Left knee pain while walking MENISCI: Again seen is attenuation of the inner edge of the posterior horn of the medial meniscus with increased signal intensity along the adjacent undersurface fibers likely representing a chronic tear. This appears similar to the prior examination accounting for slight technical differences and may not be of any true clinical significance. The lateral meniscus is intact.ARTICULAR CARTILAGE AND BONE: Again seen is what appears to be an ununited fracture fragment along the lateral aspect of the patella with mild edema and cyst formation both within the fragment itself and adjacent patella, suggesting focal instability. Overall these findings appear similar to the prior exam. Small cyst formation is also noted within the soft tissues along the superior interface of the fragment and undersurface of the patella, which is new. A cleft is seen through the articular cartilage overlying the fracture plane with mild heterogeneity of the articular cartilage of the lateral facet indicating mild degeneration.There is a full-thickness cartilage defect of the lateral tibial plateau, similar to the prior exam. The articular cartilage of the medial compartment is relatively intact.LIGAMENTS: The cruciate and collateral ligaments are intact. EXTENSOR MECHANISM: There is thickening and increased signal intensity of the quadriceps tendon with overlying metallic susceptibility artifact and fixation tracts in the patella reflecting prior surgical repair. The abnormal signal intensity and thickening likely reflects a combination of tendinosis and scarring but overall this appears similar to the prior exam. Tendon fibers can be seen extending to the medial patellar fixation tract, but not to the lateral tract; however this is also similar to the prior exam. Thickening and irregularity of the medial and lateral retinacular structures also appears similar. ADDITIONAL
1. Postoperative changes of quadriceps tendon repair with tendinosis and scarring of the quadriceps tendon, the extent of which appears similar to the prior exam.2. Chronic ununited fracture through the lateral patella with underlying edema and cystic changes suggesting focal instability. 3. Focal cartilage defects with other findings further detailed above.