49-year-old male with acute medial knee pain following twisting injury of the right knee. Evaluate for meniscal injury. MENISCI: The lateral meniscus appears intact. There is intermediate signal intensity within the posterior horn of the medial meniscus along its superior fibers, suggesting fraying/degenerative tearing. The peripheral margin of the posterior horn of the medial meniscus is also irregular suggestive of tearing in the vascular zone. The anterior horn of the medial meniscus appears intact. There is a small amount of signal intensity within the body of the medial meniscus indicating degeneration, but we see no discrete tear.ARTICULAR CARTILAGE AND BONE: There is edema within the medial aspect of the tibial plateau. Best seen on images 12, 13 and 14 of series 6, is a linear subchondral focus of low signal intensity within the medial aspect of the medial tibial plateau, suspicious for a small subchondral fracture. There is near full-thickness to full-thickness articular cartilage degeneration along the medial femoral condyle above the posterior horn of the medial meniscus extending posteriorly. There is also a focal full-thickness defect of the articular cartilage of the lateral femoral condyle above the posterior horn of the lateral meniscus. There is a small intra-articular osteophyte along the lateral femoral condyle more anteriorly above the anterior horn of the lateral meniscus. Moderate articular cartilage degeneration affects the patella as well as foci of near full-thickness to full-thickness articular cartilage degeneration affecting the femoral trochlea. There are small tricompartmental osteophytes. LIGAMENTS: The cruciate and collateral ligaments appear intact. EXTENSOR MECHANISM: There is an ossicle within the proximal patellar tendon which may reflect old trauma. The quadriceps and patellar tendons are otherwise unremarkable.ADDITIONAL
1. Edema within the medial tibial plateau may represent a contusion. There is a small linear subchondral focus within the medial tibial plateau which is suspicious for a small subchondral fracture.2. Tricompartmental osteophyte formation with articular cartilage degeneration/defects as described above.3. Fraying/degenerative tearing of the superior fibers of the posterior horn of the medial meniscus and possible tearing of the peripheral fibers of the vascular zone.4. Other findings as described above.