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{{no footnotes, date=January 2017 Meniscal cyst is a well-defined
cystic A cyst is a closed sac, having a distinct envelope and division compared with the nearby tissue. Hence, it is a cluster of cells that have grouped together to form a sac (like the manner in which water molecules group together to form a bubble); ...
lesion A lesion is any damage or abnormal change in the tissue of an organism, usually caused by disease or trauma. ''Lesion'' is derived from the Latin "injury". Lesions may occur in plants as well as animals. Types There is no designated classif ...
located along the
peripheral A peripheral or peripheral device is an auxiliary device used to put information into and get information out of a computer. The term ''peripheral device'' refers to all hardware components that are attached to a computer and are controlled by th ...
margin of the
meniscus Meniscus may refer to: * Meniscus (anatomy), crescent-shaped fibrocartilaginous structure that partly divides a joint cavity * Meniscus (liquid), a curve in the upper surface of liquid contained in an object *Meniscus (optics) A lens is a ...
, a part of the knee, nearly always associated with horizontal meniscal tears.


Signs and symptoms

Pain and swelling or focal mass at the level of the joint. The pain may be related to a meniscal tear or distension of the knee capsule or both. The mass varies in consistency from soft/ fluctuant to hard. Size is variable, and meniscal cysts are known to change in size with knee flexion/extension.


Cause

Various
etiologies Cause, also known as etiology () and aetiology, is the reason or origination of something. The word ''etiology'' is derived from the Greek , ''aitiologia'', "giving a reason for" (, ''aitia'', "cause"; and , ''-logia''). Description In medicine, ...
have been proposed, including
trauma Trauma most often refers to: *Major trauma, in physical medicine, severe physical injury caused by an external source * Psychological trauma, a type of damage to the psyche that occurs as a result of a severely distressing event *Traumatic inj ...
,
hemorrhage Bleeding, hemorrhage, haemorrhage or blood loss, is blood escaping from the circulatory system from damaged blood vessels. Bleeding can occur internally, or externally either through a natural opening such as the mouth, nose, ear, urethra, vag ...
, chronic
infection An infection is the invasion of tissues by pathogens, their multiplication, and the reaction of host tissues to the infectious agent and the toxins they produce. An infectious disease, also known as a transmissible disease or communicable d ...
, and mucoid degeneration. The most widely accepted theory describes meniscal cysts resulting from extrusion of
synovial fluid Synovial fluid, also called synovia, elp 1/sup> is a viscous, non-Newtonian fluid found in the cavities of synovial joints. With its egg white–like consistency, the principal role of synovial fluid is to reduce friction between the articul ...
through a peripherally extended horizontal meniscal tear, accumulating outside the joint capsule. They arise more commonly from the lateral joint margin, and occur most often in 20- to 40-year-old males.


Diagnosis

Magnetic resonance imaging is the
modality Modality may refer to: Humanities * Modality (theology), the organization and structure of the church, as distinct from sodality or parachurch organizations * Modality (music), in music, the subject concerning certain diatonic scales * Modalitie ...
of choice for diagnosis of meniscal cysts. In their most subtle form, meniscal cysts present as focal areas of high signal intensity within a swollen meniscus. It is not uncommon for
radiologists Radiology ( ) is the medical discipline that uses medical imaging to diagnose diseases and guide their treatment, within the bodies of humans and other animals. It began with radiography (which is why its name has a root referring to radiati ...
to miss this type of meniscal cyst because the signal intensity is not quite as great as fluid on T2 weighted sequences.2 When this fluid is extruded into the adjacent soft tissues, the swollen meniscus subsequently assumes a more normal shape, and the extruded fluid demonstrates a higher T2 signal typical of parameniscal
cysts A cyst is a closed sac, having a distinct envelope and division compared with the nearby tissue. Hence, it is a cluster of cells that have grouped together to form a sac (like the manner in which water molecules group together to form a bubble); ...
. Medial meniscus horizontal tear extending into a meniscal cyst.
Sagittal The sagittal plane (; also known as the longitudinal plane) is an anatomical plane that divides the body into right and left sections. It is perpendicular to the transverse and coronal planes. The plane may be in the center of the body and div ...
T2 images of a medial meniscus horizontal tear extending into a meniscal cyst. Large medial meniscus cyst.


Treatment

Treatment of meniscal cysts consists of a combination of cyst decompression (
intraarticular A joint or articulation (or articular surface) is the connection made between bones, ossicles, or other hard structures in the body which link an animal's skeletal system into a functional whole.Saladin, Ken. Anatomy & Physiology. 7th ed. McGraw ...
decompression versus open
cystectomy Cystectomy is a medical term for surgical removal of all or part of the urinary bladder. It may also be rarely used to refer to the removal of a cyst. The most common condition warranting removal of the urinary bladder is bladder cancer. Two m ...
) and
arthroscopic Arthroscopy (also called arthroscopic or keyhole surgery) is a minimally invasive surgical procedure on a joint in which an examination and sometimes treatment of damage is performed using an arthroscope, an endoscope that is inserted into the j ...
repair of any meniscal abnormalities. Success rates are significantly higher when both the cyst and meniscal tear are treated compared to treating only one disease process.


See also

*
Knee pain Knee pain is pain in or around the knee. The knee joint consists of an articulation between four bones: the femur, tibia, fibula and patella. There are four compartments to the knee. These are the medial and lateral tibiofemoral compartments, the ...
*
Knee osteoarthritis Osteoarthritis (OA) is a type of degenerative joint disease that results from breakdown of joint cartilage and underlying bone which affects 1 in 7 adults in the United States. It is believed to be the fourth leading cause of disability in the w ...
*
Discoid meniscus Discoid meniscus is a rare human anatomic variant that usually affects the lateral meniscus of the knee. Usually a person with this anomaly has no complaints; however, it may present as pain, swelling, or a snapping sound heard from the affected k ...


References


Meniscal Cysts
!-- archived URL goes wrong place. Checked June 2020 --> by Rob Gutierrez, M.D. *Campbell, SE, Sanders, TG, Morrison, WB. MR imaging of meniscal cysts: Incidence, location, and clinical significance
AJR 2001;177:409-413
*Helms, CA. The meniscus: Recent advances in MR imaging of the knee
AJR 2002;179(5):1115-1112
Pathology