The stoller method for diagnosing and classifying meniscal injuries is a modern method based on MRI of the knee joint. New and still expensive, it allows you to obtain maximum information about changes in cartilage tissue and select treatment that will be most effective in a particular case.
Damage to the meniscus can be traumatic or degenerative in nature. Both damages are determined accurately by stoller. Depending on the degree of injury, the patient will be prescribed conservative or surgical treatment. Other methods of detecting pathology cannot accurately reflect the level of cartilage damage.
Causes of meniscus damage according to Stoller
The causes of damage vary. Degenerative meniscus defects are most often observed in older people, in whom the problem appears due to disorders in the knee joint. Also, degenerative changes are caused by the following reasons:
- rheumatism;
- gout;
- chronic microtrauma of the knee - observed when a person constantly overloads the joint, which as a result does not have time to fully recover and gradually begins to collapse.
Traumatic injury according to Stoller occurs much more often. It occurs from a direct blow to the knee area or against the background of significant unnatural loads. Such dangerous impacts include: prolonged walking on toes, high jumping and landing on a hard surface, forced knee extension, or sudden movement of the leg after it has been in one position for a long time.
Regardless of what caused the disease, it is necessary to carry out a full diagnosis, classify the damage and undergo full treatment. At the Sinai Clinic, patients are given the opportunity to diagnose and classify meniscus lesions according to Stoller at the most favorable price for them.
Causes and symptoms of injury
Factors leading to meniscus injury:
- jumping or falling from a height onto straight legs;
- sharp turn;
- habitual dislocation;
- rapid rotation of the foot when extending the knee joint;
- rising from prolonged squatting.
Often the problem occurs in athletes who neglect protection during training, as well as in people who have hereditary or genetic features of the structure of the musculoskeletal system.
Signs:
- Sharp and acute pain in the joint area.
- Inability to move the injured lower limb.
- When bending or straightening there is severe pain.
- At the site of injury there is swelling and hyperemia.
Types of meniscal tears according to Stoller
Meniscal tears are classified by location and shape. Determining these indicators is very important for proper treatment of pathology. Injuries vary by location:
- anterior horn;
- bodies;
- posterior horn.
Depending on the form of damage, the classification is as follows:
- horizontal gap - observed in the case of cystic degeneration;
- oblique radical or longitudinal - occurs on the border of the posterior third of the cartilage and the middle;
- combined - occurs in the posterior horn.
Depending on the damage, the location of the source of the main pain changes somewhat, as well as the position of the leg in which it intensifies.
Tendinitis of the knee joint: treatment in Moscow
The multidisciplinary Yusupov Hospital is a large medical institution, which includes a modern diagnostic center and several clinics. If there are signs of knee tendinitis, patients can seek help and advice from rheumatologists at the therapy clinic.
Tendonitis of the knee joint, the symptoms and treatment of which are interrelated, does not cause serious consequences in patients if diagnosed in a timely manner. Specialists at the Yusupov Hospital help people return to an active life without pain and discomfort.
Highly qualified specialists work with patients every day, and you can make an appointment for a consultation by calling the Yusupov Hospital.
What is Stoller classification
The technique was developed by Doctor of Medical Sciences, Professor David Stoller, who is the director of the National Center for Visualization of Musculoskeletal System Structures in Orthopedics in the USA. The accuracy of the study and the possibility of layer-by-layer scanning of tissues, as well as visualization of affected tissue areas and joints, have increased significantly with the advent of MRI technology. The method proposed by Stoller is based on the fact that during scanning a signal of increased intensity appears, indicating the presence of degenerative changes in the area that occur when the meniscus is damaged. The professor has developed a system that uses criteria for the intensity of the received signal, as well as the area of its localization and propagation.
When classifying a lesion, indicators of criteria for the severity of pathology and its severity are taken into account. The classification is based on the intensity of the signal: the higher it is, the more serious the tissue damage and the more severe the degenerative process.
How to treat knee tendinitis
Drawing up a treatment plan and choosing methods is carried out by rheumatologists at the Yusupov Hospital after diagnosis. Before treatment begins, the patient is informed about the scope of therapeutic measures and their cost. Tendinitis of the pes anserine of the knee joint and other varieties involve the use of a set of methods:
- drug therapy;
- physiotherapy;
- surgical intervention;
- physiotherapeutic methods.
At the initial stage of treatment, the patient is given rest; in addition, the limb is immobilized. Auxiliary devices such as a knee brace and a cane reduce the load on the knee joint. Conservative methods are used when the disease develops without complications.
Surgical intervention, which is carried out at the Yusupov Hospital using minimally invasive techniques, is carried out in case of unfavorable course of the disease: tendon rupture, degenerative changes. The use of folk remedies for the treatment of knee tendinitis is inappropriate, since they do not eliminate the cause of the pathology.
Classification
The Stoller classification divides the condition of the meniscus into 4 stages. Depending on which of them is identified, the presence or absence of meniscus pathologies is determined.
- Stage 0 according to Stoller. The examination does not reveal foci of pathological changes in the tissues. The condition of the meniscus is assessed as completely healthy.
- Stage 1 according to Stoller. MRI reveals a signal of increased intensity, which is focal in nature and clearly localized. At the same time, it does not reach the surface of the cartilage tissue. Treatment most often in this case is not yet required or, if the need for treatment is nevertheless identified, it is carried out using conservative methods, mainly of a preventive nature.
