Large infrapatellar ganglionic cyst of the knee fat pad: a case report and review of the literature

Nikolopoulos, Ioannis; Krinas, George; Kipriadis, Dimitris; Ilias, Apostolos; Giannakopoulos, Andreas; Kalos, Stephanos

doi:10.1186/1752-1947-5-351

Cited by 19 publications

(22 citation statements)

References 15 publications

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“…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.…”

supporting

confidence: 82%

Ganglion Cysts Arising from a Canine Stifle Joint

Murata

Sogawa

Tokunaga

et al. 2014

The Journal of Veterinary Medical Science

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A 10-year-old, neutered male Labrador retriever presented with progressive left hind lameness. Ultrasonography revealed large, subcutaneous, ovoid cysts around the stifle joint. Radiographic and computed tomographic images revealed periosteal reaction of the distal femur. Magnetic resonance (MR) imaging showed a large cyst that was hypointense in T1-weighted images, hyperintense in T2-weighted images and had a thin lining that was enhanced by intravenous gadonium injection. The cyst communicated with the joint cavity and other small cysts around the joint. Histopathology of an excisional biopsy specimen led to diagnosis of ganglion cyst. This report provides MR images of a ganglion cyst in a canine stifle.

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supporting

confidence: 82%

Ganglion Cysts Arising from a Canine Stifle Joint

Murata

Sogawa

Tokunaga

et al. 2014

The Journal of Veterinary Medical Science

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“…The pathogenesis of ganglion cysts remains unclear. They may arise from herniation of the synovium into the surrounding tissue, displacement of synovial tissue during embryogenesis, mucinous degeneration of connective tissue after trauma, or proliferation of pluripotent mesenchymal cells (2). Since ganglion cysts do not seem to have a clear relation to degenerative change, it is possible that the ganglion cysts in the infrapatellar fat pad in previous cases, all of which involved adults, may have developed in childhood or adolescence.…”

Section: Discussionmentioning

confidence: 99%

“…A ganglion cyst is a cystic swelling containing myxoid matrix and lined by a pseudomembrane (1,2). These cysts sometimes occur in the knee, mainly arising from the synovial membrane of ligaments.…”

Section: Introductionmentioning

confidence: 99%

Ganglion cyst arising from the infrapatellar fat pad in a child

et al. 2015

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A ganglion cyst is a cystic swelling containing myxoid matrix and lined by a pseudomembrane (1, 2). These cysts sometimes occur in the knee, mainly arising from the synovial membrane of ligaments. The prevalence of intra-articular ganglion cyst of the knee ranges from 0.2% to 1% as determined by magnetic resonance imaging (MRI) and 0.6% as determined by arthroscopy (3). A ganglion cyst arising from the infrapatellar fat pad is very rare ; only a few cases have been reported to date (4, 5) and age in these cases ranged from 22 to 77 years. Here, we describe the case of a pediatric patient with a ganglion cyst arising from the infrapatellar fat pad, which was treated by arthroscopic excision. CASE PRESENTATIONA 10-year-old boy complained of right knee pain without any triggers. He had no traumatic or infectious history in the affected knee. He was physically active ; he practiced the martial art Shorinji Kempo and played golf. He consulted a family doctor when the pain did not improve for 1 month. MRI revealed an intra-articular mass in the right knee, and the patient was referred to our department for further examination.At presentation to us, alignment of the lower limbs was normal. Range of motion (ROM) of the right knee was slightly limited in extension compared with the opposite side. The patellofemoral joint line was tender, but there was no swelling or localized warmth on the knee. The McMurray, Lachman, and varus/valgus stress tests were all negative. Although plain radiographs were normal, MRI showed a multilobular cystic lesion between the infrapatellar fat pad and anterior cruciate ligament (ACL) (Figure 1). The mass measured approximately 30 mm! 15 mm! 20 mm and was well circumscribed, with low intensity on T1 -weighted images and high to iso-intensity on T2-weighted and fat-suppressed T2-weighted images. The origin of the mass was unclear. The ACL showed no abnormal intensity on MRI.We considered ganglion cyst, parameniscal cyst, lipoma, hemangioma, pigmented villonodular synovitis (PVNS), and synovial sarcoma as a differential diagnosis. We considered this lesion was unlikely to be synovial sarcoma because the multilobular cystic lesion existed intraarticularly and has no calcification in this case. For diagnostic treatment, arthroscopic excision of the mass was performed. Superolateral, anterolateral, and anteromedial portals were used. At the beginning of the operation, we inserted the arthroscope into the superolateral portal to observe the entire mass in one field with reference to the preoperative MR images. Arthroscopy revealed a multilobular cystic mass covered with a thin capsule. It arose not from the ACL but from the infrapatellar fat pad. The mass was filled with myxoid matrix with a jelly-like consistency. No injuries to the cartilage, ligaments, or meniscuses were evident. The synovial tissue was hyperplastic around the anterior and lateral spaces of the groove. We also confirmed the impingement of the mass between the femur and infrapatellar fat pad during the knee extension. The cystic...

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“…A ganglion is a cystic lesion containing a myxoid matrix bounded by a pseudomembrane (1). It tends to materialize within tendon sheaths, joint spaces or muscles, and can either exist as single or multilobulated entities (2).…”

Section: Introductionmentioning

confidence: 99%

Anterior cruciate ligament ganglion causing flexion restriction: a case report and review of literature

Sayampanathan

Koh

Lee³

2016

Ann. Transl. Med.

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Ganglion cysts originating from the anterior cruciate ligament (ACL) are uncommon. Often asymptomatic, they infrequently present with non-specific symptoms such as knee pain, stiffness, clicks, locking or restriction of knee extension. However, the patient we report presented with knee flexion restriction. A 37-year-old Chinese gentleman, with no history of knee trauma, presented with left knee pain. Left knee range of motion (ROM) was from 0 to 110 degrees. Magnetic resonance imaging (MRI) scan revealed a 1.5 cm × 3.3 cm × 1.7 cm cyst located in the intercondylar region arising from the ACL and extending predominantly posteriorly.Arthroscopy confirmed an intrasubstance ACL ganglion cyst, which was extending posteriorly. Complete excision of the cyst was performed. At 1-year follow-up, the patient regained knee flexion of 130 degrees. We describe one of the largest ACL ganglion cysts. Such cysts often extend anteriorly and impinge onto the roof of the intercondylar notch during knee extension, thus restricting extension. The restriction in knee motion in our patient was in flexion instead; this was because the cyst took an unusual course of extension predominantly in the posterior direction. Although rare, it must be included as a possible differential diagnosis when patients present with such knee symptoms.

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Large infrapatellar ganglionic cyst of the knee fat pad: a case report and review of the literature

Cited by 19 publications

References 15 publications

Ganglion Cysts Arising from a Canine Stifle Joint

Ganglion Cysts Arising from a Canine Stifle Joint

Ganglion cyst arising from the infrapatellar fat pad in a child

Anterior cruciate ligament ganglion causing flexion restriction: a case report and review of literature

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