Painfull Posterior Cruciate Ligament Ganglion Cyst. A Case Report

J. Fonseca
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Abstract

Ganglion cysts (GC) are benign tumor-like lesions usually going out from mucinous degeneration of collagenous structures [1,2]. They could occur in several anatomic areas but GC arising from cruciate ligaments are rare [3,4] with a prevalence of 0.36% or 0.8% respectively when diagnosed by magnetic resonance (MR) or by arthroscopy [3,5-6] However other studies of GC prevalence refer ranges from 0.2% to 1.9% [7-9], with posterior cruciate ligament ganglion cysts (PCLGC) being five times less frequent than those identify in anterior cruciate ligament [5,10]. This lesion is mainly diagnosed in people aged 20-40 years-old and a male predominance has been reported [5,11-13]. The etiology of PCLGC is not clear. They could appear from synovial herniation or congenital translocation of synovial cells. Mesenchymal stem cells proliferation with cysts formation or mucoid degeneration occurring in areas suffering chronic injuries are also reported [7,14-16]. Many of PCLGC are asymptomatic. When symptomatic the main clinical symptoms and signals includes knee pain and / or movement restrictions [17]. The knee joint could present a slight effusion, restriction to extension and particularly in extreme flexion [1,4]. The common classification of cruciate ligament cysts is supported on the position of the cyst, anterior, posterior or between cruciate ligaments [7]. MR is the gold standard for detecting GC1. Recently observation by ultrasonography is considered useful for identifying and locating the lesion, as well as being a conservative approach to treat cystic lesions [1].
疼痛的后交叉韧带神经节囊肿。案例报告
神经节囊肿(GC)是一种良性肿瘤样病变,通常由胶原结构的粘液变性引起[1,2]。它们可能发生在几个解剖区域,但由交叉韧带引起的GC很罕见[3,4],当通过磁共振(MR)或关节镜诊断时,其患病率分别为0.36%或0.8%[3,5-6]。然而,GC患病率的其他研究参考范围为0.2%至1.9%[7-9],后交叉韧带神经节囊肿(PCLGC)的发生率是前交叉韧带囊肿的五倍[5,10]。这种病变主要诊断于20-40岁的人群,据报道以男性为主[5,11-13]。PCLGC的病因尚不清楚。它们可能来自滑膜突出或滑膜细胞的先天性移位。间充质干细胞增殖伴囊肿形成或粘液样变性也有报道[7,14-16]。许多PCLGC没有症状。当出现症状时,主要的临床症状和信号包括膝盖疼痛和/或运动受限[17]。膝关节可能出现轻微渗出、伸展受限,尤其是在极度屈曲时[1,4]。交叉韧带囊肿的常见分类取决于囊肿的位置、前交叉韧带、后交叉韧带或交叉韧带之间[7]。MR是检测GC1的金标准。最近,超声观察被认为有助于识别和定位病变,也是治疗囊性病变的一种保守方法[1]。
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