Anterior cruciate ligament mucoid degeneration
Updates to Article Attributes
Anterior cruciate ligament (ACL) mucoid degeneration, along with tears and anterior cruciate ligament ganglion cysts, is a relatively common cause of increased signal within the anterior cruciate ligament (ACL).
The appearance can mimic acute or chronic interstitial partial tears of the ACL. However, in the case of mucoid degeneration secondary signs of ACL injury are usually absent. Secondary signs include bone bruising, meniscal tears, anterior subluxation of the tibia and other ligamentous injuries.
Clinical presentation
Typically patients present with knee pain or restricted movement, although often other potential causes for the patient's symptoms are found.
Pathology
The pathogenesis remains controversial. Possible etiologies include:
- age
related-related (senescent) degeneration - congenital or acquired synovial tissue entrapment between ACL
fibersfibres
It is postulated that mucoid degeneration may be a predisposing factor in the formation of ACL ganglion cysts.
Radiographic features
MRI
On MRI, the ligament is thickened and ill-defined with a "celery stalk" appearance. Its signal is increased on all sequences. Intact fibres are best seen on T2-weighted sequences.
MRI is better at detecting mucoid degeneration than arthroscopy, as the surface of the ligament is often intact.
Treatment and prognosis
No treatment is usually required. If arthroscopy is performed the, the ligament may may appear entirely normal, especially using the standard anterior portal approach. A posterior approach will allow for the detection of changes by probing the ligament and mucoid material can be expressed.
-<li>age related (senescent) degeneration</li>-<li>congenital or acquired synovial tissue entrapment between ACL fibers</li>-</ul><p>It is postulated that mucoid degeneration may be a predisposing factor in the formation of ACL ganglion cysts.</p><h4>Radiographic features</h4><h5>MRI</h5><p>On MRI, the ligament is thickened and ill-defined with a "<a href="/articles/celery-stalk-sign-acl">celery stalk</a>" appearance. Its signal is increased on all sequences. Intact fibres are best seen on T2-weighted sequences.</p><p>MRI is better at detecting mucoid degeneration than arthroscopy as the surface of the ligament is often intact.</p><h4>Treatment and prognosis</h4><p>No treatment is usually required. If arthroscopy is performed the ligament may appear entirely normal, especially using the standard anterior portal approach. A posterior approach will allow for the detection of changes by probing the ligament and mucoid material can be expressed. </p>- +<li>age-related (senescent) degeneration</li>
- +<li>congenital or acquired synovial tissue entrapment between ACL fibres</li>
- +</ul><p>It is postulated that mucoid degeneration may be a predisposing factor in the formation of <a title="ACL ganglion cysts" href="/articles/anterior-cruciate-ligament-ganglion-cyst">ACL ganglion cysts</a>.</p><h4>Radiographic features</h4><h5>MRI</h5><p>On MRI, the ligament is thickened and ill-defined with a "<a href="/articles/celery-stalk-sign-anterior-cruciate-ligament">celery stalk</a>" appearance. Its signal is increased on all sequences. Intact fibres are best seen on T2-weighted sequences.</p><p>MRI is better at detecting mucoid degeneration than arthroscopy, as the surface of the ligament is often intact.</p><h4>Treatment and prognosis</h4><p>No treatment is usually required. If arthroscopy is performed, the ligament may appear entirely normal, especially using the standard anterior portal approach. A posterior approach will allow for the detection of changes by probing the ligament and mucoid material can be expressed.</p>
Sections changed:
Unable to process the form. Check for errors and try again.