Anterior cruciate ligament ganglion cyst
Updates to Article Attributes
Anterior cruciate ligament (ACL) ganglion cysts, commonly referred to simply as ACL cysts, along with ganglion cysts arising from the alar folds that cover the infrapatellar fat pad, make up the vast majority of intra-articular ganglion cysts of the knee.
Epidemiology
These are uncommon findings, with the prevalence of ACL ganglion cysts has beenare uncommon, with prevalence reported to be between 0.3-1.3% of knee MRIs, and are usually incidental findings.
Clinical presentation
Knee pain, being the most common presenting complaint, is usually attributable to other pathology.
Pathology
ACL ganglion cysts are histologically identical to the ganglion cysts seen elsewhere, most commonly around the wrist. The pathogenesis remains controversial, with two theories being favoured:
- sequelae of ACL mucoid degeneration
- herniation of synovial tissue through a defect in the joint capsule or tendon sheath
Radiographic features
MRI
MRI is better at detecting these lesions than standard anterior portal approach arthroscopy as the surface of the ligament is often intact. In fact, the ligament may appear entirely normal. A posterior approach will allow the arthroscopist to detect changes by probing the ligament, and will allow potential aspiration of the cysts.
Typically the cysts appear as regions of high T2 signal, often multiloculated, centred on the distal ACL. Often there is some irregularity to the bone subjacent to the tibial attachment.
Differential diagnosis
Differential diagnosis of cysts around the knee joint include:
- popliteal cyst
- meniscal cyst
- ganglion cyst
- cyst within tibial tunnel after ACL reconstruction
- knee joint effusion
-<p><strong>Anterior cruciate ligament (ACL) ganglion cysts</strong>, commonly referred to simply as <strong>ACL cysts</strong>, along with <a href="/articles/ganglion-cyst">ganglion cysts</a> arising from the alar folds that cover the <a href="/articles/infrapatellar-fat-pad">infrapatellar fat pad</a>, make up the vast majority of intra-articular ganglion cysts of the <a href="/articles/knee">knee</a>.</p><h4>Epidemiology</h4><p>These are uncommon findings, with the prevalence of ACL ganglion cysts has been reported to be between 0.3-1.3% of knee MRIs, and are usually incidental findings.</p><h4>Clinical presentation</h4><p>Knee pain, being the most common presenting complaint, is usually attributable to other pathology.</p><h4>Pathology</h4><p>ACL ganglion cysts are histologically identical to the <a href="/articles/ganglion-cyst">ganglion cysts</a> seen elsewhere, most commonly around the wrist. The pathogenesis remains controversial with two theories being favoured:</p><ul>- +<p><strong>Anterior cruciate ligament (ACL) ganglion cysts</strong>, commonly referred to simply as <strong>ACL cysts</strong>, along with <a href="/articles/ganglion-cyst">ganglion cysts</a> arising from the alar folds that cover the <a href="/articles/infrapatellar-fat-pad">infrapatellar fat pad</a>, make up the vast majority of intra-articular ganglion cysts of the <a href="/articles/knee">knee</a>.</p><h4>Epidemiology</h4><p>ACL ganglion cysts are uncommon, with prevalence reported to be between 0.3-1.3% of knee MRIs, and are usually incidental findings.</p><h4>Clinical presentation</h4><p>Knee pain, being the most common presenting complaint, is usually attributable to other pathology.</p><h4>Pathology</h4><p>ACL ganglion cysts are histologically identical to the <a href="/articles/ganglion-cyst">ganglion cysts</a> seen elsewhere, most commonly around the wrist. The pathogenesis remains controversial, with two theories being favoured:</p><ul>
-</ul><h4>Radiographic features</h4><h5>MRI</h5><p>MRI is better at detecting these lesions than standard anterior portal approach arthroscopy as the surface of the ligament is often intact. In fact the ligament may appear entirely normal. A posterior approach will allow the arthroscopist to detect changes by probing the ligament, and will allow potential aspiration of the cysts. </p><p>Typically the cysts appear as regions of high T2 signal, often multiloculated, centred on the distal ACL. Often there is some irregularity to the bone subjacent to the tibial attachment.</p><h4>Differential diagnosis</h4><p>Differential diagnosis of <a href="/articles/cyst-like-lesions-aroundthe-knee">cysts around the knee joint</a> include:</p><ul>- +</ul><h4>Radiographic features</h4><h5>MRI</h5><p>MRI is better at detecting these lesions than standard anterior portal approach arthroscopy as the surface of the ligament is often intact. In fact, the ligament may appear entirely normal. A posterior approach will allow the arthroscopist to detect changes by probing the ligament and will allow potential aspiration of the cysts.</p><p>Typically the cysts appear as regions of high T2 signal, often multiloculated, centred on the distal ACL. Often there is some irregularity to the bone subjacent to the tibial attachment.</p><h4>Differential diagnosis</h4><p>Differential diagnosis of <a href="/articles/cyst-like-lesions-aroundthe-knee">cysts around the knee joint</a> include:</p><ul>
Sections changed:
Unable to process the form. Check for errors and try again.