<s>[INST] Hello doctor, I am a 25 year old and a triathlete. 3 months ago, I suffered from knee pain. Doctor checked McMurray test, and Apley grind test result was negative. Only when I twist (rotate) my knee I hear some clicking or popping sound. I took MRI and the result was shown anterior torn of lateral meniscus. It is very small tear. But, my symptoms are matching with patellofemoral compression syndrome. I am really confused. I am having Glucosamine and fish oil at present. I have attached my MRI report for your reference. Now I am doing swimming and simple knee strengthening exercise. After 2 months rest, I feel free when running continuously. When I rotate my knee, I here click or popping sound and no pain. I ran for 10 days and feel pain at the top of the knee cap. Would you recommend surgery or it will cure naturally? And can I do cycling? Does cycling affect meniscus? Please suggest. [/INST] Hi. Thank you for giving me an opportunity to assist you. It looks like you injured your knee three months ago during an athletic activity, and have been having some mechanical symptoms of clicking and popping since then. Since the knee pain has come down, it is likely that your body is trying to take care of the tear for you. While it is often difficult to know from just an MRI report (attachment removed to protect patient identity) as to where exactly the tear is (which zone, etc), it is advisable to consult an orthopedic sports medicine specialist to see if a diagnostic arthroscopy is right for you. This procedure being minimally invasive can allow you to get back to activity very early in the postoperative period. Also, any minor tears and cysts that are causing mechanical obstacle to the normal frictionless movement of your knee joint can be taken care of during the procedure. If the clicking does not bother you much and does not prevent you from athletic activity, I would recommend only strengthening exercise for now. The location that you point out maybe related to a different source of pain. Anterior knee pain is commonly seen in athletes like you with overuse of the patellofemoral joint. 1. Lateral meniscal tear. 2. cyst. 3. Patellofemoral pain syndrome (PFPS). 1. Diagnostic arthroscopy if affecting activity level 2. Physiotherapy supervised quad strengthening. For further information consult an orthopaedician and traumatologist online.---> </s>