Date : 00.00.00
Name of the Patient : Abc Xyz H. lmn / M / 38 yrs.
Referred by : Dr. Abc Xyz Kothari / Dr. Abc Xyzhah.
Examination : M.R.I. of the Left Tibia.
CLINICAL PROFILE :
C/O pain in the left leg below knee since 4-5 years which has increased since 15 days.
EXAMINATION :
M.R.I. of the left tibia was performed using the following parameters :
4 mm thick T1 Weighted and GRASS sagittal images.
4 mm thick T1 Weighted and STIR coronal images.
6 mm thick T1 Weighted and T2 Weighted axial images.
OBSERVATION :
There appears to be a horizontal fracture line through the upper one third of the left tibia involving the tibial condyles. There are ill-defined hypointense areas around the fracture line on the T1 Weighted images. These are seen to turn hyperintense on the T2 Weighted, STIR and GRASS images. Subtle hyperintense signal is also noted in the adjacent soft tissue.
A hypointense area is seen in the medial condyle of the left femur adjacent to the articular surface, on the T1 Weighted images which is seen to turn hyperintense on the GRASS and STIR images and may represent osteochondritis dessicans/subchondral cyst.
A curvilinear hyperintense signal is seen in the posterior horn of the medial meniscus
of the left knee joint, reaching upto the inferior articular surface on all the pulse sequences and would represent Grade III meniscal signal (meniscal tear). A minimal effusion is seen in the left knee joint.
The left leg was screened with 5 mm thick T1 Weighted coronal images which shows curvilinear hypointense signal at the midshaft level which would represent a vessel.
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IMPRESSION :
1. A horizontal fracture line through the upper one third of the left tibia involving the tibial condyles with altered signal which may represent bone bruise/edema. A pathological fracture should be ruled out.
2. Altered signal in the medial condyle adjacent to the articular surface of the left femur may represent osteochondritis dessicans/subchondral cyst.
3. Altered signal in the posterior horn of the meidal meniscus of the left knee joint reaching upto the inferior articular surface would represent Grade III meniscal signal (meniscal tear) (horizontal flap tear).