Intra-articular Ganglion Research Articles

Ganglion Cysts of the ACL and Meniscus: A Review of Literature

Introduction: Ganglion cysts of the anterior cruciate ligament (ACL) and meniscus may have generalized clinical symptoms that can make them difficult to diagnose, especially considering their rarity. The aim of this study is to provide a comprehensive review of cysts arising in and around the knee with a focus on differential diagnosis to emphasize the importance of proper evaluation. Methods: A literature search using the database PubMed, Cochrane, and Google Scholar was performed to find the information that comprehensively covered information relevant to this review. Conclusion: Intra-articular ganglion cysts of the knee are a rare occurrence that typically cause generalized symptoms. Each type of cyst is different with regards to its origin and location, but their similar clinical presentation makes differentiation based on a history and physical exam difficult. MR imaging is of utmost importance for the evaluation of pathologies in and around the knee joint. Once a proper diagnosis is achieved, direct arthroscopic excision of the cyst or treatment of the underlying cause in the case of a meniscus cyst can definitely treat symptoms with minimal concern for recurrence.

A rare case of extra-synovial and intracapsular ganglion cyst of the knee joint

A 23 year old female presented with knee swelling which was found to be ganglion cyst of the knee with extra synovial and intracapsular origin form the lateral meniscus which was causing pain in extreme extension. The cyst was excised and confirmation was done on histopathology. Ganglion cysts may have following differential diagnoses of ganglion cysts may include synovial chondromatosis, pigmented villonodular synovitis, meniscal or parameniscal cysts, and synovial hemangioma. Which needs good histopathological and radiological correlation. Most common sites of Intra-articular ganglion cysts are in the dorsal wrist, palm, and shoulder but rarely found in the knee joint.

Posterolateral Bundle Resection for an Anterior Cruciate Ligament Ganglion Cyst

The incidence of intra-articular ganglion cysts of the anterior cruciate ligament (ACL) is low and symptomatic presentation of this pathology is even lower. Nevertheless, symptomatic cases pose a real challenge for the orthopaedic community, as no general consensus exists regarding the most appropriate treatment. The purpose of this Technical Note is to describe the surgical treatment of an ACL ganglion cyst by arthroscopic resection of the entire posterolateral bundle of the ACL in a figure-of-four position after conservative treatment has failed.

A Ganglion Cyst in the Anterior Cruciate Ligament of a 13-Year-Old Boy

Intra-articular ganglion cysts of the knee are a rare occurrence in pediatric patients, particularly involving the anterior cruciate ligament (ACL). Only a handful of case reports have been documented in the medical literature, highlighting the rarity of this condition. Patients with intra-articular cysts often experience knee discomfort and mechanical symptoms like locking of the knee. We present the case of a 13-year-old boy who had a unilateral intra-articular ganglion cyst of the ACL in his left knee. To diagnose and treat the cyst, we conducted radiographs and MRIs, and arthroscopic drainage was performed, resulting in a successful cyst decompression. Our case report provides an overview of the pathogenesis, diagnostic methods, treatment options, and complications of treatment for intra-articular cysts of the ACL. It highlights the rarity of this condition in pediatric patients and underscores the importance of prompt diagnosis and appropriate management.

Arthroscopic Decompression of a Posterior Knee Cyst Causing Vascular Compression

Intra-articular ganglion cysts in the knee large enough to cause neurovascular claudication are rare entities only identified in singular case reports. The severity of claudication can cause debilitating symptoms and pain to previously highly functional and asymptomatic patients. Total knee arthroplasty has been described to treat these cysts in elderly patients with osteoarthritis, although this treatment pathway may not appeal to patients without antecedent pain and high activity levels. This surgical report will detail a reproducible method of arthroscopic decompression of posterior, intra-articular cysts to relieve vascular claudication by highlighting technical pearls in navigating posterior knee arthroscopy.

Intra-Articular Ganglion Cysts of the Knee.

Magnetic resonance imaging (MRI) without contrast is sufficient to diagnose an intra-articular ganglion cyst of the knee. MRI with intravenous contrast may be considered for cysts in the infrapatellar fat pad, which are not a typical presentation. The current literature supports treating symptomatic cases or those discovered accidently during knee arthroscopy with arthroscopic excision. Although aspiration of these cysts results in a higher recurrence rate than excision, it is associated with quicker recovery. Thus, aspiration might be chosen as an initial treatment for anyone who would like to avoid surgery or requires a rapid recovery, including professional athletes. Open excision may be considered for infrapatellar fat pad cysts that are >4.5 cm in size.

