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      Giant infrapatellar ganglion cyst of Hoffa's fat pad

      case-report

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          Abstract

          We present the case of a 36-year-old woman who works as a kindergarten teacher, often she is kneeling on her knees due to the nature of the job. Since a year ago, she noticed that her right knee was swelling. She had an orthopaedic examination when she could no longer bend her knee. Inspection and palpation revealed the swelling of the anterior and anterior-lateral aspect of the knee. MRI imaging revealed a large, sharply defined, lobulated lesion of the infrapatellar fat pad. After the surgical incision, a lobular lesion was found and surgically removed. Histological analysis confirmed a ganglion cyst.

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          Intra-articular ganglion cysts of the knee joint: a report of 85 cases and review of the literature.

          Marvin Schulte, Wilfried K Krudwig, C. Heinemann (2004)
          Intra-articular ganglia and cysts of the knee joint are rare and mostly incidental findings in MRI and arthroscopy. During a period of 15 years, nearly 8000 knees were arthroscopically examined. In total, 85 intra-articular soft tissue masses were found within the knee cavity. Of these, 76 were incidental and asymptomatic findings in arthroscopy performed for treatment of osteoarthritic symptoms. Several repeated minor knee traumata were reported in this group but no histories of serious traumatic events. Nine ganglion cysts were obviously solely responsible for the intermittent or chronic non-specific knee discomfort, and classified as symptomatic. There were no histories of previous injury to the knees, no clinical signs of instabilities or meniscal and femoropatellar pathologies, and no associated further intra-articular lesions in arthroscopy. Forty-nine cystic masses originated from the ACL, 16 from the PCL, 12 from the anterior (eight medial, four lateral) and three from the posterior horn of the menisci (two medial, one lateral). Three were located in the infrapatellar fat pad, one arose from a medial plica and one from a subchondral bone cyst. All ganglion cysts were successfully resected or excised using arthroscopic technique. A review of the literature is given and compared with the findings and data of this study.
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            Intraarticular ganglia of the knee: prevalence, presentation, etiology, and management.

            L Bui, R A Youngberg (1996)
            The aim of this study was to present a comprehensive review of intraarticular ganglia of the knee. Cases of intraarticular ganglia of the knee were collected from a group of 1767 consecutive patients referred for MR imaging examinations of the knee. Medical records and radiologic, arthroscopic, and pathologic reports were reviewed. Twenty-three patients (17 men and six women) had intraarticular ganglia of the knee. Three ganglia were found in Hoffa's fat pad, 10 were associated with the anterior cruciate ligament, eight were associated with the posterior cruciate ligament, and two had no definite association with either the anterior or the posterior cruciate ligament. Of the 23 ganglia, 14 (61%) were located in the intercondylar notch. Pain was the most common complaint: medial joint line tenderness, lateral joint line tenderness, or retropatellar pain. Two of the three patients with ganglia in Hoffa's fat pad had a palpable mass on physical examination. Of the 23 patients with intraarticular ganglia of the knee, 18 (78%) had no associated internal derangement. Five patients underwent arthroscopic surgery, confirming the diagnosis of ganglionic cyst. Of these five patients, none had a recurrence. With the advent of MR imaging of the knee, intraarticular ganglia of the knee have been found to occur more commonly than once thought, with a prevalence of 1.3% in this series. Radiologists interpreting knee MR images must be aware of this entity and its management.
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              MRI features of cystic lesions around the knee.

              Eddie Chung, Ali Guermazi, Shanu Roemer … (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.
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                Author and article information

                Contributors
                Miro Miljko
                Vedran Markotić
                Journal
                Journal ID (nlm-ta): Eur J Radiol Open
                Journal ID (iso-abbrev): Eur J Radiol Open
                Title: European Journal of Radiology Open
                Publisher: Elsevier
                ISSN (Electronic): 2352-0477
                Publication date PMC-release: 29 July 2019
                Publication date Collection: 2019
                Publication date (Electronic): 29 July 2019
                Volume: 6
                Pages: 275-280
                Affiliations
                [a ]University Hospital in Mostar, Departement of Clinical Radiology, Bijeli brijeg b.b., 88 000, Mostar, Bosnia and Herzegovina
                [b ]Cantonal Hospital, Dr. Safet Mujić“, Departement of Ortpedics, Mostar, Bosia and Herzegovina
                [c ]University of Sarajevo, Medical Faculty, Departemt of Anatomy, Sarajevo, Bosia and Herzegovina
                [d ]University Hospital in Mostar, Departement of Clinical Oncology, Mostar, Bosia and Herzegovina
                [e ]University Hospital in Mostar, Department of Nuclear Medicine, Mostar, Bosnia anad Herzegovina
                Author notes
                [* ]Corresponding author at: University Hospital in Mostar, Departement of Clinical Radiology, Bijeli brijeg b.b., 88 000, Mostar, Bosnia and Herzegovina. vedranmarkoticz@ 123456gmail.com
                Article
                Publisher ID: S2352-0477(19)30037-1
                DOI: 10.1016/j.ejro.2019.07.003
                PMC ID: 6667655
                PubMed ID: 31388516
                SO-VID: f9fdf079-3b5a-42b7-b829-dca5bc0a8528
                Copyright © © 2019 The Author(s)
                License:

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                Date received : 9 July 2019
                Date revision received : 17 July 2019
                Date accepted : 21 July 2019
                Categories
                Subject: Article

                Keywords: ganglion cyst,hoffa's fat pad,knee
                Data availability:
                Keywords: ganglion cyst, hoffa's fat pad, knee

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