Reason for Exam
Patient had an injury of his knee while playing soccer last fall. He reinjured his knee on April 6; now has pain and swelling.

MRI of the Right Knee
A large joint effusion is present. There is no evidence of a Baker cyst. A complex tear is present in the posterior horn of the medial meniscus. The anterior horn and mid portion are intact. There is no tear of the lateral meniscus. High signal intensity is present in the anterior cruciate ligament near its attachment on the lateral femoral condyle. The posterior cruciate and collateral ligaments are intact without abnormal signal intensity. There is no abnormality of the distal quadriceps or the patellar tendon. There are multiple areas of increased signal intensity within the bone marrow consistent with bone bruising. Small areas are present in the medial aspect of the medial tibial plateau. Larger areas of abnormal signal intensity are present in the lateral femoral condyle and in the lateral tibial plateau. No definite fracture line is identified. There is no evidence of chondromalacia.

Impression

1. Large joint effusion.
2. Complex tear of the posterior horn of the medial meniscus.
3. There appears to be at least a partial tear of the anterior cruciate ligament, although a complete tear cannot be excluded.
4. Multiple areas of bone bruising. No definite discrete fracture line is seen.

So, basically, I need arthroscopic knee surgery.

I’ve got an appointment with an orthopedic surgeon on Friday morning, and I’ll know more then.

Toto has been uncharacteristically affectionate since recovering from her cold. In the two days since we returned from Bend, she’s been purring almost non-stop, smothering us with kitty kisses.

Yesterday afternoon she was sitting on the library table, looking out the window, cackling, cackling, cackling that little cat chatter that means “I see you, bird, and I’m going to get you.” Only she was much more excited than normal. I looked out the window to see eight little birds hopping across the lawn, pecking at tasty morsels. Toto wanted a tasty morsel of her own, but all she could do was crouch on the table and cackle, and remember past adventures: