Reason: new onset of pain, difficulty ambulating, Multiple myeloma on active chemotherapy. MENISCI: There is an oblique tear through the posterior body and horn of the medial meniscus which contacts the inferior articular surface. The lateral meniscus is intact.ARTICULAR CARTILAGE AND BONE: There is mild grade 1/2 chondral thinning in the medial and lateral tibiofemoral compartments. The articular cartilage in the patellofemoral compartment is intact.There are multiple T2 hyperintense and T1/PD hypointense lesions in the proximal tibia, including in the medial and lateral tibial plateau, which are nonspecific, but given history, are concerning for myeloma lesions, which did not appear to be present on the previous PET/CT. The lesion in the lateral tibial plateau causes overlying cortical destruction of the articular surface (series 7, image 20).LIGAMENTS: The anterior and posterior cruciate ligaments are intact. The medial and lateral collateral ligament complex is normal.EXTENSOR MECHANISM: There is mild abnormal T1 and T2 signal hyperintensity at the insertion of the quadriceps tendon, which may reflect mild tendinopathy.ADDITIONAL
1.Multiple abnormal focal lesions in the proximal tibia which are concerning for myelomatous involvement, including an area of cortical disruption of the articular surface in the lateral tibial plateau.2.Oblique tear of the posterior horn of the medial meniscus.3.Diffuse muscular edema within the quadriceps and hamstring muscles which is nonspecific, but may reflect denervation injury.4.Mild diffuse interfascial and intramuscular edema surrounding the knee.