Symptomatic Soft-Tissue Mass in the Intercondylar Notch: A Case Report

Case Report

Austin J Orthopade & Rheumatol. 2018; 5(1): 1062.

Symptomatic Soft-Tissue Mass in the Intercondylar Notch: A Case Report

Athar MS¹*, Ashwood N¹, Hayward K¹, Karagkevrekis B¹, Aggouris K² and Fogg Q²

¹Department of Trauma and Orthopaedics, Queens Hospital, Burton-on-Trent, UK

²Laboratory of Human Anatomy, School of Life Sciences, University of Glasgow, UK

*Corresponding author: M Sajjad Athar, Department of Trauma and Orthopaedics, Queen’s Hospital, Burtonon- Trent, UK

Received: November 28, 2017; Accepted: January 31, 2018; Published: February 08, 2018

Abstract

Intra-articular soft tissue masses in the knee joint are quite rare and mostly incidental findings on magnetic resonance imaging and/or arthroscopy. However, when they become enlarged, they can cause mechanical symptoms, limitation in the range of motion and occasional pain. In the current study, we present a middle-aged male patient who developed a mass in the intercondylar notch which caused significant loss of extension.

Keywords: Intercondylar notch; Arthroscopy; MRI

Introduction

A list of neoplastic and reactive processes that form mass lesions in joints includes pigmented villonodular synovitis, synovial hemangioma, synovial chondromatosis, lipoma arbolescens, ganglion cyst, intra-articular nodular fasciitis and others [1]. The authors describe a quite unusual case of symptomatic soft tissue mass in the intercondylar notch which caused painful limitation in the range of motion compromising the patient’s overall function.

Case Presentation

We present a case of a 48-year-old male patient who had been complaining of persistent stiffness with pain in his left knee for about one year. He was working as an electrician spending a lot of time kneeling on his knees and could not recall any previous injury.

On clinical examination the patient was unable to fully extend his knee having about 25 degrees of fixed flexion deformity. He could also only flex his knee to about 90-100 degrees with significant pain which did not allow him further flexion. There was no tenderness at the joint space. McMurray and Apley tests were negative and the knee was stable with Lachman, posterior drawer, and medial and lateral stress tests.

Plain radiographic findings were normal without notch enlargement on the intercondylar notch view and no evidence of any calcified tissue mass (Figure 1). MRI scan findings included a softtissue mass in the intercondylar notch (Figure 2), focal degenerative changes in the medial facet of the patella (Figure 3) with early cartilaginous changes in both medial and lateral compartments.