Presentation
Anterior knee pain.
Patient Data
Thickening and hyperintensity of distal patellar tendon on PD fat sat images seen with partial longitudinal interstitial tear involving lateral fibers at the attachment site.
Grade III chondromalacia is seen along lateral articular facet of patella.
Grade I chondromalacia seen along median ridge and medial articular facet of patella. Grade II / III chondromalacia is seen along medial trochlear facet.
Lobulated intramedullary hyperintense lesion measuring approx. 8 x 5.5 mm seen in distal shaft of femur, likely benign chondroid lesion, possibly enchondroma.
Focal hypointense lesions seen in both femoral condyles and medial tibial condyles – likely bone islands (likely incidental findings).
Small Baker’s cyst is seen.
Case Discussion
Distal patellar tendinosis with a longitudinal interstitial tear near its tibial insertion.
Differentiation between tendinosis and tear is important and may change the management. Tendinosis is seen as thickening with intermediate increased signal on MRI that does not match fluid signal. On the other hand, a tear is seen as separation of fibers wherein the signal nearly matches that of fluid.
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