MRI Right Knee Result

My MRI Right Knee 27th June 2008

TECHNIQUE: Standard sequences with additional sagittal T2 and axial STIR

FINDINGS: There appears to have been extensive medial meniscal removal leaving only a small amount of meniscus posteriorly and rather more in the position of the posterior horn. The small postero-medial remnant appears to contain a focus of linear horizontal high signal which may be due to recurrent tear. This is difficult to identify on coronal images, and is only really seen on sagittal scans. The lateral meniscus is better preserved. A linear focus of high signal in its posterior third extending to the femoral surface would be rather unusual morphology for tear. It may represent a rather prominent origin of the menisco-femoral ligament. Unfortunately the interface with the lateral meniscus is not clearly shown due to metallic artefact from the ACL repair. Artefact is rather intrusive. No graft material can be seen to traverse the intercondylar notch however. Tunnel position is also difficult to determine due to artefact. The collateral ligaments are intact.

Osteophytes are noted at the medial joint line and there is chondral irregularity consistent with degeneration. A similar appearance is noted laterally, but articular cartilage does appear better preserved. The patello-femoral joint is also partially obscured, but no significant arthropathy can be seen. A patellar tendon graft is likely to have been used and there is some thickening of the residual patellar tendon and the patella itself appears rather low lying.

The lateral collateral ligaments shows appearances suggesting slight thickening of the proximal ligament on axial scans. This is however likely to be due to the adjacent popliteus tendon. Both of these structures appear intact. No definte postero-lateral corner injury is seen. Low signal material can be seen in the intercondylar notch, suggesting arthrofibrosis. Some of this may however represent ACL graft material.

IMPRESSION: The ACL graft cannot be seen to traverse the intercondylar notch. This suggests graft rupture. Assessment is hampered by intrusive artefact from graft fixation. There may be a horizontal tear in the small posterior third remnant of the medial meniscus. The appearances of the lateral mensicus are likely to be due to a prominent menisco-femoral origin. Early tibio-femoral and patello-femoral chondral degeneration.

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