Why does my knee hurt but the MRI showed nothing?
Knee joint injuries are common, and an MRI image can visually show the cause of the pain. There are instances when an MRI may show negative results even though you are in pain, and there are some knee injuries an MRI scan may not detect. In such cases, an orthopedic knee surgeon may do additional clinical exams to identify the cause of the pain and prevent further damage. Here are some knee injuries and causes of pain that an MRI scan may not detect:
Meniscal Tears
Meniscal tears are common knee injuries that occur when knee cartilage tears. This damage may cause swelling, pain, knee-catching, or locked knees. Meniscal tears can vary in grade or size. In grades 1 and 2 meniscal tears may not show on an MRI scan. An MRI can visualize the injury if it is 3mm thick and above.
Patellofemoral Pain Syndrome
Patellofemoral Pain Syndrome (PFPS) is a common knee condition known as the runner’s knee. Runner’s knee injuries affect the kneecap and the surrounding areas. PFPS is caused by a kneecap misalignment from the femur bone during movements. This injury may cause the knee to develop a grinding sensation, become painful, and swell at the joint. An MRI may not pick up on the cause of this painful condition.
Synovial Plica Syndrome
Synovial Plica Syndrome is a knee injury that occurs when the fold of the knee joint tissue, synovial plica, is irritated. The inflammation of the synovial plica may cause the knee to be painful, swollen, and have a clicking sensation. The results of an MRI may appear normal if the cause of the pain is synovial plica syndrome.
Referred Pain
Referred knee pain occurs when an injury on another part of the body causes knee pain. Your knees may not have a problem, but neck, back, or hip misalignments or pain may be felt at the knee joint. In the case of referred pain, an MRI scan may show normal knee tissues. An experienced orthopedic knee surgeon may have to do further tests to establish the injury or cause of the pain.
Cartilage Injury
Cartilage is a flexible, strong tissue that connects joints and bones. This connective tissue cushions the knee joint. Cartilage injuries are common knee joint conditions that may cause excruciating pain. These injuries may cause the knee joint to be stiff and swollen. Though most cartilage injuries may be visible on MRI, the scan can miss some if they are minor or in an uncommon area.
Iliotibial Band Syndrome
An Iliotibial Band Syndrome (ITBS) knee injury happens when the iliotibial band, the thick band of tissue connecting the hip bone to the knee, becomes inflamed. This irritation may cause the area around the knee to become painful and tender. ITBS is a common knee condition that may not show up on MRI scan results.
Meniscocapsular Separation
Meniscocapsular tears occur when the meniscus detaches from the capsular attachments. This damage may cause knee instability, pain, and joint effusion. A meniscocapsular injury may be difficult to detect due to a similar presentation with a peripheral meniscal tear, another knee condition that may have false negative MRI feedback.
Ramp Lesion
A ramp lesion is also known as a medial meniscal lesion (MRL). This injury affects the medial meniscus meniscocapsular junction and is common in young men that play contact sports such as rugby, boxing, wrestling, and others. Ramp lesion injuries cause pain at the back or inner back of the knee joint. Ramp lesions may limit the knee joint functions by increasing external and anterior rotary laxity, and an MRI may not detect a ramp lesion.
Tendon or Ligament Strain
Tendons are soft but tough tissues connecting bones and muscles to stabilize the knee joint. Ligaments are strong muscle bands that link knee joints bone to bone. Tendons and ligaments can stretch but can only extend to a certain degree. Excess stretch may strain these bands and cause significant knee discomfort. These sprain injuries may be caused by trauma, overuse, or sudden knee-twisting movements, and the sprained tissues may not show up on an MRI image.
Talk to an Orthopedic Knee Surgeon Today
An injured knee joint may cause discomfort and pain that limits your mobility. Sometimes an MRI scan doesn’t give you the feedback you expect, so further clinical investigations may be needed to resolve your condition. A qualified orthopedic knee surgeon can run further tests to establish and treat the cause of your knee pain. Contact a knee surgeon today to learn more about the potential causes of your pain.
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