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The Root Cause of a Knee Deterioration

The Root Cause of a Knee Deterioration
This is a 67-years old lady who has a history of pain in the knee and difficulty in prolonged walking for more than 8-10 years. She had a mild twisting injury a week ago, followed by significant pain that has incapacitated her.
The MRI shows marked cartilage loss as expected in the medial compartment, on the sagittal view. What is also seen, is a tear of the root of the posterior horn of the medial meniscus on the coronal image. This typically occurs after a minor injury in an osteoarthritic knee and then leads to a cascading exacerbation of symptoms and accelerated progression of the osteoarthritis.
This often coexists with marrow edema with changes of a subchondral insufficiency fracture, which however is not seen in her case.
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