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Wk 2, Case 4, Knee MR - Review

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Report

Patient History

12 F with left knee pain and swelling


Findings

Cruciate Ligaments: The ACL is torn at its mid substance. Intact PCL.

Osseous: No fracture or dislocations. No intramedullary lesions. Intact growth plates.

Menisci: Thin and delicate 2cm vertical longitudinal tear running along the outer edge (red-red zone) of the medial meniscus posterior horn and midbody associated with disruption of the meniscocapsular junction. No parameniscal cyst. No meniscal extrusion.

The lateral meniscus is intact.

Tibiofemoral Compartments: No chondromalacia, osteochondral defects or osteoarthrosis. The medial collateral ligament and lateral collateral ligament complex are intact.

Anterior Compartment: Trochlear dysplasia with a shallow Dejour type A appearance. No patellar dysplasia. No patellar translation or dislocation. Normal tibial tuberosity to trochlear groove distance (TT-TG) of 1cm. No patella alta or baja.

Induration of the infrapatellar plica with focal edema in the superolateral aspect of the Hoffa's fat pad.

Proximal Tibiofibular Joint: Normal.

Small joint effusion without internal debris or free bodies.

Extensor Mechanism: Quadriceps and patellar tendons are normal.

Flexor Mechanism: Subtle fluid distension of the distal gastrocnemius/semimembranosus bursa without dehiscence. Normal neurovascular bundle.

Impressions
1. Full-thickness tear of the ACL at its mid substance. No passive tibial translation.

2. Thin and delicate 2cm vertical longitudinal tear running along the red-red zone of the medial meniscus posterior horn and midbody associated with disruption of the meniscocapsular junction in keeping with a ramp 3 lesion.

3. Trochlear dysplasia with a shallow Dejour type A appearance associated with patellar maltracking and infrapatellar fat pad impingement.

Case Discussion

Faculty

Stephen J Pomeranz, MD

Chief Medical Officer, ProScan Imaging. Founder, MRI Online

ProScan Imaging

Gitanjali Bajaj, MD

Assistant Professor

University of Arkansas for Medical Sciences

Edward Smitaman, MD

Clinical Associate Professor

University of California San Diego

Brian Y. Chan, MD

Assistant Professor of Musculoskeletal Radiology

University of Utah

Tags

Musculoskeletal (MSK)

MRI

Knee

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