Substantial medial para-meniscal cyst with a complex meniscal tear: A case report

Introduction and importance

Meniscal cysts, while infrequent with a prevalence of 1 %–8 %, may result in considerable knee discomfort and functional limitations. The cysts are categorized according to their position in relation through the meniscus, labeled as either intrameniscal or parameniscal. Although parameniscal cysts are often small and asymptomatic, they may expand and become painful with time. This case report describes an uncommon instance of a medial parameniscal cyst.

Case presentation

A 28-year-old male presented with persistent pain and swelling in the medial aspect of his left knee, lasting for 8 months. His symptoms were exacerbated by activities such as stair climbing and general mobility. On physical examination, a firm, fluctuating mass measuring 5 × 3 cm was noted. MRI revealed a complex tear in the posterior horn of the medial meniscus, along with a cyst measuring 4.9 × 3.2 × 2.0 cm. Arthroscopy identified a degenerative medial meniscus tear, and the cyst was excised through open surgery. The patient's recovery was uneventful, with full restoration of knee function within three months.

Clinical discussion

Parameniscal cysts often coexist with horizontal meniscal tears, influenced by factors like knee laxity, trauma, and degeneration. MRI is the preferred diagnostic tool, but high-resolution ultrasound can be beneficial. Treatment options include conservative management and surgical interventions like partial meniscectomy, emphasizing the need for comprehensive diagnosis and appropriate management.

Conclusion

This unique case of a medial parameniscal cyst highlights the critical need for timely diagnosis and intervention. Surgical treatment, including meniscectomy or meniscal repair, offers significant pain relief and functional improvement, demonstrating its effectiveness in managing such cases.