Acute right knee pain for seven days. History of right knee surgery for meniscal tear (done in Netherlands), now with right knee "inside the knee" and medially. Exam today though is unremarkable other than clicking and sensation of instability on exam. MENISCI: There is abrupt truncation of the posterior horn of the lateral meniscus that may either reflect a radial tear or partial meniscectomy. There is also, however, branching signal abnormality within the body of the lateral meniscus, including curvilinear fluid signal intensity extending to the femoral articular surface, indicating a complex tear. The anterior horn of the lateral meniscus appears intact.There is abnormal, predominantly horizontally-oriented signal abnormality within the posterior horn and body of the medial meniscus extending to the femoral articular surface, indicating a tear. The tear also extends through the periphery of the meniscus and decompresses into a small heterogeneous parameniscal cyst. The anterior horn of the medial meniscus appears intact.ARTICULAR CARTILAGE AND BONE: There is a full-thickness defect of the articular cartilage of the lateral tibial plateau beneath the truncated posterior horn of the lateral meniscus with mild degenerative signal abnormality in the underlying subchondral bone. There is osteophyte formation along the medial femoral condyle anterior to the meniscus with loss of overlying cartilage. There is also surface fraying and multiple clefts/fissures affecting the articular cartilage of the patella and femoral trochlea.LIGAMENTS: The cruciate and collateral ligaments are intact EXTENSOR MECHANISM: The extensor mechanism is intactADDITIONAL
1.Medial and lateral meniscal tears as described above. Abrupt truncation of the posterior horn of the lateral meniscus may either reflect additional tearing or changes following partial meniscectomy.2.Articular cartilage defects/degeneration as above.