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Posterior medial meniscal tear and subchondral insufficiency fracture

Case contributed by Henry Knipe
Diagnosis certain

Presentation

Medial knee pain.

Patient Data

Age: 55 years

Small knee joint effusion.

Complete radial tear of the posterior medial meniscus with extension into the posterior root attachment and posterior part of the body. No extrusion of the medial meniscal body. Lateral meniscus is intact. No parameniscal cyst.

Cruciate ligaments are intact. Grade 1, likely reactive, pattern of edema of the medial collateral ligament. Lateral collateral ligament complex is intact.

Quadriceps and patellar tendons are intact. Small volume of fluid in the superficial infrapatellar bursa. Subcutaneous edema around the anteromedial knee. High signal of the superolateral Hoffa's fat pad suggestive of chronic patellar maltracking.

Moderate medial compartment chondromalacia with subchondral edema. Prominent marrow edema of the proximal medial tibia centered on a region of subchondral low T1 signal. Articular cartilage of the lateral compartment is preserved.

Case Discussion

Classic association of a subchondral insufficiency fracture with a posterior medial meniscus tear. 

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