Advanced osteoarthitic changes of the left knee is noted with marginal osteophytosis and spiking of the opposing tibio femoral articulations, bipolar patellar osteophytosis and spiking of the tibial spines.A small subchondral areas of abnormal signal intensities eliciting low t1, high t2,& bright stir signals are noted at the opposing tibio-femoral & upper patellar pole postro-lateral surface with cortical irregularity and denudation of the overlying articular cartilage.A thick globular band of high signal intensity in all pulse sequences is seen implicating the posterior horn of both menisci reaching to the menisco-capsular attachment.I'll defined fuzzy outline of the acl is noted with abnormal intra-substance band of high signals noted within yet no evidence of disruption.Intact posterior cruciate ligament as well as collateral ligaments, patellar retinaculae , quadriceps and patellar tendons.Moderate intra articular joint effusion.Normal peri-articular musculature with intact intervening fat planes.Conclusion:Advance osteo-arthritic changes of the left knee with:Osteo-chondral bone ulcers of the tibio-femoral and upper patellar pole.Grade ll torn posterior horn of both menisci.Partial thickness injury / degeneration of the acl.Moderate joint effusion.