Abstract
Ganglion cysts (GCs) can arise from a variety of different areas, but those arising from Hoffa’s fat pad in the knee are relatively rare. A number of different types of cysts are also found in the knee, including meniscus cysts, proximal tibiofibular cysts, and cruciate ligament ganglion cysts. In this case report, a 54-year-old female presented with left knee pain and swelling for eight weeks. In-office musculoskeletal ultrasound (US) was used to diagnose a Hoffa’s fat pad ganglion cyst and aid in targeted steroid injection. The patient was followed up 21 weeks after the injection. She was pain-free, and US findings showed the cyst had significantly decreased in size. This case shows how musculoskeletal ultrasound, a relatively inexpensive diagnostic modality, can be used to accurately diagnose the cause of knee pain, guide an in-office procedure for the treatment of Hoffa's fat pad ganglion cyst, and aid in monitoring.
Highlights
A ganglion cyst (GC) is a cystic, tumorlike lesion demarcated by dense connective tissue and filled with gelatinous fluid rich in hyaluronic acid and other mucopolysaccharides and is of unknown origin [1]
A GC arising from Hoffa’s fat pad is relatively rare, and the incidence on magnetic resonance imaging (MRI) is 1% [2], which correlates with the incidence reported on arthroscopy of 0.8%-1.1% [3]
MRI has been used for the diagnosis of GC and is the best imaging modality for cysts around the knee joint [5], the use of US has grown in popularity
Summary
A ganglion cyst (GC) is a cystic, tumorlike lesion demarcated by dense connective tissue and filled with gelatinous fluid rich in hyaluronic acid and other mucopolysaccharides and is of unknown origin [1]. Musculoskeletal ultrasound (US) can visualize Hoffa’s fat pad cysts and allow guided aspiration and injection [6,7]. Musculoskeletal ultrasound of the lateral Hoffa’s fat pad revealed a 1.11 x 1.29 cm GC on longitudinal view and a 1.11 x 1.59 cm CG on the cross-sectional view of the anterior-lateral knee (Figure 2). Over the week after the methylprednisolone injection of Hoffa’s fat pad ganglion cyst, the patient’s knee pain and swelling improved. She was pain-free two weeks after the injection, and her walking returned. How to cite this article Ramrattan L A, Masri G, Kaeley G S (October 11, 2021) Musculoskeletal Ultrasound Diagnosis of Symptomatic Hoffa’s Fat Pad Ganglion Cyst Successfully Managed Nonoperatively: A Case Report. A repeat ultrasound was performed at this time, which showed that the cyst was significantly smaller and measured 1.29 x 0.40 cm on longitudinal view and 0.75 x 0.96 cm (Figure 2) on cross-sectional view
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