An Unusual Knee Bump In A Former Football Player

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An Unusual Knee Bump In A Former Football Player - Page #4

Working Diagnosis: Lateral meniscus tear with large parameniscal cyst Treatment: The patient underwent arthroscopic lateral meniscectomy and open parameniscal cyst excision Case Photo #3 Case Photo #4 . Outcome: He has done very well since surgery and graduated from physical therapy. Author's Comments: Meniscal cysts consists of synovial fluid adjacent to damaged meniscal tissue outside of the joint. They are thought to result from synovial fluid extruding through the damaged meniscus and into the surrounding space. They are most often diagnosed radiographically or arthroscopically. It is not common to diagnose a meniscal cyst on physical examination. We suspect the patient in this case sustained his meniscal tear playing high school football, and the duration since the injury allowed for the formation of a relatively large, multilobulated parameniscal cyst. The firmness of his cyst is most likely caused by repetitive stress from the overlying IT band. Editor's Comments: The Pisani sign, which is pathognomonic for a para labral cyst was first described in 1947 by Dr. Pisani. It indicates that with full flexion of the knee, the parameniscal cyst will disappear, but then reappear with full extension. The cyst becomes most prominent with its greatest dimensions at about 25 degrees short of full extension. Modifications to this test have identified that with complete tibial internal rotation, the cyst will disappear, but with tibial external rotation will become prominent. References: Crowell, M. S., R. B. Westrick, and B. T. Fogarty. "Cysts of the Lateral Meniscus." Int J Sports Phys Ther 8.3 (2013): 340-8. Print. Return To The Case Studies List.		Back
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