Meniscal and ganglion cysts of the knee: MR evaluation (original) (raw)
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MR imaging of meniscal cysts: evaluation of location and extension using a three-layer approach
European Journal of Radiology, 2001
To analyze the extension of medial and lateral meniscal cysts relative to the capuloligamentous planes of the knee. Materials and methods: The MR images of 32 patients with meniscal cysts were reviewed. The location and extension of the meniscal cysts with reference to the capsule and ligaments were recorded. Results: Most medial meniscal cysts were located posteromedially. Posteromedial meniscal cysts usually penetrated the capsule and were located between layer I and the fused layers II+ III. From this site some extended anteriorly and then became located superficial to the superficial MCL. The location of lateral meniscal cysts was more varied. Anteriorly the cysts were located deep to the iliotibial band, whereas posterolateral cysts were located deep to the lateral collateral ligament. Conclusion: Although the site of capsular penetration of meniscal cysts is determined by the location of meniscal tears, the possible pathways of extension appear to be determined by the capsuloligamentous planes of the knee.
Diagnostic and interventional imaging, 2018
This article characterizes common meniscal pathologies, reviews magnetic resonance imaging (MRI) diagnostic criteria for meniscal tears, and identifies difficult-to-detect tears and fragments and the best MRI sequences and practices for recognizing these lesions. These difficult-to-diagnose meniscal lesions that radiologists should consider include tears, meniscocapsular separation lesions, and displaced meniscal fragments. Meniscus tears are either vertical, which are generally associated with traumatic injury, horizontal, which are associated with degenerative injury, or combinations of both. MRI has a high sensitivity for tears but not for fragments; MRI performance is also better for medial than lateral meniscal lesions. Fragment detection can be improved by recognizing signs secondary to migration, especially signs of epiphyseal irritation and mechanical impingement. Radial and peripheral tears, as well as those close to the posterior horn insertion, have been traditionally dif...
Insights into imaging, 2013
A variety of benign cystic or "cyst-like" lesions may be encountered during a routine magnetic resonance imaging (MRI) of the knee. These lesions comprise a diverse group of entities from benign cysts to complications of underlying diseases. In addition, normal anatomic bursae and recesses may be misdiagnosed as an intra-articular cystic lesion when they are distended. However, the majority of the aforementioned lesions have characteristic MR appearances that allow a confident diagnosis, thus obviating the need for additional imaging or interventional procedures. This article includes a comprehensive pictorial essay of the characteristic MRI features of common and uncommon benign cysts and "cyst-like" lesions in and around the knee joint. For accurate assessment of the "cystic structure", a radiologist should be able to identify typical MRI patterns that contribute in establishing the correct diagnosis and thus guiding specific therapy and avoiding unwa...
MR imaging of baker cysts—prevalence and relation to internal derangements of the knee
Magma: Magnetic Resonance Materials in Physics, Biology, and Medicine, 2000
To evaluate the prevalence of popliteal cysts in patients studied with magnetic resonance (MR) imaging. Cyst presence and volume will be related to other internal derangement of the knee. Materials and methods: Three hundred and eighty-two consecutive patients with a MR study of the knee were included. Images were obtained in the three spatial orthogonal planes and evaluated through consensus. Four categories were established for the Baker cyst and synovial fluid (absence, minimum, moderate and massive), and the presence of meniscal, cruciate ligaments and cartilage lesions were recorded. Statistical analysis was carried out with bivariate analysis ( 2 of Pearson and Gamma tests). Results: From the 382 patients, 145 had Baker cysts (38.0%). Cyst content was minimum in 99, moderate in 34 and massive in 12. Joint effusion was observed in 269 patients (70.4%), being minimal in 140 patients, moderate in 119 and massive in ten. Meniscal lesions were observed in 195 patients (51%), while 58 patients (15%) had a cruciate ligament lesion. Baker cyst had a statistically significant direct relationship with the presence and quantity of synovial fluid (P =0.002) and with the presence and type of meniscal lesion (P= 0.01) but not with cruciate ligaments or cartilage lesions. Conclusions: The prevalence of Baker cysts in MR studies of the knee is high. Its presence and volume are related to the quantity of synovial fluid, and to the presence and severity of meniscal lesions.