- Stage 2 according to Stoller. The intensity of the signal received from the tissues is increased, but its character changes to linear. Similar to the first stage, it does not reach the upper layer of the meniscus (cartilage). If horizontal damage to the meniscus is detected, it means that the cartilage tissue is partially destroyed, but there are no changes in its structure. Treatment is mandatory. It can be predominantly conservative. Stoller grade 2 meniscal damage is the most common reason for seeking medical help.
- Stage 3 according to Stoller. The signal is recorded linear with significantly increased intensity. It clearly reaches the top layer of cartilage. The patient exhibits a pronounced violation of the anatomical structures of the meniscus. This means the presence of medial meniscus tears. Also, with such a lesion, displacement of some areas of injured cartilage cannot be ruled out. This condition is diagnosed as a complete tear of the meniscus with displacement. Treatment is required and is usually carried out surgically. Stoller grade 3 meniscal damage is the most severe.
Since diagnosing and classifying a lesion according to Stoller is only possible with a magnetic resonance imaging device, this service is not available in all medical institutions. Today, the stoller method determines the degree of meniscus damage most accurately.
Causes of knee tendonitis
Tendonitis of the medial lateral ligament of the knee joint, like other types of the disease, is inflammatory in nature; not only the tendon is involved in the pathological process. But also nearby tissues. One of the reasons for the development of the disease is serious physical activity or lack thereof. With long-term or short-term exposure, microtraumas appear, at the site of which a focus of inflammation appears.
Another cause of knee tendinitis, experts believe, is skeletal structure disorders: flat feet, poor posture, which increases the load on the tendons. The development of the inflammatory process can also be caused by other diseases. So. with arthritis, patients who fail to comply with medical recommendations develop signs of tendonitis.
Establishing the causes of the disease is one of the areas of activity when diagnosing knee tendinitis. This measure is necessary to select the most effective methods aimed not only at eliminating the manifestations of the disease, but also the causes of its occurrence.
Clinical picture according to Stoller (according to Stoller) - classification
The clinical manifestations of the pathology according to the classification also vary depending on the stage of the lesion. They additionally allow us to assess the patient’s condition.
- Stage 0 according to Stoller. Since there are no pathologies of the cartilage and its integrity is not compromised, there are no symptoms of pathology.
- Stage 1 according to Stoller. Minimal changes in the joint lead to periodic pain in it. They usually appear in the evening and are more intense in people who have to seriously overload their joints during the day. There may also be a noticeable crunching sound when the knee bends.
- Stage 2 according to Stoller. The impairment in the condition of the joint is quite pronounced, causing the pain to become significant. Its intensity increases when a person moves his leg, using his knee. Also, the pain increases after a long stay in a standing position. In most cases, external manifestations of inflammation are also observed, such as redness of the skin and swelling of the tissues. A crunch in the joint appears with almost every movement.
- Stage 3 according to Stoller. Serious changes occur in the anatomical structure of the cartilage, which causes not only severe pain, but also severe limited mobility of the knee joint. The pain syndrome, as well as stiffness of movement, is greatest in this condition. The clinical picture of the pathology is acute.
The presence of symptoms in addition to MRI allows the patient's condition to be accurately determined. This is the only way the therapy will be most effective.
Prevention
The following rules will help prevent damage to the knee joint:
- Follow a proper and balanced diet with the addition of fresh vegetables and fruits to your diet.
- Take vitamins and minerals if you are deficient.
- Control your weight.
- Follow safety precautions at home, at home and when playing sports.
- Wear special protective devices for the lower extremities.
- Give your body moderate physical activity.
- To refuse from bad habits.
- In winter, walk along paths sprinkled with sand.
- Choose shoes according to the season from natural, breathable materials.
- At the first sign of injury, consult a doctor.
Lesions of the menisci of the knee joints are a disease, the treatment of which should be carried out under the strict supervision of a specialist. If you follow all the prescribed recommendations, the pain will subside faster, and the person will return to the usual rhythm of life.
How to prepare for the procedure
Special preparation is not required before MRI with further classification of the condition of the Stoller meniscus. The study is subject to the same contraindications as MRI, and primarily the presence in the body of metal elements and various electrical stimulators and insulin pumps, the operation of which can be affected by the magnetic field of the device.
There will be no pain or discomfort during the examination. The only thing that the patient needs to take into account is that the procedure is lengthy. If the patient is very nervous before the examination, it is recommended that he take valerian or another herbal sedative.
Treatment of knee meniscus damage
The diagnosis is made after an X-ray examination and, if necessary, an ultrasound examination of the articular cavity for the presence of hemarthrosis.
The therapy is complex and includes sessions of physical therapy, massage, and proper nutrition to reduce the load on the sore joint. For the entire period of treatment, the victim’s leg is fixed with a plaster cast or orthosis.
Conservative methods
Articulation blockade is eliminated by injecting lidocaine with a corticosteroid into the joint cavity. This manipulation reduces pain and prevents the risk of developing hemarthrosis and inflammatory processes. The procedure should be carried out no more than once every two weeks.
Additionally, the doctor prescribes NSAIDs and diuretics (for severe swelling).
After the inflammation is relieved, the patient is prescribed a course of physiotherapy (magnet, laser, electrophoresis, UHF) and massage sessions. If you are immobile for a long time, physical therapy exercises are recommended.