ke/sb/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz Anwar Dlmn / M / 16 yrs.
Referred by : Dr. Abc Xyzauhan.
Examination : M.R.I. of the Right Knee Joint.

CLINICAL PROFILE :

H/O fall while playing football 2 weeks ago with difficulty in bending and straightening the RLE.
C/O pain and swelling over the right knee joint with limitation of joint movements and clicking since then.

EXAMINATION :

M.R.I of the right knee joint was performed using the following parameters :

4 mm thick T1 Weighted, proton and GRASS sagittal images.
4 mm thick T1 Weighted and STIR coronal images.
5 mm thick GRASS axial images.

OBSERVATION :

Menisci

There is a curvilinear hyperintense signal on all pulse sequences within the posterior horn of the medial meniscus reaching upto the superior and the inferior articular surface and displaced medially, and would represent a Grade III meniscal signal (meniscal tear - bucket handle).

The anterior and posterior horns of the lateral meniscus and anterior horn of the medial meniscus reveal normal configuration and signal characteristics.

Cruciate Ligaments :

The anterior cruciate is not well-identified. Intermediate signal intensity lesion is seen along the course of the anterior cruciate ligament on the T1 Weighted images. This is seen to turn hyperintense on the Gradient and STIR images and would represent partial tear/strain of the anterior cruciate ligament.
..2/.




The posterior cruciate ligament shows normal contour and signal
characteristics.

Collateral Ligaments and the Patellar Tendon :

The medial and lateral collateral ligaments and the patellar tendon are normal.

Hoffas Fat Pad :

There is streaking of the Hoffas fat pad with minimal amount of fluid.

Articular cartilage and bones :

Ill-defined hyperintense areas are seen within the epiphysis of the tibia, medially as well as laterally (more so medially) on the STIR images. These are hypointense to the normal marrow on the T1 Weighted images. This is suggestive of bone bruise/edema. Similar signal is also noted in the medial femoral condyle.
There is suggestion of fracture of the tibial plateau medially (scan 106/7).

The articular cartilage overlying the patella, tibia and femur appears normal.

Effusion is seen within the right knee joint and the suprapatellar bursa.

IMPRESSION :

The MRI features are suggestive of :

1. Bucket handle tear (meniscal tear) within the posterior horn of the medial meniscus of the right knee joint.

2. Partial tear/strain of the anterior cruciate ligament.

3. Bone bruise/edema within the proximal epiphysis of the tibia, medially as well as laterally and in the medial femoral condyle.

4. Fracture of the tibial plateau medially.