What is Meniscus Tear Diagnosis and Treatment " Chris a 17-year-old male competitive skier "

Case study ( 6627 views as of May 23, 2024 )

Chris, a 17-year-old male competitive skier, fell while downhill sking and had immediate acute pain to the knee. He attempted to continue sking but was unable to turn hard without ongoing pain. He stopped sking. He did not notice any swelling but applied ice right away. He was told by the team trainer that he likely had an MCL sprain.

Chris attended physiotherapy but continued to have sharp pain along his medial joint line with routine daily activities. He denied any instability to the knee or swelling.

Chris could benefit his condition by ongoing work with a physiotherapist to help him with mobility and a sports medicine physician to further assess his injury. A bracing specialist could help him with bracing options to keep him stable and active. He might need to get an MRI for a better evaualtion. Pilates and massage could also help with his range of motion, swelling and pain. Lastly, an orthopaedic surgeon could help with a surgical consultation if imaging shows that Chris' pain is due to an MCL tear.

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Conversation based on: What is Meniscus Tear Diagnosis and Treatment " Chris a 17-year-old male competitive skier "

What is Meniscus Tear Diagnosis and Treatment " Chris a 17-year-old male competitive skier "

  • A torn meniscus is indeed one of the most frequent knee injuries. It often occurs when the knee is forcefully twisted or rotated while bearing weight on it, such as during sports activities or sudden movements. This can lead to a tear in the meniscus, causing pain, swelling, stiffness, and sometimes a sensation of locking or catching in the knee. The severity of a torn meniscus can vary, ranging from small tears that may heal on their own to larger or more complex tears that may require medical intervention. The treatment approach depends on various factors, including the location, size, and type of tear, as well as the individual's symptoms and activity level. Conservative treatments for a torn meniscus may include rest, ice, compression, and elevation (RICE therapy), along with physical therapy to strengthen the surrounding muscles and improve knee stability. In some cases, nonsteroidal anti-inflammatory drugs (NSAIDs) may be recommended to reduce pain and inflammation. If conservative measures do not provide sufficient relief or if the tear is severe, surgical intervention may be necessary. Arthroscopic surgery is a common procedure used to repair or trim the torn meniscus. During this minimally invasive procedure, a small camera and surgical tools are inserted into the knee joint through small incisions, allowing the surgeon to visualize and treat the tear. Recovery from a torn meniscus can vary depending on the extent of the injury and the chosen treatment approach. Physical therapy is typically an essential part of the recovery process, helping to restore range of motion, strength, and function to the knee. With appropriate treatment and rehabilitation, many people are able to regain normal knee function and return to their usual activities.
  • The team trainer suggested he might have an MCL sprain. It's been my experience that sprains take far longer to heal than tears
    • I would imagine that small tears can worsen if you re-injure the joint ? Even after receiving proper treatment ?
    • Some meniscal tears don't need surgery, and can be managed/treated with the RICE approach (rest, ice, compression, elevation). Smaller tears that are on the outside edge of the meniscus might fall into this category, however more significant tears may require surgical repair.
    • What is the criteria used to determine whether a tear is surgically repairable or should wait and see if it heals ?
    • Tears can be surgically repaired and sprains need to rested and rebuilt from a muscle and flexibility standpoint all around the sprain.
  • I hope this young person gets this treated properly as this could set him up for a lifetime of knee pain.
    • Agreed. Knee injuries are nothing to play around with. They can flare up repeatedly if they don't heal properly
  • An MRI should be ordered to confirm if it is indeed a meniscus tear and to give insight on next treatment steps.
    • Agreed. An orthopedic surgeon would be able to send Chris for an MRI to rule out whether he has a meniscus tear or just the sprain originally diagnosed.
  • My recent MRI resport states "a complex horizontal tear of the boday and posterior horn of the lateral meniscus of my left knee that demonstrates broad inferiorly surfacing compenent. No displaced meniscal fragment or surfacing medial meniscal tear is seen. Moderate diffuse thinning of the articular cartilage of the lateral femoral condyle is associated with a small, 2 mm full-thickness chondral defect along its weight-bearing surface. Moderate irregular thinning of the articular cartilage of the lateral patellar facet is associated with focal subchondral bone marrow edema. A superficialfissure in the articular cartilage of the posterior patellar apex is suspected. What is the best treatment for the above diagnosis based on the above report?
  • If the team trainer thought likely had an MCL sprain why was he not sent for imaging ? Could he not be doing more damage without the proper diagnosis ?
    • I don't think they send you for a scan unless they believe you have suffered a tear. If it's just a strain it doesn't usually require surgery
  • Having an MRI will provide in depth analysis of the injury and aid in determining the best course of action for recovery.
  • At such a young age and with a competitive career ahead of him, Chris should definitely follow up with a doctor to evaluate if he has a meniscus tear and to have a proactive strategy to manage the injury.
  • I suspect a sports medicine doctor would order imaging to further assess his knee injury. Obviously, he should avoid skiing or further strenuous activity on his knee until his injury is properly diagnosed and a treatment plan is underway.
  • Chris would benefit greatly by seeing a sports physiotherapist and if pain continues, a orthopedic specialist to rule out a more serious injury
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