What do you think is going on in medial compt- Quiz!

Avneesh Chhabra, M.D. M.B.A.

Professor Radiology & Orthopedic Surgery

Chief, Division of Musculoskeletal Radiology

UT Southwestern Medical Center, Dallas, Tx

5373 Harry Hines Blvd.

Dallas, Tx-75390-9178

Office: 214-648-2122

avneesh.chhabra@utsouthwestern.edu<mailto:avneesh.chhabra@utsouthwestern.edu>

www.utsouthwestern.edu<www.utsouthwestern.edu/>

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avneesh.chhabra

December 13, 2021 at 11:02 pm

Hello,

Answers are in slides. This was an interesting case as rads commonly mistake pes Anserine tug lesion for osteochondroma
Posterior root tibial pull repair is intact but v low location mimicking patellar relocation surgery.
Grade 4 lesion as well

Congrats to Damon and Atul for getting closest to the correct answers.

Best!
AC

Here are the responses

1. Osteoarthritis (medial joint space narrowing with marginal osteophytes) with subchondral cyst vs.early insufficiency fx medial femoral condyle.

2. Osteochondroma off medial tibial metaphysis.

Failed transtibial pullout repair with media compartment OA. Small osteochondroma along medial prox tibia?

1. Posterior medial meniscus root repair (transtibial pull-out), with metallic endobutton (maybe dislocated? kinda low positioned..).

2. Medial compartment osteoarthritis

3. Small spur/exostosis in medial metaphyseal region of proximal tibia

SIF?

Patellar tendon relocation

Pes anserinus spur, it can cause a bursitis.

Patellar tendon relocation

Small exostotic spur at location of the pes anserinus ( bursitis ?) Medial osteoarthritis grade 2.

post op root tear repair maybe. Obvious arthrosis of med compartment. Not sure what the “clip” is but maybe part of the anchor.

Looks like transtibial root repair.

1. Medial compartment OA
2. Possible Pes Anserine Bursitis due to small medial tibial osteochondroma
3. Quite subtle subchondral lucency weight bearing surface medial femoral condyle – raising possibility of small osteochondral lesion/OCD.

Do u call that a pes insertional spur or an osteochondroma/marrow containing exostosis?

Medial compartment
SINK/SONK
Background mild OA
Would check for meniscal root tear !

AVN ?

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Sent: Thursday, December 9, 2021 1:48 PM