Large Intraarticular Ganglion in Knee Joint: A case report

Ganglion is defined a cystic lesion composed of myxoid matrix having jelly like consistency and is lined by pseudomembrane. Large ganglionic cyst in Hoffa Pad is quite uncommon and only few are mentioned in literatures. A 25-year old female presented with history of gradually worsening anterior knee pain and swelling for 10 months duration, she was disabled due to repeated attacks of knee pain. Magnetic resonance imaging (MRI) shows large intra-articular multilocular cyst. The decision was to do open excision of the cyst in order to decrease the recurrence rate. Histopathological finding shows multi-lobulated cysts with glassy fibrous wall and clear jelly like consistency, which confirm diagnosis. Postoperative period was uneventful and she was doing well during follow up after four months. Large ganglionic cyst developed in Hoffa fat pad of the knee should be considered in deferential diagnosis of intraarticular mass causing pain around the knee. The decision was open excision depending on MRI finding to avoid incomplete resection and prevent recurrence. Keywords:Knee, Ganglion Cyst, Hoffa Fat Pad, MRI Citation:Dagher AE, Hasan FK. Large Intraarticular Ganglion in Knee Joint: A case report. Iraqi JMS. 2019; 17(2): 161-165. doi: 10.22578/IJMS.17.2.10

Medial collateral ligament-ganglion cyst: A rare case report and review of its literature

Ganglion cysts are found in locations which are under constant stress. Although somewhat controversial, one common explanation for the formation of ganglion cysts is that they are the result of mucoid cystic degeneration in collagenous structures. Most commonly, they are found along the tendons or joints of wrist or hand. The common locations of ganglion cysts are the wrist, knee, and anterolateral aspect of the ankle. Intra-articular ganglion cysts of the knee are rare, and most originate from the cruciate ligaments. The symptoms and signs of intra-articular ganglion cysts of the knee are pain, effusion, limitation of motion, and a clicking sensation. Increased size may lead to increased symptoms. Their location can sometimes interfere with joint movement. We present a case of ganglion cyst arising over medial collateral ligament which was presented as a swelling and investigated using sonography, magnetic resonance imaging and arthroscopy, surgically resected and confirmed on histopathology. Thus awareness of the symptoms and locations is necessary.

Ganglion Cyst of the Knee: A Retrospective Review of a Consecutive Case Series.

The aim of this study was to describe relevant medical history, clinical symptoms and outcomes in 12 patients having undergone surgical treatment of intra-articular ganglion cysts of the knee at our Department from January 2010 to June 2016. Patient demographics, medical history, knee manifestations, management and outcome were evaluated. The mean patient age was 26.4 (range, 16-46) years. Th ere were seven female and five male patients. Duration of symptoms prior to the operation varied from 2 months to 3 years (mean, 17.1 months). All patients had preoperative magnetic resonance imaging work-up of the knee. Pain was the most common clinical presentation. All patients were surgically treated arthroscopically, and an additional open approach was used in only one of the patients. There were no complications during surgery and the postoperative period was uneventful in all patients. The mean follow up period was 43.5 (range, 9-83) months and no recurrence was observed. All patients remained symptom-free with full range of motion at final follow up. Despite a wide range of intra-articular ganglion cyst presentations and symptoms, our cohort demonstrated an excellent remission rate and functional prognosis following surgical treatment of the ganglion cysts of the knee.

