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Small FISSURE in MEDIAL PATTELLAR FACET in MRI KNEE.

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Need help understanding MRI results.
Knee started hurting suddenly on 6/14 during lunge up and over stretch. Rested and all that for a few weeks then finally saw physicians assistant. Had MRI, results were not reviewed I was just referred to physical therapy for 4 weeks 2 x a week.
I feel like the catching is getting worse not better and only get pain when it catches which is usually during excessive walking, getting out of the car after long car ride, and during dance. I am a dance instructor. I teach 3x a week for 2 hours each.
This is my left knee. Here are the MRI findings, any help deciphering what they mean or if PT is really the best method of treatment is much appreciated.

FINDINGS: The anterior and posterior cruciate ligaments and medial
and lateral collateral ligaments are intact. There is a longitudinal
fissure in the anterior cruciate ligament anteriorly which is
probably developmental. No meniscal tears identified. No marrow
edema visualized. There is a fissure in the medial patellar
cartilage. This oblique fissure traverses approximately half the
thickness of the cartilage and results in a small flap. There is no
edema in the patellar retinaculum or lateral femoral condyle bone
bruise to suggest that the patient has had a dislocated patella
recently.
IMPRESSION: Small fissure in the medial patellar facet, otherwise
unremarkable exam.

Category: Orthopedic Surgeon

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Category: Spine Surgeon
 22 Doctors Online

Hello
Thank you for posting your query at DoctorSpring.com
I have gone through your details with diligence.

Your MRI is showing that recently your knee cap displaced out of its normal place.Most probabaly this event had created a deep oblique tear in inside covering (cartilage)of knee cap.This tear is acting as flap and giving you a feeling of catching sensation.If this tear is large one then should be treated by key hole surgery or this can be improved with rest in a brace.You should consult an orthopedic doctor for this.
Feel free to discuss further,
Regards.


Patient replied :

Thank you, just a couple more questions. I am very active as a profession so I do take it easier but need to find a solution. I'm currently in week 2 of physical therapy with no change as far as the catching is concerned. Is this an area that will heal itself over time if I opt for resting and bracing? Or does it not heal itself?


Hello.
All that depends on the size of lesion. Smaller lesions heal by themselves and with supportive treatment.
Looking at your details, it seems that this may be a large one & may need surgery.
A physical assessment of the injury by an orthopedic specialist is the best way forwards. So please do consult an orthopedic surgeon for this since you are not finding any relief with physical therapy.
With best wishes.


Dr. Mukesh Tiwari
Category: Spine Surgeon
Experience: 
Fellowship - Khandaka Hospital, Jaipur
Residency - MS, Rabindranath Tagore Medical College, Udaipur, 2000
Medical School, Internship - MBBS, SMS Medical College, Jaipur, 1995
Dr. Mukesh Tiwari and 4 other Medical Specialists are ready to help you

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