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MR Imaging of Cyclops Lesions

David M. Bradley1,2, A. Gabrielle Bergman3 and Michael F. Dillingham1

1 Sports Orthopedics and Rehabilitation, 2884 Sand Hill Rd., Ste. 110, Menlo Park, CA 94025.
2 Present address: Vail Orthopaedics, 181 W. Meadow Dr., Ste. 800, Vail, CO 81657.
3 Department of Radiology, S-062A, Stanford University Medical Center, 300 Pasteur Dr., Stanford, CA 94305.



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  		Fig. 1A. —32-year-old man with extension loss after anterior cruciate ligament (ACL) reconstruction. Arthroscopic image shows cyclops lesion (arrowhead) anterior to and blocking view of ACL graft.

 


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  		Fig. 1B. —32-year-old man with extension loss after anterior cruciate ligament (ACL) reconstruction. Arthroscopic image obtained after surgical resection of cyclops lesion shows ACL graft (arrowhead).

 


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  		Fig. 2. —24-year-old man with cyclops lesion. Axial T2-weighted MR image (TR/TE, 1800/85) shows width (arrows) of cyclops lesion outlined by joint effusion.

 


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  		Fig. 3. —27-year-old woman with cyclops lesion. Sagittal proton density—weighted MR image (TR/TE, 2700/20) shows depth (small arrows) of cyclops lesion. Intermediate signal intensity of cyclops lesion is slightly lower than that of adjacent infrapatellar fat pad. Anterior aspect of tibial tunnel is located posterior to projection (large arrows) of line along slope of intercondylar notch. Cyclops lesion extends anterior to line.

 


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  		Fig. 4. —25-year-old woman with cyclops lesion. Coronal proton density—weighted MR image (TR/TE, 1600/30) shows height (arrows) of cyclops lesion.

 


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  		Fig. 5. —16-year-old girl with loss of extension after anterior cruciate ligament reconstruction. On axial proton density—weighted MR image (TR/TE, 2700/20) at level of tibial plateau we measured distance from center of tibial tunnel (lower arrow) to front of plateau (upper arrow).

 


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  		Fig. 6. —17-year-old girl with loss of extension after anterior cruciate ligament reconstruction. Coronal T1-weighted MR image (TR/TE, 600/16) of left knee shows femoral tunnel located at 1-o'clock position.

 


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  		Fig. 7A. —25-year-old woman with loss of extension. Axial proton density—weighted MR image (TR/TE, 1900/30) reveals intercondylar notch and contents at anterior outlet of right knee after anterior cruciate ligament reconstruction.

 


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  		Fig. 7B. —25-year-old woman with loss of extension. Drawing of axial image at anterior outlet seen in A. Width of intercondylar notch at articular margin (AM), at popliteus recess (PR), and at two-thirds height of notch were measured. Level of popliteus recess was determined from subsequent images. Notch height (H), notch angle (N), and lateral wall angle (L) were also measured.

 


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  		Fig. 8A. —28-year-old man with extension loss after anterior cruciate ligament reconstruction. Coronal proton density—weighted MR image (TR/TE, 1880/25) reveals intercondylar notch and contents at anterior outlet of left knee.

 


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  		Fig. 8B. —28-year-old man with extension loss after anterior cruciate ligament reconstruction. Drawing of coronal image at anterior outlet as seen in A. Width of intercondylar notch at articular margin (AM), at popliteus recess (PR), and at two-thirds height of notch was measured. Level of popliteal recess was determined from subsequent images. Notch height (H), notch angle (N), and lateral wall angle (L) were also measured.

 


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  		Fig. 9A. —38-year-old woman with extension loss after anterior cruciate ligament (ACL) reconstruction. Sagital T2-weighted MR image of cyclops lesion (black arrow) with posterior bowing of ACL graft (white arrow).

 


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  		Fig. 9B. —38-year-old woman with extension loss after anterior cruciate ligament (ACL) reconstruction. Sagittal T2-weighted MR image obtained obtained 3 months after surgical excision of cyclops lesion. ACL grafts shows less posterior bowing than in A.

 

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