Male, 62 years old. Right knee locking, mechanical symptoms, medial joint line tenderness MENISCI: There is increased signal intensity along the posterior horn of the medial meniscus near its junction with the body of the meniscus, indicating a horizontally oriented undersurface tear. While it is possible that this could represent a flap tear, we see no displaced meniscal fragment at this time. The anterior horn appears normal. A small focus of signal abnormality seen on a single image within the body of the lateral meniscus near its junction with the anterior horn may represent a small vertically oriented tear, but this is equivocal and not necessarily of any clinical significance.ARTICULAR CARTILAGE AND BONE: There is delamination of the articular cartilage along the anterior aspect of the lateral femoral condyle with foci of degenerative signal abnormality in the underlying subchondral bone, surrounded by marrow edema. Mild heterogeneity of the articular cartilage of the medial femoral condyle above the posterior horn of the medial meniscus with small irregularly spaced foci of signal abnormality in the underlying bone may represent a site of prior microfracture. There is a full-thickness cartilage defect along the anterior aspect of the medial femoral condyle. There is severe degeneration of the articular cartilage of the patella superiorly with full-thickness cartilage loss and delamination and degenerative signal abnormality in the underlying bone. There is mild edema-type signal abnormality in the medial tibial plateau beneath the meniscal tear that is likely degenerative in etiology.LIGAMENTS: The cruciate and collateral ligaments are intact. There is edema within the medial subcutaneous fat of the knee, including along the medial collateral ligament which could reflect a sprain in the correct clinical context. EXTENSOR MECHANISM: The extensor mechanism appears intact, although there is edema in the soft tissues anterior to the patella and patellar tendon which is nonspecific.ADDITIONAL
1.Undersurface tear of the medial meniscus as described above.2.Tricompartmental cartilage abnormalities as described above including delamination of the articular cartilage of the lateral femoral condyle anteriorly with extensive subchondral edema in the underlying marrow. There is also severe degeneration of the articular cartilage of the patella.3.Nonspecific edema within the anterior and medial soft tissues of the knee as above. The possibility of a mild medial collateral ligament sprain and mild inflammation around the pes anserine tendons is considered in the correct clinical context.4.Irregular hypointensity within the lumen of the popliteal vein and its branches with surrounding increased vascularity may reflect chronic deep venous thrombosis, or less likely a vascular malformation. Of note, review of the patient's medical record indicates a history of chronic deep venous thrombosis.