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What Does This MRI Of Knee Regarding Knee Pain Indicate?

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Posted on Tue, 22 Jul 2014
Question: History of knee pain ( morning stiffness, going down stairs or paths particularly painful/popping)...xrays show bone on bone in knee caps MRI- Rt & Lt- advanced degenerative change in the patellofemoral joint and Rt- also small joint effusion and dissecting popliteal cyst and Lt- small joint effusion with scattered ganglion cyst.
this has been ongoing a couple of years. Anti-inflamatories provide some relief. Figured it was part of getting old. I am active, normal weight. Use to be a runner-, like to walk and swim for exercise. Just getting more uncomfortable and rt leg locked up a couple of weeks ago causing me to see Doc.
Doc recommending "patella retinacular release" Does that make sense?
doctor
Answered by Dr. Dr. Naveen Kumar Sharma (1 hour later)
Brief Answer:
This is knee arthritis

Detailed Answer:
Hello madam,
I have read your case and also studied your MRI. I think you are having knee arthritis with backer cyst in both knee joints. I do not think that it is only patella retinacular disease and I suggest following options to my patients with such diseases.
1. Steroid injection and hyaluronic injection if you are not willing for surgery.
2. Arthroscopic chondroplasty of patellofemoral joint.(key hole surgery)
3. If pain progresses despite above steps then last option is knee replacement surgery.
If cysts are not large and there is no pain in them then you can avoid them.
I would also suggest you some points to delay progress of the disease.
1. Avoid squatting, staircase or ground level activity.
2.Take regular calcium and Vitamin D 3
3. Do not run or do brisk walking.
I hope these measures will help you, Let me know if you want to ask any other question.
Thanks and take care.
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Dr. Naveen Kumar Sharma (31 hours later)
While it might not be the only procedurethat you suggest, why do you think the Doc I have seen has suggested the "Patella Retinacular Release"? Does the MRI report show any indication of the knee cap sliding abnormally ( patella subluxation) or is that likely a cause of the wearing down of cartilage?
doctor
Answered by Dr. Dr. Naveen Kumar Sharma (45 minutes later)
Brief Answer:
It is not due to MRI

Detailed Answer:
Hello,
Diagnosis made by your doc is on the basis that you have excessive wear of patellofemoral joint where as other part of knee joint is not so much worn.
MRI does not show any findings that suggest why that happened. But as you are also having backer cyst, so I believe that your knee is as a whole getting arthritic.

Patella-retinacular disease mostly occurs in young person in twenties, following trauma.

Let me know if you want to ask any other questions.
Thanks.

Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Dr. Naveen Kumar Sharma (11 hours later)
I know it is not due to the MRI ( an imaging procedure). The diagnosis was "patella subluxation" (not "patella-retincular disease"). The question was: is there reason to suggest that a "patella retinacular release" along with "arthroscopic chondroplasty of patellofemoral joint" might lessen the pain and slow down the degenerative arthritis?
doctor
Answered by Dr. Dr. Naveen Kumar Sharma (1 hour later)
Brief Answer:
Arthroscopy release will give pain relief.

Detailed Answer:
Hello madam,
I am really sorry for misunderstanding. when i said not due to MRI , I mean patella subluxation can not be diagnosed by MRI. As it happens when you bend your knee at certain point, so x ray is better test for it.
Arthroscopy with patella retinacular release procedure and chondroplasty will give short term pain relief. In some patients it can be a definitive cure, specially if patient is below 40.
In your case, you can try this procedure, but this will give pain relief for few months. yes, it will slow down the progress of patellofemoral arthritis. But it has no effect in other parts of knee .
Thanks.
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
Answered by
Dr.
Dr. Dr. Naveen Kumar Sharma

Orthopaedic Surgeon, Joint Replacement

Practicing since :2002

Answered : 4486 Questions

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What Does This MRI Of Knee Regarding Knee Pain Indicate?

Brief Answer: This is knee arthritis Detailed Answer: Hello madam, I have read your case and also studied your MRI. I think you are having knee arthritis with backer cyst in both knee joints. I do not think that it is only patella retinacular disease and I suggest following options to my patients with such diseases. 1. Steroid injection and hyaluronic injection if you are not willing for surgery. 2. Arthroscopic chondroplasty of patellofemoral joint.(key hole surgery) 3. If pain progresses despite above steps then last option is knee replacement surgery. If cysts are not large and there is no pain in them then you can avoid them. I would also suggest you some points to delay progress of the disease. 1. Avoid squatting, staircase or ground level activity. 2.Take regular calcium and Vitamin D 3 3. Do not run or do brisk walking. I hope these measures will help you, Let me know if you want to ask any other question. Thanks and take care.