Abstract
Intratendinous ganglia are rare. We report the case of a sedentary woman with chronic mechanical anterolateral pain of the knee and an extensive ganglion of the patellar tendon as indicated on magnetic resonance (MR) and ultrasound (US) examinations. There was evidence of a high-riding patella, patellar malalignment and patellar tendon-lateral femoral condyle friction syndrome with significantly close contact between the patellar tendon and the lateral facet of the femoral trochlea. The ultrasound-guided aspiration of the ganglion enabled a localized injection of an anti-inflammatory drug (cortivazol) and the cytopathological examination of the fluid, which confirmed the diagnosis. Clinical improvement was maintained with knee rehabilitation and was satisfactory at follow-up after 1 year. To our knowledge, we report the first case of a ganglion of the patellar tendon subsequent to patellar tendon-lateral femoral condyle friction syndrome. We found that this case was illustrative of mucoid degeneration in connective tissue due to chronic repetitive microtraumas. Additionally, this case provided the opportunity to discuss the management of this condition in a sedentary individual with a high-riding patella and patellar malalignment.
References
McCarthy CL, McNally EG. The MRI appearance of cystic lesions around the knee. Skelet Radiol. 2004;33(4):187–209.
King JB, Perry DJ, Mourad K, Kumar SJ. Lesions of the patellar ligament. J Bone Joint Surg Br. 1990;72(1):46–8.
Scranton Jr PE, Farrar EL. Mucoid degeneration of the patellar ligament in athletes. J Bone Joint Surg Am. 1992;74(3):435–7.
Shabshin N, Schweitzer ME, Morrison WB, Parker L. MRI criteria for patella alta and baja. Skeletal Radiol. 2004;33(8):445–50.
Lee PP, Chalian M, Carrino JA, Eng J, Chhabra A. Multimodality correlations of patellar height measurement on X-ray, CT, and MRI. Skeletal Radiol. 2012;41(10):1309–14.
Pandit S, Frampton C, Stoddart J, Lynskey T. Magnetic resonance imaging assessment of tibial tuberosity-trochlear groove distance: normal values for males and females. Int Orthop. 2011;35(12):1799–803.
Schoettle PB, Zanetti M, Seifert B, Pfirrmann CWA, Fucentese SF, Romero J. The tibial tuberosity-trochlear groove distance; a comparative study between CT and MRI scanning. Knee. 2006;13(1):26–31.
Soren A. Pathogenesis, clinic, and treatment of ganglion. Arch Orthop Trauma Surg. 1982;99(4):247–52.
Beaman FD, Peterson JJ. MR imaging of cysts, ganglia, and bursae about the knee. Radiol Clin N Am. 2007;45(6):969–82. vi.
Nikolopoulos I, Krinas G, Kipriadis D, Ilias A, Giannakopoulos A, Kalos S. Large infrapatellar ganglionic cyst of the knee fat pad: a case report and review of the literature. J Med Case Rep. 2011;5:351.
Kannus P, Józsa L. Histopathological changes preceding spontaneous rupture of a tendon. A controlled study of 891 patients. J Bone Joint Surg Am. 1991;73(10):1507–25.
Mao Y, Dong Q, Wang Y. Ganglion cysts of the cruciate ligaments: a series of 31 cases and review of the literature. BMC Musculoskelet Disord. 2012;13:137.
Fayad LM, Fayad L, Hazirolan T, Bluemke D, Mitchell S. Vascular malformations in the extremities: emphasis on MR imaging features that guide treatment options. Skeletal Radiol. 2006;35(3):127–37.
Wittstein JR, Bartlett EC, Easterbrook J, Byrd JC. Magnetic resonance imaging evaluation of patellofemoral malalignment. Arthroscopy. 2006;22(6):643–9.
Chung CB, Skaf A, Roger B, Campos J, Stump X, Resnick D. Patellar tendon-lateral femoral condyle friction syndrome: MR imaging in 42 patients. Skeletal Radiol. 2001;30(12):694–7.
Barbier-Brion B, Lerais J-M, Aubry S, Lepage D, Vidal C, Delabrousse E, et al. Magnetic resonance imaging in patellar lateral femoral friction syndrome (PLFFS): prospective case–control study. Diagn Interv Imaging. 2012;93(3):e171–82.
Campagna R, Pessis E, Biau DJ, Guerini H, Feydy A, Thevenin FS, et al. Is superolateral Hoffa fat pad edema a consequence of impingement between lateral femoral condyle and patellar ligament? Radiology. 2012;263(2):469–74.
Jose J, O’Donnell K, Lesniak B. Symptomatic intratendinous ganglion cyst of the patellar tendon. Orthopedics. 2011;34(2):135.
Conflict of interest statement
The authors declare no funding, grants, or potential sources of conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Touraine, S., Lagadec, M., Petrover, D. et al. A ganglion of the patellar tendon in patellar tendon-lateral femoral condyle friction syndrome. Skeletal Radiol 42, 1323–1327 (2013). https://doi.org/10.1007/s00256-013-1625-4
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00256-013-1625-4