ACL mucoid degeneration with Celery stalk sign - paediatric

Background: Mucoid degeneration of the anterior cruciate ligament (MD-ACL) is a chronic degenerative process involving a hypertrophied ACL, which may lead to notch impingement syndrome. As a treatment method, there is consensus regarding arthroscopic resection for MD-ACL resulting in good clinical outcomes; however, additional notchplasty remains controversial. The purpose of this study was to investigate clinical outcomes after arthroscopic partial resection of the ACL and additional notchplasty performed to minimize volume reduction of the ACL. Study Design: Level IIIb retrospective cohort study. Methods: Of 1810 individuals who underwent knee arthroscopic surgery performed by the same surgeon between July 2011 and October 2020, 52 were included, while 10 were excluded due to a follow-up period of <1 year. Clinical data including pain location, terminal flexion or extension pain, range of motion (ROM), Lysholm knee score, and Hospital for Special Surgery (HSS) knee score were assessed pre- and postoperatively. Additionally, according to the resected volume of the ACL, patients were classified into two groups: <25% (Group 1), and 25–50% (Group 2). Clinical outcomes were compared between the two groups. Results: There were 17 (40.5%) men and 25 (59.5%) women with a mean age of 53.9 years (range, 16–81 years) at the time of surgery. The mean duration of symptoms before surgery was 14.4 months (range, 3–66 months). Arthroscopic partial resection of the MD-ACL was performed in all patients, and concomitant notchplasty was performed in 36 (81.8%). All clinical scores improved postoperatively, and were statistically significant (p < 0.01). However, there was no significant difference in clinical outcomes between groups 1 and 2 classified according to the resected ACL volume. Recurrence of MD-ACL was recorded in only one patient, 11 months after arthroscopic treatment. No patients underwent ACL reconstruction because of symptoms of anterior instability. Conclusion: Arthroscopic partial resection of the ACL and concomitant notchplasty yielded satisfactory outcomes for the treatment of MD-ACL. Notchplasty may be an alternative procedure to avoid total ACL resection and postoperative instability.

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Association of Mucoid Degeneration of the ACL with Medial Tibiofemoral Osteoarthritis Progression at MR Imaging

QJM ◽

10.1093/qjmed/hcab106.066 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Samer Mohamed Moustafa ◽

Amany Moh. Rashad Abdel-Aziz ◽

Mennatallah Hatem Shalaby

Keyword(s):

Cartilage Damage ◽

Strong Association ◽

Pulse Sequences ◽

Joint Damage ◽

Radiology Department ◽

Proton Density ◽

Mucoid Degeneration ◽

University Hospitals ◽

Osteoarthritis Progression ◽

And Cartilage

Abstract Background Using MRI, ACL mucoid degeneration is defined as a thickened ACL with increased signal intensity on all MR pulse sequences, with discrete fibers easily distinguished on fatsaturated T2-weighted or fat-saturated proton-density (PD)-weighted images but poorly differentiated on T1-weighted or non-fat-saturated PD-weighted images. Objective To assess the prevalence of ACL mucoid degeneration in a population of patients referred for routine knee MRI, and its association with age and structural joint damage. Patients and Methods Our study is a retrospective study conducted at the radiology department of Ain Shams University hospitals and Ain Shams University Specialized Hospital including 81 cases of knees with ACL mucoid degeneration by MRI and no sex predilection. Cases and controls were scored with respect to independent articular features: cartilage signal and morphology, subarticular bone marrow abnormality, subarticular cysts, subarticular bone attrition, marginal osteophytes and medial meniscal integrity. Results Patients with ACL mucoid degeneration were older than patients with a normal ACL, without statistically significant sex difference. Knees with ACL mucoid degeneration had statistically significant medial meniscal injuries and cartilage damage involving the central and posterior MTFC compared to control knees with a normal ACL frequency matched for age, sex and MR field strength. Conclusion Our study proved that there is a strong association between ACL mucoid degeneration and cartilage damage in MTFC.

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Urinary Retention Due to Severe Pseudocystic Mucoid Degeneration of the Prostatic Matrix: A Rare Urologic Manifestation of Cystic Fibrosis

Urologia Internationalis ◽

10.1159/000368911 ◽

2015 ◽

Vol 95 (4) ◽

pp. 486-488

Author(s):

Gesa Kellermann ◽

Aristotelis G. Anastasiadis ◽

Desirée L. Dräger ◽

Friedrich Prall ◽

Oliver W. Hakenberg

Keyword(s):

Cystic Fibrosis ◽

Urinary Retention ◽

Genetic Disease ◽

Autosomal Recessive ◽

Structural Changes ◽

Histopathological Examination ◽

Underlying Disease ◽

Exocrine Glands ◽

Mucoid Degeneration ◽

Prostatic Enlargement

Cystic fibrosis (CF) is an autosomal recessive genetic disease, which is characterized by the production of thick mucus in exocrine glands. The main cause for morbidity and mortality in CF patients is respiratory failure. The gastrointestinal system is also commonly affected. Urologic manifestations of CF include infertility and azoospermia, nephrolithiasis, and stress urinary incontinence. In this report, we describe a 33-year-old male, who presented with recurrent urinary retention due to prostatic enlargement despite his young age. After transurethral resection, the voiding problems resolved. Histopathological examination, however, revealed a severe pseudocystic mucoid degeneration of the prostatic matrix as a cause of his subvesical obstruction. Although these structural changes are most probably due to his underlying disease, detailed histologic features have not been described in the literature.

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