"space" between bones...according to MRI

[knee]

Hi! I know I am skipping all ove the place..but you have been so helpful in presenting "facts" that I seem to miss in my surgical meetings...think I haven't found the surgeon...but in the meantime..thought I'd ask.

Finally, got Dr. to agree he could present a "case" for getting the right knee replaced...but wouldn't touch the left knee. So, I got a second opinion...and what I learned is...it's all in the language of the report...the left knee says "mild" ..Dr. says ther is "space" ..no one knows for sure...since MRI's are just shadows...and do not show cartilege loss..Of couse, I'm the owner of the left knee...and all the symptoms I am feeling, point to more cartilege damage than the MRI doesn't show. I had a cortizone shot...being the "good" patient in the left knee...and literally could not walk on the left knee for a day! So, three days later, I can walk..but the shot did not help. So, now what does it take? Do the right knee, get a brace for the left to get me through the right.get another cortizone shot...maybe it'll take better...and then argue again with Dr's about giving me a new left knee?

I have taken up swimming with a vengance...but I still have a lifestyle that has just simple walking...what makes me sane! Whatya think?

 

[beachcomber]

Did your doc do a standing x-ray with your knees bent? That was the final decision-maker for me because it showed that my bones were touching each other. No cartilage.

My MRI reports discuss extensive cartilage loss, subchondral sclerosis and marrow edema but it was the xray that was the final word.

 

[Gretchendz]

One small point...my doc says it usually takes a whole week for the cortizone to kick in fully--which was my experience. It hurt like heck a few days and then got better (for awhile!).

 

[JudyS]

Thanks for the cortizone info. I had my first in my knee last week and was wondering about the time frame. I've had them in the spine and I know they can take up to 10 days to work.

Judy

 

[Josephine]

Well, you're right there - it IS all in the wording! And frustrating thing is, different radiologists will say apparently very different things yet mean exactly the same thing! Truth of the matter is that MRI scans give very little information about joints. I read a great analogy for them - it's like 'trying to visualise a loaf of bread from all the slices laid out on a plate' or 'trying to sus a loaf with raisins when there are only half a dozen about 4mm in diameter and each slice is 6mm thick! You might catch one and you might not!'

So it's as beach said, the xray is usually the real clincher as it's the only one that shows the true facts - is there joint space loss and if so, how much? The only further confirmation would be via diagnostic arthroscopy.

Keep hunting!

 

[Gretchendz]

Thanks (as always) Jo...I was frankly wondering why an MRI. My OS just did xrays --both front and top down with the knee bent--which is what told the tale...By the way, as the technician put on the xrays on the wall she said casually "Boy those knees are yucky." I thought it was funny and asked if that was the technical term

 

[Josephine]

No - the technical term is 'knackered'!

 

[beachcomber]

In my case the MRI was to investigate the torn cartilage situation---- had no idea I even HAD OA! I went into the OS office thinking arthroscopic surgery to remove torn cartilage and found out I needed a partial knee replacement. It was a shock, to say the least because I never had any symptoms of OA.

 

[JudyS]

Well, as far as MRI's go. I had a plain and an arthrogram in Dec. They showed mild arthritis!!
At the arthroscopy, it was a totally different story. My doc kept warning me that he did not know what he would find when he went in there. (Hip)

Judy

 

[Gretchendz]

No - the technical term is 'knackered'!

*Laughing* That must be the British technical term

 

[Gretchendz]

In my case the MRI was to investigate the torn cartilage situation---- had no idea I even HAD OA! I went into the OS office thinking arthroscopic surgery to remove torn cartilage and found out I needed a partial knee replacement. It was a shock, to say the least because I never had any symptoms of OA.

Oh--that makes sense then

Actually a number of us report we were not in horrible pain--except we were slowing down and doing less and less all the time.

 

[knee]

Well, you're right there - it IS all in the wording! And frustrating thing is, different radiologists will say apparently very different things yet mean exactly the same thing! Truth of the matter is that MRI scans give very little information about joints. I read a great analogy for them - it's like 'trying to visualise a loaf of bread from all the slices laid out on a plate' or 'trying to sus a loaf with raisins when there are only half a dozen about 4mm in diameter and each slice is 6mm thick! You might catch one and you might not!'

So it's as beach said, the xray is usually the real clincher as it's the only one that shows the true facts - is there joint space loss and if so, how much? The only further confirmation would be via diagnostic arthroscopy.

Keep hunting!

Josephine! You do the most amazing job on answering most of everyone's questions...are you a DR.? I will keep hunting...glad I started "hunting" before I was in worse condition! You are very helpful! Thanks!

 

[knee]

Well, as far as MRI's go. I had a plain and an arthrogram in Dec. They showed mild arthritis!!
At the arthroscopy, it was a totally different story. My doc kept warning me that he did not know what he would find when he went in there. (Hip)

Judy

So, what did the Dr. do while he was looking in with the arthroscopy? Did he just look and then close you up, bring you back and then tell you the corrected prognosis? If its exploratory...was it? How long were you out of commission...if he did nothing but look, I'm asuming you were up and out and normal..recovering wise, right? What did you say to him that finally got him to actually do the arthroscopy? Think that's what I may have to push for eventually. Meanwhile, since, everyone can see the bone on bone with the right knee..just go for that one..worry about the left later...what do you think?

 

[Josephine]

It's called a diagnostic arthroscopy, knee. And the recovery can be painful (though not as much as a TKR obviously!). I was off work two weeks and went back using my TENS to get me through my short part-timer days. Was using a crutch and/or cane on and off for about 6 weeks.

And no, I'm not a doctor - just a working nurse who spent almost her entire life working in joint replacement surgery - 1962-2006 and developed a real passion for the subject. (In 10 days I celebrate 50 years as a working nurse!!)