Indian Journal of Radiology and Imaging Indian Journal of Radiology and Imaging

QUIZ
Year
: 2006  |  Volume : 16  |  Issue : 4  |  Page : 957--958

Radiological quiz - musculoskeletal


P Sharma, U Hemal 
 Deptt. of Radiology, L.H.M.C., N. Delhi - 1, India

Correspondence Address:
P Sharma
Senior Resident, Deptt. of Radiology, L.H.M.C., N. Delhi - 1
India




How to cite this article:
Sharma P, Hemal U. Radiological quiz - musculoskeletal.Indian J Radiol Imaging 2006;16:957-958


How to cite this URL:
Sharma P, Hemal U. Radiological quiz - musculoskeletal. Indian J Radiol Imaging [serial online] 2006 [cited 2019 Sep 20 ];16:957-958
Available from: http://www.ijri.org/text.asp?2006/16/4/957/32399


Full Text

A 7 year old male presented with right side knee pain. USG of knee was done using high frequency small part linear probe. What is your diagnosis?

 Radiological Diagnosis



 View AnswerMEDIAL MENISCAL CYST

USG revealed a 0.97 x 0.28 cm cystic lesion involving right side medial meniscus suggestive of right side meniscal cyst.

Meniscal cysts may be defined as encapsulated mass lesions containing synovial - like fluid continuous with a meniscus [1]. The incidence varies in reports from 1% to 20%. [2]. They present with pain and swelling at the joint line. They usually arise as a result of fluid passage from the joint to the periphery of the meniscus through a horizontal cleavage tear or complex tear of the meniscus. The cysts tend to have a broad base, and communication with the meniscus can usually be demonstrated, which aids in differentiating the meniscal cyst from the distended bursa [1].

Lateral meniscal cysts are two to four times more common than medial meniscal cysts. Medial cysts, though less common, frequently tend to be asymptomatic even though they may be larger than cysts in the lateral meniscus [3]. The exact etiology of meniscal cysts is unknown. A myxoid degenerative process is identified histologically. There is often a history of precedent trauma [2].

Meniscal cysts appear at sonography as hypoechoic fluid - filled mass that may or may not be compressible. They may be multiloculated. Because there is stasis, the fluid in a meniscal cyst may become progressively complex with the passage of time, demonstrating increasing echoes and may even appear solid on sonography [4]. Demonstration of the underlying tear is possible in some but not all cases.

Conservative treatment in the patient with few symptoms is recommended. Should the cyst become significantly symptomatic, it is necessary to treat the meniscal pathology to prevent a cyst recurrence [2][8].

References

1Ptaszick R. Ultrasound in Acute and Chronic Knee Injury. Radiologic clinics of North America. 1999 July; 37(4): 814-817.
2Lantz B, Singer KM. Meniscal cysts. Clinic Sports Med. 1990 Jul; 9(3): 707-725.
3Kelly EA, Berquist TH. Knee. In : MRI of the Musculoskeletal system, 5th ed. Philadelphia : Lippincott Williams & Wilkins. 2006: 343.
4Schmitz MC, Schaefer B, Bruns J. A ganglion of the anterior horn of the lateral meniscus invading the infrapatellar fat pad. Knee Surg Sports Traumatol Arthrosc. 1996; 4: 97-99.
5Kurian J, Schindler OS, Hussain A. Medial meniscal cyst of the knee - an usual presentation : a case report. J Orthop Surg (Hong Kong). 2003 Dec; 11(2): 234-236.
6Spence KJ Jr, Robertson RJ. Medial meniscal cysts. Case report and review of the literature. Orthopedics. 1986 Aug; 9(8): 1093-1096.
7Lippe CN, Suprock MD. Bilateral medial meniscal cysts in a 15 year old girl. Am J Orthop. 2005 Apr; 34(4): 195-197.
8Kanamiya T, Naito M, Hara M, Cho K, Fujiwara A, Morishita Y. Bilateral meniscal cysts of medial menisci occurring in a career soldier. Arthroscopy. 2004 July; 20 Suppl 2: 13-15.