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ACL degeneration and radial meniscal tear

Case contributed by Andrew Lawson
Diagnosis certain

Presentation

Knee pain

Patient Data

Age: 75
Gender: Female

The PCL is intact. The ACL remains intact, but is expanded with diffuse central high signal with extrusion of cystic fluid into the into cruciate space posteriorly. These findings are consistent with mucinous degeneration of the ACL giving rise to the typical celery stalk appearance. 

Chronic, impaction fracture of the medial tibial plateau with thinning of the articular cartilage of both the medial plateau and medial femoral condyle. Associated marginal osteophyte formation. 

Extrusion of the medial meniscus with ghosting of the posterior horn and root consistent with a full thickness radial tear through the posterior meniscal root. The medial collateral ligament is intact. The lateral meniscus and lateral collateral ligaments are intact. High signal along the anterior horn of the lateral meniscus is consistent with the confluence of the anterior cruciate ligament insertion on the tibial plateau. 

Mild marginal osteophyte formation. Full-thickness chondromalacia patellae at the apex of the patella femoral joint. Small associated chondral fissure within the trochlear groove. The quadriceps and patellar tendons are intact.

Case Discussion

Comment:  Full-thickness radial tear of the posterior root of the medial meniscus. Minor chondral loss. (aside from patella). Mucinous degeneration of the ACL.

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