49 year old male patient with left medial knee pain for many years. No improvement with physical therapy and injection. MENISCI: There is a horizontal cleavage tear of the posterior horn of the medial meniscus (image 13, series 8) and complex tearing of the anterior horn and body, with extrusion of the body. The lateral meniscus appears intact, however, parameniscal cyst formation along the anterior horn raises the suspicion of an unseen tear.ARTICULAR CARTILAGE AND BONE: There is generalized thinning of the patella medial facet articular cartilage with fraying and delamination. There is generalized thinning of the trochlear articular cartilage and the lateral tibial condylar articular cartilage. There is complete loss of the articular cartilage of the weight bearing portion of the medial femoral condyle with underlying bony edema. There is marked thinning of the medial tibial plateau articular cartilage with a short segment full thickness defect. There is tricompartmental osteophyte formation.LIGAMENTS: The cruciate and collateral ligaments are intact. EXTENSOR MECHANISM: The extensor mechanism is intact. Enthesopathic changes are noted about the tibial tubercle.ADDITIONAL
1. Complex tearing of the medial meniscus and suspicion of an unseen lateral meniscal tear. 2. Tricompartmental chondromalacia, most predominately affecting the medial femoral compartment. 3. Probable loose bodies within the suprapatellar pouch which can be confirmed with plain radiograph. 