Fig. 9

A 34-year-old male patient underwent ACL reconstruction and medial meniscectomy 8 years ago, the patient complained of knee pain and swelling. In assessment of the MRI knee, the conventional images show ACL graft buckling and thickening, medial meniscal tear and mild knee joint effusion. Sagittal T2 image (A) at lateral femoral condyle level shows thickening of the articular cartilage upon the lateral femoral condyle anterior segment. On the post processing T2 mapping image: (C, D) The colour image along the articular cartilage of the lateral femoral condyle anterior segment revealed internal areas of blue colour (Yellow ROI) within the deep part with increased T2 value (as demonstrated within the curve image (B)) that corresponds to articular cartilage degeneration. According to the international cartilage Repair Society (ICRS) grading system, this corresponds to grade I cartilage degeneration. Sagittal STIR image (E) at the intercondylar notch level shows relative anterior position and vertical orientation of the tibial tunnel is noted. Mild thickening and buckling of the anterior cruciate ligament graft with intrinsic high signals, yet no evidence of fiber disruption. Findings suggestive of ACL graft roof impingement (White arrows). Coronal (F) and focused sagittal STIR image upon the medial meniscus level(f), the body and posterior horn of medial meniscus show intra-substance linear band of bright signals reaching the menisco-capsular attachment and abutting the inferior articular surface, corresponds to meniscal tear (White arrows). Note the patchy bone marrow edema signals surrounding the tibial tunnel, displaying high STIR signals (Yellow arrow)