MENISCAL DISORDERS

Meniscal cysts
Meniscal cysts are uncommon and occasional arthroscopy findings. These usually occur in lateral meniscus. However these can be symptomatic. The patient can present with pain accentuated by activity. There may be episodes of snapping.
A firm mass is felt, proximal to fibular head. The mass is prominent on knee extension and disappears on knee flexion (Pisani’s sign).
Treatment for symptomatic cysts is surgical. Decompression is done with partial meniscectomy.

Congenital Discoid menisci
Congenital Discoid menisci is persistence of thick and oval menisci in adult life. It occurs as failure of resorption. Discoid meniscus is more common on lateral side. The discoid meniscus may be asymptomatic. Occasionally , it causes locking episodes. It produces a characteristic finding of causing audible pop on knee flexion. The discoid menisci are classified by Wantanabe.
Wantanabe’s types
1.Complete
2.Incomplete
3.Wrisberg’s type.
Management:
Asymptomatic discoid meniscus is left alone. Symptomatic discoid associated with tears can be treated by partial meniscectomy.

Calcification in menisci
The menisci like any other part of body can get calcified. The calcification can be metastatic or dystrophic.
Causes
1.Primary : Degenerative
2.Secondary
a. Torn meniscus
b. Gout
c. Pseudo Gout
d. Haemochromatosis
e. Hyperparathyroidism
f. Onchronosis

Chondrocalcinosis articularis
Calcium Pyrophosphate crystals are laid in cartilage commonly in knee and Pubis symphysis. Patient gets recurrent attacks of joint pains and swelling. The condition is associated with pseudo gout. Radiograph shows thin bands of calcification or thin line parallel to subchondral bone. Colchicine can give relief in acute pain.