Cysts and pseudocysts around de knee. Classification and diagnostic algorithm and treatment

Abstract

Introduction: the appearance of magnetic resonance imaging and its evolution in the quality of the images, has led to the diagnosis of unusual pathologies. The objective of this work is to evaluate cystic and pseudocystic images in a series of magnetic resonance imaging of patients treated at our center, classifying and analyzing their frequency of appearance and the development and application of a diagnostic and therapeutic algorithm.

Materials and methods: the clinical histories and magnetic resonances of 1808 patients whose reason for consultation was knee paint of different etiology were retrospectively evaluated. Inclusion and exclusion criteria were applied. The presence of cystic and pseudocystic images was assessed, location, frequency, applied treatment and recurrence were recorded. 530 men and 311 women were included in this study, aged between 11 and 84 years (with an average of 41 years).

Results: 894 knees were obtained from a total of 841 patients, where 1128 images compatible with cysts or pseudocysts were observed. In 103 patients we observed two or more images. Seventeen patients required arthroscopic surgical treatment, of these, fourteen were cysts associated with meniscal injury and three were ganglions of the anterior cruciate ligament sheath. One hamstring cyst and two pre-patellar collections were openly resolved. We did not record any recurrence.

Conclusion: knee cysts and pseudocysts are common pathologies, we consider the correct clinical imaging analysis important to avoid errors of appreciation and treatment. MRI is the main study tool for knee pathologies, allowing the evaluation of images that are difficult to observe by another method, thus enabling a more accurate diagnosis. We consider it essential to be familiar with the specific anatomy, know its location, understand the relationship with adjacent structures, and understand the analysis of the characteristics and patterns of the different lesions observed on MRI in order to establish a correct diagnosis.