Correlation between musculoskeletal ultrasound, magnetic resonance imaging, arthroscopic and clinical findings in a 30-year-old male with a medial meniscus ganglion: A case report

Abstract

Summary Objective To date, magnetic resonance imaging (MRI) has been the method of choice to visualize meniscal ganglions; however, an MRI is quite costly. Studies have shown that high-resolution ultrasonography (HRUS) is an alternative form of investigative imaging with comparable accuracy. Aim To present a case where ultrasound was used to diagnose a medial meniscus ganglion and illustrate its usefulness in deciding on the subsequent therapeutic intervention. Design Case report. Setting Radiography department at the Anglo-European College of Chiropractic (AECC), Bournemouth. Subject A 30-year-old student with a 10-month history of right-sided knee pain and clinical suspicion of a medial meniscal cyst and concomitant medial meniscal lesion. Method HRUS of the right knee was used to confirm the clinical diagnosis. Complementary MRI was available. The author was able to observe the subsequent surgical intervention (knee arthroscopy). Result Ultrasound examination confirmed the clinical findings and offered additional information as to the extent of the cyst. Ultrasound could not assist in determining the size or the location of the medial meniscal lesion for which MRI was required. Although this was important for the management of the patient, the decision on the therapeutic procedure (knee arthroscopy) could have been made from the ultrasound findings alone. The MRI findings did not change the method/technique of the planned operative procedure. The arthroscopy confirmed all the MRI findings; additionally, it demonstrated the connection between the meniscal tear and meniscal cyst and a partial detachment of the anterior cruciate ligament at its proximal insertion site. Conclusion HRUS is rapid, low-cost and non-invasive. This case illustrates its reliability and usefulness in the detection, characterization and differentiation of meniscal cysts.