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Name: hhhhhhhhhhhhhhh Date of Birth: Oct31 2015
DOWNLOAD REQUEST SUMMARY
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System Request Date/Time: 31 Aug 2014 @ 1926
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My HealtheVet Account Summary
VA Radiology Reports
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MY HEALTHEVET ACCOUNT SUMMARY
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Source: VA
Authentication Status: Authenticated
Authentication Date: 25 Apr 2011
Authentication Facility ID: 666
Authentication Facility Name: SHERIDAN VAMC
_____________________________________________________________________
Procedure/Test Name: KNEE 2 VIEWS
Date/Time Exam Performed: 12 Feb 2009 @ 1332
Ordering Location: SHERIDAN VAMC
Requesting Provider: GRAVES,CHARLES B
Reasons for Study: To be done in conjunction w/MRI per DVA
Clinical History:
left knee pain consistent with meniscal tear
Performing Location: SHERIDAN VAMC 1898 FORT ROAD, SHERIDAN 82801
Radiologist: DONAHUE,FRANCIS I
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RADIOLOGY REPORT
Report:
Severe medial, moderate patellofemoral and lateral joint
compartment narrowing with marginal and central osteophytes and
genu varus. No joint effusion. Patellar alignment cannot be
ascertained on axial images.
Impression:
Tricompartmental osteoarthritis as described above
=========================================================================
Procedure/Test Name: KNEE LEFT W/O (MRI)
Date/Time Exam Performed: 12 Feb 2009 @ 1331
Ordering Location: SHERIDAN VAMC
Requesting Provider: GRAVES,CHARLES B
Reasons for Study: left knee pain consistent with meniscal tear
Clinical History:
Performing Location: SHERIDAN VAMC 1898 FORT ROAD, SHERIDAN 82801
Radiologist: DONAHUE,FRANCIS I
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RADIOLOGY REPORT
Report:
Maceration posteriorly horn medial meniscus with almost total
displacement of the medial meniscus into the medial gutter.
Opposing joint surface bone marrow edema and marginal
osteophytes. There is extensive grade IV chondromalacia of the
medial joint compartment. Synovitis medial gutter
No tears of the lateral meniscus. Extensive low-grade
chondromalacia and marginal osteophytes.
Chronic ACL tear, intact PCL
Medial and lateral collateral support structures intact
Extensor mechanism is intact. Patella anatomically aligned with
extensive low-grade chondromalacia of patellofemoral joint with
marginal osteophytes about the patella. Patellofemoral ligaments
intact.
Small popliteal cyst. No joint effusion.
Impression:
Severe osteoarthritis medial joint compartment, moderate
osteoarthritis patellofemoral joint
ACL deficient knee, see above comments
=========================================================================
=========================================================================
Procedure/Test Name: KNEE 3 VIEWS
Date/Time Exam Performed: 20 Apr 2012 @ 1431
Ordering Location: SHERIDAN VAMC
Requesting Provider: YAPUNCICH,VICTOR P
Reasons for Study: Right knee pain following injury
Clinical History:
National Patient Flag
Reason for request: Right knee injury and subsequent pain
Performing Location: SHERIDAN VAMC 1898 FORT ROAD, SHERIDAN 82801
Radiologist: WEIN,GREGORY
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RADIOLOGY REPORT
Report:
Comparison: None
Technique: Three views.
Findings: No fracture, dislocation or bone destruction. Chronic
appearing 19-mm heterotopic ossification posterior to the
proximal tibia. Degenerative change of the proximal tibiofemoral
articulation. Severe narrowing of the medial joint compartment.
Prominent peripheral osteophytes. Osteophyte suggested involving
the articular surface of the lateral femoral condyle.
Degenerative spurring intercondylar notch. Mild degenerative
change patellofemoral articulation. Small joint effusion.
Impression:
Moderate degenerative change. No definite fracture. Consider
MRI..
============================================================================
For a change of pace, here's an MRI of my brain tumor!
=========================================================================
Procedure/Test Name: BRAIN W/WO IV CONTRAST (MRI)
Date/Time Exam Performed: 01 Jun 2012 @ 1015
Ordering Location: SHERIDAN VAMC
Requesting Provider: YAPUNCICH,VICTOR P
Reasons for Study: Follow up brain tumor
Clinical History:
National Patient Flag
CREATININE 4/19/12 13:59 1.2
***************************
Collection DT Spec CREAT CR-eGFR
04/19/2012 13:59 SERUM 1.2 66.6
Reason for requesting MRI: Follow up brain tumor - Pt has follow
up appt with Denver neurosurgery on 6/13/12 @ 0830
Does the patient have ESRD? No Does the patient have an eGFR <
60ml/min in the last
30 days? No Does the patient have acute kidney injury and/or
significant liver
disease? No Does the patient have a liver or kidney transplant?
