Tendon/Ligament Pain for Two Months. MRI? Ligaments OK, but Torn Meniscus. WT?

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In April I experienced a severe, level 6 "tearing" pain that went through my right patellar ligament, patella, and into the quadriceps tendon during an incline press exercise to treat osteoarthritic joint pain.

The next day I felt a "razor blade"-like flash of pain through the ligament, and the day after that I experienced yet another tear-like sensation--once again going through the ligament, patella, with "biting" pain at the patella-tendon junction--that forced me to substantially slow down an elliptical bike session before having to pause from fatigue. And after the initial tearing pain a continual "stretched" pain/stiffness in the ligament.

The next day I reported all this during a visit to the doc and no explanation for the ligament pain aside from possible tendonitis and no evidence of swelling in the joint, but for the next two months fairly continual ligament and tendon pain, stiffness, and irritation that generally increased with exertion, especially after extensive "clamshell" exercising that neither therapists nor docs can explain aside from "That shouldn't happen.".

Fast forward to last week and finally an MRI scan to examine all this.

The verdict? Osteoarthritis, ligament and tendon "intact", but a "complex tear of the posterior horn to body segment of the medial meniscus" along with a "complex hyperintense cystic lesion".

I am in the process of translating all this into English, but it looks like meniscal tears have to be treated, through therapy or surgery, and sooner rather than later.

Just as well that I had this looked at, but I am totally confused because I haven't experienced any "locking" except for a jolting pain in the knee during a simple sit-to-stand exercise two days before the exam, and never any obvious swelling.

And when I looked into causes of meniscal tears, one explanation

"Medial meniscal injuries are usually considered as either traumatic or degenerative. Whilst degenerate tears may present with a gradual history of increasing symptoms, traumatic injuries will usually occur as the knee is extended and rotated from a flexed position against resistance. This may occur as a single event during a sporting endeavor or during a period of unaccustomed squatting such as laying flooring or playing with children. The most commonly injured area is the posterior horn."

(Google: "Medial Meniscus Syndrome" "Stephan Joseph"wink

While Googling "Meniscal Tear Patterns - Radsource" will bring a decent explanation and images of "complex" meniscal tears.

Sounds close to the injury that brought on the ligament/tendon pain and the MRI.

But I'm still confused, because if anything the left "OK" knee has a "clicky" crepitus while the right has a smoother, audible "crickly" crepitus, and I've actually had the left lock/fail once during therapy.

And still no apparent reason for the ligament/tendon irritation.

Dazed and confused here. Any input would be greatly appreciated.

Thanks in advance.

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11 Replies

  • Posted

    This is why you don't diagnose this stuff from searching the Internet.  It will drive you completely crazy.  You have the radiologist's report but how does your orthopedic surgeon interpret all of this?  What is the definitive diagnosis and treatment modality?  You will not get those answers here or anywhere else...except from your surgeon who will study the imaging and make the call.

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    • Posted

      Hi Chico,

      "What is the diagnosis? What is the prognosis?"

      Exactly.

      I'm here because answers haven't been forthcoming: it took a lot of researching and pain logging to convince the docs to seriously look at this and record an actual injury (versus a subjective "he said, she said" report of pain) that can diagnosed and treated.

      True, there's a lot medical info and opinions of varying quality on the net, but also some gems that got my butt inside an MRI, as confusing as the actual results turned out.

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    • Posted

      But only the doc can give you a definitive diagnosis, devise a treatment plan and give you a long term prognosis for your recovery and future life. 

      Plus, if you consult the Internet, please be aware of some very important issues...

      https://patient.info/forums/discuss/reliable-tkr-information-582123

      Do your research correctly.  Be skeptical.  Use the info to ask the docs questions and get real, effective answers.  Arm yourself with good information...not just the stuff at the top of a Google search. 

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    • Posted

      Chico,

      Read through your posting, and agree.

      I fully understand that I'm stating a case to docs and refer either to high rank specialty medical web sites [e.g. Orthobullets, number 17 in "Health-Education and Resources" on the SimilarWeb ranking site] or journal articles, lately going the extra mile on even those references by checking the journal's ranking on the  Scimago Journal & Country Rank to be sure they are journals a doc would actually recognize and respect: they're liable to throw your voice into File 13 to begin with, but perhaps slightly less so if you demonstrate a little scholarship.

      And once I find a solid looking reference I take the time to make sure I understand the terminology before making reference to them, and making sure they're referring to my condition.

