Complicated Parameniscal Giant Cyst With Distal Dissection and Regional Infection

Abstract

We present the case of an 80-year-old woman with obesity BMI: 32.4), who had Kellgren–Lawrence stage IV osteoarthritis f the right knee. She had a history of an anterolateral mass on er right knee for the past 6 years which was round, fluctuating n consistency, non-painful and with no associated erythema, and id not impede movement (Fig. 1A). No prior trauma had been ocumented. She had recently undergone a Magnetic Resonance maging study (MRI) which described the presence of a cyst in the ateral region of the knee and which came into contact with the oint space at the meniscal space level (Fig. 1B–D). This paramenisal cyst had been drained on several occasions obtaining mucoid, septic material, with no complications. The most recent drainage ad been performed 2 months prior to the hospitalization date. The atient came to the clinic due to enlargement of the parameniscal yst and due to the appearance of a second mass on the same leg, istal and lateral to the original. This new mass had developed over he past 30 days, was accompanied by pain upon light touch and howed unequivocal local signs of inflammation. In the 2 days prior here had been spontaneous drainage of pus from the new mass hich coincided with the appearance of fever. X-rays showed an ovoid, well limited structure with an ir–liquid level 8 cm distal from the parameniscal cyst, on the pper, lateral third of the leg, as well as an increase in the opacity of oft tissue at that level (Fig. 2). The culture of the fluid obtained from his newer collection isolated methicillin-sensitive Staphylococcus ureus. Faced with the possibility of a macroscopic communication