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Radiological Evaluation of Cystic Lesions Presenting as Painful Knee

Year 2014, Volume: 39 Issue: 3, 550 - 557, 22.07.2014
https://doi.org/10.17826/cutf.26051

Abstract

Purpose: Painful knee is a common clinical scenario in any outpatient clinic. Although, the commonest cause of painful knee is blunt trauma, many non traumatic cystic lesions too present as painful knee. For appropriate management of these conditions, a correct diagnosis is required. Clinical examination alone is often not sufficient to reach the exact diagnosis in patients with underlying cystic lesions manifesting as painful knee. Here comes the role of imaging. This study was therefore undertaken to evaluate how imaging can help in pinpointing the exact cause of cystic lesion presenting as painful knee and therefore assist in proper management. Material and Methods: 50 consecutive patients with painful knee as the presenting complaint were radiologically evaluated for assessing how common are cystic lesions as the cause of knee pain. The findings were then noted in this descriptive study. Results: 26 patients were found to have an underlying cystic lesion as the cause of painful knee. Popliteal cyst was the commonest lesion and was seen in 12 cases. Suprapatellar bursitis as well as infrapatellar bursitis was seen in 3 cases each. Meniscal cyst was seen in 8 cases. Conclusion:Painful knee can be a presenting symptom of many cystic lesions of knee. Ultrasound can show the cystic abnormality, but it is only the Magnetic Resonance Imaging which can demonstrate the complete entity.

References

  • Yoon YS, Rah JH, Park HJ: A prospective study of the accuracy of clinical examination evaluated by arthroscopy of the knee. Int Orthop. 1997;21:223-7.
  • Terry GC, Tagert BE, Young MJ: Reliability of the clinical assessment in predicting the cause of internal derangement of the knee. Arthroscopy. 1995;11:56876
  • Trieshmann HW Jr, Mosure JC: The impact of magnetic resonance imaging of the knee on surgical decision making. Arthroscopy. 1996;12:550-5.
  • Christian SR, Anderson MB, Workman R, Conway WF, Pope TL. Imaging of anterior knee pain.Clin Sports Med. 2006;25:681-702.
  • McCarthy CL, McNally EG. The MRI appearance of cystic lesions around the knee. Skeletal Radiol. 2004;33:187–209
  • Janzen DL, Peterfy CG, Forbes JR, Tirman PF, Genant HK. Cystic lesions around the knee joint: MR imaging findings. AJR Am J Roentgenol. 1994;163:155–61.
  • Hirji Z, Hanjun JS, Choudur HN. Imaging of Bursae. J Clin Imaging Sci. 2011;1:22.
  • Dorsey ML, Liu PT, Leslie KO, Beauchamp CP. Painful suprapatellar swelling: Diagnosis and discussion. (951-2).Skeletal Radiol. 2008;37:937–8.
  • Recht MP, Applegate G, Kaplan P, et al. The MR appearance of cruciate ganglion cysts: A report of 16 cases. Skeletal Radiol 1994;23:597-600
  • Burk DL, DalinkaMK, Kanal E, et al . Meniscal and ganglion cysts of the knee: MR evaluation AJR Am J Roentgenol. 1988;150:331-6
  • Fielding JR, Franklin PD, Kustan J . Popliteal cysts: a reassessment using magnetic resonance imaging. Skeletal Radiol. 1991;20:433-5
  • Miller TT, Staron RB, Koenigsberg T, et al. MR imaging of Baker’s cyst: association with internal derangement, effusion and degenerative arthropathy. Radiology. 1996;201:247-50.
  • Fritschy D, Fasel J, Imbert JC, Bianchi S, Verdonk R, Wirth CJ. The popliteal cyst. Knee Surg Sports Traumatol Arthrosc. 2006;14:623–8.
  • Pouders C, De Maeseneer M, Van Roy P, Gielen J, Goossens A, Shahabpour M. Prevalence and MRIanatomic correlation of bone cysts in osteoarthritic knees. Am J Roentgenol. 2008;190:17–21.
  • Crotty JM, Johny UV, Thomas LP, et al Synovial osteochondromatosis Radiol Clinics North Am. 1996;34:327-42. Schick C, Mack MG, Marzi I, Vogl TJ. Lipohemarthrosis of the knee: MRI as an alternative to the puncture of the knee joint. European Radiology. 2003;13:1185-7.
  • Yazışma Adresi / Address for Correspondence: Dr. Sushil Ghanshyam Kachewar Rural Medical College PIMS (DU), Loni, Ta-Rahata, Ahmednagar Maharashtra, İNDİA Email: sushilkachewar@hotmail.com G eliş tarihi/Received on: 03.01.2014
  • Kabul tarihi/Accepted on:31.01.2014

Ağrılı Diz Bulgusuyla Sunulan Kistik Lezyonların Radyolojik Değerlendirilmesi

Year 2014, Volume: 39 Issue: 3, 550 - 557, 22.07.2014
https://doi.org/10.17826/cutf.26051

