40-year-old female with history of left knee pain and structural damage to representing with worsening knee pain and swelling MENISCI: The anterior and posterior horns of the lateral meniscus are markedly small, deformed, and have abnormal signal intensity consistent with complex tears and degeneration, progressed since the prior study. The anterior horn of the medial meniscus is macerated. The posterior horns of the medial meniscus is also small and deformed and has abnormal signal intensity consistent with complex tears and degeneration. There is medial extrusion of the body of the medial meniscus and lateral extrusion of the body of the lateral meniscus.ARTICULAR CARTILAGE AND BONE: Greater than 50% thinning of the articular cartilage of the medial femoral condyle. Thinning and irregularity of the articular cartilage of the lateral femoral condyle. Near-complete thinning of the articular cartilage of the medial facet of the patella. Severe tricompartmental osteoarthritis most pronounced along the medial tibiofemoral compartment. There is increased bone marrow signal abnormality along the proximal aspect of the medial tibial plateau and medial femoral condyle which like represents bone marrow reactive change or contusions. New bone marrow edema type signal along the posterior aspect of the tibial condyle beneath the tibial spine.Confluent residual red marrow is noted in the distal femoral metaphysis as well as patchy areas within the proximal tibial metaphysis. LIGAMENTS: Posterior cruciate ligament is intact. New intermediate signal within the ACL is suspicious for at least a partial tear. Some fibers can be followed along the course of the ligament. The medial collateral ligament is intact. The lateral collateral ligament complex is intact. EXTENSOR MECHANISM: The extensor mechanism is intact. Susceptibility artifact from metal and fibrosis in the fat pad of Hoffa compatible with prior surgery.ADDITIONAL
1.Progression of bilateral complex tears and degeneration involving both menisci.2.At least a partial tear of the ACL.3.Marked osteoarthritis affects the knee with near full-thickness to full-thickness articular cartilage defects as described above.