MRI
Sagittal PD
Sagittal PD fat sat
Axial PD fat sat
Coronal PD fat sat
Is there a meniscal tear?
No - both menisci are intact with a satisfactory "bow tie" appearance on sagittal views. The ACL and PCL are also intact.
Is the patella normal?
No - the patella is malaligned with a shallow trochlea and lateral tilt, and pulled off centre by the tibial tuberosity (increased TT-TG distance). There is also oedema/bruising in the medial patella and in the lateral femoral condyle consistent with a recent dislocation.
Any other abnormal structures?
Yes - look a the medial structures attaching to the patella. The retinaculum has signal change (too bright on PD FS sequences) and the medial patellofemoral ligament is torn.
Small joint effusion.
Pattern of bone bruising (high signal on PD fat sat sequence) in the medial patellar facet and lateral femoral condyle suggests recent lateral dislocation.
A number of features supporting patellar instability: shallow trochlea, borderline tibial tuberosity - trochlear groove (TT-TG) distance, and lateral patellar tilt.
Signal change in the medial patellar retinaculum, with discontinuous/torn medial patellofemoral ligament. Oedema extends along the medial supporting structures, including the MCL.
Normal menisci, ACL, PCL and lateral collateral complex. Normal patellar and included quadriceps tendon.