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.

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