Reason: knee osteoarthritis History: severe knee pain MENISCI: Increased signal intensity in the posterior horn of the lateral meniscus is compatible with intrasubstance degeneration, which extends to the tibial articular surface in linear fashion on one and possibly two sagittal sequences, suspicious for an undersurface tear. The posterior horn of the lateral meniscus also appears small, which may represent additional attritional tearing. The aforementioned degenerative signal/tearing extends into the body of the lateral meniscus. The anterior horn of lateral meniscus is within normal limits.There is a small focus of branching signal within the peripheral fibers of the posterior horn of the medial meniscus, extending to the femoral articular surface, which could conceivably represent a small partial thickness tear, but we see no fluid signal intensity entering the meniscus, and the current clinical significance of this finding is uncertain. There is mild intrasubstance degeneration of the body of the medial meniscus. The anterior horn of the medial meniscus is within normal limits.ARTICULAR CARTILAGE AND BONE: There is diffuse, near-full to full-thickness loss of cartilage along the lateral facet of the patella, with relatively mild degeneration of the articular cartilage of the medial facet. There is also near-full to full-thickness loss of articular cartilage along the lateral facet of the femoral trochanter along the inferior aspect. There are small underlying subchondral cysts within the patella.There is full thickness degeneration of the articular cartilage along the medial femoral condyle, above and anterior to the posterior horn of the medial meniscus, measuring approximately 2 cm in length in AP dimension, and over 1 cm in length in medial-lateral dimension.There is also full thickness cartilage loss along the posterior aspect of the lateral femoral condyle, with adjacent foci of intermediate signal, that we suspect represent displaced cartilaginous fragments. Thinning of the articular cartilage of the lateral tibial plateau, beneath the posterior horn of the lateral meniscus, is also noted.Tricompartmental osteophytosis is compatible with osteoarthritis.LIGAMENTS: There is mild edema along the medial collateral ligament, but the ligament itself is intact. The lateral collateral ligament complex is intact. EXTENSOR MECHANISM: No significant abnormality noted.ADDITIONAL
1.Tricompartmental osteoarthritis as described above, most severely affecting the patellofemoral joint. Suspected meniscal tears may be degenerative in etiology.2.Large joint effusion with intra-articular loose bodies.3.Other findings as above.