PORTER – Patient-Oriented Radiology Reporter

HISTORY: Left knee pain following flag football injury.

TECHNIQUE: Axial, coronal and sagittal images of the LEFT knee were obtained on a 1.5 Tesla magnet.

CONTRAST: None.

COMPARISON: Left knee radiographs from 11/5/2014.

FINDINGS:

Fluid: Large effusion.

Medial compartment:
- Medial meniscus: Oblique tear of the posterior horn extending to the inferior to the undersurface with edema in the underlying tibial plateau.
- Medial collateral ligament: Edema surrounding the ligament in keeping with a grade 1 sprain.
- Cartilage: Intact.

Lateral compartment:
- Lateral meniscus: Radial tear of the posterior horn with a displaced fragment into the intercondylar notch (series 12 image 18; series 9 image 14). There linear extension of the tear the posterior root (best seen series 12 image 11).
- Lateral collateral ligament complex: Edema surrounding the proximal aspect of the ligament in keeping with a grade 1 sprain.
- Cartilage: Intact.

Posterolateral corner:
- Popliteus tendon: Grade 1 strain of the popliteus myotendinous junction.
- Proximal tibiofibular joint: Normal.
- There appears to be a disruption of the popliteofibular ligament (series 12 image 8).

Anterior compartment:
- Alignment: Lateral patellar tilt, which could be related to the large effusion.
- Quadriceps tendon: Normal.
- Patellar tendon: Normal.
- Retinaculum: Normal.
- Patellar cartilage: Normal.
- Trochlea: Normal.
- Hoffa fat pad: Normal.

Popliteal cyst: None.

Intercondylar compartment:
- Anterior cruciate ligament: Proximal to mid-substance full thickness tear with a few distal fibers identified (series 9 image 15).
- Posterior cruciate ligament: Normal thickness and signal.

Bones:
Impaction fracture of the anterior aspect of the lateral femoral condyle with bone marrow edema. Nondisplaced impacted fracture of the posterior aspect of the lateral tibial plateau with extensive bone marrow edema. Bony contusion in the medial margin of the medial femoral condyle and medial tibial plateau.

IMPRESSION:

1. Full thickness ACL tear with lateral femoral condyle contusion/impaction fracture and contrecoup nondisplaced lateral tibial plateau impaction fracture posteriorly. Large joint effusion.

2. Grade 1 popliteus myotendinous junction strain and disruption of the popliteofibular ligament, suggesting posterolateral corner injury.

3. Lateral meniscal tear with a displaced meniscal fragment in the intercondylar notch.

4. Medial meniscal tear as above.

5. Medial femoral condyle and tibial contusions.

6. Grade 1 MCL and LCL sprains.