Congenital Cartilage Thickening or Syndrome?

Dear colleagues,

I’d appreciate your thoughts on a chronic knee pain case with MRI findings of thickened cartilage in the tibia and femur (suspected congenital), irregular signal changes with cystic alterations, and mild downward-facing medial/lateral tibial joint surfaces.
ACL, PCL, collateral ligaments, quadriceps tendon, and patellar ligament: Normal.

Minimal posterior degeneration in the medial meniscus.

History: Chronic pain since childhood, no major trauma, recurrent episodes after minor twists, resolves with rest.

Exam: Thin leg muscles, no swelling/effusion, full ROM, localized pain lateral knee → fibular head, normal stability.

Could this be isolated congenital thickening or part of a broader syndrome?

Love to hear your insights

Best,
Volker

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