Intraarticular Ganglion between the Cruciate Ligaments of the Knee

Abstract

Intraarticular ganglion cysts arising from the cruciate ligaments are rare. Only 9 cases have been described in the literature (2, 4-6, 8-10, 13, 14). Only in one case was the diagnosis suggested before operation by the appearance on MR imaging (4). We report a case of a patient presenting with a bone erosion in the proximal tibial epiphysis caused by an intraarticular ganglion cyst arising from the anterior cruciate ligament.

Ganglion Cyst of the Hoffa Fat Pad

“…Currently, two theories relating to the pathogenesis of ganglion cysts exist, although the true cause is still unknown [1,2]. The first theory attributes the presence of ganglion cysts to being a product of mucinous degeneration of the connective tissue [3,4].…”

“…The first theory attributes the presence of ganglion cysts to being a product of mucinous degeneration of the connective tissue [3,4]. The second theory considers it a cause of herniation of synovial tissue through a defect in the joint capsule or tendon sheath, similar to those of wrist joint origin [2,4]. For both theories, the relationship to previous trauma is uncertain and has not been documented.…”

“…These cysts, when associated with an adjacent ligament, are associated with mucoid degeneration of the ligament with degenerative cysts at its attachment [2]. Long-standing pressure of a ganglion cyst against an adjacent hard surface may produce an indentation through gradual erosion of the bone, creating an intraosseous ganglion.…”

Bilateral Ganglion Cysts of the Cruciate Ligaments: A Case Report

“…The aetiology of intra-articular cysts is unknown. Theories of causation include herniation of synovial fluid between damaged ligament fibres, 10 connective tissue degeneration after trauma, 11 and congenital causes. Between 38% and 67% of patients recall a traumatic event involving the symptomatic knee.…”

Anterior Cruciate Ligament (ACL)

“…In MR images ganglion cysts appears as a lobulated fl uid-fi lled structures with internal septation having a similar signal intensity to that of joint fl uid on T2-weighted images ( Fig. 1.21 ) [ 10 ]. On T1-weighted images after contrast administration the cyst often displays diffuse enhancement, larger ganglion cysts may show only peripheral enhancement.…”