Diagnosis and treatment of ganglion cysts of the cruciate ligaments

Abstract

Ganglion cysts of the cruciate ligaments can easily be detected by MRI and should be arthroscopically resected, not only treated by ultrasound but also by CT-guided paracentesis. Complete resection of the cyst and cyst walls is recommended to avoid recurrence. Positive diagnosis of this disease can be improved by clinical manifestations and specific MRI findings. Trauma and chronic strain were the primary etiological factors responsible for ganglion cysts that were more common in ACL than PCL.

Ganglion Cysts Arising from a Canine Stifle Joint

“…In this case, our MR images allowed us to diagnose the number and size of the cystic lesions and their connection to the stifle joint, to determine that the ligaments and tendons of the joint were not ruptured and to confirm that no tumor-like solid masses were present. The lesions in this dog had a similar appearance in the MR images to those reported for ganglion cysts in both humans and dogs [5, 6, 8]. Ganglion cysts usually have a homogenous low signal intensity in T1-weighted images and a high signal intensity in T2-weighted images, as we saw in this case.…”

“…Although Lunhao et al . discuss the advantages of the ultrasound for the detection of small cruciate ligament cysts and assessment of the other joint components in human medicine [5], we were not able to visualize the cruciate ligaments or the caudal cysts in this case because of the extremely large cyst presented over the cranial portion of the stifle joint.…”

An intra-articular ganglion cyst in a patient with juvenile idiopathic arthritis

“…There have only been a few case reports of children without arthritis with IAGC who presented with knee pain [6-8]. Possible causes of IAGC include synovial herniation through a defect in the joint capsule or tendon sheath, mucinous degeneration of connective tissue from repeated minor trauma, or proliferation of pluripotent mesenchymal cells [13-15]. IAGC are most commonly associated with the anterior cruciate ligament (ACL), but can also occur at the posterior cruciate ligament (PCL), infrapatellar fat pad, posterior joint capsule, from chondral fractures, or with subchondral bone cysts [5,13,14,16].…”

“…These include knee pain, clicking or popping sensations, a palpable mass, and decreased range of motion [14,16]. Many patients with IAGC had lesions discovered on MRI or at arthroscopy after being evaluated for these non-specific symptoms [5,15,16]. These overlapping symptoms may mimic similar common complaints in patients with JIA.…”

“…In our case, the patient presented with complaints of knee pain and the IAGC was identified on MRI. Current treatment of IAGC includes arthroscopic resection, or ultrasound- and CT-guided joint paracentesis [15,19]. It is still possible to have some IAGC recurrence after paracentesis, but recurrence is rare after resection.…”