Please explain these MRI results in plain English as if I am 5. IKYANMD
January 11, 2016 9:47 AM Subscribe
I got an MRI on my ankle, the written report of the images has complex language that I don't understand, please help me understand it in plain English. IKYANMD
IKYANMD. I will attach the results below, I googled a lot of the stuff but I had trouble understanding even the google explanations, and also I don't know which parts of the "findings" I should even be googling? I also wonder what is the most concerning finding? from which finding does the majority of my current pain likely come from? I met with the Dr. and asked him questions but he seemed rush and didn't answer my questions well and then ran off to his next appointment :(
FINDINGS:
Effusion:
There is a small to moderate-sized tibiotalar joint effusion.
Soft Tissue:
There is no significant soft tissue swelling.
Ligaments:
There is thickening of the anterior tibiofibular, the anterior talofibular and
calcaneal fibular ligaments likely related to remote sprain. There is
thickening of the deep fibers of the deltoid ligament as well as the
thickening of the talonavicular ligament. The components of the lateral
collateral ligament, deltoid ligament, and syndesmotic ligaments appear
otherwise grossly intact.
Tendons:
There is mild thickening of the Achilles tendon consistent with tendinosis.
There is tenosynovitis of the posterior tibial tendon, the flexor digitorum
longus tendon and the peroneal brevis and longus tendons. Fluid is seen along
the flexor hallucis tendon which is likely related to the joint effusion.
There is a probable focal split tear of the posterior tibial tendon of the
level of the anterior talus. The extensor tendons, flexor tendons, and
peroneal tendons appear grossly intact.
Plantar Fascia:
Plantar fascia and surrounding soft tissue are unremarkable.
Bone:
No talar osteochondral defect. There is an osteochondral defect of the
posterior tibial plafond measuring up to 0.8 cm in AP dimension. No unstable
fragment or undercutting of fluid identified. Only mild surrounding edema is
present. Visualized bones of the hindfoot and midfoot appear otherwise normal
in morphology and marrow signal intensity.
Joint:
The tibiotalar joint and visualized intertarsal joints are anatomically
aligned.
Impression
IMPRESSION:
1. Evidence of remote high and low ankle sprains.
2. Tenosynovitis of the flexor and peroneal tendons with a focal split tear of
the posterior tibial tendon.
3. Osteochondral defect of the posterior tibial plafond with no evidence of an
unstable fragment.
4. Mild Achilles tendinosis.
IKYANMD. I will attach the results below, I googled a lot of the stuff but I had trouble understanding even the google explanations, and also I don't know which parts of the "findings" I should even be googling? I also wonder what is the most concerning finding? from which finding does the majority of my current pain likely come from? I met with the Dr. and asked him questions but he seemed rush and didn't answer my questions well and then ran off to his next appointment :(
FINDINGS:
Effusion:
There is a small to moderate-sized tibiotalar joint effusion.
Soft Tissue:
There is no significant soft tissue swelling.
Ligaments:
There is thickening of the anterior tibiofibular, the anterior talofibular and
calcaneal fibular ligaments likely related to remote sprain. There is
thickening of the deep fibers of the deltoid ligament as well as the
thickening of the talonavicular ligament. The components of the lateral
collateral ligament, deltoid ligament, and syndesmotic ligaments appear
otherwise grossly intact.
Tendons:
There is mild thickening of the Achilles tendon consistent with tendinosis.
There is tenosynovitis of the posterior tibial tendon, the flexor digitorum
longus tendon and the peroneal brevis and longus tendons. Fluid is seen along
the flexor hallucis tendon which is likely related to the joint effusion.
There is a probable focal split tear of the posterior tibial tendon of the
level of the anterior talus. The extensor tendons, flexor tendons, and
peroneal tendons appear grossly intact.
Plantar Fascia:
Plantar fascia and surrounding soft tissue are unremarkable.
Bone:
No talar osteochondral defect. There is an osteochondral defect of the
posterior tibial plafond measuring up to 0.8 cm in AP dimension. No unstable
fragment or undercutting of fluid identified. Only mild surrounding edema is
present. Visualized bones of the hindfoot and midfoot appear otherwise normal
in morphology and marrow signal intensity.
Joint:
The tibiotalar joint and visualized intertarsal joints are anatomically
aligned.
Impression
IMPRESSION:
1. Evidence of remote high and low ankle sprains.
2. Tenosynovitis of the flexor and peroneal tendons with a focal split tear of
the posterior tibial tendon.
3. Osteochondral defect of the posterior tibial plafond with no evidence of an
unstable fragment.
4. Mild Achilles tendinosis.
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Effusion is fluid build-up. You will have that with all sorts of injuries and inflammation.
the tibial plafond, I think, is the part of the ankle that connects with the leg. You have injured that.
(osteochondral defect)
Tendons are soft tissues that connect muscle to bone. Tendons allow muscles to move the skeletal system. A complete tear of the posterior tibial tendon is known as a posterior tendon rupture. The posterior tibial tendon attaches the posterior muscles on the inner portion of the back of the lower leg (tibialis muscles) to foot. The posterior tibialis muscles help straighten (plantarflex) and rotate the foot inward (medially rotate) the foot. A posterior tibial rupture will result in a decreased ability to perform these tasks. You have torn your tendon.
