Osteochondritis dissecans of the medial femoral condyle with a MCL tear and radial tear of the PHMM
Diagnosis almost certain
Presentation
14 years old karate player with sport-induced knee pain for the last 12 days.
Patient Data
Age: 14 years.
Gender: Male
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- 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 edematous 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 edema 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 edematous marrow signal as well as marrow edema 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.