you just want to walk not limp, run after my 14 month on grandbaby and be normal!
Brief Answer:
Ligament laxity, Wear and tear reaction of the prosthesis, Implant loosenin
Detailed Answer:
Hi there.
Yes. I agree. Kindly discuss with your Surgeon about possible reaction to wear and tear of the prosthesis, ligament laxity and implant loosening.
A revision surgery could help you once the cause is ascertained.
Wishing you a speedy recovery.
Ligament laxity, Wear and tear reaction of the prosthesis, Implant loosenin
Detailed Answer:
Hi there.
Yes. I agree. Kindly discuss with your Surgeon about possible reaction to wear and tear of the prosthesis, ligament laxity and implant loosening.
A revision surgery could help you once the cause is ascertained.
Wishing you a speedy recovery.
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.
Above answer was peer-reviewed by :
Dr. Sonia Raina
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
