Osteochondritis dissecans of the medial femoral condyle with a MCL tear and radial tear of the PHMM

Case contributed by Dr Mohammad A. ElBeialy

Presentation

14 years old karate player with sport-induced knee pain for the last 12 days.

Patient Data

Age: 14 years.
Gender: Male
  • a peripheral radial tear is seen as an oblique band of increased signal intensity within the posterior horn medial meniscus with disruption of both articular surfaces. 
  • intact anterior horn medial meniscus and lateral menisci.
  • a small osteochondral lesion of the lateral aspect of medial femoral condyle is seen with subchondral oedematous marrow changes demonstrating low T1 and high PD FS / STIR signal intensity.
  • no articular disruption or loose fragment.
  • high grade partial thickness tear of the tibial attachment of the medial collateral ligament.
  • intact lateral collateral ligament and cruciate ligaments.
  • minimal joint effusion. 
  • marrow oedema signal of the lateral femoral condyle and posterior tibial plateau with patchy area of low T1 and high STIR signal.

Case Discussion

This case shows a constellation of findings in knee trauma: 

  • peripheral radial tear of the PHMM. 
  • medial femoral condyle osteochondritis dissecans (OCD) with subchondral oedematous marrow signal as well as marrow oedema signal of the lateral femoral condyle and posterior tibial plateau.
  • high grade partial thickness tear of the medial collateral ligament.
  • minimal joint effusion.

The morale is never get staisfied with a finding (satisfaction of search); once you get a finding, search for another.

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Case Information

rID: 23551
Case created: 23rd Jun 2013
Last edited: 26th Jan 2016
Tag: knee
Inclusion in quiz mode: Included

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