47-year-old presents with pain of the distal quadriceps tendon. MENISCI: We see no meniscal tear.ARTICULAR CARTILAGE AND BONE: There is mild to moderate predominantly superficial degeneration of the articular cartilage of the patella along both the medial and lateral facets.There is thinning of the articular cartilage of the weightbearing surface of the medial femoral condyle anterior to the posterior horn of the medial meniscus with focal delamination of the cartilage just above the free edge of the meniscus.There is also superficial degeneration of the articular cartilage of the weightbearing portion of the medial tibial plateau.Increased signal intensity of the articular cartilage of the lateral tibial plateau beneath the free edge of posterior horn of the lateral meniscus indicates focal degeneration.Bone marrow signal intensity is within normal limits. Note is made of small osteophytes.LIGAMENTS: Cruciate and collateral ligaments are intact. EXTENSOR MECHANISM: There is an incomplete tear of the quadriceps tendon that appears to predominantly involve the deep fibers (vastus intermedius). There is thickening and increased signal intensity in these distal deep fibers of the quadriceps tendon likely representing a combination of tendinosis and full-thickness insertional tearing with up to 2 cm of retraction.There is also a small tear of the medial component of the quadriceps tendon (consisting of the vastus medialis and vastus lateralis fibers) centrally with approximately 2 cm of retraction, although the majority of the vastus medialis and vastus lateralis tendons can be traced to their patellar insertions.There is a small focus of intermediate signal intensity in the distal fibers of the anterior component of the tendon (rectus femoris) which may represent focal tendinosis or tearing. Otherwise, however, the rectus femoris tendon appears intact.The patellar tendon appears intact.ADDITIONAL
1. Incomplete tear of the distal quadriceps tendon as described above, predominately involving the vastus intermedius.2. Osteoarthritis with tricompartmental cartilage degeneration.3. Small to moderate joint effusion.