The prevalence and characteristics of osseous erosions associated with parameniscal cysts on knee MRI
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SCIENTIFIC ARTICLE
The prevalence and characteristics of osseous erosions associated with parameniscal cysts on knee MRI Olaitan Ogunkinle 1,2 & Kawan S Rakhra 1,2 & Zaid Jibri 1,2 Received: 6 March 2020 / Revised: 16 April 2020 / Accepted: 26 April 2020 # ISS 2020
Abstract Objectives To determine the prevalence and characteristics of erosions associated with parameniscal cysts (PMCs) and to evaluate the profile of the associated meniscal tears Materials and methods PACS database was reviewed for knee MRI scans performed over a 5-year period identifying those with PMCs in patients aged 18 years and above. The scans with PMCs were evaluated for the presence of associated osseous erosions. These erosions and PMCs were then analyzed. Results The search revealed 6773 knee MRI examinations, of which 555 had confirmed PMCs. There were 7 PMC-associated erosions for a prevalence of 1.3% (95% CI 0.6, 2.6). All erosions involved the proximal tibia. Three of 7 erosions had underlying marrow edema, and 4 out of 7 had an overhanging margin. The mean dimension of all PMCs was 13 mm (SD = 11). The mean dimension of PMCs associated with erosions was 38 mm (SD = 22), while that of PMCs without erosions was 12 mm (SD = 10) (P < 0.001, Wilcoxon rank sum test). Ninety-three percent (95% CI 90.5, 94.8) of PMCs had associated meniscal tears, most commonly of the horizontal type (57%). All PMCs with underlying erosions were associated with meniscal tears, most commonly complex type tears (5/7). Conclusion Erosions can rarely be associated with contiguous parameniscal cysts (PMCs). These cysts are significantly larger compared with those without underlying erosions. Keywords Meniscus . Cyst . Erosion . Bone . Knee joint . Magnetic resonance imaging
Abbreviations PMC Parameniscal cyst PD Proton density SD Standard deviation CI Confidence interval MRI Magnetic resonance imaging
* Zaid Jibri [email protected] Olaitan Ogunkinle [email protected] Kawan S Rakhra [email protected] 1
Department of Radiology, University of Ottawa, Ottawa, Canada
2
Department of Medical Imaging, The Ottawa Hospital, Ottawa, Ontario K1H 8L6, Canada
Introduction Parameniscal cysts (PMCs) are relatively common findings on knee magnetic resonance imaging (MRI) in both symptomatic and asymptomatic subjects. The reported prevalence of meniscal cysts on knee MRI range from 4 to 8%, and they are frequently associated with meniscal tears [1, 2]. Intra-operatively, meniscal cysts have been found in 1–22% of meniscectomy patients [3–5]. PMCs can be associated with underlying osseous erosions, which have been previously described in a few case reports [4, 6–12]. Presumably, PMCs exert pressure effect on the adjacent bone leading to remodeling and erosions [6]. These erosions can mimic those of various conditions such as inflammatory arthropathy, gout, tenosynovial giant cell tumor (pigmented villonodular synovitis), or even neoplastic entities, which can potentially result in misdiagnosis particularly on the radiograph or could lead to unnecessary clinical work up [4, 6–12].
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