Patient History
11-year-old male with complaint of medial pain in the right knee. No known injury.
Findings
The ACL and PCL are intact.
Medial compartment: Partially displaced, nondepressed and nonshouldered acute osteochondral defects surrounded by arthropathic cysts and osteoedema located at the posterolateral aspect of the medial femoral condyle nonweightbearing surface adjacent to the central compartment measuring 0.6 cm in depth, 1.4 cm in width and 2.3 cm in anteroposterior dimension. Although potentially unstable, the osteochondral lesion is lodged within its defect.
No meniscal tears. No osteoarthrosis. No cortical erosions. The medial collateral ligament is intact.
Lateral compartment: No osteochondral defects, chondromalacia or osteoarthrosis. No cortical erosions. No meniscal tears. Lateral collateral ligament complex is intact.
Anterior compartment. No patellofemoral dysplasia. No osteochondral defects. No osteoarthrosis or chondromalacia. The medial patellofemoral ligament and lateral patellar retinaculum are intact.
Proximal tibiofibular joint is unremarkable.
Quadriceps and patellar tendons are normal.
Borderline patella alta with an Insall-Salvati ratio of 1.5 cm. Induration of the infrapatellar plica with linear edema in the Hoffa's fat pad.
The flexor compartment and neurovascular bundle are noncontributory.
Trace joint effusion without internal debris or free bodies.
Impressions
1. A 0.6 cm non shouldered acute osteochondral lesion located at the posterolateral aspect of the medial femoral condyle non weight bearing surface adjacent to the central compartment. Although potentially unstable, the osteochondral lesion is lodged within its defect. Findings compatible with active osteochondritis dissecans.
2. Medial femoral condylar dysplasia/hypoplasia.
3. Patella alta with maltracking.
4. Trace joint effusion without internal debris or free bodies.
