________________________________
Sent: Thursday, May 19, 2022 3:00 PM
EXTERNAL MAIL
Hello,
I was hoping for a little help on this case from last week. This is a 62 year old male with recurrent knee effusions and pain over the past year. Immediately anterior to the anterior horn and root of medial meniscus, is an oval shaped structure that isn’t truly cystic. This is immediately anterior to the anterior intermeniscal ligament insertion site. When evaluating the meniscus, the intermeniscal ligament insertion seems to extend farther medially than I am used to. My first question is can you get a “wrisberg rip” type injury associated with the anterior intermeniscal ligament?
If so, could this structure be a parameniscal cyst with blood products (explaining the intermediate signal)? Alternatively, would you consider a synovial process ie focal pvns?
Finally, Do I need to bring them back for contrast to ensure this isn’t a true mass. The patient doesn’t want to return for contrast unless necessary because of financial reasons.
It’s a ganglion of the transverse meniscus ligament, leave alone
This ligament is covered by synovium and any syn inj can lead to a ganglion like ACL mucoid/ganglion
ps case from today (3 images)- similar on lateral aspect and couple of older cases with larger cysts
Avneesh Chhabra, M.D. M.B.A.
Professor Radiology & Orthopedic Surgery
Chief, Division of Musculoskeletal Radiology
UT Southwestern Medical Center, Dallas, Tx
5373 Harry Hines Blvd.
Dallas, Tx-75390-9178
Office: 214-648-2122
avneesh.chhabra@utsouthwestern.edu<mailto:avneesh.chhabra@utsouthwestern.edu>
http://www.utsouthwestern.edu<http://www.utsouthwestern.edu/>
________________________________
Sent: Thursday, May 19, 2022 3:00 PM
EXTERNAL MAIL
Hello,
I was hoping for a little help on this case from last week. This is a 62 year old male with recurrent knee effusions and pain over the past year. Immediately anterior to the anterior horn and root of medial meniscus, is an oval shaped structure that isn’t truly cystic. This is immediately anterior to the anterior intermeniscal ligament insertion site. When evaluating the meniscus, the intermeniscal ligament insertion seems to extend farther medially than I am used to. My first question is can you get a “wrisberg rip” type injury associated with the anterior intermeniscal ligament?
If so, could this structure be a parameniscal cyst with blood products (explaining the intermediate signal)? Alternatively, would you consider a synovial process ie focal pvns?
Finally, Do I need to bring them back for contrast to ensure this isn’t a true mass. The patient doesn’t want to return for contrast unless necessary because of financial reasons.
I appreciate your thoughts and advice in advance.
JLambert
Images below
Sent from my iPhone
[https://ipmcdn.avast.com/images/icons/icon-envelope-tick-round-orange-animated-no-repeat-v1.gif]<http://www.avast.com/sig-email?utm_medium=email&utm_source=link&utm_campaign=sig-email&utm_content=webmail&utm_term=icon> Virus-free. http://www.avast.com<http://www.avast.com/sig-email?utm_medium=email&utm_source=link&utm_campaign=sig-email&utm_content=webmail&utm_term=link>
Cor T1
[image0.jpeg]
Cor pdfs
[image1.jpeg]
Ax t2 FS
[image2.jpeg]
Sag pd
[image3.jpeg][image4.jpeg][image5.jpeg][image6.jpeg][image7.jpeg][image8.jpeg]
Sag pdfs
[image11.jpeg][image12.jpeg][image13.jpeg][image14.jpeg][image15.jpeg][image16.jpeg]
[gallery]