MRI Analysis of Right Knee Pain
For a few months now, I've been experiencing discomfort in my right knee, specifically on the medial aspect. Recently, I've noticed a protrusion on this same side when I move my knee. To alleviate the sensation, I often have to rotate my knee slightly to push the bulge back into position. In response to my symptoms, I underwent an MRI, and I have translated the findings below from Greek, as I reside in Greece. What insights can be drawn from my MRI results? **MRI Findings:** - There is a complex tear located at the edge of the posterior horn of the medial meniscus, which extends to the junction between the meniscus and the capsule. - A small amount of joint fluid is present, indicating minimal effusion. - The fat pad anterior to the patellar tendon is swollen, particularly where it attaches to the lower part of the patella. - The articular cartilage of the patella shows no significant abnormalities. - The cruciate and collateral ligaments, along with the patellar tendon, are intact; however, findings suggest a Grade I sprain of the medial collateral ligament, characterized by fiber stretching without rupture, accompanied by a smooth swelling along its length. - There are no indications of bone marrow edema. - A small volume of fluid is present at the mucous fold of the infrapatellar fat pad, located toward the posterior medial aspect of the joint.
Answers (1)
8/10/2025, 7:20:42 PM
OpenHealth AI
Your MRI results indicate some issues in your right knee, particularly with the medial meniscus and a mild sprain of the medial collateral ligament (MCL). Here are the key points from the findings and what you might consider doing next.
Main Points from MRI:
- Medial Meniscus Tear: You have a complex tear in the medial meniscus, which can lead to pain and instability.
- Joint Effusion: There’s a small amount of fluid, indicating some inflammation or irritation.
- MCL Sprain: You have a Grade I sprain of the MCL, meaning there is slight stretching but no complete tear.
- Fat Pad Swelling: Swelling at the fat pad suggests additional irritation but no significant damage to the surrounding structures, like the cartilage.
Explanation:
- The medial meniscus is a C-shaped cartilage that helps cushion the joint. A complex tear can often lead to pain and reduced mobility. Common symptoms include a "catching" sensation or swelling.
- Joint effusion implies some inflammation, which is often a response to stress or injury.
- A Grade I MCL sprain means that while the ligament is stretched, it remains intact, allowing for some recovery with proper care.
- The anterior fat pad swelling can indicate irritation, commonly seen in conditions like knee impingement or patellar tendinopathy.
Next Steps:
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Activity Modification: Reduce activities that put strain on your knee, such as running or squatting, to avoid aggravation. Focus on low-impact exercises like swimming or cycling.
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Rest and Ice: Initially, rest your knee and apply ice for 15-20 minutes every couple of hours. This can help reduce inflammation and pain.
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Compression and Elevation: Use a knee brace or wrap for support, and elevate your knee whenever possible to minimize swelling.
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Gentle Range of Motion Exercises: Once you can tolerate it, begin gentle range-of-motion exercises to maintain flexibility. Avoid any movements that cause pain.
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Consult Healthcare Provider: If symptoms persist or worsen (especially if you begin to experience locking of the knee, significant swelling, or severe pain), consulting with a healthcare provider or a physical therapist could be beneficial. They can provide targeted rehabilitation exercises or assess if surgical intervention might be necessary, given the complexity of the meniscus tear.
Feel free to reach out for more detailed advice or clarification on any steps! Take care of your knee, and remember that gradual recovery is key.
