yogabook / pathology / meniscus ganglion

Definition

The meniscal ganglion is a synovial cyst, usually at the base of the meniscus. As most authors do not differentiate between synovial cysts and ganglionic cysts, the term meniscal ganglion is commonly used. The peak incidence is in men and over the age of 50. The external meniscus is more frequently affected than the internal meniscus. One source claims to have found a meniscal ganglion in 10% of all arthroscopically operated external meniscus lesions, other sources state 3-15%. The former source did not find a single inner meniscus ganglion in 246 inner meniscus arthroscopies. Regardless of the very different incidence, medial meniscus ganglions tend to be caused by trauma, while lateral meniscus ganglions tend to be degenerative.
The lateral meniscus ganglions are often located near the capitulum fibulae. Cysts located in this area often change their size with the flexion of the knee joint: they are they semiflexed or largest in the extended position of the knee joint, quite different from those located on the anterior horn, which are largest when extended.

The meniscus ganglion originates from a lesion of the meniscus, which is usually degenerative in nature and can be up to approx. 1 cm in diameter and extend visibly under the skin. It is located directly at the base of the meniscus or is connected to a style. It causes pain on movement in the joint space similar to that of a meniscus lesion. However, phenomena such as snapping or entrapment are rare. Meniscal ganglions can also occur intrameniscally and become symptomatic even if they are small.

Stenosis valve mechanisms are also described from the bursa m. poplitei (recessus popliteus) for the outer meniscus ganglion and the pedis anserinae. Bursa pedis anserinae for the medial meniscus ganglion.
A local increase in height of the meniscus base appears to precede the ganglion.

Meniscal ganglia do not significantly restrict joint function, but can cause a feeling of stiffness from around 90° flexion.
The cyst can become perceptible at the joint space in the palpation. It appears in the palpation between soft and elastic. Its interior is serous or gel-like. Apart from the localised cyst, there is no swelling in the knee joint due to the cyst itself. The meniscus tests are predominantly positive.

Cause

1. Traumatic or degenerative meniscus lesions
2. traumatic: trauma can disrupt the arterial supply to the meniscus and lead to mucous degeneration that forms cysts
3. arthritis of the knee joint
4. Diseases of the knee joint with overproduction of synovial fluid
5. mesenchymal hyperplasia
6. Overuse

Predisposing

1. Degenerative peniscus damage
2. possibly predisposing alterations of the tibial condyles and femoral condyles

Diagnosis

1. Sonography shows the cyst, MRI shows the underlying peniscus damage
2. Prallelastic swelling at the joint space
3. Sono, MRT

Symptoms

1. pain on movement and pain on weight-bearing at the joint space, similar to those in meniscus damage
2. depending on the degree of flexion of the knee joint, palpable pressure-dolent swelling at the joint space of possibly fluctuating filling level. Larger cysts are also visible.
3. Rarely meniscus entrapment or joint snapping

Complications

Therapy

1. In mild cases, stress reduction, symptomatic therapy, cold, NSAIDs
2. Stretching and strengthening training for the relevant muscles
3. Manual non-invasive squeezing
4. Puncture
5. If necessary: Arthroscopy to remove the ganglion and repair the meniscus

Externe Links

https://www.tandfonline.com/doi/pdf/10.3109/17453673808988908
https://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-2008-1047948