Monoarthropathy – Knee | Cases

27 female 10 Year history of Knee pain. Used to do running but now doesn’t due to pain. Previous diagnosis – Bakers Cyst which was drained.

Examination

• No effusion
• Full ROM, no pain with overpressure
• NAD ligaments
• NAD meniscal test (McMurrays)
• Cyst present in Popliteal fossa over gastrocnemius region. Non tender

MRI requested to ascertain cause for Bakers cyst.

Investigations

MRI

Axial

Sagittal

The menisci , cruciates and collateral ligaments are intact.
There is no significant osteochondral lesion.
The extensor mechanism is intact.
There is a moderate effusion and Baker’s cyst.
Hoffa’s fat pad is within normal limits.
Small reactive popliteal fossa lymph nodes
CONCLUSION
An inflammatory arthropathy or PVNS should be considered in the differential diagnosis of the mono arthropathy

Outcome

• Patient was referred to Rheumatology who did not find the problem to be inflammatory in nature.
• The patient was then referred to Orthopaedics who diagnosed it as Patellofemoral maltracking and advised Physiotherapy