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Do You Need An MRI For Your Knee? You Might Not
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- Опубликовано: 22 июн 2024
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Retired ER nurse here: worked in a 25 bed hospital E.R. More than once I told people with injuries they should be re-assessed at the bigger hospital. And, of interest, an ER doctor fell down a river bank while fishing. Did he have to undergo six weeks of P.T., pain, lost wages, and anxiety? Nope. Came in, had xray, followed by MRI, had surgery within a day or two, back to work on a let scooter---
So if we had a patient that presented with a locked knee due to a suspected meniscal tear they would get an urgent MRI and surgery as well
10yrs ago, I had sudden excruciating pain in my right knee. (While moving from one house to another. Could not put pressure on my leg at all. Went to urgent care, xray showed "the worst arthritis they had ever seen in someone my age" sent to ortho. Ortho said knee replacement was the only option, but would not do it until I lost 100lbs. After sleeping, the pain was completely gone until a couple of days later when it was back u expectedly. Saw a different ortho. He said he could do a arthroscopy he thought it was a meniscus tear. I had been also experiencing heal pain from my achilles tendon coated with arthritis. He could not do a knee replacement with the heal the way it was. So we opted to do the heal and knee at the same time. Arthroscopy of the knee, debridment of the achilles. 10yrs larer leg and heal feel great.
i am recovering from a partial knee replacement. I saw several orrthos and only one from Chicago said I was one in a hundred who was a candidate for a partial. This advice was invaluable. Few MDs do partials as they are not appropriate for most.
Twenty something years ago I had a scope on one knee. I had a torn meniscus.
I had an epidural during the surgery and no pain until the epidural wore off. Afterwards I had the worst pain of my life!
That knee was fine for a while but both knees hurt now. I haven't seen anyone about them since I've had bigger problems with other parts of my body.
I'll probably need surgery at some point but I'd feel better if it was someone like you!
Thanks for sharing another great video!👍
Back in the mid 80's my cartilage wore out, I had surgery on the left knee about 5 years earlier to fix a tear but there wasn't much help for worn out cartilage so I lived with the pain and actually wore the bone smooth and was able to function normally, then I tore the ACL in the left knee around 2008 and had surgery again, this time the surgeon showed me the scope pictures of my knee because he couldn't figure out how I was able to walk as my knee was ravaged by Osteoarthritis and looked like a course gravel road. Still walking fine minus one foot on the same leg(cancer), right knee complains once in a while but otherwise still functions. Played a lot of sports in my younger years and knew there would be a price to pay later in life, I say thanks to all of the Orthopedic Surgeons I've had over the years that have kept this ragged old body going. Great job guys, really enjoy the videos.
When I first went in for my knee pain the X-rays showed not a lot of gap between the bones, especially on the inside of the joint and some arthritis but the thought was I didn’t need surgery yet.
I tried knee injections, they didn’t help all, and was then fitted for an unloader brace and basically told I didn’t really need much else yet as the x-rays didn’t show anything too serious.
While the brace allowed me to walk any thought of hiking or pickleball was just not something I could do anymore.
I still had considerable pain and the brace itself was uncomfortable to wear so I paid for a private MRI and the results showed a large hole in the cartilage on the inside of the joint allowing bone on bone contact.
After my Dr saw this he agreed that surgery was necessary.
So for me, the MRI was worth it
As of today it’s been just over 4 weeks since my surgery and while it has been a lot more painful than I thought it was going to be, as of this week the pain is starting to drop and my mobility and such is returning. If not for that MRI I think I’d still be hobbling around in a knee brace.
My goal is pickleball by the new year. 😃
I developed knee arthritis rather young. A few years and multiple doctors later, finally found one who listened and gave a good examination. He saw arthritis in the X-ray. Still had an MRI, which showed arthritis was worse than the X-ray indicated. I also had a CT for surgery planning. Now at 37, I've had 2 partial replacements and an osteotomy. I can function again!
2 weeks of PT and no improvement. Finally convinced my primary to get a mri. After a full 2 weeks of healing and PT the MRI showed clear bone bruising. Ortho thought they were going to have to "unlock" my knee. Thankfully not necessary. But many more weeks of PT
The Dr. had me go to P/T two months ago for my knee pain. He gave me the injections recently and I feel better. 82 here.
