We are looking for a second opinion on my friend's MRI scan of both the knee joints as he is experiencing excruciating pain just above the patella.
He has a sudden onset of severe pain on both the knee joints about two weeks ago. Previously he had a similar episode about two to three months ago and it subsided after resting and painkillers.
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I viewed the right and left knee MRI images. (attachment removed to protect patient identity).
Left knee: The MRI, left knee joint shows a complex tear in the posterior horn of the medial meniscus area and mild left knee joint effusion. There is some fluid between the semimembranous and medial head of gastrocnemius muscles. There is a small area of focal cartilage defect in the upper pole of the patella with mild edematous fat. The anterior and posterior cruciate ligaments are normal. The medial and lateral collateral ligaments are normal.
Right knee: The right knee joint shows mild increased signal intensity in the posterior horn of the medial meniscus area and minimal knee joint effusion. There is minimal fluid in the back of the lower thigh and not significant. There is a suspicious strain in the left anterior cruciate ligament interiorly but largely the attachments are normal. The posterior cruciate ligament is normal. There are subtle changes in the upper pole area of the right patella and mild edema.
There is mild edema around the bilateral distal quadriceps tendons, but there is no obvious tear of the tendons.
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Thank you doctor,
Can you please confirm if the right knee and left knee findings have not been swapped by mistake as the patient is complaining of excruciating pain on the right knee more?
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The images marked right knee and left knee have been double confirmed and the findings are not swapped.
Further, I agree that the patient can have more discomfort in the right knee joint given the above findings. Though the left knee findings are more as compared to the right, we can see that the anterior cruciate ligament in the right knee is showing changes that can cause more pain during movements of the right knee joint and that needs a clinical examination to confirm the exact cause of pain.
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