Help interpreting an MRI

[jenl8270]

I had an MRI last Friday and don't see the knee doctor until this Friday, but am in a lot of pain and was just wondering if someone could help me with this MRI. I've been having problems with this knee since March of 2016 and have had 3-4 cortisone injections since that time, but the pain always returns. This time, I had the cortisone injection Friday and already it's in pain again.

1. Intact ligaments.

2. Attenuation, degeneration and early radial pattern tearing anterior root medial meniscus. 2mm peripheral medial meniscal subluxation noted.

3. Free edge fraying and tearing body and anterior horn lateral meniscus. Attenuation and degeneration posterior and anterior roots.

4. Grade 3-4 medial compartment chondromalacia central medial fremoral condylar and opposing medial tibial plateau articular surfaces. Grade 2-3 lateral compartment chondromalacia central to posterior lateral femoral condylar and opposing lateral tibial plateau articular surfaces. Grade 2 chondromalacia patella lateral patellar facet and patellar apex. No acute or occult fracture.

5. No significant knee joint effusioo, or distinct loose bodies identified in the synovial space.

6. Intact extensor mechanism. Popliteal neurovascular structures maintained. No significant muscular atrophy, nor signal alteration to suggest denervation-type injury. No high-grade musculotendinous injury seen.

The pain is severe. It locks up all the time and constantly makes a "popping" sound which is also pretty excruciating. I also would like to note that since the pain started back in March 2016, I have lost 94 pounds which one would think would have made it better, but it only seems to have gotten worse.

Thank you so much!!

[vickster]

You have arthritis throughout the knee unfortunately (the articular cartilage damage) and tears to the meniscus, not uncommon given the arthritis

You should try to find solution other than cortisone, it's not good for the bone surfaces, probably not the cause of your problems, but not good to have long term and certainly not with such frequency. If that's the only thing your knee doctor is offering, I'd find another

The symptoms you describe could be due to the torn meniscii are getting caught in the joint and locking, also causing pain. Have you discussed keyhole surgery to tidy up the joint to help the symptoms and pain? I'd discuss that asap. Perhaps also try hyaluronic acid injections, or PRP to reduce the inflammation in a less damaging way than the steroid shots.

How old are you by the way? Where do you live?

Good luck, wear and tear damage in the knee can certainly be miserable

[jenl8270]

I probably should have put that information in the original post. I'm 47 years old and live in Surprise, AZ. I have been heavy my whole life. I had a gastric bypass surgery in November and have went from 278 lbs to 185 lbs and am still losing, however, the pain seems to be still getting worse.

[vickster]

Congrats on the weight loss

I think that you definitely need to discuss your options for the short, medium and longer term. You're not too young for a knee replacement although many surgeons are unwilling to go down that one way street unless all other options are exhausted. I'd discuss having keyhole surgery to tidy the meniscus tears and the ragged joint surfaces. I personally find hyaluronic acid injections really helpful and don't destroy cartilage like cortisone can

Perhaps seek a second opinion if you feel it's warranted.
Exercise such as swimming, cycling etc can be very beneficial to the arthritic knee as can physio or hydrotherapy.

There's a really good arthritis primer in the learning portfolio linked at the top of the page