Now you have me nervous ... just had an MRI two nights ago for the knee, suspicious of meniscus tear. And yes, was told, nothing could be done until we had the results! *sigh*
Thanks for sharing this video. I know my old orthopedic doctor wouldh do the x-rays at first if I haven't been there in awhile then we would do the mri in my left knee all the time from meniscus, cartilage repair to a partial knee replacement, acl twice. I remember the pictures from the scopes and I still have them from my knee. Like right know I'm still waiting for my new knee about 3 more years to go before I can get it. When I stand straight I have to keep that left knee bent if not it hurts me to bend it when I try to walk. .❤❤❤❤
Hurt my knee in an accident at home. Heard the loud pop and couldn't immediately stand on my knee. Elevated and iced it a bit, there was no significant swelling. Walked to Urgent care a couple of hours later. Doc examined, said leg was strong, most likely just a sprain, not even Xray was needed. Sent me home with instructions to RICE and wrap. A week later saw my regular doctor for yearly physical, didn't even mention the knee but she saw the wrap and did a couple of tests on it (Lachman, etc) and said to keep doing RICE and if not back to normal in 2 weeks, see an Ortho. Went to Ortho 3 weeks later. Xray showed nothing, after manual exam she said most likely torn ACL.
MRI showed fully torn ACL, sprained MCL. torn medial meniscus and nondisplaced tibial plateau fracture. Couldn't believe it, was walking on it all along. Had surgery after a couple of weeks of PT.
So yes, if you have knee pain, see an Ortho. They will be able to better evaluate - MRI or not - but the MRI was needed for the insurance to approve the surgery.
Hope you are ok
I had a MRI recently to help diagnose a medial meniscus tear. Initial X-rays did not show any arthritis but I had unrelenting pain. After the MRI the surgeon said I could wait to see if surgery is needed. I’m getting PT and the knee is almost back to normal after just a couple of weeks of therapy. So I’m hoping to avoid surgery and return to normal activities which for me include hiking, biking, and skiing which is how I injured the knee in the first place. I’m 72. I can’t prove it but I’m taking turmeric and I think it is also helping with the inflammation and pain.
Thank you for making these videos. Very helpful.
in my situation, I had an acute injury doing some wall squats.the doctor I went to thought I just had an MCL sprain,he did trigger point injections and I did physical therapy.I kept telling him that I had severe pain that would wake me up in the middle of the night going around my kneecap in both directions.he finally did an MRI. Upon reviewing it with me he said I'm sorry, you actually have a surgical knee because your meniscus is shredded.
this was unfortunate because I kept telling him I knew something more was wrong than he thought.so unfortunately part of his assessment.should have also been listening to me. I ended up spending months in pain and spinning my wheels for no good reason. I wore a heavy long brace all that time and as an RN had to keep working :(
Key think you said (imo) is if he'd listened to me. So many people seem to know 'intuitively' what's going on. Important for doc to listen and interpret. Often docs hear and observe symptoms and concludes in diagnosis which is sometimes (IME) a 'fishing expedition. Important to listen seriously to a patient's thinking based on what they know, from experienced knowledge, about their body (imo).
Accuracy in diagnosing is a challenge.
, for sure. Experience +knowledge & wisdom do often trump experienced knowledge BUT the patient, like a mother /child intuition may well know more than is credited. (IMO)
Very interesting info listening to all 3 docs. Thanks Dr. Deacon for 40 years on knees!😊👍🇨🇦
I had an MRI for other reasons and my main memory is being shouted at by the operator for not lying still 🤣
After damaging my left knee as a teenager in a motorcycle accident I had a lot of instability and an arthroscopy maybe 10 years later fixed that for 25+ years until I started to get issues again. My surgeon than said could do another arthroscopy but recommended I lose weight and exercise (everything bar running). I walk a lot since then and used the gym a lot and so far so good.
Your "wrong diagnosis" concern of MRIs seemed surprising, but then I remembered a study where MRI results for baseball pitchers at various levels of the sport showed 80% of them had tears to their pitching shoulder without any symptoms or performance impact. I guess that can make diagnosis for patients with pain and/or loss of function challenging - hence the patient history being an important diagnostic tool.
24 years ago, I had an MRI on my knee, and my situation then fit the parameters described at 9:21.
The mri was a machine I stuck my leg in. It wasn't bad at all.
Thank you doctors. I appreciate your time.
I am loving your videos I've been watching for a long while
I am a disabled vet here in the US. I need 2 knee replacements but have been putting off the surgery. My Dr. prescribed the H-Wave machine in the meantime to use. Have any of you ever heard of H-Wave?
Excellent, detailed explanation! Have been through a very unnecessary series of testing, including MRI. P.T. at my request helped Immensely.
Thank you.
My MRI was to build my R TKR , surgery 7/31.
Is there any real way to replace the cartilage in the knee rather than have the regular knee surgery.
