48-year-old female patient with right tibial pain, medial and lateral joint line tenderness. MENISCI: The posterior horn of the medial meniscus is attenuated compared to that seen on the prior study which may represent progression of attritional tearing or interval partial meniscectomy. The attenuated posterior horn appears separate from the root of the posterior horn compatible with a full-thickness radial tear. There is medial extrusion of the body of the medial meniscus that appears more prominent on the current compared to the prior study. The anterior horn appears relatively intact.Best seen on the coronal sequences is an obliquely oriented tear that appears to transect the body of the lateral meniscus. There is blunting of the free edge of the posterior meniscus which may reflect prior meniscectomy.ARTICULAR CARTILAGE AND BONE: Foci of subchondral osteonecrosis in the lateral and medial femoral condyles posteriorly appears similar to the prior study. There is a small cyst in the tibial plateau near the attachment of the posterior cruciate ligament that is new compared to the prior study.There is moderate to severe degeneration of the cartilage along the medial facet of the patella, appearing similar to the prior study. There has been progression of cartilage degeneration along the weightbearing portion of the medial femoral condyle. Cartilage degeneration/osteophyte formation along the lateral femoral condyle anterior to the meniscus appears similar to the prior study.LIGAMENTS: The patient has undergone an ACL reconstruction. The intra-articular portion is markedly thinned compatible with interval tearing. The posterior cruciate ligament is intact. The medial collateral ligament and lateral collateral ligament complex are intact.EXTENSOR MECHANISM: There is thickening and increased signal intensity of the distal patellar tendon representing tendinosis with adjacent foci of metallic susceptibility artifact suggesting surgery at this site. There is a thin collection of heterogeneous signal intensity in the subcutaneous fat overlying the distal patellar tendon suggesting a bursitis.ADDITIONAL
1. Medial and lateral meniscal tears.2. Progression of osteoarthritis as described above.3. Progressive thinning of the anterior cruciate ligament graft indicating interval attritional tearing.4. Distal patellar tendinosis with findings suggestive of chronic overlying bursitis.5. Joint effusion and small Baker's cyst.