Abstract

Amaç: Ağrılı diz; ayakta tedavi edilen hastalarda yaygın bir durumdur. Ağrılı dizin en yaygın nedeni künt travma olmasına rağmen bir çok travmatik olmayan kistik lezyonlarda ağrılı dize aracılık eder. Böyle durumların yönetimi için öncelikle doğru teşhis gereklidir. Klinik inceleme çoğu zaman ağrılı dize aracılık eden kistik lezyonlara sahip hastalarda doğru teşhis açısından tek başına yeterli olmaz. Bu notkada görüntülemenin önemi ortaya çıkar. Bu çalışma ağrılı dize aracılık eden kistik lezyonların kesin nedenini belirleyebilmede görüntülemenin nasıl yardımcı olabileceğini göstermek ve böylece doğru yönledirmeyi sunmak içindi. Materyal ve Method: Ağrılı diz şikayeti olan 50 hasta, ağrılı dize neden olan kistik lezyonların hangi durumlarda yaygın olduğunu göstermek için radyolojik olarak değerlendirildi. Bulgular bu tanımlayıcı çalışmada kaydedildi. Bulgular: 26 hastanın ağrılı dize neden olan kistik lezyonlara sahip olduğu bulundu. Popliteal kist 12 vakada görülmüş olup en yaygın lezyon olarak kaydedildi. İnfrapatellar bursan iltihaplanması yanı sıra suprapatellar bursan iltihaplanması 3 vakada gözlendi. Menisküs kist ise 8 vakada gözlendi. Sonuç: Ağrılı diz; bir çok diz kistik lezyonların semptomu olabilir. Ultrason kistik anomaliliği gösterebilir, manyetik rezonans görüntüleme ise daha kapsamlı olarak bütün herşeyi gösterebilir.

References

  • Yoon YS, Rah JH, Park HJ: A prospective study of the accuracy of clinical examination evaluated by arthroscopy of the knee. Int Orthop. 1997;21:223-7.
  • Terry GC, Tagert BE, Young MJ: Reliability of the clinical assessment in predicting the cause of internal derangement of the knee. Arthroscopy. 1995;11:56876
  • Trieshmann HW Jr, Mosure JC: The impact of magnetic resonance imaging of the knee on surgical decision making. Arthroscopy. 1996;12:550-5.
  • Christian SR, Anderson MB, Workman R, Conway WF, Pope TL. Imaging of anterior knee pain.Clin Sports Med. 2006;25:681-702.
  • McCarthy CL, McNally EG. The MRI appearance of cystic lesions around the knee. Skeletal Radiol. 2004;33:187–209
  • Janzen DL, Peterfy CG, Forbes JR, Tirman PF, Genant HK. Cystic lesions around the knee joint: MR imaging findings. AJR Am J Roentgenol. 1994;163:155–61.
  • Hirji Z, Hanjun JS, Choudur HN. Imaging of Bursae. J Clin Imaging Sci. 2011;1:22.
  • Dorsey ML, Liu PT, Leslie KO, Beauchamp CP. Painful suprapatellar swelling: Diagnosis and discussion. (951-2).Skeletal Radiol. 2008;37:937–8.
  • Recht MP, Applegate G, Kaplan P, et al. The MR appearance of cruciate ganglion cysts: A report of 16 cases. Skeletal Radiol 1994;23:597-600
  • Burk DL, DalinkaMK, Kanal E, et al . Meniscal and ganglion cysts of the knee: MR evaluation AJR Am J Roentgenol. 1988;150:331-6
  • Fielding JR, Franklin PD, Kustan J . Popliteal cysts: a reassessment using magnetic resonance imaging. Skeletal Radiol. 1991;20:433-5
  • Miller TT, Staron RB, Koenigsberg T, et al. MR imaging of Baker’s cyst: association with internal derangement, effusion and degenerative arthropathy. Radiology. 1996;201:247-50.
  • Fritschy D, Fasel J, Imbert JC, Bianchi S, Verdonk R, Wirth CJ. The popliteal cyst. Knee Surg Sports Traumatol Arthrosc. 2006;14:623–8.
  • Pouders C, De Maeseneer M, Van Roy P, Gielen J, Goossens A, Shahabpour M. Prevalence and MRIanatomic correlation of bone cysts in osteoarthritic knees. Am J Roentgenol. 2008;190:17–21.
  • Crotty JM, Johny UV, Thomas LP, et al Synovial osteochondromatosis Radiol Clinics North Am. 1996;34:327-42. Schick C, Mack MG, Marzi I, Vogl TJ. Lipohemarthrosis of the knee: MRI as an alternative to the puncture of the knee joint. European Radiology. 2003;13:1185-7.
  • Yazışma Adresi / Address for Correspondence: Dr. Sushil Ghanshyam Kachewar Rural Medical College PIMS (DU), Loni, Ta-Rahata, Ahmednagar Maharashtra, İNDİA Email: sushilkachewar@hotmail.com G eliş tarihi/Received on: 03.01.2014
  • Kabul tarihi/Accepted on:31.01.2014
There are 17 citations in total.

Details

Primary Language Turkish
Journal Section Research
Authors

Rajpal Yadav This is me

Sushil Ghanshyam Kachewar This is me

Publication Date July 22, 2014
Published in Issue Year 2014 Volume: 39 Issue: 3

Cite

MLA Yadav, Rajpal and Sushil Ghanshyam Kachewar. “Ağrılı Diz Bulgusuyla Sunulan Kistik Lezyonların Radyolojik Değerlendirilmesi”. Cukurova Medical Journal, vol. 39, no. 3, 2014, pp. 550-7, doi:10.17826/cutf.26051.