Nope not at this time
Wonderful informative videos - love your style! 😊 🙏
Your videos are great! Can you do a video on genicular artery embolization? Thanks!
I love your sports orientated videos. Thanks Docs :)!
So I went to the Orthopedic doctor because I have pain in my knee which is getting worse. I was told back in 2018 that I had a meniscus tear and Baker's Cyst and that everything else was normal. The doctor suggested to try cortisone shot(3) over 4 years and just last year they gave me an Large Joint Inj/Asp R Knee Cortisone injection all of which has not helped. The pain is 8 out of 10 everywhere except the outside of the knee, and I have sharp pain on the interior part of the knee. Based on my history and the pain the doctor wanted to get an MRI, as the doctor said that you only get a Baker's Cyst if something is wrong with the knee, so I just had an MRI of my Right knee and results are - Lateral Compartment Cartilage surface irregularities of the posterior non-weightbearing femoral condyle. Patellofemoral Compartment Full-thickness cartilage loss along the central trochlea, Edema of the suprapatellar fat pad. Tendons: Mild distal quadriceps tendinosis. Ligaments: Small intra-cruciate ganglion along the distal ACL, possibly sequela of prior injury. Intact PCL. Intact collateral ligaments. Joint: Physiologic joint fluid. Small amount of fluid within the semimembranosus-gastrocnemius bursa and along the popliteus recess. Soft Tissues: Patellar subcutaneous edema. Can't wait to hear from the doctor this week.
Had knee pain after landing from a jump so I got an mri and it said I had a very small grade 3 cartilage fissure in my patella. Also, they couldn’t see a re-tearof my meniscus (was previously repaired 6 months ago). My doctor doesn’t recommend surgery, but consistent pain for two months isn’t fun either. He said just wait it out some more.
That’s good advice. Scoping your knee would be unlikely to help it improve. Best of luck!
Thank you for this video. I had been asking my Dr. for a MRI. I had a knee replacement in December and he sent me back to work in February. I Stand up and walk for about 10 hours per day for 5 to 6 days a week. Well, my quad muscle wasn't strong enough, and my knee was swollen with a lot of pain. I couldn't walk. I had to take off work again. I asked him for an MRI and he wouldn't. But he didn't tell me why. I got very aggressive with him about it. He's sending back to work in July. I'm not sure if I'm ready but I'm gonna try.
If it takes 6 months to a year to heal why do doctors rush you back to work. I work for a automotive company. I'm always on line twisting, bending, standing, walking etc.
I'd like to see your take on CMC joint arthitis and relief please n thanks
I guess it's important to remember (?) that your ortho surgeon will do an MRI in prep for a TKR, different circumstances correct? Getting my 2nd TKR later this year! (oh joy...actually yes, oh joy to not have to worry about it anymore!).
Usually we only need an xray for a tkr. Need it more for arthroscopy. Good luck Dino!
@@TalkingWithDocs Thanks Docs! My surgeon did order a MRI in prep for my 1st TKR using the MAKO robot; the way it was explained to me as a lay person was that helped build the model for the robot to follow. I'll ask him again with the pre-op this next time. Keep up the great work, always a real treat to see your videos regardless of topic!
Most importantly examine the Range of motion of the ipsilateral hip. I have seen countless patients with "KNEE PAIN" who had a slipped capital femoral epiphysis. or avascular necrosis of the hip or degenerative arthritis of the hip without a simple hip exam. Most commonly is loss of internal rotation of the hip.(ipsilateral). Kind Regards. Craig
Yes joint above and below for sure
I couldn't figure out how to ask a general question, so im just going to try here. I love your videos...just found them 2 days ago and wish I would have sooner. Can yall please create a video on phototherapy patches?
You need an MRI of your knee problem is significant enough to warrant surgery. Thats pretty much it.
E.g. significantly lax or locked knee, or debilitating knee pain or loss of function without adequate explanation from xray and history.
Fell at work. Knee went out sideways landed on inside of my knee. Instant swelling and bruised. 4 weeks later. Pain left joint area and burning sensation left knee and pain into back of my knee. X ray looked fine. Mri soon but not done yet. Unsteady knee side to side and turns. In a fancy brace. Knee catches and then let's go like a sling shot and cracks very loudly. I have never had issues with my knees. I am 35. Was an Olympic athlete in the past.
What do you think is wrong?
My husband had an X-ray on his right knee and let me tell you it is messed up. The ortho said if he did surgery on it, then he would hate him for giving him surgery. I had an x-ray on my left knee, but mine is not as bad as my husband, but it is messed up.
