62-year-old female with pain and locking. Evaluate for meniscus tear. MENISCI: There is branching linear signal abnormality within the posterior horn of the medial meniscus extending to the body of the meniscus indicating a complex tear, seen on multiple sequential sagittal images. The tear predominantly involves the inner two thirds of the meniscus with fragmentation of meniscal tissue, but does appear to extend to the peripheral one third as well. The anterior horn appears intact. The lateral meniscus appears intact.ARTICULAR CARTILAGE AND BONE: There are full-thickness clefts of the articular cartilage of the femoral trochlea, centrally and along its medial facet. There is perhaps mild degeneration of the articular cartilage of the medial facet of the patella, but this is equivocal. There is full-thickness degeneration of the articular cartilage of the medial femoral condyle above and anterior to the posterior horn of the medial meniscus. There is also moderate degeneration of the articular cartilage along the posterior aspect of the medial femoral condyle with subchondral cyst formation. There are small cysts within the posterior aspect of the tibia, near the attachment of the posterior cruciate ligament, which are not necessarily of any clinical significance.LIGAMENTS: The anterior cruciate ligament is markedly thinned, and on the sagittal images is indistinct, compatible with a chronic tear, although we suspect some fibers extend from the femur to the tibia based on evaluation of the ligament in all 3 planes. There is band-like low signal intensity extending along the intercondylar eminence which may represent torn ACL fibers or less likely a displaced meniscal fragment. The PCL, MCL and LCL appear intact.EXTENSOR MECHANISM: The extensor mechanism appears intact.ADDITIONAL
1. Complex tear of the medial meniscus.2. Cartilage degeneration as described above.3. Poor visualization of the anterior cruciate ligament on sagittal images with thinning of the ligament on the remaining pulse sequences suggestive of a chronic tear.4. Mild pes anserine bursitis and moderate size joint effusion.