Chronic anterior knee pain, not improved with physical therapy. Evaluate for OCD. MENISCI: The medial meniscus appears normal. The body and anterior horn of the lateral meniscus are usually prominent, suggesting a discoid morphology. Furthermore, there is branching signal abnormality within the anterior horn and body extending to the tibial articular surface indicating a complex tear. While there do appear to be popliteal meniscal fascicles, the posterior horn of the lateral meniscus does not appear to have a well-defined root, and instead extends to the medial femoral condyle via a ligament of Wrisberg. Small cysts are noted along the medial aspect of the lateral meniscus that may either arise from the meniscus itself or less likely from the adjacent anterior cruciate ligament.ARTICULAR CARTILAGE AND BONE: The lateral tibial plateau appears slightly wider than normal, presumably a developmental abnormality. I see no fluid-filled articular cartilage defects. Bone marrow signal intensity is within normal limits.LIGAMENTS: The cruciate and collateral ligaments are intact EXTENSOR MECHANISM: The extensor mechanism is intact. The Insall-Salvati ratio is approximately 1.3 suggesting a mild patella alta. The superior aspect of the femoral trochlea appears shallow and there is prominence of the lateral facet relative to the medial facet suggesting femoral trochlear dysplasia. There is slight lateral translation of the patella relative to the center of the femoral trochlea. The tibial tubercle to trochlear groove distances 18mm which is borderline abnormal.ADDITIONAL
1.Discoid lateral meniscus with tear as described above.2.Slight lateral translation of the patella with respect to the center of the femoral trochlea and anatomic findings as described above that may predispose to patellofemoral instability.