Reason: 74-year-old male with left knee pain medial, history of left knee surgery 25 years ago, evaluate for medial meniscus tear, chondral injury. History: Left knee pain MENISCI: The body and posterior horn of the lateral meniscus are markedly attenuated which may reflect prior subtotal meniscectomy, however, there is also fragmentation of the remainder of the posterior horn of the lateral meniscus indicating complex tearing. Only a thin rind of the periphery of the body of the lateral meniscus remains, which is extruded laterally from the joint. There is intrasubstance degeneration of the anterior horn of the lateral meniscus. There is globular intermediate signal intensity within the body and posterior horn of the medial meniscus that approaches the tibial articular surface likely representing intrasubstance degeneration/chondrocalcinosis and degenerative undersurface fraying/tearing. The anterior horn of the medial meniscus appears intact.ARTICULAR CARTILAGE AND BONE: There is severe degeneration of the articular cartilage of the lateral tibiofemoral compartment with the posterior half of the weightbearing portion of the compartment nearly devoid of articular cartilage, with associated small foci of degenerative subchondral marrow signal abnormality. The articular cartilage of the medial compartment appears relatively intact, although there is mild degeneration of the articular cartilage of the weightbearing portion of the medial femoral condyle. There is also superficial degeneration of the articular cartilage along the lateral facet of the patella. There is tricompartmental osteophyte formation including osteophytes along the inferior aspect of the femoral trochlea, centrally, with overlying cartilage loss. There are also small foci of edema-type signal along the periphery of the medial tibial plateau, likely degenerative in etiology.LIGAMENTS: A thin remnant of the anterior cruciate ligament remains which does not appear to attach to the femur consistent with a chronic tear. The PCL appears intact. The MCL appears intact. The LCL appears intact.EXTENSOR MECHANISM: The extensor mechanism appears intact.ADDITIONAL
1. Attenuation and fragmentation of the lateral meniscus likely representing a combination of subtotal meniscectomy and complex tearing.2. Intrasubstance degeneration and undersurface degenerative tearing/fraying of the medial meniscus as described above.3. Articular cartilage degeneration most severely affecting the lateral tibiofemoral compartment.4. Chronic tear of the anterior cruciate ligament.5. Edema along the posteromedial aspect of the proximal tibia suggesting inflammation, perhaps representing a pes anserine bursitis.