Andreozzi Valerio, Monaco Edoardo, Conteduca Fabio, Iorio Raffaele, Mazza Daniele, Drogo Piergiorgio, Ferretti Andrea
Department of Orthopaedics, Sapienza University of Rome, Italy.
Case Rep Orthop. 2019 Mar 5;2019:9192347. doi: 10.1155/2019/9192347. eCollection 2019.
Intra-articular ganglion cysts of the knee joint are rare and mostly incidental findings in magnetic resonance imaging (MRI) or arthroscopy. Posterior cruciate ligament (PCL) ganglion cyst in a child is an extremely rare finding, and to the best of our knowledge, only one case has been described in the literature. We report a case of a large intra-articular ganglion cyst of the knee arising from the PCL in an autistic child.
An 8-year-old Caucasian boy affected by autism presented with nontraumatic knee pain. His parents, observing child's gait, reported recurrent limp while walking, sometimes accompanied by knee locking. Clinical examination was hindered by the noncompliance of the patient and revealed painful limitation of terminal flexion and extension. MRI scans showed a large ganglion cyst located in the intercondylar notch. Arthroscopy confirmed an intrasubstance PCL ganglion cyst, extending both anteriorly and posteriorly. Complete excision of the cyst was performed, with full recovery of the child and no recurrence.
In pediatric patients with pain or limited knee range of motion, physicians should consider the possibility of a ganglion cyst arising from the PCL, despite its rarity. Arthroscopic excision is a safe and effective procedure that guarantees a complete recovery of the patient with the lowest rate of recurrence.
膝关节内腱鞘囊肿罕见，多为磁共振成像（MRI）或关节镜检查时的偶然发现。儿童后交叉韧带（PCL）腱鞘囊肿极为罕见，据我们所知，文献中仅描述过1例。我们报告1例自闭症儿童发生的源自PCL的膝关节内大型腱鞘囊肿病例。
一名8岁患自闭症的白人男孩出现非创伤性膝关节疼痛。其父母观察孩子步态后报告，孩子行走时反复跛行，有时伴有膝关节交锁。由于患者不配合，临床检查受到阻碍，结果显示终末屈伸时疼痛受限。MRI扫描显示一个位于髁间切迹的大型腱鞘囊肿。关节镜检查证实为PCL实质内腱鞘囊肿，向前和向后延伸。囊肿被完全切除，患儿完全康复且无复发。
在有膝关节疼痛或活动范围受限的儿科患者中，尽管PCL腱鞘囊肿罕见，医生仍应考虑其可能性。关节镜下切除是一种安全有效的手术，能保证患者完全康复且复发率最低。
