Reason: Right knee pain, hx of gout. Medial and lateral joint line pain. Evaluate for meniscal or ligamentous injury History: knee pain MENISCI: Note is made of linear branching increased signal abnormality within the posterior horn of the medial meniscus which extends to the tibial and femoral articular surface consistent with complex degenerative tearing which extends to the body of the meniscus. The anterior horn appears intact. There is intrasubstance degeneration of the posterior horn of the lateral meniscus. Some of the signal in the posterior horn of the lateral meniscus extends to the tibial articular surface indicating superficial fraying/degenerative tearing. There is blunting and deformity of the anterior horn of the lateral meniscus indicating degeneration/degenerative tearing.ARTICULAR CARTILAGE AND BONE: There is full-thickness articular cartilage degeneration along the weightbearing surface of the lateral femoral condyle with large portions completely devoid of articular cartilage. There is subjective thinning of the articular cartilage of the medial tibial femoral compartment. There is full-thickness articular cartilage degeneration affecting the patellofemoral compartment most pronounced along the lateral facet of the patella and femoral trochlea. There are tricompartmental osteophytes.LIGAMENTS: There is thickening and increased signal abnormality within the proximal fibers of the lateral collateral ligament proper which likely represents a gouty tophus formation although this could reflect a sprain or partial thickness tear of the LCL proper. The MCL appears intact. EXTENSOR MECHANISM: The extensor mechanism appears intact.ADDITIONAL
1. Complex degenerative tearing of the medial and lateral meniscus as described above.2. Findings consistent with a prepatellar bursitis as described above which can be seen in patients with gout.3. Findings which appear most consistent with a gouty tophus along the lateral aspect of the lateral femoral condyle, although this could conceivably represent a sprain/partial thickness tearing of the lateral collateral ligament proper in the correct clinical setting, particularly if there is a recent history of trauma/injury.4. Severe osteoarthritis of the knee including full-thickness articular cartilage degeneration. Other findings as described above