Bad Bad Bad News for a Runner

Got the following report on the morning of June 7.  Ironically, perhaps mercifully, I won the Corporate Challenge Mile race for my age group the same evening in a respectable time of 4:58.0.  But the following has really been sinking in hard this week  I guess it explains a lot about my running (pain) this spring.

Exam: MRI of the left knee without contrast.

Indications: Recurrent left knee pain with joint clicking.

Technique: Routine MRI of the left knee using standard image sequences.

Findings:
Comparison is made with the prior MRI from St. Joseph's Medical Center dated 1/27/2009. There are surgical changes of an ACL reconstruction. The graft is intact.
There is attenuation and irregularity of the posterior horn and body of the lateral meniscus. Previously the meniscus appears intact. Although the findings may reflect a partial lateral meniscectomy, a recurrent tear is a consideration, particularly if there had been no prior meniscectomy. There is high-grade partial-thickness chondral irregularity along the weight-bearing surface of the lateral femoral condyle and lateral tibial plateau. On the cartilage sensitive sequences there is an unstable appearing chondral flap along the lateral margin of the lateral femoral condyle. There appears to be fluid undercutting of the cartilage in this region. The chondral abnormality measures approximately 11 mm
anterior to posterior x 12 mm transverse. There is reactive marrow edema signal involving the lateral margin of the lateral compartment with early arthrosis and subchondral cyst formation in the lateral tibial plateau. The medial meniscus is intact.
The posterior cruciate ligament is preserved. The collateral ligaments and extensor mechanism are intact. There is mild chondromalacia along the lateral patellar facet.
There is a physiologic amount of joint fluid. The muscle signal intensity is normal.
The proximal tibiofibular joint is intact.

Impression:
Development of irregularity along the inner margin of the posterior horn and body of the lateral meniscus since 2009. The findings are most suspicious for meniscectomy changes, however, if a meniscectomy has not been performed then this represents a lateral meniscal tear. Moderate lateral compartment arthrosis. There is a 12 mm high-grade partial-thickness chondral flap involving the lateral margin of the lateral femoral condyle. There is fluid undercutting this chondral defect suggesting an unstable chondral tear.

Electronically Signed By: Xxxxx, M.D., Xxxx
Signed on: 05/20/2011 08:15:38