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Posts Tagged ‘torn meniscus’

The long awaited MRI results are in….

February 7, 2010 3 comments

Drum roll please…….And the winner is……tear of the meniscus.. 😦  A horizontal cleavage tear of the posterior horn of the medial meniscus to be exact.  AND and a special bonus that only 5% of meniscus tears get…a parameniscal cyst (I guess I’m an overachiever).  Awesome right?  Yeah that’s what I thought too, awesome.  Well, I haven’t seen the doctor yet to hear what he thinks but I got the results mailed to me.  I thought they would send the MRI pictures, but they sent a diagnosis in words.  That is probably better since I’ve been studying MRI pictures online for a month now and still have see what the descriptions are talking about.

What is a parameniscal cyst….good question, here is the answer,

Definition: A meniscal cyst is an outpouching of joint fluid caused by a tear within the meniscus. Meniscal cysts are most commonly seen near the lateral meniscus (outside of the knee) and are associated with a specific type of meniscal tear called a horizontal cleavage tear. Meniscal cysts can be drained with a needle in the office, but they will often come back. The reason for the return of the meniscal cyst is that the tear that leads to the cyst must also be treated. The meniscal cysts are usually best treated with arthroscopic treatment of the meniscal tear. The meniscal cyst will usually decompress and less commonly returns.

Meniscal cysts are related to popliteal or Baker’s cysts–however, these types of cysts are located in the back of the knee joint.

Although, my tear was not in the lateral meniscus, but the medial (inner part of knee).  So my original thought of an inflamed bursa sac was incorrect, it was actually the cyst that was bulging out of my knee, I guess.  At least it is much smaller now, 6mm to be exact.

I’m not too worried.  Although not the greatest news, I can handle it.  I will have a doctor visit hopefully sometime next week to get his thoughts on the next step.  Meanwhile I will strengthen my leg muscles as much as possible to help with a speedy rehab (assuming of course, I go under the knife).

I am confident in a quick and full recovery.  Boston Marathon plans will obviously have to be put on hold until next year.

Not mine, but an MRI of cyst and tear

Bad Knee News…(but don’t worry)

January 14, 2010 2 comments

Went to the doctor on Tuesday to check out the knee problem I’ve been having since extended kneeling while cleaning.  It appears to be a meniscus problem in my left inner knee.  The good thing is both of my knees are stable.  There is no problem with ACL, MCL, or PCL.  Everything is sturdy.  AND everything is relatively pain free.  I mean, I came in 4th in a triathlon with ease 🙂

Anyway, my knee doesn’t feel right, it feels “loose” and pops more then usual, which is why I succumbed to the medical professionals, which I really don’t like doing…

The doctor was cool, I actually picked him from a giant list of available doctors online with my insurance company.  The reason I picked HIM in particualar was he was a D.O. and not an M.D.

D.O.s bring something extra to medicine:

  • Osteopathic medical schools emphasize training students to be primary care physicians.
  • D.O.s practice a “whole person” approach to medicine. Instead of just treating specific symptoms or illnesses, they regard your body as an integrated whole.
  • Osteopathic physicians focus on preventive health care.
  • D.O.s receive extra training in the musculoskeletal system-your body’s interconnected system of nerves, muscles and bones that make up two-thirds of your body mass. This training provides osteopathic physicians with a better understanding of the ways that an illness or injury in one part of your body can affect another.

I didn’t even know what D.O. meant, and had never seen or noticed the abbreviation before.  I decided it would be a good option for my knee.  I then got lucky in that the D.O. I saw was a fellow triathlete!  I love athlete doctors!  They understand athletes so much better than normal doctors.  So the preliminary diagnosis is partial meniscus tear or fraying.  So I will take 2 weeks off of running or biking, so scar tissue can form and then I can test it out again.  If it is still swelling after running, an MRI will be taken to check out the extent of the damage.

This gives me more time to work on my swim stroke, which I did today.  I think I’m faster already!

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How to Rehab a Torn Meniscus-VIDEO

My knee has been feeling good.  Still popping from time to time.  I’m working on hamstring flexibility and doing the standard R.I.C.E with an addition of ultrasound, so U.R.I.C.E.  Ultrasound is good because it increases blood flow to the injured area, and since swelling is down, blood flow is a key to healing, especially in things like cartilage which get very little blood flow as it is.

A few more great articles from Livestrong…

5 Things You Need to Know About the Knee Mensicus

1. What Is a Meniscus?

The meniscus is a C-shaped piece of fibrocartilage that acts like a cushion between the femur (thigh bone) and tibia (shin bone). It is wedge-shaped, such that it is larger on the outer rim of the meniscus and tapers towards the inner rim. There is one on the lateral side and one on the medial side of the knee. The medial one is torn approximately three times more often than the lateral meniscus.

