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Question

EXAM: MR RIGHT KNEE WITHOUT CONTRAST

HISTORY: Right knee pain and swelling for one month. 61 -year -old female.

TECHNIQUE: Multiplanar multisequence MR images were obtained through the right knee without contrast

administration.

COMPARISON: None available.

FINDINGS: Axial sequences demonstrate thinning of the posterior patellar cartilage, particularly along the lateral

facet and centrally in the region of the trochlea. Subcortical cystic changes to bone and high signal change of

subcortical bone is seen in the region of the trochlea, with cartilage loss over the medial aspect. The medial patellar

retinaculum demonstrates increased signal along its posterior attachment and a high signal laminated appearance

anteriorly, as well. The lateral patellar retinaculum is intact. A joint effusion is present.

Coronal sequences show abnormal thickening with intermediate signal of the medial collateral ligament above the

level of the joint line, on fat -suppressed proton density. High signal change with abnormal thickening is also seen at

the origin of the femoral fibular ligament in the posterolateral corner. High signal change of subcortical bone is again

seen in the region of the trochlea and extending into the intercondylar notch. Good preservation of the articular

cartilage over the weight -bearing area of both femoral condyles and over the tibial plateau.

Centrally, on sagittal sequences, the posterior cruciate ligament is intact. Abnormal thickening with redundancy and

high signal change is seen throughout the anterior cruciate ligament, particularly along the posterior aspect on fatsuppressed

T2 -weighted sequences. Hoffa's fat pad is unremarkable. Both the quadriceps and patellar tendons are

intact.

In the lateral compartment, increased signal is seen central to the lateral meniscus, but no visible surface extension.

In the medial compartment the medial meniscus is intact..

IMPRESSION: Mild to moderate degenerative joint disease of the patellofemoral compartment of the right knee.

Grade 1 strain or partial tear of the medial collateral ligament at both its patellar attachment and the posterior

attachment. A right knee, joint effusion is present. No visible loose bodies.

Grade 1-2 partial tear of the anterior cruciate ligament of the right knee. The posterior cruciate ligament is intact.

Grade 1 strain or partial tear of the medial collateral ligament above the level of the joint line. Grade 1-2 partial tear

at the origin of the femoral fibular ligament in the posterolateral corner. No meniscal tear. Central myxoid

degeneration is seen throughout the lateral meniscus. No visible surface tear.