New observations on meniscal cysts.
Summary of "New observations on meniscal cysts."
OBJECTIVE:
The purpose of this study was to determine the incidence of meniscal cysts, assess the frequency of various magnetic resonance (MR) imaging characteristics, and emphasize radiographic observations not commonly reported. MATERIALS AND
METHODS:
A total of 2,095 consecutive knee MR imaging reports from a 22 month period were retrospectively reviewed for the presence of meniscal cysts. Two musculoskeletal radiologists reviewed the cases where cysts were reported. A meniscal cyst was considered present if abnormally increased signal was identified within an enlarged meniscus (i.e., intrameniscal cyst) or if a loculated fluid-intensity lesion with a clear connection to the adjacent meniscus was identified (i.e., parameniscal cyst). Presence or absence of a meniscal tear, intrameniscal and parameniscal signal intensity, patient age, sex, location of meniscal cyst, presence of discoid meniscus, and size of the parameniscal cyst component were recorded. All knee imaging examinations were performed on a 1.5T MR unit. Imaging findings were correlated with arthroscopic reports when available.
RESULTS:
A total of 167 cases (8.0%) of meniscal cysts were diagnosed in 161 patients. Of the 167 cysts, 69 (41.3%) were located in the lateral meniscus and 98 (58.7%) in the medial meniscus. In 6 patients (3.7%), meniscal cysts were present in both menisci of the same knee. Twelve (7.2%) meniscal cysts were associated with discoid menisci. Ninety-seven (57.8%) meniscal cysts were associated with meniscal tears. Of the total number of meniscal cysts, 104 (62.3%) had a parameniscal cyst. An isolated intrameniscal cyst was present in 63 (37.7%) cases. One hundred (96%) of the parameniscal cyst components were isointense to fluid on T2-weighted FSE images. All cysts exhibited abnormal intrameniscal signal. Only 14 (8.4%) of the intrameniscal components were isointense to fluid on T2-weighted FSE images. The arthroscopic reports of 88 of the 161 (54.7%) patients were available for review and correlation. A tear extending to the articular surface of the meniscus was reported to be present in 74 of the 88 (84%) arthroscopic examinations.
CONCLUSIONS:
Knowledge of the spectrum of findings and the relative frequency of various MR imaging characteristics as well as common potential pitfalls is important to the accurate diagnosis and management of mensical cysts. In particular, controversy exists as to the incidence of articular surface tears in association with meniscal cysts, with some authors reporting greater than 98% correlation with tears. Only 58% of cysts were associated with an articular surface tear. Ninety six percent of the parameniscal signal was isointense to fluid, only 8% of the intramensical signal was isointense to fluid.
Affiliation
Duke University Medical Center, Durham, NC, USA, anderson.jada@gmail.com.
Journal Details
This article was published in the following journal.
Name: Skeletal radiology
ISSN: 1432-2161
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20680623
- DOI: http://dx.doi.org/10.1007/s00256-010-0993-2
Medical and Biotech [MESH] Definitions
Odontogenic Cysts
Cysts found in the jaws and arising from epithelium involved in tooth formation. They include follicular cysts (e.g., primordial cyst, dentigerous cyst, multilocular cyst), lateral periodontal cysts, and radicular cysts. They may become keratinized (odontogenic keratocysts). Follicular cysts may give rise to ameloblastomas and, in rare cases, undergo malignant transformation.
Bone Cysts
Benign unilocular lytic areas in the proximal end of a long bone with well defined and narrow endosteal margins. The cysts contain fluid and the cyst walls may contain some giant cells. Bone cysts usually occur in males between the ages 3-15 years.
Pancreatic Cyst
A true cyst of the PANCREAS, distinguished from the much more common PANCREATIC PSEUDOCYST by possessing a lining of mucous EPITHELIUM. Pancreatic cysts are categorized as congenital, retention, neoplastic, parasitic, enterogenous, or dermoid. Congenital cysts occur more frequently as solitary cysts but may be multiple. Retention cysts are gross enlargements of PANCREATIC DUCTS secondary to ductal obstruction. (From Bockus Gastroenterology, 4th ed, p4145)
Jaw Cysts
Saccular lesions lined with epithelium and contained within pathologically formed cavities in the jaw; also nonepithelial cysts (pseudocysts) as they apply to the jaw, e.g., traumatic or solitary cyst, static bone cavity, and aneurysmal bone cyst. True jaw cysts are classified as odontogenic or nonodontogenic.
Tarlov Cysts
Perineurial cysts commonly found in the SACRAL REGION. They arise from the PERINEURIUM membrane within the SPINAL NERVE ROOTS. The distinctive feature of the cysts is the presence of spinal nerve root fibers within the cyst wall, or the cyst cavity itself.
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