‘Not Always a Baker’s Cyst’ – An Unusual Presentation of a Central Voluminous Postero-Medial Meniscal Cyst

Abstract

Meniscal cysts are rare and often are a result of extrusion of synovial fluid through a tear of the meniscus, resulting in a one-way valve effect of the tear. Arthroscopic partial meniscectomy of the meniscus with intra-articular cyst drainage has become the standard of care. We report a case of an unusually large symptomatic medial meniscal cyst, situated postero-medially and pressing on the posterior cruciate ligament, which was initially clinically misdiagnosed as a Baker’s cyst. The patient had difficulty and pain on squatting. He was successfully treated with arthroscopic debridement and needle decompression; a rarity in literature for such a voluminous perilabral cyst tenting the posterior cruciate ligament. This procedure has the advantage of being able to obtain the cystic fluid for histological and cytological analysis before debridement. This case also highlights the importance of the use of Magnetic Resonance Imaging (MRI) to accurately diagnose a central, posterior knee swelling.

Compared performance of Spot and SW800 photoscreeners on Chinese children

“…Pretest probability was calculated as (True positive + False negative)/ Total sample. All of the statistical analyses and figures were performed using the software R13 version 3.4.0 and RStudio 14. A value of p<0.05 was considered statistically significant.…”

School-based epidemiology study of myopia in Tianjin, China

“…Data are presented as the mean ± standard deviation of the mean (SEM). The analyses and figures were performed using the software R [ 15 ] version 2.5.1, and RStudio [ 16 ]. Statistical analysis was applied using the software R version 2.5.1.…”

A giant medial parameniscal cyst of the knee joint

“…Although a majority of the parameniscal cysts are very small and patients almost never present with a mass around the knee, they rarely exceed 2 cm or present with a painful mass. MRI is the diagnostic method of choice for detecting meniscal cysts which can provide information about the size, location and concomitant intra-articular pathologies 3. A synovial cyst, baker cyst, ganglion cyst, bursitis, haematoma and cystic neoplasms such as synovial sarcoma should be considered in the differential diagnosis of parameniscal cysts.…”

“…A synovial cyst, baker cyst, ganglion cyst, bursitis, haematoma and cystic neoplasms such as synovial sarcoma should be considered in the differential diagnosis of parameniscal cysts. Open cystectomy with simultaneous arthroscopic menisectomy or meniscal repair is usually curative 1–3Learning points

The two most common causes of a meniscus tear are traumatic injury (often seen in active people) and degenerative processes (often seen in the elderly).

Meniscal cysts are rare and often are a result of extrusion of synovial fluid through a tear in the meniscus.

Open cystectomy with simultaneous arthroscopic menisectomy or meniscal repair has become the standard of care for the best possible outcome with pain relief and functional improvement.

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