MRI EXAMINATION OF THE LEFT KNEE WITHOUT CONTRAST

MRI EXAMINATION OF THE LEFT KNEE WITHOUT CONTRAST

INDICATION FOR STUDY:         717.9.  Pain.

FINDINGS:               Axial, sagittal, and coronal images were obtained on the 1.5 Tesla GE MRI without contrast.  There is degenerative joint disease.  There are changes noted at the proximal tibia especially towards the lateral aspect and there is degenerative spurring.  The changes in the left knee are not as great as seen on the right.  There is small amount of joint fluid and a small Baker’s cyst.  The anterior and posterior cruciate ligament, medial and lateral collateral ligament, and quadriceps patellar tendon are intact.  The menisci show intrasubstance degenerative changes and there is degenerative meniscal tear in the posterior horn of the medial meniscus to the left knee also.

IMPRESSION:         Degenerative joint disease especially in the medial aspect.  These changes do not appear as prominent as the right knee.  There is a degenerative meniscal tear in the posterior horn of the medial meniscus.  There is small Baker’s cyst.  Please see comments above.

Thank you for the referral.

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MRI EXAMINATION OF THE LEFT KNEE WITHOUT CONTRAST

MRI EXAMINATION OF THE LEFT KNEE WITHOUT CONTRAST

INDICATION FOR STUDY:         719.46 and 715.16.

FINDINGS:               Axial, sagittal, and coronal images were obtained on the 1.5 Tesla GE MRI without contrast.  There are no prior studies for comparison.  There are significant degenerative changes, degenerative joint disease, and joint space loss especially in the medial joint space compartment.  There are changes in the femoral condyle and tibial plateau in the medial aspect consistent with degenerative joint disease.  There is signal change in the bone marrow, which appears somewhat prominent in the distal femur of uncertain significance.  There is no clear evidence of significant mass or other gross abnormality and would recommend clinical correlation or further evaluation as necessary.  Given the extensive degenerative changes and chronic changes in the medial aspect, there is also slight chronic edema surrounding the medial collateral ligament, but there is no evidence of tear of the medial collateral ligament.  This most likely is secondary to chronic strain in this region.  The lateral collateral ligament, anterior and posterior cruciate ligament, and quadriceps patellar tendon are intact.  There is no significant loss of the posterior patellar cartilage and no significant joint effusion.  There is small Baker’s cyst.  In the menisci, there are intrasubstance degenerative changes and there is a tear in the posterior horn of the medial meniscus along with joint space loss.

IMPRESSION:         Significant degenerative joint disease especially in the medial joint space and degenerative meniscal tear in the posterior horn of the medial meniscus most likely.  Small Baker’s cyst.  Please see comments above.  Would recommend further evaluation as necessary.

Thank you for the referral.

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MRI EXAMINATION OF THE LEFT KNEE WITHOUT CONTRAST

MRI EXAMINATION OF THE LEFT KNEE WITHOUT CONTRAST

INDICATION FOR STUDY:         Swelling.  Pain.

FINDINGS:               Axial, sagittal, and coronal images were obtained on the Open MRI at XXXXXXX.  The examination shows a prominent joint effusion.  There are chronic changes, degenerative changes, degenerative joint disease, joint space loss, and degenerative spurring.  The anterior cruciate ligament is not optimally seen, but there does not appear to be significant secondary signs to clearly suggest a tear and would recommend clinical correlation.  The posterior cruciate ligament is intact.  The medial and lateral collateral ligaments are intact as is the quadriceps patellar tendon.  The patient’s body habitus is somewhat large.  There is no significant Baker’s cyst.  There is loss of some of the posterior patellar cartilage.  The examination shows almost complete loss of the joint space on the medial aspect and degenerative meniscal tear in the posterior horn of the medial meniscus.  There are intrasubstance degenerative changes in the remainder of the menisci.

IMPRESSION:         Significant degenerative changes, degenerative joint disease, degenerative spurring, and osteoarthritis.  Prominent joint effusion.  Complete loss of the joint space on the medial aspect and degenerative meniscal tear in the posterior horn of the medial meniscus.  Would recommend further evaluation as needed.  Please see comments above.

Thank you for the referral.

XXXXXXX

MRI EXAMINATION OF THE LEFT KNEE WITHOUT CONTRAST

MRI EXAMINATION OF THE LEFT KNEE WITHOUT CONTRAST

INDICATION FOR STUDY:           Prior MRI examination from XXXXXXXX.  Persistent left knee pain after injury.

FINDINGS:               Axial, sagittal, and coronal images were obtained on the 1.5 Tesla GE MRI.  The patient’s prior study was compared.  There is osteonecrosis noted in the region of the previous contusion.  This extends to the articular surface.  This does not represent a loose bony fragment.  This is consistent with the patient’s previous injury and correlates with the area of prior contusion.  This is consistent with injury to the articular cartilage.  The remainder of the articular surfaces appear intact.  There is no significant acute contusion at this time.  The patella appears in good position.  There is no significant joint effusion.  The anterior and posterior cruciate ligament, medial and lateral collateral ligament, and quadriceps patellar tendon appear intact.  There is continued evidence of intrasubstance degenerative changes in the menisci.  At this time, there is evidence of intrasubstance degenerative changes in the posterior horn of the posterior meniscus, which appear to extend to the inferior articular surface and are concerning for a subtle tear in the posterior horn of the medial meniscus.  This is better delineated on the present study than the previous study.  The previously described meniscal cyst is once again seen.  There is no other significant abnormality or change.

IMPRESSION:          Osteochondral defect noted in the medial tibial plateau region as discussed.  This is seen best on approximately images 11 and 12 of series 5.  There is also a subtle tear in the posterior horn of the medial meniscus.  Please see comments above.  The area of osteochondral defect does correlate with the area of contusion the patient had on the prior study from XXXXXXXX and would recommend clinical correlation and appears delineated to that area of injury.

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