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"A linear hypertense signal in body and posterior horn of medial meniscus, reaching articular surface, suggestive of grade III tear". Traumatic or degenerative in a 24 year old female. Leg just gave way, No lifting, no direct trauma...
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My immediate thought is tincture of time if this is a recent occurrence. Bone contusion and synovial effusion makes it seem more likely to be recent.
If it's been a month or more and rest and perhaps drainage with concurrent cortisone injection has not helped, then arthoscopy to repair the damages may be considered.
Some people never remember the injury that caused the tear. Just planting your foot wrong can cause it, tripping over the dog, etc. They may think it's little to nothing at the time and dismiss it. If she doesn't remember falling or hitting something, then there is little we can do to determine the exact cause of injury. Certainly it isn't likely to be degererative at all in someone her age unless perhaps she is a top athlete. However, with bone contusion, she must have injured it in some way. Like you, I don't have a crystal ball to determine exactly how that was done. Wouldn't it be wonderful if we always could?
I know what you mean! Sometimes there are no answers, especially when the patient isn't a good historian :-)
I tend to try to put it into perspective as one of those "...up to your a..s in alligators" kind of things and just work on fixing it.