Diagnostic
Tests For Chondromalacia Chondromalacia usually is a clinical diagnosis
where the physician examines the patient. Occasionally, there might be reasons
to do an MRI scan because the knee pain is so pronounced that the physician suspects
a meniscus tear. However, to the surprize of everybody the MRI scan
that may have been ordered, shows knee chondromalacia, chondromalacia of the patella
and possibly also chondromalacia of the adjacent femoral bone (the inside articulating
part of the lower thigh bone) instead. In this case where the meniscus was normal
an arthroscopy is not necessary. On the other hand, the patient may have been
booked already for an arthroscopy without the benefit of a prior MRI scan. The
surgeon may be surprised to find only chondromalacia, but no meniscal tear. If
there is grade III or IV chondromalacia, the surgeon may have to shave off any
irregularities
on the joint surface, although the literature regarding this is not
convincing that this is effective on the longterm. However, it may give the patient
some symptom relief from the knee pain for a year or two. Ultimately this joint
disease turns into knee osteoarthritis and a total knee replacement would have
to be considered a few years further down. X-rays are of no use as the
hyaline cartilage does not show up on X rays except for grade IV chondromalacia
indirectly as a slight joint narrowing. However, at that time there is palpable
crepitation (=grinding) in the joint on physical examination. Summary re. diagnostic tests for chondromalacia of the knee: 1.
history of joint pains and confirming crepitation (grinding) by physical examination.
2. MRI scan or CT scan prior to arthroscopy. 3. Arthroscopy when
a tear of the meniscus is confirmed or when chondromalacia grade iV is found on
MRI. 4. With end stage chondromalacia a few more years of functioning can
be gained by arthroscopy with shaving of joint irregularities prior to a knee
replacement at a future date.
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