MRI Interpretation: Pain in the knee joint (Radiologist / Sports doctor / Orthopedist)
MRT Interpretation: Knee Pain
(Radiologist / Sports Doctor / Orthopedist)
Background:
Man, age 47, height 1.80m, weight 81.5kg has been training for more than a year, 7 times a week: 5 times badminton in the club (2-3 hours per session) plus 2 times strength training on machines (2 hours each) and running (30 minutes).
Condition of the legs: slight flat feet, occasional mild knee pain. Wearing so-called 'Roots' shoes, shoes with lowered heels, caused knee pain at the age of 17. Seven years ago, X-ray examination of both knees showed no pathological findings. Patellas are slightly outward facing.
Case:
About 6-8 weeks ago, after badminton training, pain developed in the left knee. There is no specific, sudden pain event remembered. Despite the pain, training continued (taking aspirin), with short training breaks of up to 3 days. After each training session, the left knee slightly swelled on the left side with a feeling of warmth. After a warm bath, the knee swelled even more. Subsequently, there were sometimes sharp pains on the left side and very undefined around the patella (mostly on the left side - top, but sometimes also on the right side - top). Pain when going downstairs and bending the knee. Slight pain on the patella with intense, prolonged exposure to cold on the knee without extra warmth protection. The knee could not be fully bent due to the swelling. Attempting to bend it caused very sharp, pressing pains. Getting up from a squat was sometimes impossible without pain. No knee joint blockages, complete extension of the leg, even slight overextension, was always possible. The knee does not give out. So far, there has never been any pain in the back of the knee or the lower part of the knee. Relief and pain reduction after training with the leg press (strength training on a machine where a counterweight is attached to the lower leg/foot and pulled from the thigh from the bend to the straight position). Pain reduction also after slow manual movement of the patella.
Training break of about 3 weeks over the Christmas holidays. Taking Ibuprofen (400) twice daily for one week plus Kytta ointment externally on the knee and surrounding area. This led to swelling reduction and pain reduction without completely resolving the issue. Before the Christmas holidays, examination by an orthopedist with various 'manual' examinations (without imaging procedures). Findings or assessment (quoted from memory): "Joint bruising with (blood) effusion" (Bursitis? Meniscus bruising?) and possibly "Runner's knee" Ilio-tibial band syndrome (ITBS).
To clarify the situation, an additional MRI was performed at another practice. The evaluating practice came to a different conclusion.
Question:
Is it possible
