Pain. Evaluate meniscus. MENISCI: There is a complete vertical tear through the red/white zone of the medial aspect of the posterior horn of the medial meniscus that contains fluid signal intensity. This tear appears similar to that seen on the MRI study from 2005. I suspect that this tear extends into the body of the medial meniscus, which has undergone further medial extrusion compared with the prior study. The morphology of the extruded meniscal body suggests the possibility of an adherent flap of displaced meniscal tissue, but this is equivocal. The posterior horn of the medial meniscus lateral to the aforementioned vertical tear is abnormally small which may reflect chronic attritional tearing. The anterior horn of the medial meniscus appears intact. There is perhaps mild surface fraying of the lateral meniscus, but I see no findings to suggest an unstable tear of the lateral meniscus.ARTICULAR CARTILAGE AND BONE: There has been progression of osteoarthritis of the knee were compared with the prior MRI study. There is diffuse degeneration of the articular cartilage of the medial compartment, most severe medially where there is near-full-thickness to full-thickness cartilage loss (see image 25 of series 5). Small subchondral cysts and degenerative edema-type signal are noted within the far medial aspect of the medial femoral condyle and medial tibial plateau. There is more focal degeneration of the articular cartilage of the weight-bearing surfaces of the lateral tibiofemoral compartment, with focal full-thickness degeneration along the lateral femoral condyle above the posterior horn of the lateral meniscus and near full-thickness degeneration of the articular cartilage of the lateral tibial plateau just lateral to the lateral tibial spine. There is moderate degeneration of the articular cartilage of the patella with small foci of degenerative marrow abnormality in the subchondral bone. Similar findings affect the femoral trochlea. There are tricompartment osteophytes. I see no fracture. LIGAMENTS: The anterior cruciate ligament appears normal. The posterior cruciate ligament appears normal; the findings seen on the previous examination suggestive of a partial thickness tear are no longer evident. The medial collateral ligament is slightly bowed by the aforementioned extruded medial meniscus, but otherwise intact. The lateral collateral ligament complex components are intact. EXTENSOR MECHANISM: The quadriceps and patellar tendons are intact.ADDITIONAL
2.3.Progression of osteoarthritis as described above.4.Complex tear of the posterior horn and body of the medial meniscus, with progression of medial extrusion of the body of the medial meniscus. Fluid signal intensity within the vertical component of the tear may indicate an unstable flap.5.Slight enlargement of lobulated fluid signal intensity structure within the posterolateral aspect of the knee as described that I suspect represents a ganglion or less likely a venous malformation.6.Other findings as described above.