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Painful knee

Q1: What are features seen on MRI (see p 556)?
The T2-weighted coronal image shows a well defined oval shaped, homogenous, multiseptated high signal intensity lesion adjacent to the lateral margin of the lateral meniscus. The lesion is lying deep to the iliotibial tract.

Q2: What are the differential diagnoses?
The differential diagnoses include lateral meniscus cyst, pes anserinus bursitis, bursitis of the lateral collateral ligament, and lateral meniscus injury.

Q3: What is the diagnosis?
The fluid filled multiseptated cystic lesion-like appearance on the MRI is consistent with a left anterolateral multiseptated parameniscal cyst arising from the lateral meniscus. T1-weighted images confirmed the same.

Q4: What is the frequently associated finding with this condition?
Lateral meniscus cysts are usually associated with horizontal cleavage tears of the meniscus.

Q5: How should the condition be managed?
Asymptomatic meniscal cyst can be treated non-operatively. Symptomatic cysts need partial menisectomy along with decompression of the cyst either arthroscopically or by an open method.

Discussion
This young woman was suspected of having a meniscal cyst and hence had the MRI investigation. The T2-weighted coronal images (shown in fig 1; see p 556) clearly . . . [Full text of this article]

Relevant Article

Painful knee

K Selvarajan, R Vadivelu, and T P Green
Postgrad. Med. J. 2004 80: 556. [Extract] [Full Text] [PDF]