2. What Is Its Function?

The meniscus serves to distribute the forces more evenly across the joint. The end of the femur is curved, whereas the tibia is relatively flat. A curved object meeting a flat surface only has a small contact area, and therefore higher peak contact pressures. The meniscus “cups” the end of the femur and spreads out the pressure. It also functions as a shock-absorber. Its collagen fibers are oriented both radially and circumferentially to accomplish these tasks.

3. How Is It Torn?

The meniscus can be torn with an injury (traumatic) or with wear-and-tear over time (degenerative). Traumatic tears usually happen in younger patients, with twisting motions or sudden changes in direction or speed. They also happen in conjunction with other injuries, especially anterior cruciate ligament (ACL) tears, up to 70% of the time in some studies. Degenerative tears occur because the meniscus thins out and becomes more easily torn. Over time, the meniscus has less collagen and more water content. It is less able to resist the forces put upon it. There are numerous configurations of meniscus tears–horizontal, vertical, radial, longitudinal, complex, bird beak, flap and bucket-handle tears.

4. How Do I Know If I Tore My Meniscus?

People with traumatic tears can sometimes pinpoint it to a specific activity, oftentimes associated with a popping or tearing sensation. In other cases, there is no inciting event and no limitations to activity, except for occasional pain. Common symptoms include pain and swelling, tenderness on the joint line, effusion (water on the knee), catching or locking, and a sensation of your knee giving out. Sometimes, the tear is large and unstable. It can flip inside-out upon itself, like the handle of a pail (bucket-handle tears). When that happens, the knee can lock up and get stuck at a certain angle or it is unable to be fully straightened. A radiograph (x-ray) may be useful in ruling out other causes of these symptoms, but it largely only shows bones. Remember, the meniscus is made up of cartilage. Magnetic resonance imaging (MRI) is useful in diagnosis, because it shows not only bones, but muscles, tendons, ligaments, articular cartilage and, of course, the meniscus.

5. I Don’t Want Surgery–What Are My Options?

Non-surgical treatments include rest, anti-inflammatory medications and physical therapy. Meniscus tears tend not to heal by themselves due to a poor blood supply. However, it may get to the point where it doesn’t bother you, especially with smaller tears. There are plenty of people out there walking around with meniscus tears. By calming down the inflammation and strengthening the muscles around the knee, the tear may only cause an occasional twinge or flare-up. If you know certain activities aggravate the meniscus tear, but if you can live within those limitations, then you may want to just observe tear to see what happens. On the other hand, if the symptoms are affecting the activities you want to do, then it’s probably time to talk about surgery.

Signs of a Torn Miniscus

The purposes of the knee meniscus (menisci for plural because there are two in each knee joint) is to disperse the stresses of weight across a large area of the knee in an attempt to keep the joint cartilage healthy. The menisci also serve as shock absorbers in the knee as well as stabilizers of the joint during most activities. They are crescent-shaped and have a tapered appearance.
Because the meniscus is composed of a tough rubber-like cartilage, it tends to not heal when torn. In turn, the knee can exhibit certain particular signs and symptoms indicating a torn meniscus.

Pain

If the injury is recent enough, there may be pain, ranging from mild soreness to severe disabling pain. This occurs primarily because there are pain nerve endings in the outer zones of the cartilage, as well as pain receptors located within the joint cartilage cells. When weight is applied, or motion exerted, on the knee joint, pain receptors fire to warn the host of a problem within the knee.

Excessive Fluid Production in the Knee (Effusion)

In cases of a torn meniscus, the tear pattern can be such that a portion of the meniscus can displace into the knee joint, creating a mechanical blockage or irritant. If this happens, the body only knows one way to battle against the irritation that is caused by the meniscal tear, and that is to produce additional joint fluid. This is done as the body’s effort to increase lubrication to reduce the local mechanical irritation. This is called “joint effusion.”

Limited Range of Motion

Meniscal tears, especially with the added problem of extra fluid buildup in the joint, can easily translate into altered range of motion of the knee. The mere presence of excess fluid can cause hydraulic pressure to be exerted when there is an attempt to bend the knee, effectively blocking full motion.

Additionally, the torn meniscus can, and usually does, play an important role in altered mobility of the joint, particularly if the meniscus has been damaged to the point of mobile flasp that flip in and out of the knee, causing a “catching” sensation.

Popping Sensation

A torn cartilage can often “flip” in and out of the joint, getting “stuck” and then releasing back to its near-normal position and shape. The catching is frequently referred to as a “popping” in the knee and is one of the most common complaints.

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