Male 15 years old; Reason: left knee pain and swelling after Leland surgery MENISCI: The posterior horn of the lateral meniscus is now identified in its normal location compared to the prior exam. The posterior horn is attenuated with abnormal signal extending to both the femoral and tibial articular surfaces. Given the extensive tearing seen on the prior study, it is difficult to determine to what degree this represents expected postoperative changes versus interval tearing. Increased signal within the body and anterior horn of the lateral meniscus may reflect resolving meniscal "contusions"..Vertically oriented increased signal traverses the peripheral fibers of the posterior horn of the medial meniscus, indicating a longitudinal tear. Currently, this tear is of intermediate signal intensity, which may indicate some interval healing, however this is equivocal. There is slight medial extrusion of the body of the medial meniscus. The meniscofemoral coronary ligament is not well seen and may be torn. The meniscotibial coronary ligament appears thickened.ARTICULAR CARTILAGE AND BONE: Again seen is mild depression of the lateral femoral condyle, representing sequelae of prior impaction fracture, likely sustained at the time of the initial injury. There is mild thinning of the overlying cartilage, without full-thickness fluid-filled defect seen. There is minimal fraying of the superficial articular cartilage of the patella, without fluid-filled defect.LIGAMENTS/TENDONS: The ACL has been reconstructed and the graft appears intact. Edema in the bone marrow adjacent to the intercondylar notch is nonspecific. The PCL is intact. The superficial band of the MCL is intact. Intermediate signal between the superficial band of the MCL and underlying medial meniscus may represent synovitis or scarring. The LCL complex appears intact. Edema signal is seen within the popliteus muscle indicating strain, however the tendon is intact.EXTENSOR MECHANISM: The quadriceps tendon is intact. The patellar tendon is intact, however there is focal thickening of the proximal medial aspect of the tendon indicating scarring, likely postoperative in etiology.ADDITIONAL
1. ACL reconstruction. Moderate joint effusion with a rind of intermediate to low signal intensity likely representing a combination of synovitis and arthrofibrosis. Globular signal abnormality anterior to the ACL graft likely represents additional arthrofibrosis (cyclops lesion).2. Deformity and abnormal signal intensity of the posterior horn of the lateral meniscus likely in part represents meniscal surgery, however, we cannot exclude the possibility of interval tearing.3. Longitudinal tear of the peripheral fibers of the posterior horn of the medial meniscus, which in is now of intermediate signal intensity, perhaps representing interval healing, however this is equivocal.4. Other findings as described above.