Although patients with parameniscal cysts usually have underlying meniscal tears, we noted that this association was less common with anterior lateral cysts. We wished to determine whether the frequency of a meniscal tear underlying a parameniscal cyst varied with cyst location.
We reviewed a database of 7,771 knee MR examinations and identified 134 patients with an MR diagnosis of 138 parameniscal cysts and correlative arthroscopy in 78 patients. We reviewed their medical records and MR studies to determine the location of the cysts and presence of an underlying meniscal tear as determined by MRI or arthroscopy.
There were 50 lateral and 88 medial parameniscal cysts. Medial meniscal tears were found underlying a cyst in 96% of arthroscopy patients and 86% of patients who had only MR examinations without a location difference in tears (p = 0.68). Meniscal tears were found on MRI or arthroscopy in all 28 patients with a lateral cyst overlying the body or posterior horn of the lateral meniscus, whereas a tear was found on MRI or arthroscopy in only 14 (64%) of 22 patients with cysts adjacent to or extending to the lateral meniscus anterior horn (p = 0.006). Anterior lateral cysts extended medially either into the root or into Hoffa fat-pad, but the type of extension did not correlate with the presence of an underlying meniscal tear.
In contrast to medial parameniscal cysts or cysts at other locations adjacent to the lateral meniscus, anteriorly located lateral parameniscal cysts are less likely to have underlying meniscal tears.
[Show abstract][Hide abstract] ABSTRACT: Acetabular labral tears or paralabral cysts in the hip are frequently detected using magnetic resonance imaging or arthrography. Unlike parameniscal cysts in the knee and paralabral cysts in the shoulder, reports of the outcomes of surgical treatment for paralabral cysts in the hip recalcitrant to conservative management are limited in the literature.The authors report 2 cases of paralabral cysts in the hip that were treated with arthroscopic surgery. The patients presented with chronic hip pain, and preoperative magnetic resonance imaging showed paralabral cysts at the superior aspect of the acetabulum. After failure of conservative management for more than 6 months, arthroscopic surgery was performed while the patients were under general anesthesia and in a supine position on a fracture table. Arthroscopic examination confirmed the preoperative diagnosis of paralabral cysts with degenerative labral fibrillation or tears in both patients. Arthroscopic cyst decompression and debridement of the degenerative labral tissues were performed using an arthroscopic thermal probe and a shaver.Clinical outcomes, determined by the Harris Hip Score, Western Ontario and McMaster Universities Osteoarthritis Index score, and University of California, Los Angeles activity score, were satisfactory for the 2 patients at 2 and 3 years postoperatively, respectively. Magnetic resonance imaging obtained for 1 patient at 6 months postoperatively showed complete decompression of the paralabral cyst. The authors believe that arthroscopic treatment for symptomatic hip paralabral cysts is a safe and effective procedure with excellent clinical outcomes.
[Show abstract][Hide abstract] ABSTRACT: Objectives and methods:
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 unwarranted interventional procedures such as biopsy or arthroscopy.
• Cystic lesions are common in knee MRI and the commonest, the Baker's cyst, has an incidence of 38 %. • Synovial cysts, meniscal cysts, normal knee bursae and recesses have characteristic MR appearances. • Miscellaneous "cyst-like" lesions may require a more dedicated MR protocol for a correct diagnosis.
Insights into Imaging 03/2013; 4(3). DOI:10.1007/s13244-013-0240-1
[Show abstract][Hide abstract] ABSTRACT: BACKGROUND: 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: On the basis of a retrospective review of an MRI database, we identified parameniscal cysts in 34 patients 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, such as the size of the meniscal tear, the location of the tear, the pattern of each tear, and any associated ligamentous 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<0.001). A critical size of the meniscal tear along the circumferential axis of 12mm 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, 12mm along the circumferential axis as identified using MRI, is a discrimination value for parameniscal cyst formation. Level of Evidence: Level III.
The Knee 04/2013; 20(6). DOI:10.1016/j.knee.2013.03.008 · 1.94 Impact Factor
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