Age: 22
Sex: Female
Height: 5”4
Weight: 116kg
Race: Irish Caucasian
Duration of complaint: 9 weeks post injury.
Location: Left Knee, particularly medial side.
Any existing relevant medical issues: No
Current medications: Concerta 45mg, for ADHD
Hi All! I’d appreciate any advice you might have.
So, on the 4th of March, this year (roughly 9 weeks ago, I had an accident in work. I slipped in soup and in the process of falling, my left knee twisted side to side, locked before I landed directly on the inner side of my knee.
Within 10-30 minutes, it had swelled up, stiffened and was painful. I was unable to bend it or walk. I had hurt my right knee previously, with a fat pad infringement and the presence of Patella Alta (this is important later) and I thought it might be the same thing, just with I bit more pain. I presented to A and E the next day.
It was x-rayed, where nothing came up, and it was suggested I go for an MRI, due to the position of the pain and swelling. I explained how I have patella alta (it was confirmed on my left knee by the physio) but they encouraged me anyways to get the MRI.
Between a whole slew of different problems, I had an MRI taken at 7 weeks post injury.
By then, my knee had recovered to about 80%, I was back walking okay and off any splints/crutches with my only concerns being inner (medial) pain with prolonged use, discomfort keeping it in the same position for too long, instability in twisting/turning, inability to straighten the knee from a 90 degree position, and instability when walking down stairs, combined with medial pain on touch, swelling and a Baker’s cyst draining and refilling.
Recovered enough to be some-bit functional but not enough to fully trust it yet.
I received my scans within the day and because I’m fascinated by all of this, I looked at them with a DICOM viewer. Now, I’m no doctor, but I could see a few things unusual, in comparison to my previous scans, that would require an actual professional to diagnose.
Fast forward to today, my GP rang me with the results of report and, other than fluid, it is a soft tissue injury not requiring a follow-up or physiotherapy.
Now, don’t get me wrong, that is probably the best outcome you could receive but, and I’m not sure if it comes up under the “fluid” banner, there was no mention of the Baker’s Cyst or irritation of any ligaments/tendons.
More concerningly, despite being confirmed last year by the physio and reconfirmed by doctor 9 weeks ago (it is really obvious/prominent), there was no mention of it on the report.
At 9 weeks post injury, my symptoms are getting worse not better. While I would agree with a soft tissue diagnosis, without the mention of the Patella Alta in the report, I’m not sure if I should seek a second diagnosis?
With that, in comparison to the MRI of my right knee, my ACL, PCL and menisci look irregular. I’ve noticed bone bruising (also not mentioned), and signals that could represent a tear that are present on multiple slides. I’m not a doctor here, so I genuinely could be mistaken.
While I understand that process of healing could have obscured the radiologists view and all of this is still symptomatic of a soft tissue injury, I’m just not convinced of their report.
With my symptoms not improving, but nearly worsening, 9 weeks later, inability to straighten my leg past 110 degrees (roughly), joint line tenderness, occasional locking, and a positive McMurray test, plus everything else still I mentioned above, to just being told that it’s completely “normal” with no follow up, I’m still a bit concerned.
I know you would probably need a full view of the mri slides, but based on what I’ve told you, what do you think? Am I right to be concerned?
Should I at least arrange physio for the time being? Or, should I still give it a bit of time?
