mri decipher

[emtlinz7]

below is reports from presurgery menisicectomy as well as post surgery. Surgeon says no further surgical option despite pain and knee instability

MRI from march

CLINICAL STATEMENT: Rule out meniscus injury.
TECHNIQUE: MRI of the knee was performed using the following sequences: axial,
sagittal, and coronal proton density weighted with fat saturation; sagittal proton density
weighted; sagittal 3D GRE.
284 images were presented for interpretation.
Comparison(s): Right knee radiograph, 12/7/15
FINDINGS:
Menisci:
Medial meniscus: Horizontal tear of the posterior horn of the medial meniscus with
extension into the body.
Lateral meniscus: Small amount of signal within the body of the lateral meniscus, might
represent a small tear with adjacent small parameniscal cysts.
Ligaments:
Anterior cruciate ligament: Mild increased signal within the anterior cruciate ligament,
might be related to prior sprain.
Posterior cruciate ligament: Intact
Medial collateral ligament: Thickening of the MCL at the femoral attachment site is
suggestive of prior injury.
Medial and lateral retinaculum: Intact
Tendons:
Extensor mechanism: Intact
Semimembranosus and Pes Anserinus tendons: Intact
Posterolateral Corner Structures including the Lateral collateral ligament, Iliotibial band
and Popliteus tendon: Mild thickening of the LCL at the femoral attachment site,
suggestive of prior injury. The posterior lateral corner structures are otherwise intact.
Cartilage:
Medial compartment: Intact. No high-grade cartilage defect.
Lateral compartment: Intact. No high-grade cartilage defect.
Patellofemoral compartment: There is a focal cartilage fissuring of the medial femoral
trochlea.
Joint fluid and synovial structures: A small knee effusion is noted.
Muscles: Unremarkable
Bones and Marrow: Unremarkable
Others: Foci of susceptibility artifact in the subcutaneous soft tissue anterior to the knee
and Hoffa fat pad indicate post surgical changes. There is aberrant high origin of the
anterior tibial artery which courses between the popliteal muscle and posterior tibial
cortex.
Impression:
1. Horizontal tear of the medial meniscus posterior horn and lateral meniscus body with
para meniscal cysts.
2. Findings suggestive of prior arthroscopy.
3. A small knee joint effusion.

MRI after surgery
MRI of the right knee without contrast, dated 6/30/16 (CPT 73721)
CLINICAL STATEMENT: Medial knee pain for 6 months following mild direct trauma.
Meniscectomy in 3/16.
TECHNIQUE: MRI of the knee was performed using the following sequences: axial,
sagittal, and coronal proton density weighted with fat saturation; sagittal proton density
weighted; sagittal 3D GRE.
194 images were presented for interpretation.
Comparison(s): MRI from 3/4/16.
FINDINGS:
Menisci:
Medial meniscus: There is marked loss of substance of the body of the medial meniscus
at the site of the tear seen on the prior MRI from 3/4/16, consistent with interval
meniscectomy of the free edge and inferior portion. Redemonstrated is a horizontal
oblique tear of the posterior horn of the medial meniscus, extending to the undersurface.
Lateral meniscus: Redemonstrated is linear signal of the body of the lateral meniscus,
extending to the undersurface, in keeping with a horizontal oblique tear, unchanged
compared to the prior study from 3/4/16.
Ligaments:
Anterior cruciate ligament: Intact.
Posterior cruciate ligament: Intact.
Medial collateral ligament: Mildly thickened proximally, unchanged.
Medial and lateral retinaculum: Intact.
Tendons:
Extensor mechanism: Intact.
Semimembranosus and Pes Anserinus tendons: Intact.
Posterolateral Corner Structures including the Lateral collateral ligament, Iliotibial band
and Popliteus tendon: There is linear signal of the proximal popliteus tendon, suspicious
for a split tear. Redemonstrated is mild thickening of the proximal lateral collateral
ligament at its femoral attachment, unchanged, probably related to prior injury.
Cartilage:
Medial compartment: There is near full-thickness cartilage loss and fissuring over the
weightbearing portions of the right medial femoral condyle and medial tibial plateau,
slightly progressed compared to the prior study from 3/4/16.
Lateral compartment: There is partial thickness cartilage thinning over the
weightbearing portions of the lateral femoral condyle and tibial plateau.
Patellofemoral compartment: Intact.
Joint fluid and synovial structures: Moderate-sized right knee joint effusion.
Muscles: Normal in signal and bulk.
Bones and Marrow: Mild osteophytosis of the medial and patellofemoral compartments.
No bone marrow signal abnormality.
Other: Foci of susceptibility artifact of the anterior knee, related to prior arthroscopy.
There is an aberrant high origin of the anterior tibial artery which courses between the
popliteal muscle and posterior tibial cortex.
Impression:
1. Interval meniscectomy of the body of the medial meniscus of the right knee, and
unchanged horizontal tear of the posterior horn of the medial meniscus.
2. Unchanged horizontal oblique tear of the body of the lateral meniscus of the right
knee.
3. Near full-thickness cartilage loss and fissuring over the weightbearing portions of the
medial femoral condyle and medial tibial plateau, slightly progressed.
4. Moderate-sized right knee joint effusion.