I had a fracture involving the right knee about 40 years ago, a result of a motor cycle collision. In 2004 I had a meniscal tear in the right knee and this was repaired by athroscopic surgery. In October I caught mu right foot when walking and twisted my lower leg and it became extremely painful and I assumed that I had again torn the meniscus. I have had an X ray and a MRI and the following is the report. Could you tell me what this means and the most likely treatment. There is moderate loss of joint space in the medial compartment in keeping with degenerative change. There is also loss of joint space in the patello-femoral compartment especially medially. MRI RIGHT KNEE Technique: Sagittal, axial and coronal multisequence images were acquired per protocol. The ACL and PCL are intact as is the patellar tendon . There is thickening of the quadriceps tendon at the upper pole of the patella in keeping with moderate tendinosis with a small amount of bony spurring. There is a small knee joint effusion and mild synovitis , no popliteal cyst. The collateral ligaments are intact as are the posterolateral corner structures. In the lateral compartment, the lateral meniscus is intact as is the lateral compartment articular cartilage. There is mild osteophytic spurring in the lateral compartment. In the medial compartment, the body of the medial meniscus is extruded. The posterior horn and body junction is very indistinct in keeping with maceration and the posterior horn elsewhere is also diminished in volume. There is diffuse Grade II chondral irregularity in the medial compartment. Diffuse chondral irregularity is demonstrated in the patella especially in the medial facet with a tiny focus of subchondral oedema. There is also diffuse Grade Ill chondral irregularity in the trochlea involving most of the articular surface. Impression: Extrusion of the medial meniscus body on a background of macerated posterior horn/body junction with diffuse chondral wear in the medial compartment. There is also more extensive chondral wear in the trochlea.