40 year-old male with right knee pain and swelling, history of ACL repair MENISCI: A vertically oriented band of increased signal intensity extending through the anterior horn of the medial meniscus is consistent with a tear. We cannot tell on this single exam whether this is old or new, but we see no fluid signal intensity entering the meniscal substance. The body and posterior horn are intact. There is a small focus of increased signal intensity within the free edge of the lateral meniscal body, which could represent a tiny radial tear or postoperative changes; this may not be of any current clinical significance.ARTICULAR CARTILAGE AND BONE: While there are no focal defects within the articular cartilage of the patella, there is increased signal intensity within the deeper cartilage at the medial patellar eminence and medial patella facet likely representing early delamination. Focal increased signal intensity within the central femoral trochlea inferiorly suggests full-thickness degeneration with degenerative signal abnormality within the underlying marrow.There is thinning of the articular cartilage of the weight-bearing portion of the medial femoral condyle and a tiny near full-thickness defect of articular cartilage overlying the posterior horn of the medial meniscus. Regularly spaced foci of low signal intensity along the subchondral bone may represent prior microfracture. Slight depression of the articular cartilage along the lateral femoral condyle is consistent with old impaction fracture from prior ACL injury, with a small focus of full thickness cartilage loss noted within the overlying articular cartilage.LIGAMENTS: Status post ACL reconstruction. The graft appears intact. Mild edema within the marrow along the tibial tunnel is of questionable significance. The PCL is intact. The MCL, and LCL are intact.EXTENSOR MECHANISM: There is expected deformity of the patella and patellar tendon from ACL harvest. The patella tendon is otherwise intact. The quadriceps tendon is intact.ADDITIONAL
1. Intact ACL graft.2. Foci of articular cartilage degeneration as described above.3. Tear of the anterior horn of the medial meniscus, which may be old or new; we see no fluid signal intensity to confirm an unstable tear.