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MRI showed small joint effusion. What does the report suggest?

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Orthopaedic Surgeon
Practicing since : 2000
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I just got my mri report and it noted that i have subtle bone edema of the medial and lateral femoral condyles as well as anterior lateral and medial tibial plateaus. there was also small joint effusion. it states the acl is intact but i also had a positive lachman test at my os office. i cant see him to discuss this because he is out of town and i am nervous about acl injury.
Posted Thu, 9 Aug 2012 in Bones, Muscles and Joints
Answered by Dr. Atul Wankhede 1 hour later
Thanks for posting your query.

Though your lachman test is positive, the MRI is pretty clear of ACLU being intact. The trouble will be if you have instability while walking or running. If not you have nothing to worry. I feel the oedema of femur and tibia needs more evaluation though.

Joint effusion too needs to be checked for presence of blood or infection. For more clarity please post more history of the incident that initiated this.
Awaiting further reply.
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Follow-up: MRI showed small joint effusion. What does the report suggest? 12 minutes later
Knee hyperextended and very audible and painful pop heard. Knee buckled and looked like an orange within 3 hours. Knee very unstable, especially down stairs and making left turns, knee gives and I almost fall. Could this be a partial acl tear because the bone contusion pattern fits
Answered by Dr. Atul Wankhede 3 hours later
Thanks for replying back.

The information you gave is very much indicative of a grade III tear of ACL or PCL or both. The instability of all is the most confirming symptom. Patients with ACL/PCL with or without posterolateral complex (PLC) tear usually feel apprehension of buckling on walking, descending stairs and turning with foot stabilised.

It is possible that the radiologist might have misssed the tear on MRI, since the ligament could have some fibres intact keeping the whole tissue in position. Nevertheless in my opinion you must plan an arthroscopic evaluation soon (after minimum 6 weeks post trauma) and contemplate a reconstruction of ACL (if found torn) in the same sitting. Arthroscopy I must say is the hallmark investigation for diagnosing ligament tears precisely.

The fluid in the joint is definitely blood and it needs to be drained out under asceptic precautions to relieve pain. Bone contusion is an additional and probably incidental finding which might be associated with initial trauma and only direct observation under arthroscope will give us its true nature.

Hope you seek an appointment with sports injury specialist soon. For any further assistance I'm available for follow up.
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