Reason: S/p R knee ACL reconstruction, MFC allograft, evaluate for meniscus tear or cartilage lesion Evaluation of medial compartment is limited by metallic susceptibility artifact.MENISCI: Evaluation of the medial meniscus is somewhat limited due to adjacent metallic susceptibility artifact. There is attenuation of the medial meniscus, which we suspect is from prior partial meniscectomy, but may reflect chronic attritional tearing if there is no such history. Slight medial extrusion of the body of the medial meniscus is noted. However, we see no intrameniscal fluid signal or other findings to suggest unstable medial meniscal tear.There is a thin vertically oriented increased signal intensity in the anterior horn of the lateral meniscus near the root (series 3 image 10). This may simply reflect normal signal that can be seen in the lateral meniscus at this location, but also could conceivably reflect vertical tear, which may not be of current clinical significance.ARTICULAR CARTILAGE AND BONE: There is slight prominence of the bone along the articular surface of the medial femoral condyle above the posterior horn of the medial meniscus, which presumably reflects the site of medial femoral condyle allograft placement (series 3 image 19). The allograft appears healed. There is mild heterogeneity of the overlying cartilage, which may reflect degeneration, but we see no fluid-filled defect of the cartilage. There is mild heterogeneity of the medial tibial plateau cartilage suggestive of mild degeneration. There is also cyst formation in the posterior tibial plateau.There is small focus of increased signal intensity in the articular cartilage of the lateral tibial plateau below the free edge of the anterior horn of the lateral meniscus (series 3 image 9), likely reflecting focal defect/degeneration. There is also small focus of increased signal intensity in the articular cartilage of the lateral femoral condyle more centrally along the intercondylar notch (series 3 image 14), suggestive of focal defect/degeneration.Increased signal intensity of the articular cartilage of the trochlea centrally reflects focal degeneration (series 3 image 15). Patellar cartilage appears intact.There are small tricompartmental osteophytes.LIGAMENTS: Patient has undergone ACL reconstruction. The ACL graft appears thin but intact (series 3 image 14). There is increased signal intensity of the PCL proximally, which may reflect degeneration or prior injury. Intermediate signal intensity in the vicinity of the cruciate ligaments likely reflect scarring. The medial collateral ligament and lateral collateral ligaments appear intact. EXTENSOR MECHANISM: Quadriceps tendon and patellar ligament are intact.ADDITIONAL
Evaluation of the medial compartment is limited by extensive metallic susceptibility artifact.1. Attenuation and mild extrusion of the medial meniscus without intrameniscal fluid signal or other findings of unstable meniscal tear.2. Vertically oriented increased signal intensity in the lateral meniscus near the anterior horn/root may represent tear of questionable current clinical significance or may simply represent normal signal at this location.3. Postsurgical changes of the medial femoral condyle allograft with mild heterogeneity of the overlying cartilage, which may represent degeneration. However, we see no fluid-filled cartilage defect. Additional foci of cartilage degeneration as described above.4. Postsurgical changes of ACL reconstruction. ACL graft appears thin but otherwise intact.5. Other findings as above.