Radiology Forums

MommiChris · Joined: 06 Jul 2008 Posts: 1 Location: california

hello everyone. I saw an orthopedic surgeon thinking I only had a meniscal tear (medial) I got my MRI back and was floored at my findings. Here is what it says : There is a large bone infarct in the proximal tibia metaphysis and proximal diaphysis. There is a large bone infarct in the medial femoral condyle, which extends to the articular surface, with moderate adjacent bone marrow edema. There is a small infarct of the posterior weightbearing surface of the lateral femoral condyle and mild infarct in the lateral trochlea. There is a typical appearance of the bone infarcts about the knee. Only the large infarct of the medial femoral condyle has surrounding bone marrow edema. suggesting an acute or subacute infarct. There is a mild degenerative signal w/i the posterior horn of the medial meniscus. There is a small joint effusion.

Ok that is alot to take in, s this really serious? And is this the same as osteonecrosis? Thank you for your time in advance!
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MommiChris

CigarPete · Power User Joined: 21 May 2007 Posts: 89

What does your doctor say? You can't make a diagnosis sometimes from just one aspect. That's why there are so many tests done. All the test data needs to be brought together under one roof and examined.

So, rather than doing this it's much better you talk to your doctor and receive a proper diagnosis. If you don't trust this physician then get another or perhaps just another opinion.. Which you are entitled to.

meme · Joined: 07 Jul 2008 Posts: 1 Location: California

You need to get to your ortho. The interpretation on your MRI shows the classic signs of osteonecrosis in the tibial plateau as well as your femoral condyle knee component. The effusions as the reading says are indicators of some activity that is going on currently in the one lesion area. You show infarcts of the bone and that are the classic indications of osteonecrosis.

Osteonecrosis is often under treated and under recognized by many an ortho still today. Yet there is a lot that can be done for ON and early care, treatment, surgical management is important to get going with. However as I said, not many OS's do much until your pain is so bad and the signs are there on x-ray (or they are $ hungry), then they will recommend joint replacement. A few OS's might do core decompressions but that is successful BEST if it's done with newer techniques that not many OS's are familiar with that are showing much better outcomes then older methods.

CA lacks unfortunately in having a lot of really top ON orthos. Stewart Goodman at Standford is really the best in the state as far as being up to date with what the East Coast orthos are doing, principally East referring to Michale Mont in the Baltimore area, Hungerford at Johns Hopkins (also Baltimore area. Oddly enough there is a very good small town ortho doing more advanced things for ON cases in San Luis Obispo, Dr. Ferro and he's not too much into his own ego to know if your case over all is too difficult to manage within the limits of the small area hospitals in that smaller town area.

There is a fabulous group for ON (the best on the Web) for knowledgeable and worthwhile self support at Yahoo groups at http://health.groups.yahoo.com/group/osteonecrosis/?v=1&t=directory&ch=web&pub=groups&sec=dir&slk=1

You have to join and it's a well monitored group with many contacts to help you as you go through phases of getting to your answers along the way.
MRI is the 'gold standard' for diagnosis of osteonecrosis.

SEE YOUR OS ASAP. Your reaction to this news is completely normal. I am surprised you even know the term osteonecrosis as many never have heard of the disease until they are diagnosed.

Wishing you the very best.

meme