A 14-year-old with lateral knee pain and locking

Dheer, Sachin; Silverberg, Chad; Zoga, Adam C.; Morrison, William B.

doi:10.1007/s00256-011-1286-0

Cited by 4 publications

(4 citation statements)

References 6 publications

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“…Qualitative results : The majority of the studies included in the qualitative synthesis (11/15) were published within the last 15 years (Akansel et al, 2006; Corvalan et al, 2018; Dheer et al, 2012; Duarte et al, 2017; Dykes & Vijay, 2014; Galifi, 1950; Khanna & Maldjian, 2014; Mishra & Jurist, 1996; Munk et al, 2009; Pearson & Davin, 1921a; Reddy et al, 2007; Rehmatullah et al, 2014; Siefferman & Sheth, 2012; Slanina, 1956; Thomas, 2018), highlighting a recent surge in interest in the cyamella. Two studies were carried out with the intention of identifying cyamellae, and 13 studies were case reports, where cyamellae were discovered incidentally.…”

Section: Resultsmentioning

confidence: 99%

“…While rare, five cases of symptomatic cyamellae are reported in the literature. (a) A painful cyamella presented with a bone marrow edema‐like signal within the cyamella and the adjacent femoral condyle, which may have be due to repetitive micro‐trauma/friction between the cyamella and the femoral condyle, or a transient dislocation of the popliteus tendon/cyamella, which spontaneously reduced prior to evaluation (Dheer et al, 2012). (b) A painful cyamella exhibited sesamoiditis after a traumatic twisting injury to the knee during sports activity (Dykes & Vijay, 2014).…”

Section: Resultsmentioning

confidence: 99%

“…Quantitative results : Nearly all studies reported on the age of the individual at the time the cyamella was discovered. The youngest individual was 14 years old (Dheer et al, 2012), implying the earliest age of cyamella ossification may be similar to that of the fabella (i.e., 12 years old) (Berthaume et al, 2019; Berthaume & Bull, 2020; Ehara, 2014; Pancoast, 1909). The oldest individual was a 95‐year‐old cadaver (Corvalan et al, 2018), with the average age of our sample being 45.5 ± 21.4 years old.…”

Section: Resultsmentioning

confidence: 99%

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Cyamella (a popliteal sesamoid bone) prevalence: A systematic review, meta‐analysis, and proposed classification system

Berthaume

Bull

2021

Clinical Anatomy

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The cyamella is a rare, generally asymptomatic, knee sesamoid bone located in the proximal tendon of the popliteal muscle. Only two studies have investigated cyamella presence/absence in humans, putting ossified prevalence rates at 0.57%–1.8%. We aim to (a) determine cyamella prevalence in a Korean population, (b) examine coincident development of the cyamella and fabella, and (c) perform a systematic review and meta‐analysis on the cyamella in humans. Medical computed tomography scans of 106 individuals were reviewed. A systematic review and meta‐analysis were performed following PRISMA guidelines. Cyamellae were found in 3/212 knees (1.4%), and presence/absence was uncorrelated to height, age, and sex. The cyamella was not found coincidentally with the fabella, although the statistical power was low. Our systematic review/meta‐analysis revealed cyamellae were generally asymptomatic and ossification could occur at 14 years. Cyamellae were equally likely to be found in both sexes, knees, one or both knees, and there appeared to be no global variation in prevalence rates. Cyamellae were found in three distinct locations. There is little support for the role of intrinsic genetic and/or environmental factors in cyamella development in humans. However, the apparent phylogenetic signal in Primates suggests genetics plays a role in cyamella development. We propose a cyamella classification system based on cyamella location (Class I, popliteal sulcus; Class II, tibial condyle; Class III, fibular head) and hypothesize locations may correspond to distinct developmental pathways, and cyamella function may vary with location.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Cyamella (a popliteal sesamoid bone) prevalence: A systematic review, meta‐analysis, and proposed classification system

Berthaume

Bull

2021

Clinical Anatomy

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“…Posterolateral knee pain can be associated with the presence of a fabella and this incidence may be referred to as a fabella syndrome [ 8 - 15 ].…”

Section: Introductionmentioning

confidence: 99%

The fabella syndrome - a rare cause of posterolateral knee pain: a review of the literature and two case reports

Driessen

Balke

Offerhaus³

et al. 2014

BMC Musculoskelet Disord

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BackgroundThe purpose of this article was to evaluate the risks and benefits of non-operative treatment versus surgical excision of a fabella causing posterolateral knee pain. We performed a systematic review of literature and also present two case reports.Twelve publications were found in a PubMed literature review searching the word “fabella syndrome”. Non-operative treatment and surgical excision of the fabella has been described.Case presentationTwo patients presented to our outpatient clinic with persisting posterolateral knee pain. In both cases the presence of a fabella was identified, located in close proximity to the posterolateral femoral condyle. All other common causes of intra- and extra articular pathologies possibly causing the posterolateral knee pain were excluded.Following failure to respond to physiotherapy both patients underwent arthroscopy which excluded other possible causes for posterolateral knee pain. The decision was made to undertake surgical excision of the fabella in both cases without complication.Both patients were examined 6 month and one year after surgery with the Tegner activity score, the Visual Analogue Scale (VAS), and International Knee Documentation Committee Score (IKDC).ConclusionConsistent posterolateral pain during exercise might indicate the presence of a fabella syndrome. Resecting the fabella can be indicated and is a minor surgical procedure with minimal risk. Despite good results in the literature posterolateral knee pain can persist and prevent return to a high level of sports. Level of evidence: IV, case reports and analysis of literature.

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Sesamoiditis of the cyamella: imaging features of this rare presentation

Dykes

Vijay

2013

Jpn J Radiol

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We report a unique case of sesamoiditis in an extremely rare accessory genicular ossicle. Common to lower primates, the cyamella or popliteus tendon sesamoid bone is usually absent in humans. A 19-year-old male sustained a twisting injury to the right knee and presented with mechanical symptoms of knee pseudo-locking. A plain radiograph of the knee illustrated the presence of a cyamella. Magnetic resonance imaging demonstrated marked bone marrow oedema of this sesamoid structure and in the adjacent popliteus tendon. To our knowledge, documented sesamoiditis of this osseous structure on radiological imaging has not been published in English literature and this case highlights the imaging features of this uncommon entity.

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A 14-year-old with lateral knee pain and locking

Cited by 4 publications

References 6 publications

Cyamella (a popliteal sesamoid bone) prevalence: A systematic review, meta‐analysis, and proposed classification system

Cyamella (a popliteal sesamoid bone) prevalence: A systematic review, meta‐analysis, and proposed classification system

The fabella syndrome - a rare cause of posterolateral knee pain: a review of the literature and two case reports

Sesamoiditis of the cyamella: imaging features of this rare presentation

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