Findings:
A joint effusion is present. Marginal osteophytes are present in all 3 joint compartments, greater in the lateral joint compartment. No other significant osseous abnormalities are noted.
No masses or cystic abnormalities are seen.
The medial meniscus is normal in morphology. The lateral meniscus however is markedly abnormal. The main body of the meniscus is small and blunted at its medial aspect and there appears to be at least one meniscal fragment within the joint space, not contiguous with the meniscus. Articular cartilages of the lateral joint compartment are also noted to be markedly thinned and irregular.
The articulate cartilages of the patellofemoral and medial joint compartments demonstrate no focal abnormalities, and are mildly heterogeneous in signal intensity.
The posterior cruciate ligament is intact. The anterior cruciate ligament is poorly visualized and appears disrupted or torn. The medial and lateral collateral ligaments likewise are normal in morphology with no evidence of strain.

Anteriorly, the quadriceps and infra patellar tendons are intact with no evidence of tear. Some edema is present in Hoffa’s fat pad. Posteriorly, soft tissues posterior to the knee are normal in appearance. Blood flow is incidentally noted in the popliteal vein and artery.

Impressions:
1. Extensive degenerative changes the knee, much greater than normally expected for age, and greater in the lateral joint compartment with a torn lateral meniscus.
2. Complete tear of the ACLU also is noted.