Posterior Cruciate Ligament Ganglion: Case Report

Intra-articular ganglion of the knee is uncommon and it shows non-specific symptoms. In this report, we present for a treatment of the ganglion arising from the PCL and the mechanism of pain. The case is a 33-year-old male with pain in his left knee. On presentation, he had no history of locking or giving way of the knee, but had pain on standing. At the first medical examination, the range of motion of his knee was full, with no loss of extension, and there was no effusion or swelling, but the terminal knee flexion was painful. McMurray’s test was negative, and the collateral and cruciate ligaments were clinically stable. On MRI, ganglion cysts droved from PCL appear as well-defined cystic multiloculated masses. The patient underwent arthroscopy through the standard anteromedial and anterolateral portals. Consequently, it was diagnosed as a ganglion cyst. The pain disappeared completely after the surgery and neither PCL ganglion nor symptoms recurred up to 9 months post-surgery. The intra-articular ganglion of the knee often is asymptomatic and discovered incidentally. But the reports of ganglion cysts of the knee have been increasing with the increasing availability and use of MRI. We considered that the mechanism of the pain due to ganglion in the cruciate ligament was stimulation of the synovial nerve terminal. One key point for consideration in this study is that arthroscopy should be performed through posterior portal to observe the whole of the PCL and ganglion cysts because it was difficult to observe both the PCL and ganglion cysts with anterior portal. While arthroscopy did not confirm continuity of the ACL and meniscus, it was considered that the ganglion cysts developed in the PCL because of the continuity with the PCL.

Intraosseous ganglion cyst of scaphoid: A case report

Background: Intraosseous ganglion cysts are rare causes of hand and wrist pain. Differential diagnosis of painful cystic radiolucent carpal lesions includes osteoid osteoma and osteoblastoma. Isolated cases of ganglion cysts occurring in the lunate, scaphoid, pisiform, hamate, triquetrum, capitate, metacarpal, and phalanx have been reported. Case Presentation: A case of intra-articular intraosseous ganglion cyst of the scaphoid is presented. A 32-year-old right-handed man presented with a 2 year history of progressive left-wrist pain. No history of trauma was reported. Conservative treatment with anti-inflammatory medications before referral was unsuccessful. This case was treated with curettage and bone grafting having excellent results with visual and analog pain scores reduced from 68 to 11 and range of motion was 90° extension to 80°flexion and full grip strength. Conclusion: Cases of intraosseous ganglions are reported in literature mostly in lower limbs and lunate among carpals, with scaphoid being a rare site of the involvement. In this report, we described a symptomatic case which was successfully treated by intralesional curettage, and autogenous bone grafting.

Dual ACL Ganglion Cysts: Significance of Detailed Arthroscopy.

Intra-articular ganglion cysts of the knee joint are rare and most frequently are an incidental finding on MRI and arthroscopy. Most of the previous studies have reported a single ganglion cyst in the knee. There have been previous reports of more than one cyst in the same knee but not in the same structure within the knee. We are reporting a case of dual ACL (anterior cruciate ligament) ganglion cysts one of which was missed on radiological examination but later detected during arthroscopy. To the best of our knowledge, no such case has been reported in the indexed English literature till date.

Intra-articular ganglion cysts of the knee joint: A report of nine cases

Intra-articular ganglion cysts of the knee joint: A report of nine cases

Arthroscopic dorsal wrist ganglion excision with color-aided visualization of the stalk: minimum 1-year follow-up.

Dorsal wrist ganglia (DWG) are a common, benign soft-tissue mass of the wrist. Excision of DWG is a common procedure performed by hand surgeons and may be performed using either open or arthroscopic techniques. This study aims to evaluate the frequency of stalk visualization with intralesional injection of inert dye in the course of arthroscopic excision along with incidence of recurrence with a minimum of 1-year follow-up. Upon IRB approval, a retrospective chart review was performed identifying 27 patients who had consecutively undergone arthroscopic excision of a DWG with the color-aided technique at our institution with a minimum follow-up duration of 12months. Intraoperative findings were reviewed. Patients were contacted to investigate for incidence of recurrence. Of the 27-patient cohort, the ganglion stalk was identified in 100% of the color-aided arthroscopic DWG excisions. Ganglion recurrence was identified in one patient, an incidence of 3.7%. The color-aided technique for arthroscopic DWG visualization was found to be a safe and valuable tool for surgeons performing arthroscopic DWG resection. The intraarticular ganglion stalk was identified in 100% of cases and patients responded well with a low incidence of recurrence.