No
Performing Location: SHERIDAN VAMC 1898 FORT ROAD, SHERIDAN 82801
Radiologist: WEIN,GREGORY
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RADIOLOGY REPORT
Report:
MRI of the brain with and without contrast
Comparison: 1/24/11 and multiple earlier studies..
Technique: 20 cc Multihance utilized.
Findings: Increased T2 signal identified in the left superior
medulla oblongata, left side of the pons, left brachium pontis,
inferomedial left cerebellar hemisphere and superomedial left
cerebellar hemisphere sparing the vermis. In addition there is
mild prominence of the left brachium pontis which effaces the
left side of the fourth ventricle. this is not enhance. No
change in the size and distribution of the abnormality compared
to studies dating back to 5/3/7.
Scattered areas of increased T2 signal identified in the flair
pulse sequence throughout the white matter tracks of the cerebral
hemispheres. These are stable. In a patient of this age this
may represent chronic microangiopathic ischemic white matter
change.
No evidence of abnormal enhancement.
Corpus callosum, optic chiasm , pituitary gland and clivus normal
for age.
Mild volume loss not advanced for age.
No acute infarction.
Signal abnormality involving the inferior medial right frontal
cortex is noted which is stable compared to prior exams and may
represent evidence of remote posttraumatic encephalomalacia.
Prominent perivascular spaces in the inferior basal ganglia
redemonstrated and unchanged. Perivascular space versus small
lacunar infarction right periventricular temporal lobe white
matter is stable..
Impression:
Increased T2 signal identified in the left superior medulla
oblongata, left side of the pons, left brachium pontis,
inferomedial left cerebellar hemisphere and superomedial left
cerebellar hemisphere sparing the vermis. In addition there is
mild prominence of the left brachium pontis which effaces the
left side of the fourth ventricle. This may represent a low
grade glioma. No change from prior studies. No new findings.
=============================================================================
Procedure/Test Name: KNEE RIGHT W/O (MRI)
Date/Time Exam Performed: 13 Feb 2013 @ 0842
Ordering Location: SHERIDAN VAMC
Requesting Provider: YAPUNCICH,VICTOR P
Reasons for Study: rt knee pain
Clinical History:
National Patient Flag
CREATININE 2/7/13 08:53 1.4 H
********************
Collection DT Spec CREAT CR-eGFR
02/07/2013 08:53 SERUM 1.4 H 55.5 L
Reason for requesting MRI: Right knee pain
Does the patient have ESRD? No. Does the patient have an eGFR <
60ml/min in the last 30 days? No. Does the patient have acute kidney injury and/or
significant liver disease? No. Does the patient have a liver or kidney transplant?
No
Performing Location: SHERIDAN VAMC 1898 FORT ROAD, SHERIDAN 82801
Radiologist: MOUBRY,RONDLE M
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RADIOLOGY REPORT
Report:
MRI right knee: As demonstrated on plain film radiograph there is
medial compartment space narrowing with degenerative changes of
the knee.
There is some increased signal within the anterior cruciate
ligament suggesting partial tear. The posterior cruciate
ligament is intact.
Quadriceps tendon and patellar ligaments are grossly intact.
Heterogeneous marrow is seen in the distal aspect of the femur
suggesting some hematogenous marrow. Clinical correlation
recommended i.e. does patient have chronic illness.
The medial and lateral retinacula appear intact. Small
suprapatellar bursal joint effusion is seen. There is some
thinning of the posterior patellar cartilage consistent with
chondromalacia patella.
Medial and lateral collateral ligaments are intact. There are
degenerative changes of the anterior and posterior horns of the
medial and lateral menisci with horizontal tear of the posterior
horn medial meniscus. There is thinning of the anterior and
posterior horns of the lateral meniscus.
Impression:
Degenerative changes. Heterogeneous bone marrow signal. Does
the patient have a chronic illness?
Degenerative changes of the knee with tear of the posterior horn
of the medial meniscus.
Partial tear/tendinosis of the anterior cruciate ligament.
