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.
