18-year-old female soccer player status post noncontact knee injury with positive Lockman's. Assess for ACL or meniscal injury. MENISCI: There is linear branching increased signal abnormality within the posterior horn of the medial meniscus which extends to the femoral articular surface consistent with a complex tear with a horizontal component. There is linear increased signal abnormality within the posterior horn of the lateral meniscus which extends to the femoral articular surface consistent with a horizontal tear.ARTICULAR CARTILAGE AND BONE: There is increased signal abnormality within the lateral femoral condyle and the posterior aspect of the lateral tibial plateau consistent with bone contusions. There is depression of the cortex of the lateral femoral condyle overlying this edema which may represent an impaction fracture of the lateral femoral condyle/ lateral "notch" sign. Focus of low signal intensity within the proximal tibial metadiaphysis likely represents a bone island. There is subchondral cyst formation within the lateral facet of the patella. Evaluation of the articular cartilage of the patellofemoral joint is suboptimal secondary to patient motion artifact.LIGAMENTS: There is complete disruption of the proximal and midsubstance fibers of the anterior cruciate ligament. The PCL appears intact. There is increased signal abnormality within the meniscofemoral coronary ligament which may represent a sprain. The superficial band of the MCL appears intact. There is increased signal abnormality within the lateral collateral ligament proper suggesting a sprain.EXTENSOR MECHANISM: The extensor mechanism appears intact. The proximal fibers of the medial retinaculum at the level of their insertion on the femur are indistinct and associated with increased signal abnormality on fluid sensitive sequences indicating partial thickness tearing. There is a slight lateral tilt of the patella.ADDITIONAL
1. Complete rupture of the ACL. 2. Medial and lateral meniscus tears. Bone contusions. Moderate size joint effusion.3. Elevated tibial tubercle to trochlear groove distance and partial thickness tearing of the medial retinacular structures as described above, which can be seen in patient's with patellofemoral instability. Other findings as described above.