      Didn't know there was a thing called "Sophomore Syndrome" but I'm fully aware of the risk of talking myself into an illness and always ask "Is this what I'm actually experiencing?" , look at multiple sources, and don't hesitate to change my opinion given evidence to the contrary.

      In this case I'm talking about pain that won't go away, and right after the initial injuries made sure that I was accurately reporting my pain. The best site that I found is "What The Pain Scale Really Means" [Google "What The Pain Scale Really Means - Prohealth"] that clearly explains the categories and subcategories of the pain scale and above all wisely cautions "If you want your pain to be taken seriously, it’s important that you take the pain scale seriously." and I do, erring on the side of underreporting my pain. I always send this to docs when I report pain levels.

      And I also stick to the point and state my case--based on my observed  [though still subjective] pain--as concisely as possibly and only use the references to back specific points [in this case getting tangible results via MRI], once again considering they're probably going to trash it regardless, but knowing that I honestly made an effort to be heard.

      In this case the diligence was rewarded with a result that no one, including me, saw coming.

      Did a little more digging and found a site that gave percentages of presentation of meniscus tear symptoms and, as MAT2018 observed below, a lot of people fall out of the symptom pigeonholes with this injury, so I probably would have been walking around with this none the wiser based on [highly educated] poking and prodding.

      But I do disagree on the usefulness of this forum. I'm here to listen to others' experiences with their real live pain and the health system outside of pain logging and Googling and journal reading, because there are so many docs that don't care or listen.

      And speaking of rankings, SimilarWeb ranks Patient number 58 worldwide in "Health", so it has to be worth something; after all, you're here. You have to agree with that smile

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    • Posted

      A torn meniscus is very painful, even after they tidied mine up it was dreadful , told me to give it a year and that would be as good as it would be , it never really improved , as I said in another post I had to get a replacement , in hindsite  I should have got it sooner , just limped for 18 mths 
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    • Posted

      Hi Jenny,

      Thanks for the heads up. <sigh> This is starting to sound pretty awful.

      Still no pain in the knee except at the "usual" arthritis locations and the so far unexplained ligament-tendon irritation, but as I wrote yesterday quite a good percentage don't have pain.

      No orthopedic appointment until July to get a blow-by-blow accounting of the reading, but reading through it [with Google ever at the ready] to understand it, and so far it sounds like the tear isn't completely "open", so maybe that's why I haven't felt anything.

      I'm taking a little sanity break from this today <smile> and will dig in some more this weekend.

      Thanks again.

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  • Posted

    I am no doctor just someone that has had LOTS of knee injuries and am now recovering from a total knee replacement in my right knee because of the injuries (from sports and bad luck).  

    While in the Army, practicing karate I went up to kick a board and came down and my knee locked...never did swell but it locked in place, couldn't bend it at all.  Since this was before the age of MRIs (1979) they thought because it wasn't swollen that I was trying to get out of our PT drills.  So it was 2 months before they sent me to a hospital where at that time they just removed my medial meniscus (they didn't trim them at that time).  I don't really remember the pain that I had...

    Has anyone said anything about the pain being from your bursa?   I have had a lot of problems with the bursas in my knees and they are painful (that pain I remember) and the pain I had was in the areas you discussed.   But you need to have a trained medical person talk with you about this.  If you are not getting answers find someone else!

    The one thing I have learned while recovering from the knee replacement is we heal/not heal and respond to pain differently and while they put the "average response" to things like medial meniscus tears in books or on the internet...some of us don't fit in that average response category.    

     

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  • Posted

    I tore my meniscus 7 years ago running , didn’t feel it till next day , had mri on it and was told if I had arthroscopy it would probably be okay , but when they looked it wasn’t and I needed a knee replacement. I didn’t want to have it so waited too long putting weight on my good leg and in the end I had it done . My other knee was done 6 mths ago and I believe if I had had first op immediately then this one would have been avoided for much longer . So good luck 
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  • Posted

    Haleba,   Like I have said I have had lots of pain in my tendons and ligaments over the years that could fill books...I am in the US and have worked with doctors, acupuncturist, chiropractors and physical therapist.   My free two cents, when it comes to tendons and ligaments doctors/surgeons don't know and/or don't care because there is nothing they can do for $$$ to fix.

    It took awhile but I asked around  and found a wonderful physical Therapist company and that made all the difference for me since they worked on the ligament/tendon irritations and understood them.   

    Not sure if you have that option.  

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    • Posted

      Kind of in this mess because of excessive physical therapy, but sure there are good ones out there that will carefully monitor your pain in order not to worsen things.

       PM me a link if these "good guy" therapists have a web site.

      Thanks

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