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my mother's mri of her right knee after four weeks of severe pain shows the following:Cruciate:IntactExtensor mechanism: the quadriceps and patellar tendons are intact without tear. Quadriceps distal enthesophyte is noted.Collateral:intactMeniscus: The lateral meniscus is intact. Horizontal and oblique tear of the anterior horn of the medial meniscus is identified. Outward displacement of the anterior horn at the medial meniscus is noted. This is suggested of degeneration tear.Cartilage: near total eburnation of the articular cartilage in the medial compartment is identified. Cartilage fraying and small fissuring is noted in the weight bearing surface of the lateral compartment. Cartilage fraying with deed fissuring is noted n the lateral patellar facet. Cartilage fraying with small fissuring is noted in the trochlear groove and medial patellar facet.Marrow: There is no evidence of marrow edema. No suspicious marrow signal is identified. Small compartmental osteophytes are noted with joint space narrowing of the medial compartment.Periarticular soft tissues: mild to moderate joint effusion is present. No soft tissue mass is evident. No evidence of tendinous or muscle injury is noted. No parameniscal cyst is present. Bursal fluid is noted along the medial gastrocnemius head. There is also mild pre patellar burial fluid.She got a cortisone injection a week before the MRI. Now the pain is not as bad but because she is resting most of the time. I am a vet by education so I understand well the medical terminology, however, I do not have a good a idea of the prognosis of this problem and how much longer before surgery she has. The real question is that she has a planned trip from DC to LA this coming monday, July 2. We would like to know if only pain is the issue at this point and perhaps she can go to her trip in LA for a month and come back home to deal with surgery in August. Should she use a cane? is it better to get surgery ASAP? as you can see it is the weekend and we did not expect the results of the MRI be so serious. So, she was planning on following up with the doctor later in August. What can she do for exercise? she has controlled HBP with medication and exercise but she isn't right now.
Optional Information: Person's Gender: Female Person's Age: 73 Already Tried: see question
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Normally I answer questions in Q and A mode but I figured this was pretty complex so we should discuss in a chat.
Hello Dr.
Are you there?
thank you
Okay. Basically it seems as if your mom has degeneration of the medial knee components
correct
Meniscus, ligaments and joint space
This is the most common place for degenerative arthritis
Basically, he only limitation is pain really.
that is exactly what i told her
so there will be no more damage if she travels to LA for a month and takes pain medication?
She will eventually need surgery. The surgeon will probably start out with either hyaluronic acid injections or a knee scope. Probably a knee scope
The joint will continue to wear down over time but it won't change prognosis or management at all.
If she goes on the trip that is
You seem to be having difficulty with the chat. Should I switch to Q and A?
It might be easier.
i am okay
Ok. Did you get my replies?
i did doctor.. thanks
Do you have any further questions for me, Dr.?
in terms of waiting for surgery a couple of months , is that okay? and what to do about exercise? she has HBP and needs to exercise often but with the Knee it has been difficult
That is fine to wait. It won't make much difference. I would try to focus on low impact stuff....exercise bike, swimming, etc.
Swimming would definitely be the best for her.
Bike is a good alternative though.
i feel better now.. i am only a vet... the doctor makes her feel better too... what is the best medicine for the pain? and should she use a cain?
Good, I'm glad I could help.
The best is ibuprofen but make sure the doctor says its okay. Ibuprofen can cause high blood pressure, ulcers and kidney problems in the elderly. Tylenol is very safe but not as effective. Yes, if the cane helps, she should use one.
she is being taking tramadol for pain, should get a new prescription?
Tramadol is good...very powerful but it's doesn't have any anti inflammatory properties. The doctor might not want her on ibuprofen and if that is the case, tramadol is a good alternative.
i will get the cane...thank you so much for your help...
You're welcome. Dr.
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If you have more questions, just ask.
let me see if she wants me to ask you something
No problem. I will wait. :)
she is really worried about recovery time from surgery... how bad will it be?
Not bad at all actually. with proper rehab, she will be back to normal in a matter of a few weeks. Probably 4-6 weeks total
thank you... i guess i have the end of the summer planned ...:-)
Haha. :)
You're welcome.
Anything else?
no, thank you ... I will print for my records and grade the interaction as excellent
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