Symptomatic ganglion cysts of cruciate ligaments of the knee: A series of nine cases

BackgroundGanglion cysts of cruciate ligaments of the knee are uncommon, especially because a proportion of them are asymptomatic. Moreover, symptomatic lesions have diverse presentation and are not easily detected in physical examinations. The purpose of this report was to define the relationship between clinical symptoms and the sites of ganglia of cruciate ligaments of the knee. Materials and methodsWe conducted a retrospective review of a series of nine patients treated at our institute for intra-articular ganglion cysts of cruciate ligaments of the knee. One patient presented with pain and an inability to fully extend the knee. The remaining eight patients presented with nonspecific pain or pain during knee flexion and/or extension. The diagnosis and definite location of ganglia of cruciate ligaments were confirmed by arthroscopy. All patients were treated by ganglionectomy using arthroscopic techniques. ResultsSubstantial cyst impingements were observed during knee motion using arthroscopy. At the last follow-up, all but one patient had achieved considerable symptomatic improvement after arthroscopic ganglionectomy. ConclusionWe suggest that depending on cyst location, a more applicable hypothesis for knee joint pain during motion is cyst impingement on the other cruciate ligament or the intercondylar notch.

“What's Going On Between the Condyles?”

The femoral intercondylar notch is a complex 3-dimensional space that can be difficult to evaluate using 2-dimensional images. Normal structures residing in the femoral intercondylar notch are the cruciate ligaments. Several normal variants also course through the femoral intercondylar notch, including the meniscofemoral ligament, intermeniscal ligament, oblique meniscomeniscal ligament, and infrapatellar plica. Abnormalities within the femoral intercondylar notch include internal derangements (i.e., cruciate ligament rupture and bucket-handle meniscal tears) and masses (i.e., intra-articular ganglion [cyst], intra-articular body, pigmented villonodular synovitis, arthrofibrosis, and synovial hemangioma). Radiologic signs can signify abnormalities within the femoral intercondylar notch or elsewhere in the knee, including empty notch sign, double posterior cruciate ligament sign, double anterior cruciate ligament sign, and reversed double posterior cruciate ligament sign. The shape of the femoral intercondylar notch and the presence of meniscal variants can be predictors of future pathology. This article discusses the anatomy and pathology of the femoral intercondylar notch.

Report of ganglion cyst in the anterior cruciate ligament of a 6-year-old child

BackgroundIntra-articular ganglion cysts of the knee are extremely rare within the pediatric population. To our knowledge, only seven case reports have been published in the medical literature identifying pediatric patients with intra-articular cysts of the anterior cruciate ligament (ACL). Intra-articular cysts of the knee are a rare cause of knee discomfort and mechanical symptoms such as locking of the knee. To our knowledge, up until now the youngest patient reported in the medical literature with an intra-articular ganglion cyst of the ACL was a 7-year-old boy. Case reportWe describe a 6-year-old boy who presented with a unilateral intra-articular ganglion cyst of the ACL in the right knee. In addition to the diagnostic work-up of radiographs and MRI, the cyst was successfully treated with arthroscopic resection and debridement to decompress the cyst. Clinical relevanceWe provide a review of the proposed pathogenesis, diagnostic modalities, differential diagnosis, treatment options, and complications of treatment for intra-articular cysts of the ACL. Level of evidenceLevel V, case report.

Therapeutic experience of intra-articular ganglion of the knee

Therapeutic experience of intra-articular ganglion of the knee

A radiological pitfall – large intra-articular ganglion cyst diagnosed in a runner who presented with chronic hip pain and previously reported normal radiological findings

AbstractThe case of a female runner presenting with previously undiagnosed chronic hip pain is reported. Initial X-ray and MRI of her affected hip were reported as normal; a subsequent review of these films by a specialist musculoskeletal radiologist revealed this was incorrect. A repeat MRI scan was performed using dedicated hip views which revealed a large, intra-articular, ganglion cyst within the acetabulum and an acetabular labral tear. This case raises awareness of acetabular ganglions as a possible cause of hip pain. It also reinforces the need to be alert to potential operator variability when interpreting radiology reports.

Snapping knee symptoms caused by an intra-articular ganglion cyst

Snapping knee syndrome describes the sudden movement of a soft-tissue structure across a bony prominence around the knee with a popping sound at some specific activity. Symptomatic snapping knee syndrome may result from an intra-articular tumor, but this situation is rare. To the best of our knowledge, an intra-articular ganglion cyst leading to snapping knee has not been reported previously. A 20 year old female with painful snapping knee was successfully treated by open en-bloc excision of the ganglion cyst sized 4.5×1.5×1 cm on the ligamentum mucosum. Snapping and pain were completely relieved after surgery. Although the snapping knee is not common over the antero-lateral portion of the knee joint, a ganglion cyst from the ligamentum mucosum is a possible cause.