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Author Topic: Help translate MRI results and advice - MPTL thin + PFchondrosis + bone shard  (Read 508 times)

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Offline MissDislocate

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Hi everyone! I'm a 36 y/o female and I've had knee pain (front and lateral) for about 10 years (when I dislocated my left knee). Sometime after that dislocation, I also apparently broke a shard off my tibia that is now floating about on the left side. I got the following MRI results and I want to be prepared going into my follow up appointment. I'd like to avoid endless physical therapy and injections and get back to hiking without pain. If anyone can look at this and tell me what I should be prepared for and what I should advocate for, I'd appreciate it SO much!


HISTORY: History of transient patellar dislocation. Persistent pain and swelling, evaluate for cartilage disease.

COMPARISON: 07/05/2016.

TECHNIQUE: The following MR pulse sequences were performed through the knee:
1. Coronal PD- and fat-suppressed intermediate TE-weighted FSE.
2. Sagittal PD- and fat-suppressed intermediate TE-weighted FSE.
3. Axial fat-suppressed intermediate TE-weighted FSE.
4. Sagittal GRE.


CRUCIATE LIGAMENTS: The anterior and posterior cruciate ligaments are intact.

COLLATERAL LIGAMENTS: The medial collateral ligament is intact. The components of the lateral collateral ligament complex are intact. There is attenuation and increased signal of the popliteus tendon, potentially related to prior injury or artifact.

MEDIAL COMPARTMENT: The medial meniscus is intact. The articular cartilage is normal. Alignment is normal.

LATERAL COMPARTMENT: The lateral meniscus is intact. There is a deep partial thickness chondral heterogeneity. Alignment is normal.

EXTENSOR MECHANISM/PATELLOFEMORAL COMPARTMENT: The quadriceps and patellar tendons are intact. Patellofemoral alignment is normal. There appears to be chronic tearing of the medial patellofemoral ligament. The ligament appears thinned and may be discontinuous at its patellar attachment. There is diffuse full-thickness chondral loss along the inferior aspect of the median ridge with extension over the medial and lateral facets. There is more diffuse chondral thinning and low-grade fissuring over the medial and lateral facets.
Subchondral reactive changes are seen within the patella. There is low-grade fibrillation along the trochlea.

BONE: Bone marrow signal is otherwise normal. There is a 1.5 cm x 0.6 cm corticated osseous fragment seen along the anterior margin of the lateral femoral condyle, likely related to a remote impaction injury.

MISCELLANEOUS: There is no joint effusion. No bursitis or popliteal cyst is seen. The muscles are normal in bulk and signal intensity.


1. Sequela of prior transient lateral patellar dislocation with a thinned and discontiguous medial patellofemoral ligament and a remote cortical fracture along the lateral femoral condyle.

2. Severe chondrosis within the patellofemoral compartment.

3. Deep partial thickness chondral heterogeneity within the lateral femoral tibial compartment.