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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

Semimembranosus insertional cyst. The coronal (a), sagittal (b) and axial (c) fat saturated proton density weighted images show an intraosseous cyst (white arrows) located at the semimembranosus insertion. Semimembranosus tendon is shown with a black arrow. Findings of ACL reconstruction are also visible
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Fig13: Semimembranosus insertional cyst. The coronal (a), sagittal (b) and axial (c) fat saturated proton density weighted images show an intraosseous cyst (white arrows) located at the semimembranosus insertion. Semimembranosus tendon is shown with a black arrow. Findings of ACL reconstruction are also visible

Mentions: As their name implies, they most likely originate from focal bone resorption due to chronic avulsive and traction stress at the insertional site of the ligament [1, 2, 6–9]. They are most commonly observed at the cruciate or at the meniscotibial ligamentous attachments. Regarding MRI, they are manifested as small, sharply and well defined, usually homogeneous fluid-filled lesions, surrounded by an outer low-signal margin due to fibrous tissue. Most of the times there is no perilesional bone marrow oedema, although it has been described in large insertional cysts, possibly due to bone weakening and microfractures (Fig. 13).Fig. 13


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)

Semimembranosus insertional cyst. The coronal (a), sagittal (b) and axial (c) fat saturated proton density weighted images show an intraosseous cyst (white arrows) located at the semimembranosus insertion. Semimembranosus tendon is shown with a black arrow. Findings of ACL reconstruction are also visible
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

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

Fig13: Semimembranosus insertional cyst. The coronal (a), sagittal (b) and axial (c) fat saturated proton density weighted images show an intraosseous cyst (white arrows) located at the semimembranosus insertion. Semimembranosus tendon is shown with a black arrow. Findings of ACL reconstruction are also visible
Mentions: As their name implies, they most likely originate from focal bone resorption due to chronic avulsive and traction stress at the insertional site of the ligament [1, 2, 6–9]. They are most commonly observed at the cruciate or at the meniscotibial ligamentous attachments. Regarding MRI, they are manifested as small, sharply and well defined, usually homogeneous fluid-filled lesions, surrounded by an outer low-signal margin due to fibrous tissue. Most of the times there is no perilesional bone marrow oedema, although it has been described in large insertional cysts, possibly due to bone weakening and microfractures (Fig. 13).Fig. 13

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