=========================================================================
Procedure/Test Name: KNEE 2 VIEW RIGHT
Date/Time Exam Performed: 13 Feb 2013 @ 0841
Ordering Location: SHERIDAN VAMC
Requesting Provider: YAPUNCICH,VICTOR P
Reasons for Study: to be done in conjunction w/MRI per DVA
Clinical History:
National Patient Flag
Reason for request: rt knee pain
Performing Location: SHERIDAN VAMC 1898 FORT ROAD, SHERIDAN 82801
Radiologist: BEST,ALAN C
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RADIOLOGY REPORT
Report:
Comparison: MRI right knee from the same time, and radiographs
4/20/2012
Findings: Since prior exam there has been progression of medial
compartment joint space narrowing, now severe. Mild lateral
compartment and moderate patellofemoral compartment joint space
loss. Increased patellar osteophytes. Unchanged 1.8-cm
heterotopic ossification posterior soft tissues of the proximal
leg.
Impression:
Progression of severe medial compartment degenerative changes
and joint space loss.
=========================================================================
Procedure/Test Name: KNEE LEFT W/O (MRI)
Date/Time Exam Performed: 22 Aug 2013 @ 1339
Ordering Location: SHERIDAN VAMC
Requesting Provider: YAPUNCICH,VICTOR P
Reasons for Study: knee pain
Clinical History:
Reason for requesting MRI: knee pain
CREATININE 2/27/13 08:33 1.4 H
***************************
Collection DT Spec CR-eGFR
07/02/2013 12:52 PLAS 51.3 L
Does the patient have ESRD, an eGFR < 60ml/min in the last
30 days, acute kidney injury or transplant and/or significant
liver disease or transplant? No
National Patient Flag
Performing Location: SHERIDAN VAMC 1898 FORT ROAD, SHERIDAN 82801
Radiologist: WEIN,GREGORY
--------------------------------------------------------------------------
RADIOLOGY REPORT
Report:
MRI of the left knee.
Technique: Routine noncontrast MRI of the knee performed.
The study is limited due to patient motion
Findings:
Osseous structures: No acute fracture. Gross narrowing medial
joint compartment with bone-on-bone appearance and complete
denudation of large areas of medial femoral condyle and medial
tibial plateau cartilage. Severe grade 2 and 3 chondromalacia
lateral compartment. The multiple large peripheral osteophytes.
Moderate joint effusion..
Cruciate ligaments: The anterior cruciate ligament is severely
degenerated but probably not torn. The posterior cruciate
ligament intact..
Menisci: There is severe maceration of the body and posterior
horn of the medial meniscus which is displaced into the medial
gutter. Moderate degeneration lateral meniscus without tear..
Collateral ligaments: The tibial collateral ligament is effaced
by the large medial osteophytes are grossly intact. The tibial
collateral ligament intact.
Patella and extensor mechanism: Diffuse grade 2 and 3
chondromalacia and patella with a superficial blistering and
fissuring. similar chondromalacia of the trochlear cartilage
with multiple large peripheral osteophytes. Patellar retinaculum
intact. Quadriceps tendon and patellar tendons grossly intact
with tendinosis of the distal patellar tendon. Edema of Hoffa's
fat pad..
Surrounding soft tissues: No cyst or mass.
Posterolateral corner: Degenerative change. No acute fracture.
There is popliteus tendinosis..
Impression:
Advanced degenerative change detailed above.
Maceration medial meniscus.
Please see report for additional body/details.
=========================================================================
Procedure/Test Name: KNEE 2 VIEW LEFT
Date/Time Exam Performed: 22 Aug 2013 @ 1338
Ordering Location: SHERIDAN VAMC
Requesting Provider: YAPUNCICH,VICTOR P
Reasons for Study: knee pain
Clinical History:
National Patient Flag
Reason for request: x-ray to be done in conjunction with MRI
Performing Location: SHERIDAN VAMC 1898 FORT ROAD, SHERIDAN 82801
Radiologist: MOUBRY,RONDLE M
--------------------------------------------------------------------------
RADIOLOGY REPORT
Report:
Left knee: Medial compartment space narrowing is noted. A collar
and then spurring is seen. Posterior patellar spurring is also
noted. No fracture or dislocation. Bone mineral density is
grossly normal.
Impression:
Degenerative changes.
