Reason: r/o retear ACL graft History: pain and instability Exam is slightly limited secondary to artifact from femoral and tibial tunnels.MENISCI: There is evidence of prior partial medial meniscectomy. There is superimposed abnormal proton density and T2 signal hyperintensity signal in the anterior aspect of the posterior horn of the medial meniscus, which is more pronounced than on the prior study, suggesting a more acute oblique tear, which contacts the inferior articular surface (series 6, image 25). There is persistent abnormal signal hyperintensity in the anterior horn of the lateral meniscus, which was also seen previously, compatible with fibrosis.ARTICULAR CARTILAGE AND BONE: There is grade II chondromalacia in the posterior aspect of the medial femoral condyle. Otherwise, the articular cartilage is intact.There is a 14 x 13 mm osteochondral defect in the posterior aspect of the medial femoral condyle with near complete underlying T2 signal hyperintensity, and evidence of previous repair.LIGAMENTS: There is indistinctness of the anterior cruciate ligament graft along its midportion, which suggests at least partial tear (series 5, image 17).The posterior cruciate ligament is intact. The medial collateral ligament and lateral collateral ligament complexes are intact. EXTENSOR MECHANISM: The extensor mechanism is intact.ADDITIONAL
1.Indistinctness of the ACL graft along its midportion suggesting at least partial tearing.2.Status post repair of an osteochondral defect in the medial femoral condyle with near complete underlying T2 signal abnormality which suggests there may be a component of partial instability.3.Prior partial medial meniscectomy with evidence of superimposed tear.