66-year-old male with very painful medial sided knee pain with any range of motion or provocative testing. Evaluate for medial meniscus bucket-handle tear. MENISCI: Best seen on sagittal image 7 of series 401 and coronal image 23 of series 801 is a defect within the peripheral undersurface fibers of the medial meniscus at the junction of the body and the posterior horn that measures approximately 6 mm in AP dimension. Despite the presence of this defect, we do not see a displaced flap fragment on this study. There is, however, additional obliquely-oriented vertical signal abnormality more centrally within the posterior horn of the medial meniscus, best seen on sagittal image 10 of series 401 and coronal image 22 of series 801, that appears to extend to both the femoral and tibial articular surfaces and is associated with a slight step-off of the meniscal contour. We suspect that this constellation of findings represents 2 separate tears of the medial meniscus, although it is conceivable that this could represent a single complex tear with meniscal fragments currently situated in a relatively normal position. There is perhaps minimal medial extrusion of the body of the medial meniscus, but the root of the medial meniscus appears intact. The anterior horn of the medial meniscus appears normal. The lateral meniscus appears normal.ARTICULAR CARTILAGE AND BONE: There is perhaps minimal superficial degeneration of the articular cartilage of the medial femoral condyle just above the aforementioned suspected meniscal tear, but we see no discrete fluid-filled defect. The articular cartilage of the lateral compartment appears normal. There is focal blistering of the articular cartilage of the medial facet of the patella indicating degeneration. There is also a near-full-thickness cleft of the articular cartilage of the medial facet of the femoral trochlea with adjacent articular cartilage degeneration. The bone marrow signal intensity is within normal limits.LIGAMENTS: The ACL and PCL are within normal limits. There is mild inflammation along the superficial fibers of the medial collateral ligament, which is nonspecific, but the ligament itself appears intact. The lateral collateral ligament structures are intact. EXTENSOR MECHANISM: The extensor mechanism is intact.ADDITIONAL
1. Medial meniscus tear(s) as described above, likely with a displaced/displaceable flap, although the flap itself is not visualized on this study.2. Focal articular cartilage abnormalities and other findings as described above.