By Steve Mora MD
Orange County Knee Specialist
ON THE TOPIC KNEE PAIN WITH A NEGATIVE MRI.
It’s not unusual for patients who are suffering with knee pain to have a “negative” MRI. This situation is relatively common. In cases of a strain or inflammation the MRI may indeed be negative for structural problems. Or perhaps the patient does not have anything wrong with the knee joint and the problem is involving the soft tissues such as tendinitis, fibrosis, or nerve entrapment. However there are cases where the MRI is falsely negative. In cases where there is a strong clinical suspicion for joint pathology the doctor may want to take these extra steps.
1- The doctor should read the MRI images themselves and not rely solely on the report. If the doctor is not adept at reading images the patient should be referred to a experienced orthopedic surgeon.
2- The doctor can call the radiologist and let them know that the suspicion is high and have them read the MRI again. It’s for this reason that patients should get MRI studies done at quality facilities with quality radiologists.
3- If the work up remains negative, get an MRI with injected contrast into the joint. This is called a MR arthrogram. The contrast will enhance the ability to find small hidden lesions
4- Lastly consider doing a diagnostic arthroscopy to look for occult pathology such as a plica band (pictured), vs small meniscus tear vs small chondral defect. These lesions are known to be difficult to identify on MRI images. This is after all a surgery so the patient needs to understand that the surgery is being done because of the high level of suspicion.
I think the best advice that I can give someone with persistent knee pain but a negative MRI is to look for a musculoskeletal specialist such as they experience orthopedic surgeon who is willing to dig a little deeper. There is hope !
Please let me know if I could ever be of service.
About Steve A. Mora MD:
Dr. Mora is a board-certified orthopedic surgeon at Restore Orthopedics and Spine Center in Orange County.
He specializes in:
-Sports Trauma -Arthroscopy of the knee, shoulder, hip and elbow.
-Arthritis of the Knee
-Mixed Martial Arts Injuries
-First Responder Injuries
-Regenerative Medicine:Lipogems, Bone Marrow Stem Cells, Plasma therapy.
For a consultation please call Restore Orthopedics and Spine Center in the City of Orange 714-332-5498
Dr. Mora’s family heritage is Peruvian. He speaks fluent Spanish.
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Address:
Restore Orthopedics and Spine Center
112o W. La Veta Ave, Third Floor
Orange, CA 92868
Office: (714) 332-5498
Fax: (714) 941-9539