Final US follow up
Posted by quirksalight on February 7, 2008
And the story continues…
On Monday, I met with the Orthopedic Surgeon I’ve been seeing in VA to go over the MRI results from last Wednesday, and the scans from NY (which just arrived in the mail). This is the last time I’ll be seeing the OS before heading to Korea, barring any unusual circumstances, so I wanted to get a full accounting, etc.
One thing that’s pretty cool is that you get a cd with the MRI scans burned in to it. So of course I was perusing my knee prior to my appointment. And… well… it looks like the defect decreased in the inferior-superior direction and grew in the medial-lateral direction.
However, the MRI images are in 2-D. So if the scan isn’t in the middle of the chondral defect, then there can be interpretation issues. For example:
Here are two possible scans in figure 1. The circle is representing the focal defect, and the lines the plane of scan.
Figure 1: Lines A & B represents the plane that the MRI took a cross sectional scan of the focal defect (which is the circle)
Scan A is directly in the center, it’ll give an accurate read. Scan B is off center, giving a false reading of the defect, indicating it is smaller than it actually is.
Figure 2 A,B: Cross sectional view of how the chondral defect changes depending on scan location
Figure 2 illustrates this, as the image of the defect in the plane of scan would look like 2a for scan A and 2b for scan B.
Basically, since the damn thing is still there and b/c my knee still hurts, the Baker’s cyst is there, I still have a problem. The OS recommends surgery, to realign the patella. And I can understand the reasoning, but I really don’t want to do a pretty invasive procedure if I can avoid it. Right now, the knee pain is not a severe detriment to my quality of life, it just forces me to be more careful of my physical activities than I had in the past. Yes, pain and swelling is there. But hopefully it’ll continue to be manageable via NSAIDs, ice, PT, and exercise.