What is the cause of my knee pain based on my MRI results showing a possible intrasubstance tear of the medial meniscus, posterior cruciate ligament (PCL) tear, and chondromalacia patella?

Understanding Your Knee MRI Results

Your knee pain is likely caused by multiple issues including a possible medial meniscus tear, a posterior cruciate ligament tear, and inflammation of the patella (kneecap). 1

Breaking Down Your MRI Findings

1. Medial Meniscus Issue

• You have what's called an "intrasubstance tear versus degeneration" of the posterior horn of the medial meniscus
• This means there's damage within the inner structure of your meniscus (the cushioning cartilage in your knee)
• There's also a focal tear extending to the inferior surface in one area 2
• This type of meniscal damage can cause pain, especially with weight-bearing activities 3

2. Posterior Cruciate Ligament (PCL) Tear

• Your MRI shows a "longitudinal intrasubstance tear" of the PCL
• The PCL is one of the main stabilizing ligaments in your knee
• Fortunately, this tear is "without retraction," meaning the ligament hasn't completely pulled apart 1
• PCL tears can cause pain and some instability, particularly when going down stairs or with deep knee bending 4

3. Patella (Kneecap) Issues

• You have "mild chondromalacia patella" - softening/damage to the cartilage under your kneecap
• There's also edema (swelling) in the patella itself
• The radiologist questions if you have "sesamoiditis" (inflammation of the patella) 1
• These patellofemoral issues commonly cause pain at the front of the knee, especially when climbing stairs or sitting for long periods 5

Why These Findings Matter

Your knee pain is likely the result of all three issues working together:

1. Stability problems: The PCL tear affects the stability of your knee joint 1
2. Cushioning problems: The meniscus damage reduces shock absorption 1, 2
3. Tracking problems: The patella issues cause friction and inflammation at the front of your knee 5

What This Means For You

The combination of these findings explains why you're experiencing knee pain. MRI is highly accurate for diagnosing these types of knee problems, with studies showing it correctly identifies most significant knee injuries 6.

Important Considerations

• Meniscal tears that don't clearly extend to the joint surface (like yours may be) sometimes don't require surgical intervention 2
• PCL tears without retraction may respond to conservative treatment in some cases
• Chondromalacia patella often responds well to physical therapy focused on quadriceps strengthening 5

Next Steps

Based on these findings, you should discuss with your doctor:

1. Whether physical therapy with quadriceps strengthening might help your condition
2. If activity modification would be beneficial to reduce load on the damaged areas
3. What pain management options might be appropriate
4. Whether you might need referral to an orthopedic specialist to discuss possible surgical options if conservative treatment fails 1, 5

Remember that MRI findings should always be interpreted alongside your clinical symptoms and physical examination findings to determine the best treatment approach.