MRI features of cystic lesions around the knee
The Knee, 2008
Cystic lesions around the knee are a diverse group of entities, frequently encountered during routine MRI of the knee. These lesions range from benign cysts to complications of underlying diseases such as infection, arthritis, and malignancy. MRI is the technique of choice in characterizing lesions around the knee: to confirm the cystic nature of the lesion, to evaluate the anatomical relationship to the joint and surrounding tissues, and to identify associated intra-articular disorders. We will discuss the etiology, clinical presentation, MRI findings, and differential diagnosis of various cystic lesions around the knee including meniscal and popliteal (Baker's) cysts, intra-articular and extra-articular ganglia, intra-osseous cysts at the insertion of the cruciate ligaments and meniscotibial attachments, proximal tibiofibular joint cysts, degenerative cystic lesions (subchondral cyst), cystic lesions arising from the bursae (pes anserine, prepatellar, superficial and deep infrapatellar, iliotibial, tibial collateral ligament, and suprapatellar), and lesions that may mimic cysts around the knee including normal anatomical recesses. Clinicians must be aware about the MRI features and the differential diagnosis of cystic lesions around the knee to avoid misdiagnosis.
Knee MR-arthrography in assessment of meniscal and chondral lesions
Orthopaedics & Traumatology: Surgery & Research, 2009
Introduction. -No study, so far in France, has investigated the diagnosis value of knee MRarthrography since the recent approval of intra-articular gadolinium use, by this country's healthcare authorities. This study objective is to verify the MR-arthrography superiority on conventional knee MRI, in meniscus and cartilage knee lesions diagnosing accuracy both in regard to sensitivity and specificity. Hypothesis. -MR-arthrography, represents in some pathologic situations, a more accurate source of information than conventional MRI. Materials and methods. -Over a 27 months period, 25 patients, scheduled to undergo a knee arthroscopy volunteered, after having been fully informed of the possible interest and risk of the MR-arthrography examination, to participate in this study. Twenty-one of them were finally included since in four cases the surgical indication was not confirmed. The group consisted of 15 males and six females with an average age of 35.7 years. All of them consecutively underwent conventional MRI, MR-arthrography finally followed by arthroscopy. The MRI and MR-arthrograms results were compared to the arthroscopy findings using the nonparametric Kappa test.
High-resolution ultrasonography (HRUS) of the meniscal cyst of the knee: our experience
La Radiologia medica, 2007
This study was undertaken to assess the diagnostic accuracy of high-resolution ultrasonography (HRUS) in the detection of meniscal cysts. Over a 2-year period, 1,857 patients underwent magnetic resonance imaging (MRI) of the knee for traumatic or degenerative disorders. All patients with MRI evidence of a meniscal cyst were studied by HRUS. HRUS was also performed on an equal number of patients without MRI evidence of meniscal cyst who were used as a control group. All HRUS examinations were conducted by a radiologist blinded to the MRI findings. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of HRUS were assessed with reference to MRI. All patients underwent surgery, and the resected masses were studied by histological examination. MRI allowed identification of a meniscal cyst in 52 patients. HRUS enabled correct detection of the meniscal cyst in 49/52 cases. In the control group, HRUS excluded the presence of meniscal cysts in all cas...
Parameniscal cyst formation in the knee is associated with meniscal tear size: An MRI study
The relationship between meniscal tears and parameniscal cyst formation is contentious. We investigated whether the development of a parameniscal cyst is related to the size of the meniscal tear by using magnetic resonance imaging (MRI). Methods: Onthebasis ofaretrospective review ofanMRIdatabase, weidentifiedparameniscal cysts in34patients with adjacent meniscal tears extending to the meniscocapsular junction. The size of the meniscal tear was measured by dividing the length of the tear along two axes: circumferential and radial. We compared parameters, suchasthesizeofthemeniscaltear,thelocationofthetear,thepatternofeachtear,andanyassociatedligamentous injury and intra-articular lesion, between the 34 patients and the 30 control patients who only had meniscal tears with torn components extending to the meniscocapsular junction. Results: Compared with the controls, patients with parameniscal cysts had significantly larger meniscal tears along the circumferential axis (P b 0.001). A critical size of the meniscal tear along the circumferential axis of 12 mm was associated with the formation of a parameniscal cyst. Conclusions: A larger meniscal tear extending into the meniscocapsular junction is more likely to be associated with the occurrence of a parameniscal cyst. The critical size of the meniscal tear, 12 mm along the circumferential axis as identified using MRI, is a discrimination value for parameniscal cyst formation. Level of Evidence: Level III