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Cyclops lesion with chronic anterior cruciate ligament tear

Case contributed by Amr Farouk
Diagnosis almost certain

Presentation

History of ACL tear 10 years ago for which he did not have any interventional procedure for. He is presenting with knee pain and difficult knee extension.

Patient Data

Age: 35 years
Gender: Male

Osteoarthritic changes of the left knee joint evidenced by narrowing of joint spaces, marginal osteophytosis of the articular surfaces, denudation of the articular cartilage and sub-chondral degenerative marrow changes of the lateral femoral and to less extent tibial condyles. Grade II degeneration of posterior horn of lateral meniscus and torn posterior horn of medial meniscus.

Chronic complete tear of the anterior cruciate ligament with the anterior inter-condylar notch showing a soft tissue signal eliciting central intermediate to high signal on T2WI and peripheral low T2WI signal. It is seen measuring 2.3 x 2.2 x 1.4 cm along its maximal axial and cranio-caudal dimensions.

Mild left knee joint effusion is noted with a distended gastrocnemius/semimembranosus bursa.

Case Discussion

Arthroscopy confirmed a cyclops lesion in a 35-year-old-man with a 10-year history of chronic ACL tear and loss of extension. There has been no prior ACL reconstruction. 

The original description of cyclops syndrome was in patients who had undergone ACL reconstruction, however, reports about its occurrence after ACL injury in the absence of ACL reconstruction has been documented as illustrated in this case 1.

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