Did the doctor say you need surgery? It seems as if most medical journals on-line suggest surgery as only reliable solution for the torn tendon.
posted by linder6 at 10:02 AM on January 11, 2016 [1 favorite]
the tibial plafond, I think, is the part of the ankle that connects with the leg. You have injured that.
(osteochondral defect)
Tendons are soft tissues that connect muscle to bone. Tendons allow muscles to move the skeletal system. A complete tear of the posterior tibial tendon is known as a posterior tendon rupture. The posterior tibial tendon attaches the posterior muscles on the inner portion of the back of the lower leg (tibialis muscles) to foot. The posterior tibialis muscles help straighten (plantarflex) and rotate the foot inward (medially rotate) the foot. A posterior tibial rupture will result in a decreased ability to perform these tasks. You have torn your tendon.
Did the doctor say you need surgery? It seems as if most medical journals on-line suggest surgery as only reliable solution for the torn tendon.
posted by linder6 at 10:02 AM on January 11, 2016 [1 favorite]
I could not begin to tell you what that means but when I had my MRI the doctor carefully explained what was there causing my problem. He then suggest three possible courses of action.
posted by Postroad at 10:04 AM on January 11, 2016
posted by Postroad at 10:04 AM on January 11, 2016
Response by poster: The Doctor I saw said surgery was unlikely for this kind of injury since it wasn't a complete tear? I felt like he wasn't giving me much attention or care though and I think he could have easily missed something. I have been resting and doing rehab for 4 months with little improvement.
posted by crawltopslow at 10:06 AM on January 11, 2016
posted by crawltopslow at 10:06 AM on January 11, 2016
the MRI is from 4 months ago? go back to the doctor and say your symptoms haven't improved much.
there's no way a doctor can be 100% right first time. they're going to try what they think best (good chance of success, little chance of doing more damage) first. they don't expect that always to work and they expect you to return if it doesn't.
posted by andrewcooke at 10:33 AM on January 11, 2016
there's no way a doctor can be 100% right first time. they're going to try what they think best (good chance of success, little chance of doing more damage) first. they don't expect that always to work and they expect you to return if it doesn't.
posted by andrewcooke at 10:33 AM on January 11, 2016
Response by poster: The MRI is from 12/17/2015. What I want to really know though is of the "impressions" which one is a real problem, and which ones aren't a big deal? Which "impression" item would be approached if there were surgery?
posted by crawltopslow at 10:45 AM on January 11, 2016
posted by crawltopslow at 10:45 AM on January 11, 2016
The tear.
http://orthoinfo.aaos.org/topic.cfm?topic=a00166
But keep doing therapy to have it documented. When PT is shown to have been tried, and fails, they'll be more likely to consider surgery.
posted by cotton dress sock at 10:47 AM on January 11, 2016 [1 favorite]
http://orthoinfo.aaos.org/topic.cfm?topic=a00166
But keep doing therapy to have it documented. When PT is shown to have been tried, and fails, they'll be more likely to consider surgery.
posted by cotton dress sock at 10:47 AM on January 11, 2016 [1 favorite]
(Or wear the boot, orthotics, etc., whatever they suggested.)
posted by cotton dress sock at 10:58 AM on January 11, 2016
posted by cotton dress sock at 10:58 AM on January 11, 2016
You have a tear in your tendon and according to your doctor, it's not likely to improve with surgery.
Sometimes it happens.
Here's an interesting article about it on a running site.
If you're a runner or an active person, it must be frustrating to know that rest and decreased activity over a long period of time is the answer to healing this, but rushing it will only make it worse.
If you don't feel like you got a good explanation from your doctor or a good plan of action (or inaction) make another appointment to discuss this, and be assertive until all of your questions are answered.
posted by Ruthless Bunny at 11:30 AM on January 11, 2016
Sometimes it happens.
Here's an interesting article about it on a running site.
If you're a runner or an active person, it must be frustrating to know that rest and decreased activity over a long period of time is the answer to healing this, but rushing it will only make it worse.
If you don't feel like you got a good explanation from your doctor or a good plan of action (or inaction) make another appointment to discuss this, and be assertive until all of your questions are answered.
posted by Ruthless Bunny at 11:30 AM on January 11, 2016
If you're not satisfied with your doctor's approach or your recovery after talking to them again, try a doctor who specifies in sports medicine, esp. one familiar with running injuries, for a second opinion. There are minimally invasive anchor implants that reattach a ruptured tendon to bone that may be appropriate (I don't know if it is here, but I know that sports med. doctors who are responsible for getting football players back on the field will be familiar with techniques that drastically reduce the amount of required rest).
posted by zippy at 12:48 PM on January 11, 2016
posted by zippy at 12:48 PM on January 11, 2016
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But I'm also not sure what you want to get from the MRI, though - probably you need to work with another health professional to come up with some kind of treatment plan?
posted by mskyle at 10:01 AM on January 11, 2016 [1 favorite]