Reason: concern for R knee ligamentous/tendinous injury; unable to do weight bearing History: as above Exam is limited secondary to patient motion.MENISCI: Lateral meniscus: There is a tiny focus of intermediate signal intensity within the inner half of the posterior horn of the lateral meniscus extending to the tibial articular surface, compatible with a small undersurface tear. The remainder of the lateral meniscus is within normal limits.Medial meniscus: Increased signal along the undersurface of the posterior horn of the medial meniscus suggests fraying. Furthermore, there is attenuation of the body of the medial meniscus that may reflect chronic attritional tearing, however, we see no findings to suggest an unstable meniscal tear.ARTICULAR CARTILAGE AND BONE: Examination of the articular cartilage is limited by patient motion. There is focal degeneration of the articular cartilage of the far medial facet of the patella as well as focal degeneration of the femoral trochlea centrally. There is subjective thinning of the articular cartilage of the medial tibiofemoral compartment. Focal depression of the articular surface of the lateral femoral condyle anterior to the meniscus with underlying bone edema may represent an impaction fracture. There is also edema in the lateral aspect of the posterior tibial plateau as well as edema within the medial aspect of the medial tibial plateau.LIGAMENTS: The distal fibers of the anterior collateral ligament appear taut and normal in signal; however, the proximal fibers appear slightly thickened with increased signal intensity, which may reflect sprain/partial thickness tear, particularly in light of the lateral compartment marrow edema pattern suggestive of contusions. The posterior cruciate ligament is within normal limits. The medial collateral ligament is intact, however, a lobulated fluid signal intensity collection superficial to the medial collateral ligament complex (measuring approximately 3 x 1 cm in transverse and 4 cm in craniocaudal dimension) may represent a ganglion or parameniscal cyst. The lateral collateral ligament complex is within normal limits.EXTENSOR MECHANISM: The quadriceps tendon appears within normal limits. There is thickening and increased signal intensity of the distal fibers of the patellar tendon with what appears to be extrusion of mucoid material into the overlying subcutaneous fat; we suspect this reflects severe chronic degeneration of the tendon, although could conceivably be due to prior injury.ADDITIONAL
1.Edema within the distal femur and proximal tibial as described above suggestive of bone contusions and a possible small impaction fracture along the lateral femoral condyle.2.Mild thickening and increased signal intensity of the proximal fibers of the anterior collateral ligament may represent a partial tear.3.Thickening and increased signal intensity of the distal patellar tendon suggests severe mucoid degeneration, although could conceivably be secondary to prior trauma.4.Large joint effusion and evidence of synovitis. 5.A lobulated fluid collection medial to the knee joint may represent a ganglion or parameniscal cyst. 6.Undersurface tearing/fraying of the bilateral menisci.7.Other findings as described above.