The MRI appearance of cystic lesions around the knee

Abstract

This review presents a comprehensive illustrated overview of the wide variety of cystic lesions around the knee. The aetiology, clinical presentation, MRI appearances and differential diagnosis are discussed. Bursae include those related to the patella as well as pes anserine, tibial collateral ligament, semimembranosus-tibial collateral ligament, iliotibial and fibular collateral ligament-biceps femoris. The anatomical extension, imaging features and clinical significance of meniscal cysts are illustrated. Review of ganglia includes intra-articular, extra-articular, intraosseous and periosteal ganglia, highlighting imaging findings and differential diagnoses. The relationship between proximal tibiofibular joint cysts and intraneural peroneal nerve ganglia is discussed. Intraosseous cystic lesions, including insertional and degenerative cysts, as well as lesions mimicking cysts of the knee are described and illustrated. Knowledge of the location, characteristic appearance and distinguishing features of cystic masses around the knee as well as potential imaging pitfalls such as normal anatomical recesses and atypical cyst contents on MR imaging aids in allowing a specific diagnosis to be made. This will prevent unnecessary additional investigations and determine whether intra-articular surgery or conservative management is appropriate.

Radiological Mimics of Popliteal Cysts: An Algorithmic Approach Using US and MRI to Identify the Potentially Malignant Lesions: Case Series

“…On MRI, the classic feature is a lamellated appearance consisting of high and low signal intensity due to multilayered mural thrombus. The presence of pulsation artifact can also be useful [5] [14]. Figure 5 and Figure 6 show axial T2 and T2 fat saturated axial images demonstrate the lack of communicating neck with the joint as seen with a Baker's cyst.…”

“…Unlike other cysts, the popliteal cysts have a communicating neck with the joint, which is a chief differentiating feature (on ultrasound and MRI) not seen with other lesions mimicking popliteal cysts, including: solid tumors (liposarcoma, synovial sarcoma, synovial osteochondromatosis), or vascular abnormalities (popliteal artery and vein thrombosis) [4] [5].…”

Quistes intraneurales del nervio ciático poplíteo externo en edad pediátrica: presentación de 2 casos y revisión de la literatura

“…Las tasas de recurrencia publicadas han sido hasta del 30% 1,3,4,12,14,16 , e inclusive podrían ser aún mayores ya que, en muchos casos publicados, no se realizaron estudios de imágenes postoperatorios con RM. Actualmente, el reconocimiento de la teoría articular formulada por Spinner et al en el año 2003 12 , ha demostrado ser importante en la reducción de las recidivas y la mejora de los resultados del tratamiento de los quistes intraneurales 3,5,6,12,13,14 . Esta teoría, fundamentada sobre datos clínicos, radiológicos, anatómicos y exámenes histológicos, explica la patogénesis y el patrón de propagación de los quistes intraneurales del nervio CPE.…”

Endoscopic Resection of Lateral Synovial Cyst of the Knee

“…14 Preoperative magnetic resonance imaging is an important investigation for preoperative planning because it provides information about the nature, dimension, and location of the cystic lesion and its relation with adjacent neurovascular structures (Fig 1). 1,3,5,10,15 …”