DOI: 7/17/2015. Patient is a 71-year-old female driver who sustained injury when she tripped over a wheel on a sign, falling on her right knee and shoulder. Per OMNI, she was diagnosed with strain of the right shoulder/knee and scrap of the right knee.
MRI of the right knee obtained on 09/01/15 revealed mild to moderate medial erosive and hypertrophic osteoarthritis. There is a subtle horizontal tear of the peripheral body of the lateral meniscus, indeterminant in age. Compression and erosion of the body of the medial meniscus is seen with a complex of small tears in the posterior horn, indeterminant of age. There is a cluster of small subchondral cysts in the proximal mid tibia with surrounding edema of indefinite age. Small knee …show more content…
She has been diagnosed with medial meniscus tear and arthritis by MRI. She was seen 2 weeks ago, but was unsure if she wanted to pursue an arthroscopy, given the fact that she has significant arthritis and may not benefit from a scope.
Examination of the right knee shows medial and lateral joint line tenderness. She has pain with McMurray’s test. Assessments include right knee tear of the medial meniscus and right knee unilateral primary osteoarthritis. Despite the fact that she may not receive complete relief from arthroscopy due to her arthritis, the patient would like to proceed with arthroscopy to treat her meniscus symptoms. This would include chondroplasty for her arthritis.
Per the adjuster’s letter dated 03/10/16, the MRI testing of 09/01/15 indicates a pre-existing condition. The requested chondroplasty surgery is for arthritis not caused by this accident. Dr. Homan does not agree that the major contributing cause of the need for surgery is the patient’s arthritis and not this accident. Dr. Homan also notes that surgery is to address pain from meniscus tear, and not for arthritis. The meniscus tear is the result of the work
MRI of the right knee obtained on 09/01/15 revealed mild to moderate medial erosive and hypertrophic osteoarthritis. There is a subtle horizontal tear of the peripheral body of the lateral meniscus, indeterminant in age. Compression and erosion of the body of the medial meniscus is seen with a complex of small tears in the posterior horn, indeterminant of age. There is a cluster of small subchondral cysts in the proximal mid tibia with surrounding edema of indefinite age. Small knee …show more content…
She has been diagnosed with medial meniscus tear and arthritis by MRI. She was seen 2 weeks ago, but was unsure if she wanted to pursue an arthroscopy, given the fact that she has significant arthritis and may not benefit from a scope.
Examination of the right knee shows medial and lateral joint line tenderness. She has pain with McMurray’s test. Assessments include right knee tear of the medial meniscus and right knee unilateral primary osteoarthritis. Despite the fact that she may not receive complete relief from arthroscopy due to her arthritis, the patient would like to proceed with arthroscopy to treat her meniscus symptoms. This would include chondroplasty for her arthritis.
Per the adjuster’s letter dated 03/10/16, the MRI testing of 09/01/15 indicates a pre-existing condition. The requested chondroplasty surgery is for arthritis not caused by this accident. Dr. Homan does not agree that the major contributing cause of the need for surgery is the patient’s arthritis and not this accident. Dr. Homan also notes that surgery is to address pain from meniscus tear, and not for arthritis. The meniscus tear is the result of the work