14-year-old male with history of right knee injury during soccer. Positive Lachman. Evaluate for ACL tear, meniscus tear. Right knee pain. MENISCI: The menisci are intact.ARTICULAR CARTILAGE AND BONE: There is bone marrow edema within the distal femoral metaphysis concentrated along the physis anteriorly. There is poorly defined band like low signal intensity within the anteromedial aspect of the distal femoral metaphysis that is suspicious for a nondisplaced fracture although it is not evident on the T2 weighted images. Furthermore there appears to be periosteal elevation along the lateral aspect of the distal femoral metaphysis and there is a tiny 3 mm linear focus of low signal intensity within the soft tissues along the lateral aspect of the distal femoral physis with surrounding soft tissue edema. The constellation of findings suggests a nondisplaced Salter-Harris type II fracture. There are also subarticular foci of edema within the anterior aspect of the medial and lateral femoral condyles likely representing bone contusions. There is also edema within the anterior aspect of the proximal tibial epiphysis that extends to the tibial tubercle. There also appears to be slight depression of the anterior aspect of the tibial plateau. This pattern of bone contusions may reflect a hyperextension type injury. The articular cartilage appears intact.LIGAMENTS: The anterior cruciate ligament is intact. The posterior cruciate ligament is intact. The medial collateral ligament is intact. The proximal fibers of the lateral collateral ligament proper appear thickened which may represent edema related to the aforementioned suspected Salter-Harris type II fracture. The lateral collateral ligament complex otherwise appears intact. EXTENSOR MECHANISM: The extensor mechanism is intact.ADDITIONAL
1.Bone marrow abnormalities as described above suggesting contusions from hyperextension injury perhaps with mild impaction fracture of the anterior aspect of the tibial plateau as well as what we suspect to be a nondisplaced Salter-Harris type II fracture of the distal femur.2.There is slight swelling of the proximal fibers of the lateral collateral ligament proper but otherwise the ligaments appear intact.3.No evidence of meniscal tear.