What's the Diagnosis - Case 22

History 43 year old man with 1 year of knee pain.

What’s the Diagnosis - Case 22

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What’s the Diagnosis - Case 22

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What’s the Diagnosis - Case 22

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What’s the Diagnosis - Case 22

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Findings/Diagnosis: Meniscal Tear Multiple planes of imaging demonstrate a displaced lateral meniscal tear with the posterior horn and body displaced into the intercondylar notch. This is in the setting of a long standing ACL disruption with anterior translation of the tibia and focal scarring at the synovial reflection of the ACL or a so called cyclops lesion.

What’s the Diagnosis - Case 22

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What’s the Diagnosis - Case 22

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What’s the Diagnosis - Case 22

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What’s the Diagnosis - Case 22

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What’s the Diagnosis - Case 22

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Discussion Tears oriented along the longitudingal axis of the meniscus may displace either into the intercondylar notch, anteriorly, or both. Meniscal fragments displaced into the intercondylar notch are rare on the lateral side because of the ACL. In the setting of a disrupted ACL, the meniscal tissue may displace into the intercondylar notch as in this case. About the ACL is a synovial reflection accounting for its intracapsular, extrasynovial position. In the setting typically of ACL reconstruction, there may be prominent focal scar tissue at the reflection yielding a block to extension. The arthroscopist sees this as a focal nodular density similar to the one eyed cyclops; hence the term cyclops lesion. Although not as common, a similar focal fibroproliferative process can occur in the setting of a long standing ACL tear without previous reconstruction as in this case.

What’s the Diagnosis - Case 22

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What’s the Diagnosis - Case 22

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