Left knee pain and mechanical change Note that the exam is slightly limited by the presence of metallic artifact relating to prior ACL repair.MENISCI: Medial meniscus: There is diffuse attenuation of the medial meniscus likely relating to a combination of changes from prior partial meniscectomy and chronic attritional tearing. There is marked attenuation of the body and posterior horn with a large gap within the body of the meniscus representing a radial tear (axial image 20/38 of series 4). Increased signal within the posterior horn likely represents additional degeneration.Lateral meniscus: There is blunting of the free edge of the posterior horn which may reflect changes from prior partial meniscectomy or free edge tearing. There is signal abnormality extending to the femoral articular surface representing a tear of the posterior horn. The root of the posterior horn is not well seen, likely representing additional tearing. There is blunting of the free edge of the body of the lateral meniscus with horizontally-oriented tearing. The anterior horn demonstrates attenuation likely relating to changes of prior meniscectomy and/or chronic tearing.ARTICULAR CARTILAGE AND BONE: There is severe tricompartmental osteoarthritis with multiple large osteophytes noted.Medial compartment: The weight bearing portions of the medial femoral condyle and medial tibial plateau are devoid of cartilage and there is underlying degenerative signal within the subchondral marrow.Lateral compartment: Moderate osteoarthritis is also noted with areas of partial and full-thickness degeneration. Edema within the lateral tibial spine is likely degenerative in nature.Patellofemoral compartment: There are moderate osteoarthritic changes with cartilage defects particularly along the lateral patellar facet. Additionally, there is partial thickness tearing of the articular cartilage of the medial facet of the femoral trochlea.LIGAMENTS:There is evidence of prior ACL repair however the ACL graft is ruptured. The PCL is intact but demonstrates increased intrasubstance signal perhaps representing degenerative change. The medial collateral and lateral collateral ligaments are intact.EXTENSOR MECHANISM: There is thickening of the patellar tendon with vertically oriented splitting likely relating to prior ACL graft harvest. The quadriceps tendon is normal.ADDITIONAL
1. Severe osteoarthritis with multiple loose bodies as described above. There is a defect of the posterior capsule of the knee that contains a cyst like collection of fluid measuring approximately 1.5 cm. Additionally, an elongated structure situated between the proximal tibia and the popliteus muscle likely represents a large ossicle.2. Bilateral meniscal pathology likely representing a combination of tearing and surgical change.3. Ruptured ACL graft.4. Moderate to large joint effusion with additional findings described above.