I don't understand, I had x-rays by the second most prominent ortho doctor in my community and they threw everything in the arthritis bucket but when I went back 10 weeks later because I could barely stand anymore and they did the MRI. they said my meniscus was torn in seven places and I have the printout where they did the orthoscopy and wrote right on there what they did to repair it. and that doctor apologized to me for telling me it was just arthritis and that the meniscus was just flopping around in there. his words not mine
How is it possible for a Titanian knee to hurt. What causes post-replacement surgery pain long after surgery.
So, got the analysis part BUT if many ppl have knee pain while getting up, or from a squat (no excessive weight issues) what is the best strengthening exercise may be beneficial? Do cartilage/dietary supplements assists for us late 60-70 yr old ppl?
I am 64 and I have knee pain that wakes me up. No injury, just starting. What should I do?
I don't know your medical history but I'm going to suggest that you go to your doctor and tell him what's going on. exam by him or her and then x-rays. I'm going to also suggest that you probably have arthritis of some sort, there are a number of things that you can do including dietary changes weight change and physical therapy . good luck :)
🎉great info
I presume that after a total knee replacement, I will NOT be able to have an MRI on ANY body part due to the metallic parts of the knee replacement hardware.
Nope ... Two nights ago, I had an MRI on my left knee. Right knee and left hip have already been replaced. Left is now suspicious of meniscus tear.
I just had one on my left knee
Good luck!
Just had 2nd mri for my knee. Had meniscus fixed twice.
Waiting MRI results now, somewhat wary of finding more than is helpful! After a worsening chronic flare-up, I got a cortisone. shot, but 4 days later felt a sharp pop on a step down, with bad pain and instability following. Got re-examined and MRI ordered. Pain is better now, but I’m curious to know what I’m dealing with given the popping injury, and how to get stability back.
Fingers crossed
History: At age 22 in 1975, fell snow skiing. Diagnosed with bucket handle tear of medial meniscus, left knee. Open surgery to remove every speck of medial meniscus. Thirteen years later, injured left knee again, had scope to clean out loose bodies. Again, five years after that. Then again, three years later. In 1997, scope did not result in no knee pain, so new knee surgeon recommended me as a candidate for meniscal allograft and autologous chondrocyte implantation. No arthritis present at all, which was why the recommendation for this double procedure, which was done in summer, 1997. Could run up and down stairs again, with no pain! Then, in 2022, knelt down on left knee, which resulted in intense stabbing pain, and massive swelling. MRI conducted 6 weeks later. Report said Stage 4 osteoarthritis and replacement meniscus is shredded and extruding. I said the hospital mixed up my report with someone else. Continued swelling. A month ago, second MRI confirms Stage 4 O/A and shredded meniscus, bone spurs. Since this was a different facility, I had to accept that my left knee is bad.
So, trying to get appointment with knee replacement specialist. GP says I was facing a replacement two years ago. I live in denial and said maybe a scope to clean out the raggedy bits. He smiled. Old rebuild surgeon confirmed I was facing replacement. I said no, just do what you did 27 years ago. He said 'we don't do that anymore.' Because you're not 22 anymore. I've developed arthritis. HAH, I say.
Seriously, at age 72, only arthritis I have showing symptoms is both thumb base joints, very occasionally. Not constant. Those present with a dull ache, not sharp stabbing pain.
I am terrified at facing replacement surgery. Is this really the only answer? Do not take anything for the pain, as pain meds do not work on me. Now, walking is difficult. I used to walk quickly, and now I am very slow, and am not accepting that well at all. Any advice, recommendations?
U said it the real reason is not enough machines….lack of money…..
Who wouldnt want an xray and mri if they have major knee pain…..come on boys…..u said it not enough machines …xrays are cheap thats the reality….
So yes that’s part of the reason but the management doesn’t change with the MRI in many cases that’s why it should only be ordered for specific pathology. Hope that’s more clear.
I had fallen down hard on both kneecaps.
Due to caregiving for my husband I put off arthroscopic surgery for 2 years.
By then I couldn’t climb stairs without shooting pain in my knees.
Had the arthroscopic surgery done 5 years ago and found out I had 3 tears in my meniscus and quite a bit of arthritis.
My knees felt very good after surgery and a few weeks of therapy.
My R knee is just now starting to really bother me again.( pain and a feeling of weakness).
Latest X-rays show arthritis hasn’t gotten much worse but orthopedic dr is concerned about the stability of my knee.
He is recommending an MRI.
Do you think I should try a few weeks of therapy first? 11:35
What's the difference between cartilage and meniscus?
