RESEARCH ARTICLE


‘Not Always a Baker’s Cyst’ – An Unusual Presentation of a Central Voluminous Postero-Medial Meniscal Cyst



Harish Sivasubramanian* , 1, Gerard Ee2, Manjunatha Ganiga Srinivasaiah2, Shamal Das De2, AM Sing2
1 Yong Loo Lin School of Medicine, National University of Singapore, Singapore
2 Department of Orthopaedic Surgery, National University Hospital (S) Pte Ltd., 5 Lower Kent Ridge Road, 119074, Singapore


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© Sivasubramanian et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 11, 119228, Singapore; Tel: (65) 9678 9547; Fax: (65) 6468 6883; E-mail: harishsiva@hotmail.com


Abstract

Meniscal cysts are rare and often are a result of extrusion of synovial fluid through a tear of the meniscus, resulting in a one-way valve effect of the tear. Arthroscopic partial meniscectomy of the meniscus with intra-articular cyst drainage has become the standard of care. We report a case of an unusually large symptomatic medial meniscal cyst, situated postero-medially and pressing on the posterior cruciate ligament, which was initially clinically misdiagnosed as a Baker’s cyst. The patient had difficulty and pain on squatting. He was successfully treated with arthroscopic debridement and needle decompression; a rarity in literature for such a voluminous perilabral cyst tenting the posterior cruciate ligament. This procedure has the advantage of being able to obtain the cystic fluid for histological and cytological analysis before debridement. This case also highlights the importance of the use of Magnetic Resonance Imaging (MRI) to accurately diagnose a central, posterior knee swelling.

Keywords: Medial meniscal cyst, Large, Needle decompression, Baker's cyst.