It’s Beginning To Look A Lot Like, Oh Shit.

The day has finally come, my MRI results are in. The results were very descriptive, and used a lot of medical lingo that I had to research to figure out what exactly they were saying, but I think I have it mostly figured out.

First on the list is a short blurb about the dysplasia and the current appearance of the hip socket. There is an “upsloping of the lateral acetabular roof.” This is fairly apparent in the x-ray I took a photograph of, you can see the angle that the top of the socket is sitting at. It’s turned into more a plate than the bowl it should be. There has been a “superolateral migration of the femoral head.” Because of the high angle of the socket itself, the ball of the femur bone has slowly been migrating upwards because there isn’t anything surrounding it on the top to keep it in the proper position. Except my muscles, but they seem to be giving up all hope.  And there has also been a “widening of the medial joint space.” This is likely because of the wear that has been taking place in the joint over the years.

Something that has also been known since pretty much the beginning is that fact that there is secondary degenerative arthritis. “Mild to moderate grade heterogeneity and irregularity the articular cartilage in the superior aspect of the joint.” From what I can surmise, this is just a fancy way of saying that the cartilage that is surrounding the femoral head and the inside of the socket is weird and irregular. There is a “focal full-thickness cartilage loss at the acetabular margin…” A loss of cartilage has taken place on the front portion of the hip socket.

Because of the osteoarthritis I have developed something called, subchondral sclerosis. Upon some further investigation the best definition I have been able to put together is that when the osteoarthritis wears away the cartilage and bone, the body tries to regenerate that bone loss. The bone that is regenerated is far thicker and more opaque than the bone that was there previously. Typically this is a condition that is found in later stages of osteoarthritis. This condition can cause additional pain, bone spurring, and decreased range of movement in the affected joint.

Which brings me to the next item, “bony marginal spurring the acetabulum, mild bony spurring at the margins of the femoral head.” Bone spurs are abnormal bone growths that typically happens when the underlying osteoarthritis begins to wear away at the protective cartilage. This can cause the femoral head, or the socket itself to have a rough and sometimes jagged appearance. The spurs themself typically don’t cause pain, but if they start rubbing against nerves or other sensitive spots in the joint, there can be pain.

Next on the list is a “focal tear through the base of the labrum at the anterior superior and superolateral margins.” It’s seeming like there is a tear in the cartilage that attaches to the hip socket itself. From the translation of the directional words, it looks as though the front, top ⅓ of the hip socket has the tear. That area seems to have a large amount of the damage, so I suppose that would make the most sense.

And last but not least, there is an “8mm paralabral cyst that is present chronically.” The cysts are usually caused by swelling and fluid build up that is secondary to labral tears.

Well, that was, enlightening.

Of course there were some things that I wasn’t surprised about. The status of the dysplasia itself, and the secondary osteoarthritis. I had some idea about the bone spurs, but it hadn’t ever been something that the doctors I had seen in the past, really talked about or brought us. The things I was unaware of was the underlying sclerosis and the labral tear. Last time I received an MRI, which I believe was about three years ago, nothing about a labral tear was mentioned. So this much has been something that had happened in the time between this MRI and the last.

I’m glad that the results have shown everything that is going on, because I feel like maybe this will give some validity to what I’m feeling. Whenever I bring up the amount of pain and discomfort I’m feeling, it seems to get dismissed. But hopefully with these results, physicians and surgeons will pay more attention.

Below I have created a collage of images that show what each of the above described issues typically look like.

IMG_1987

  1. Labral Tear. This is what I have on the front/top ⅓ of my hip socket.
  2. Paralabral Cysts. It wasn’t mentioned how many cysts I have, but this is an example of what they can look like.
  3. Bone Spurring. The jagged, rough surfaces of the femoral head and the socket. The severity of the spurring can vary from case to case, this image depicts a more advanced version.
  4. Osteoarthritis. In this image we see the damaged cartilage that happens with osteoarthritis, and the underlying bone spurs.
  5. Personal X-Ray. This image has been posted previously but it’s just an image that shows the steep angle of my hip socket.

As for the subchondral sclerosis, I was unable to find a clear animated image of what this may look like, but it can look close to the bone spurs, perhaps just a bit smoother and a much brighter white.

I have e-mailed my physician to let him know that everything is done and the results have been released, hopefully he’ll be contacting the surgeon in California soon.

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