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# 7-Month-Old Child with Abernethy Malformation - Exploring Treatment Options ## [7-Month-Old] Identified with Abernethy Malformation (Congenital Portosystemic Shunt) - Treatment Methods? **Age:** 7 months **Gender:** Female **Height:** Age-appropriate **Weight:** Currently 9 kg, was 2.8 kg at birth **Ethnicity:** Asian **Duration of Symptoms:** Present since birth **Location:** Uzbekistan **Pre-existing Health Issues:** Abernethy malformation (congenital portosystemic shunt), liver hemangiomas, chronic jaundice, anemia **Current Treatments:** Supportive management --- ## INITIAL PRESENTATION (June 2025 - July 2025) Our daughter arrived on **June 27, 2025**, presenting with: - Birth weight: **2.8 kg** - Marked jaundice (yellowing of skin and sclera) - Pale or clay-colored stools - **Bilirubin level: 245 μmol/L** (typically <20) An immediate ultrasound indicated multiple liver anomalies, initially thought to be hemangiomas. --- ## FIRST COMPREHENSIVE ASSESSMENT (August 1, 2025 - 1 Month Old) ### Multislice Computed Tomography (MSCT) with 3-Phase Contrast (August 1, 2025): **RESULTS:** - 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7 Months Old) - **Weight:** 9 kg (good growth rate in spite of condition) - **Jaundice:** Continues to be present (yellow skin) - **Stools:** Remain pale/clay-colored - **Development:** Achieving appropriate milestones - **Energy:** Appears to have a good energy level - **Feeding:** Normal appetite --- ## QUESTIONS FOR r/AskDocs We have been informed this is **Type 2 Abernethy malformation** (portal vein present). **Three treatment avenues have been proposed:** ### Option 1: **Endovascular Coil Embolization** (minimally invasive approach) - A catheter is inserted via the leg vein to access the shunt and deploy coils/plugs to close the abnormal vessels - Pros: No surgical incision, minimal discomfort, short hospital stay (2-4 days), no scars, enhanced safety - Duration: 1-2 hours - Recovery: 2-4 weeks for jaundice to show improvement ### Option 2: **Open Surgical Intervention** - An incision in the abdomen to ligate abnormal vessels and redirect blood to the liver - Pros: Direct visualization, effective results - Cons: Surgical scar, longer recovery time (7-14 days in hospital) - Duration: 2-4 hours ### Option 3: **Liver Transplantation** - We have been advised this is not necessary as the portal vein is functional and liver health is improving. --- ## SPECIFIC QUESTIONS TO CONSIDER: 1. **With a functional portal vein (6.1 mm) and improving liver function (ALT normalized), is it advisable to pursue endovascular closure as the preferred treatment?** 2. **Despite ALT levels improving, the bilirubin remains consistently high (242). Should this be a cause for concern? Is there a prospect for it to normalize post shunt closure?** 3. **Are the hemangiomas/nodules (11.6×20.7 mm) linked to the shunt? Will they likely resolve following shunt repair?** 4. **How urgent is the proposed intervention? Is immediate action required, or is there flexibility to wait a few months?** 5. **What complications should we be vigilant for during the waiting period?** 6. **Regarding endovascular closure - what is the average success rate for infants aged 7 months? Are there concerns regarding the shunt size (9.9 mm)?** 7. **The measurement of the portal vein has shown improvement from 6.1 mm to 3.9 mm; should this be perceived as a positive sign or a reason for concern?** 8. **Are there special directives (diet modifications, medications) we should consider while awaiting the procedure?** 9. **Post-procedure, how long should we expect it might take for:** - Normalization of bilirubin levels? - Return of stool color to normal? - Resolution of jaundice? - Regression of hemangiomas? 10. **Can you recommend any specialized centers for pediatric Abernethy malformation treatments? We are located in Uzbekistan but are prepared to travel (to Turkey, Russia, South Korea, etc.)** --- ## ADDITIONAL INFORMATION - No family history of hepatic diseases - Pregnancy and delivery were normal - No additional congenital defects identified - Immunizations up to date - No history of bleeding disorders - No signs indicative of encephalopathy - Child is alert and engaged --- **I can supply actual MSCT images and comprehensive lab reports if they would be of assistance.** We sincerely appreciate any insights you can provide. We are striving to make the most informed decision regarding our daughter’s care and highly value expert medical opinions. **TL;DR:** 7-month-old diagnosed with Abernethy Type 2 malformation (9.9 mm portocaval shunt, patent portal vein). Liver functionality is improving (normalized ALT) while bilirubin remains elevated (242). Evaluating options between endovascular coil embolization and open surgery. Seeking expert advice on optimal treatment strategy and timing.