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What Causes Pins And Needles With Swollen Leg After Partial ACL Tear And Cartilage Damage?

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Posted on Mon, 16 Dec 2013
Question: I have a partial tear of my L ACL, cartilage damage on the medial side and my hoffa pad is moderately swollen. I am having trouble walking and I see my surgeon in 9 days. I have recently developed pins and needles in my lower leg and my foot is puffy and swollen I fell on my left knee on the 11/11, I have problems with my right knee which gave precipitating the fall. I am unable to upload the MRI report. An MRI taken of my L knee in July this year showed no tear. Medial femoral condyle and tibial plateu articular cartilage maintained. Collateral ligament normal. The MRI taken last Sunday There is some cartilage defect medial femoral condyle. Patchy subarticular marrow oedema approx 10 x 10 mm Medial meniscus intact. The ACL looks mildy thickened and there is evidence of cystic change within the ACL which is prob indicatice of mucoid degeneration. It may be associated with some partial thickness tearing which is chronic within the ACL. I am confused that a report from July shows nothing and the report from last Sunday shows chronic degeneration. If you can explain this too I would appreciate it. I am concerned with the recent pins and needles and puffiness.
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Answered by Dr. Vivek Chail (3 hours later)
Brief Answer: Further information requested Detailed Answer: Hi, Thanks for writing in. I have read through your query in detail and would be glad to help you. MRI scan is a very sophisticated imaging investigation. Outcome of the scan dependson the machine, sequences done and the doctor who interprets it in the light of patient's problems and medical history. Having said that, I would like to know what prompted you to go for the first MRI and another one 6 months later. It is important to know if you suffered any fall or twisting of the knee between the two scans. If the ligaments were normal on earlier scan and you did not have any knee injury, tear is less likely to be there. However cystic mucoid degeneration may occur in due course which wasn't obvious in the earlier scan. I would like to know more about your pins and needles problem with puffiness. What exactly you mean by that and the duration and extent of the symptoms. There might also be a nerve pinching somewhere in your leg causing it. A history of diabetes and hypertension if present, might also be causing your problems. Lastly, technical false appearances may also be seen in MRI scans but with the description of findings mentioned by you, this is less likely. Please do write in with an update. Regards, Dr.Vivek
Above answer was peer-reviewed by : Dr. Prasad
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Follow up: Dr. Vivek Chail (3 hours later)
Thanks for your reply. I had both knees MRI in July as I was having problems with my right knee with kneeling and squating and having pain. I am seeing an orthopaedic surgeon but at the time my mother was dying from lung cancer so any surgery had to be postponed. The MRI conclusion for the right knee is chondromalacia weight bearing medial fem condyle with delamination component and focal flap tear suspected. Small joint effusion. My left knee at the time showed only patellar chondromalacia. 2 weeks ago I fell onto both knees taking most of my weight into my left knee, I left it for a week but swelling and pain increased so I saw my GP to get an MRI as I will be seeing my surgeon on the 7th of December. The latest MRI is now showing a partial tear, cartilage defect med femoral condyle, marrow oedema. Moderate sized joint effusion to the patellofem joint. This is all in keeping with the current level of pain and inability to mobilize easily. Although it is not long until I see the surgeon over the last 2 days I have experienced intermittent pins and needles (like a numbness) and my left foot is visibly puffy. Shoes leave a marked indentation. I am trying to keep my leg raised as much as possible and have applied ice regularly. I can wait but I just want to be sure about the numbness and swelling of my foot. I do have hypertension and take eprosartan - hydrochlorothiazide and have very well controlled blood pressure. I am currently taking a codeine/paracetamol pain reliver (panadeine forte) I do have arthritis as well as my auto immune problems, I have previously had both left and right successful rotator cuff repairs. Despite my problems I am a very active person and this really has stopped me from doing most things, even driving my car is problematic. I guess what I really need to know is do you think I am ok to wait until the 7th when I see my ortho surgeon? Thanks
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Answered by Dr. Vivek Chail (13 hours later)
Brief Answer: Yes you can wait until 7th to meet orthopedic surg Detailed Answer: Hi, You are welcome and thanks for writing in with an update. With the latest MRI scan knee showing a partial tear, cartilage defect in medial femoral condyle, marrow oedema with a moderate sized joint effusion to the patellofemoral joint, this does show an injury related inflammation in the area. At your age the bones may get weak due to hormonal variations and although you are actively mobile, there has been a bit of damage due to the fall. I would suggest you to wait for the appointment with your orthopedic surgeon. At the same time please be careful not to over stress the affected limb. The puffiness can be due to your hypertension and it is more prominent due to injury. As you are doing the rest, ice application, compression, elevation of foot, you may continue to do that. If you are having severe pain on mobilization, please get examined by your GP and use a knee brace in felt necessary. Continuing with your activities can delay the healing. I think waiting to see your orthopedic surgeon until the 7th is fine, however please limit your activities and if pain is severe, please get assessed for the need to have a knee brace. Hope your query is answered. Regards, Dr.Vivek
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Vivek Chail

Radiologist

Practicing since :2002

Answered : 6857 Questions

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What Causes Pins And Needles With Swollen Leg After Partial ACL Tear And Cartilage Damage?

Brief Answer: Further information requested Detailed Answer: Hi, Thanks for writing in. I have read through your query in detail and would be glad to help you. MRI scan is a very sophisticated imaging investigation. Outcome of the scan dependson the machine, sequences done and the doctor who interprets it in the light of patient's problems and medical history. Having said that, I would like to know what prompted you to go for the first MRI and another one 6 months later. It is important to know if you suffered any fall or twisting of the knee between the two scans. If the ligaments were normal on earlier scan and you did not have any knee injury, tear is less likely to be there. However cystic mucoid degeneration may occur in due course which wasn't obvious in the earlier scan. I would like to know more about your pins and needles problem with puffiness. What exactly you mean by that and the duration and extent of the symptoms. There might also be a nerve pinching somewhere in your leg causing it. A history of diabetes and hypertension if present, might also be causing your problems. Lastly, technical false appearances may also be seen in MRI scans but with the description of findings mentioned by you, this is less likely. Please do write in with an update. Regards, Dr.Vivek