Hi Mike,
I am not particularly concerb=ned by these images.
There is a joint effusion and that would be my main diagnosis.
The bit of fluid adjacent to the proximal edge of the medial meniscus i think is just joint fluid as well.
The fluid I mentioned in the presentation is where there is fluid between the meniscus and the MCL. To describe it better imaging th meniscus is a triangle on the ultrasound. The base of the triangle is closest to the transducer and the apex of the triangle is deeper. Fluid between the flat part of the base of the triangle and the MCL is what I mentioned and this represents a menisco’capsular separation. I don’t this is the case here as the base f the triangle is nicely attached to the MCL.
The distal patella tendon is also fairly normal. I see what you mean that the very superficial fibres are slightly less echogenic but I would not make much of this.
I agree fat pad impingement is not often an ultrasound diagnosis but if the fat pad is more echogenic than the other side you can suggest the diagnosis.
Nice images Mike,
Steve