So meniscus is a type of cartilage. But the other type is the kind that lines the end of the bones and as it wears away that’s what arthritis is
Thank you
I had a bone scan on my left knee. The report says that Impression
- Periprosthetic uptake at the left knee particularly around the femoral prosthetic component, seen only on the delayed images. Can you please explain what this means?
How far if any should the tibial component overhang the tibia?
Ideally none
I had a fall and injured my knee, xray days no fracture. I have a requisition for ultrasound not mri. What will that show?
👍
Hey docs what kind of docs r u guys?
Orthopedic Surgeons
Orthopedic surgeons.
Yes!
The MRI doesn't have radiation but they usually are done with contrast medium, gadolinium. That's not good for you.
It depends on the MRI. Some are performed with contrast, and some without.
@@michaelvittori8525 and that's why I said, usually, instead of always.
There is recent research showing the body has difficulty fully clearing the chelated gadolinium from the body. The FDA has released an advisory because deposition of the gadolinium commonly used as the MRI contrast agent has been found remaining in the bones, soft tissues, and especially the brain. It is unknown how long the chelation bond may remain stable in those areas where the gadolinium remains. A toxic heavy metal, gadolinium presents concern once the bond begins to break down.
@@Sometimes-even-lyrical I'm sure it's better to get MRI's without contrast healthwise even though they show more detail. My knee and shoulder MRI's were performed without contrast.
@@michaelvittori8525 I did that for a cardiac function MRI.
Visiting doctor wasn't allowed to talk much or explain anything? for example what is a mri for or when to get one? The orthopedic foc didnt answer. They asked a question and the other doc answers? And the Visiting doc either agreed or disagreed or clarified what they missed😊
Why have a guest if you're not going to let him speak?
Elephant in the room…..not enough mri machines and cost of them.
Seriously athletes get mri’s.
U may have arthritis but u may have other things happen….or going on…sounds like u write of oder people….
We do see a lot of older patients for sure. If a younger patient has severe knee pain and their xray is normal they will often get an MRI
Everything would be fine, but this doctor on the right, who is always the most active, speaks the loudest, is just annoying and spoils the whole video, so I switched it off. He looks more like a Sales Person than a Doctor., too hyper 🙈
I enjoy the wit and wisdom. Both are specialists and experienced docs with personality. Save the formality for the office/clinic. Entertaining plus informative. Yep, choice. Change the 'channel' or relax and learn.(Imo).👍🇨🇦
I was referred for an MRI for hip/knee but the cost on Medicare was ridiculous. After going back to my rheumatologist, she said an x-ray was more than sufficient. After the x-ray neither the hip or the knee reflected terrible arthritis, but my pain was off the charts. I only recently heard from my Primary Care Doctor that I am suffering with bursitis, now months later I can barely walk and must use a cane in my home to get around. I will soon purchase a walker for mobility.
I had an epidural cortisone for nerve pain relief which was a total waste of time and money. The ONLY relief I ever experience was a cortisone shot into my hip. The knee cortisone shot did absolutely nothing. I started with lower back pain in my 30's now in my 70's I live alone and am fearful of a fall and I am awaiting death to put this crap to an end. Doctors in the States are CRAP!!
How’s your weight?
An x-ray won't show soft tissue damage. You should consider getting the MRI if you can afford it.
Hey Docs, you asked for comments about frustrations, so here’s mine. Often an X-ray and complaint of knee pain is not enough to get a referral to an orthopedic. I have had 2 X-rays over the past year ordered by 2 different doctors and neither ordered standing X-rays. I certainly didn’t know better. Perhaps there is a disconnect there? As my knee got worse, I finally got an MRI in Feb (crossed the border to get it faster $). My knee is pretty bad and my ortho appt is not until Aug. Tried Cingal but it was a bust. So while a surgeon may not need me to get an MRI, it seems like it’s the ticket to see someone that can actually help. 🫤 Now that I’ve had an MRI, should I get a standing X-ray too? Thanks for all the info.
That is fascinating, thanks for the great video. Glad to have this information if I ever have knee issues. 🦵
I had fallen down hard on both kneecaps.
Due to caregiving for my husband I put off arthroscopic surgery for 2 years.
By then I couldn’t climb stairs without shooting pain in my knees.
Had the arthroscopic surgery done 5 years ago and found out I had 3 tears in my meniscus and quite a bit of arthritis.
My knees felt very good after surgery and a few weeks of therapy.
My R knee is just now starting to really bother me again.( pain and a feeling of weakness).
Latest X-rays show arthritis hasn’t gotten much worse but orthopedic dr is concerned about the stability of my knee.
He is recommending an MRI.
Do you think I should try a few weeks of therapy first? 11:35