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Procedure/Test Name: KNEE 2 VIEWS
Date/Time Exam Performed: 12 Feb 2009 @ 1332
Ordering Location: SHERIDAN VAMC
Requesting Provider: GRAVES,CHARLES B
Reasons for Study: To be done in conjunction w/MRI per DVA
Clinical History:
left knee pain consistent with meniscal tear
Performing Location: SHERIDAN VAMC 1898 FORT ROAD, SHERIDAN 82801
Radiologist: DONAHUE,FRANCIS I
--------------------------------------------------------------------------
RADIOLOGY REPORT
Report:
Severe medial, moderate patellofemoral and lateral joint
compartment narrowing with marginal and central osteophytes and
genu varus. No joint effusion. Patellar alignment cannot be
ascertained on axial images.
Impression:
Tricompartmental osteoarthritis as described above
=========================================================================
Procedure/Test Name: KNEE LEFT W/O (MRI)
Date/Time Exam Performed: 12 Feb 2009 @ 1331
Ordering Location: SHERIDAN VAMC
Requesting Provider: GRAVES,CHARLES B
Reasons for Study: left knee pain consistent with meniscal tear
Clinical History:
Performing Location: SHERIDAN VAMC 1898 FORT ROAD, SHERIDAN 82801
Radiologist: DONAHUE,FRANCIS I
--------------------------------------------------------------------------
RADIOLOGY REPORT
Report:
Maceration posteriorly horn medial meniscus with almost total
displacement of the medial meniscus into the medial gutter.
Opposing joint surface bone marrow edema and marginal
osteophytes. There is extensive grade IV chondromalacia of the
medial joint compartment. Synovitis medial gutter
No tears of the lateral meniscus. Extensive low-grade
chondromalacia and marginal osteophytes.
Chronic ACL tear, intact PCL
Medial and lateral collateral support structures intact
Extensor mechanism is intact. Patella anatomically aligned with
extensive low-grade chondromalacia of patellofemoral joint with
marginal osteophytes about the patella. Patellofemoral ligaments
intact.
Small popliteal cyst. No joint effusion.
Impression:
Severe osteoarthritis medial joint compartment, moderate
osteoarthritis patellofemoral joint
ACL deficient knee, see above comments
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There you have it, yet the VA refuses to do a damn thing except give me pain meds.
They even refused me physical therapy in the VA swimming pool due to the fact I
used up my limited number of billable visits, as the VA Managements rules.
It is the only effective therapy for me at this time due to severe pain,
and unable to use the land borne PT apparatus. the PT department has tried to
help as much as they were allowed to, but they had to follow managements
outrageous rules.
The folks in VISN-19 have their rules regarding weight, but I was told that
Black Hills VA Health Care System would have no problem doing my knees. I was also
told by a little bird that vets even heavier then me have had their knees fixed.
I am in pain 24/7/365, even with the pain meds. A few years back one of my primary
care docs even asked if I wanted to take morphine. M-O-R-P-H-I-N-E!!!! Like they
inject in battlefield serets.
Although I originally tore my ACL the Wednesday before Thanksgiving 2008, I didn't
get the 1st MRI till February 2009 for 2 reasons, One, I was going to NY for
Christmas to see family, siblings, parents, etc, some whom I hadn't seen in years,
so I didn't want to not go because of surgery, or whatever they do to fix ACLs.
Secondly, I had to setup an appointment with a VA over 330+ miles away, the
closest one to me that had an orthopedic department, although they could have done
it here in Sheridan WY, as they had done with other vets who had situations that
prevented lengthy travel. In my case I had a car that I didn't even leave town with
yet they wanted me to drive almost 700 miles round trip, in my old beater car,
actually a Ford Aerostar minivan, but still, it was old. I white knuckled my drive
down to the Cheyenne VA that winter, fearful of a breakdown, or blizzard, or just
the vehicle crapping out. I still have that same vehicle here today, and still
throwing money into the money pit. There is another option, the DAV Van to get
there and back is usually a 3-4 day event, so after the surgery, all the Post-Op
visits would take 1/2 week, just so they, the upper management and bean-counters
could get their performance bonuses!
My last letter and response to this issue to the director at the Sheridan VA, Ms.
Deb Hirshmann, she just blew me off anf told me to go and complain to the Chief of
Staff for the docs, as she didn't want to deal with it. Propably didn't want to
ruin her retirement/performance BONUS!
For 6 YEARS I have lived in Constant Pain, only to have it get worse with each
passing day. My physical therapist once said, when I asked about my leg braces,
and when to wear them, she said it doesn't matter, as your knees are so screwed
up, they are bone on bone now, and you'll be getting new knees soon (That was
almost 2 years since she said this comment.) so don't worry about wearing them,
as they will not help.
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