posterior cruciate ligament ganglion cyst
Posterior cruciate ligament (PCL) ganglion cysts are intra-articular ganglion cysts and represent one type of many cyst-like lesions around the knee.
Terminology
Posterior cruciate ligament (PCL) ganglion cysts are also referred to as PCL cysts or PCL ganglia .
Epidemiology
The estimated prevalence of all (anterior and posterior) cruciate ligament cysts ranges from 0.2% to 1.9%. They seem to occur more commonly in the anterior cruciate ligament and males seem more commonly affected .
Clinical presentation
Similar to anterior cruciate ligament ganglion cysts the most common symptom in patients with posterior cruciate ligament ganglion cysts seems to be knee pain, limited range of motion especially terminal flexion, snapping, clicking or locking .
Pathology
Posterior cruciate ligament ganglion cysts as other ganglion cysts are usually well-defined, smooth-walled, multiloculated cystic masses filled with clear, mucoid material and are surrounded by dense connective tissue without synovium .
Etiology
As with anterior cruciate ligament ganglion cysts, the pathogenesis is controversial and few theories exist :
- a sequel of mucoid degeneration
- cyst formation as a consequence of trauma or tissue irritation
- release of hyaluronic acid by mesenchymal stem cells and consecutive cyst formation
- synovial herniation
- congenital translocation of synovial cells
Location
Most posterior cruciate ligament ganglion cysts are located along and adjacent to the posterior cruciate ligament. The origin of the main cystic component is located posteriorly in most cases .
Radiographic features
MRI
MRI is the best modality for the visualization and evaluation of cruciate ligament cysts . The typical appearance is that of a well-defined multilocular cystic mass within or adjacent to the posterior cruciate ligament .
- T1: will depend on protein content, but mostly hypointense
- T2: hyperintense
- PDFS/T2FS: hyperintense
Treatment and prognosis
Management options depend vastly on clinical symptoms and include conservative measures, image-guided percutaneous aspiration as well as arthroscopic excision, the latter being the preferred technique for symptomatic cysts due to good outcomes .
Differential diagnosis
- mucoid degeneration of the posterior cruciate ligament
- anterior cruciate ligament ganglion cyst
- Hoffa’s fat pad ganglion cyst
- posteromedial meniscal cyst with central extension
- synovial cyst
- synovial sarcoma
Siehe auch:
- Ganglion (Überbein)
- Ganglion des vorderen Kreuzbandes
- zystische Läsionen des Knies
- posterior cruciate ligament (PCL)
- posterior cruciate ligament (PCL)
und weiter:
Assoziationen und Differentialdiagnosen zu Ganglion des hinteren Kreuzbandes:
