Reason: Evaluate left knee for loose body, MPFL tear (patellar dislocation), chondromalacia patella History: Recent traumatic patellar dislocation 2 weeks ago Evaluation of the proximal tibia and the surrounding soft tissues is limited due to metallic susceptibility artifact related to the patient's prior tibial tuberosity transfer.MENISCI: The lateral meniscus appears intact. There is poorly defined increased signal intensity within the posterior horn of the medial meniscus suggesting intrasubstance degeneration, appearing similar to the prior study. We see no discrete meniscal tear.ARTICULAR CARTILAGE AND BONE: Moderate osteoarthritis affects the patellofemoral joint with intra-articular osteophytes and foci of cartilage degeneration that appear slightly more prominent on the current study than on the prior examination. There are central patella and trochlear osteophytes which have increased in size with mild underlying bone marrow edema. However, we see no bone contusions within the patella. Subjectively, the superior aspect of the femoral trochlea appears shallow, appearing similar to the prior study. There are intra-articular osteophytes along the medial femoral condyle just above the posterior horn of the meniscus, which appear to have increased in size and there has been progression of articular cartilage degeneration anterior to this osteophyte. There is also relatively mild degeneration of the articular cartilage of the medial tibial plateau. There has been progressive thinning of the articular cartilage of the lateral femoral condyle above the posterior horn of the lateral meniscus as well as progression of articular cartilage degeneration more centrally along the weightbearing surface of the lateral femoral condyle and lateral tibial plateau. We see no bone marrow edema to suggest contusions.LIGAMENTS: The cruciate and collateral ligaments appear intact. EXTENSOR MECHANISM: The posterior fibers of the medial patellofemoral ligament are not well visualized which may represent a chronic tear, but this appears similar to the prior study. There is irregularity of the lateral retinacular structures likely reflecting prior release. The quadriceps and patellar tendons appear normal.ADDITIONAL
1. Progression of tricompartmental osteoarthritis of the knee.2. Poor visualization of the posterior fibers of the medial patellofemoral ligament which may represent a chronic tear, appearing unchanged when compared to the prior study.3. Other findings as described above.