Case 4. Medial femoral condyle lesions

From Eva Escobedo:

Two cases of pathology high and posterior on the medial femoral condyle: we have assumed that this was an area with minimal weight bearing because of location. Yet these cases and another like them recently seem to suggest otherwise. Any thoughts on mechanisms? Any similar cases?

Patient 1:

History: Left knee pain in a 54 y/o obese female. In May when she was moving furniture, she developed some left knee pain. Since that time, it has been swollen.The pain is on the medial aspect and it is worse when she is going up and down stairs. It can pretty much hurt at any time. No improvement with rest.

Sagittal T2W FSE fat sat and PD images


Axial T2W FSE fat sat and GRE images

Other than mild OA changes, no other findings noted on MR or plain films.

Patient 2:

21 y/o male with fall on hyperflexed knee and medial joint line tenderness. The mechanism is more apparent in this case.

Sagittal and coronal T2W FSE fat sat images


Axial T2W FSE fat sat image

Medial femoral condyle contusion was only MR finding.

These lesions are in different areas of the medial femoral condyle posteriorly, but appear to indicate that this is an area under potential stress. In patient 1, the pathology seems to be OA, in patient 2, direct trauma.