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MRI characteristics of cysts and "cyst-like" lesions in and around the knee: what the radiologist needs to know.

Perdikakis E, Skiadas V - Insights Imaging (2013)

Bottom Line: A variety of benign cystic or "cyst-like" lesions may be encountered during a routine magnetic resonance imaging (MRI) of the knee.In addition, normal anatomic bursae and recesses may be misdiagnosed as an intra-articular cystic lesion when they are distended.For accurate assessment of the "cystic structure", a radiologist should be able to identify typical MRI patterns that contribute in establishing the correct diagnosis and thus guiding specific therapy and avoiding unwarranted interventional procedures such as biopsy or arthroscopy. • Cystic lesions are common in knee MRI and the commonest, the Baker's cyst, has an incidence of 38 %. • Synovial cysts, meniscal cysts, normal knee bursae and recesses have characteristic MR appearances. • Miscellaneous "cyst-like" lesions may require a more dedicated MR protocol for a correct diagnosis.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, 412 General Military Hospital-212 Mobile Army Surgical Hospital, Terma Lefkou Pyrgou, Xanthi, 67100, Greece, perdikakis_ev@yahoo.gr.

ABSTRACT

Objectives and methods: A variety of benign cystic or "cyst-like" lesions may be encountered during a routine magnetic resonance imaging (MRI) of the knee. These lesions comprise a diverse group of entities from benign cysts to complications of underlying diseases. In addition, normal anatomic bursae and recesses may be misdiagnosed as an intra-articular cystic lesion when they are distended. However, the majority of the aforementioned lesions have characteristic MR appearances that allow a confident diagnosis, thus obviating the need for additional imaging or interventional procedures.

Results: This article includes a comprehensive pictorial essay of the characteristic MRI features of common and uncommon benign cysts and "cyst-like" lesions in and around the knee joint.

Discussion: For accurate assessment of the "cystic structure", a radiologist should be able to identify typical MRI patterns that contribute in establishing the correct diagnosis and thus guiding specific therapy and avoiding unwarranted interventional procedures such as biopsy or arthroscopy.

Teaching points: • Cystic lesions are common in knee MRI and the commonest, the Baker's cyst, has an incidence of 38 %. • Synovial cysts, meniscal cysts, normal knee bursae and recesses have characteristic MR appearances. • Miscellaneous "cyst-like" lesions may require a more dedicated MR protocol for a correct diagnosis.

No MeSH data available.


Related in: MedlinePlus

Subarticular cyst (geode). The sagittal fat saturated proton density weighted image shows a cystic lesion (asterisk) in the subarticular surface of the lateral tibial condyle at the proximal tibiofibular joint. Note chondral defects of the tibial-femoral articular surfaces (black arrows)
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Fig12: Subarticular cyst (geode). The sagittal fat saturated proton density weighted image shows a cystic lesion (asterisk) in the subarticular surface of the lateral tibial condyle at the proximal tibiofibular joint. Note chondral defects of the tibial-femoral articular surfaces (black arrows)

Mentions: Geodes are not true cysts, since they do not have an epithelial lining [29–34]. They are usually associated with osteoarthritis and most of the times they are multiple, small cystic lesions located in both opposing sides of weight-bearing regions of the knee joint [29–34]. Common osteoarthritic changes such as osteophyte formation, absence of overlying cartilage, joint space narrowing and presence of marked surrounding bone oedema are common accompanying diagnostic clues in MR diagnosis [29–34]. These features are usually adequate to differentiate geodes from other cystic lesions that can be encountered in the same anatomic area of the bone, such as insertional and ganglion cyst, intraosseous abscess, giant cell tumour, chondroblastoma and chondrosarcoma (Fig. 12).Fig. 12


MRI characteristics of cysts and "cyst-like" lesions in and around the knee: what the radiologist needs to know.

Perdikakis E, Skiadas V - Insights Imaging (2013)

Subarticular cyst (geode). The sagittal fat saturated proton density weighted image shows a cystic lesion (asterisk) in the subarticular surface of the lateral tibial condyle at the proximal tibiofibular joint. Note chondral defects of the tibial-femoral articular surfaces (black arrows)
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3675245&req=5

Fig12: Subarticular cyst (geode). The sagittal fat saturated proton density weighted image shows a cystic lesion (asterisk) in the subarticular surface of the lateral tibial condyle at the proximal tibiofibular joint. Note chondral defects of the tibial-femoral articular surfaces (black arrows)
Mentions: Geodes are not true cysts, since they do not have an epithelial lining [29–34]. They are usually associated with osteoarthritis and most of the times they are multiple, small cystic lesions located in both opposing sides of weight-bearing regions of the knee joint [29–34]. Common osteoarthritic changes such as osteophyte formation, absence of overlying cartilage, joint space narrowing and presence of marked surrounding bone oedema are common accompanying diagnostic clues in MR diagnosis [29–34]. These features are usually adequate to differentiate geodes from other cystic lesions that can be encountered in the same anatomic area of the bone, such as insertional and ganglion cyst, intraosseous abscess, giant cell tumour, chondroblastoma and chondrosarcoma (Fig. 12).Fig. 12

Bottom Line: A variety of benign cystic or "cyst-like" lesions may be encountered during a routine magnetic resonance imaging (MRI) of the knee.In addition, normal anatomic bursae and recesses may be misdiagnosed as an intra-articular cystic lesion when they are distended.For accurate assessment of the "cystic structure", a radiologist should be able to identify typical MRI patterns that contribute in establishing the correct diagnosis and thus guiding specific therapy and avoiding unwarranted interventional procedures such as biopsy or arthroscopy. • Cystic lesions are common in knee MRI and the commonest, the Baker's cyst, has an incidence of 38 %. • Synovial cysts, meniscal cysts, normal knee bursae and recesses have characteristic MR appearances. • Miscellaneous "cyst-like" lesions may require a more dedicated MR protocol for a correct diagnosis.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, 412 General Military Hospital-212 Mobile Army Surgical Hospital, Terma Lefkou Pyrgou, Xanthi, 67100, Greece, perdikakis_ev@yahoo.gr.

ABSTRACT

Objectives and methods: A variety of benign cystic or "cyst-like" lesions may be encountered during a routine magnetic resonance imaging (MRI) of the knee. These lesions comprise a diverse group of entities from benign cysts to complications of underlying diseases. In addition, normal anatomic bursae and recesses may be misdiagnosed as an intra-articular cystic lesion when they are distended. However, the majority of the aforementioned lesions have characteristic MR appearances that allow a confident diagnosis, thus obviating the need for additional imaging or interventional procedures.

Results: This article includes a comprehensive pictorial essay of the characteristic MRI features of common and uncommon benign cysts and "cyst-like" lesions in and around the knee joint.

Discussion: For accurate assessment of the "cystic structure", a radiologist should be able to identify typical MRI patterns that contribute in establishing the correct diagnosis and thus guiding specific therapy and avoiding unwarranted interventional procedures such as biopsy or arthroscopy.

Teaching points: • Cystic lesions are common in knee MRI and the commonest, the Baker's cyst, has an incidence of 38 %. • Synovial cysts, meniscal cysts, normal knee bursae and recesses have characteristic MR appearances. • Miscellaneous "cyst-like" lesions may require a more dedicated MR protocol for a correct diagnosis.

No MeSH data available.


Related in: MedlinePlus