Posterior root tear and subchondral insufficiency fracture

Case contributed by Henry Knipe


Knee pain.

Patient Data

Age: 50 years

Generalized edema around the medial joint capsule. Small knee joint effusion. 

Extruded medial meniscal body with a complete radial tear of the posterior horn - posterior root junction with the posterior root flipped posteriorly to lie behind the posterior cruciate ligament. No lateral meniscal tear or lateral meniscal body extrusion. 

Cruciate are intact. Medial collateral ligament is intact but bowed outwards with a presumably reactive type I pattern of edema. Lateral collateral ligament complex is intact. 

Quadriceps and patellar tendons are intact. Severe patellofemoral osteoarthritis.

Severe medial compartment osteoarthritis with prominent marrow edema through the medial femoral condyle centered on a subchondral low signal focus. Mild subchondral edema in the medial tibial plateau bone anteriorly, with more prominent fluid signal and edema in the meta-epiphyseal region, possibly representing intra-articular ganglion cyst formation. Lateral compartment articular cartilage depth is preserved with moderate chondromalacia.

Case Discussion

A classic combination of a posterior meniscal radial tear, extruded meniscal body, and subchondral insufficiency fracture, which often seems to occur with osteoarthritis

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