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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

Suprapatellar bursa. The sagittal (a) and coronal (b) fat saturated proton density weighted images shows the suprapatellar bursa (white arrow) with a partially perforated suprapatellar plica (black arrow)
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Fig14: Suprapatellar bursa. The sagittal (a) and coronal (b) fat saturated proton density weighted images shows the suprapatellar bursa (white arrow) with a partially perforated suprapatellar plica (black arrow)

Mentions: The suprapatellar bursa lies between the quadriceps tendon and the femur. It commonly communicates with the knee joint cavity, unless the suprapatellar plica, a normal embryonic remnant, fails to perforate and involute. In such cases, MRI reveals a focal fluid accumulation anterior to the distal part of femur, separated from the knee joint by a thin intact suprapatellar plica [1, 2, 6–9]. MR signal may be heterogeneous in chronic post-traumatic bursitis and differential diagnosis from pigmented villonodular synovitis (PVNS), haemangioma or synovial sarcoma should be made. Loose bodies and free osteochondral fragments may be present within this bursa, if it communicates with the knee joint (Fig. 14).Fig. 14


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)

Suprapatellar bursa. The sagittal (a) and coronal (b) fat saturated proton density weighted images shows the suprapatellar bursa (white arrow) with a partially perforated suprapatellar plica (black arrow)
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

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

Fig14: Suprapatellar bursa. The sagittal (a) and coronal (b) fat saturated proton density weighted images shows the suprapatellar bursa (white arrow) with a partially perforated suprapatellar plica (black arrow)
Mentions: The suprapatellar bursa lies between the quadriceps tendon and the femur. It commonly communicates with the knee joint cavity, unless the suprapatellar plica, a normal embryonic remnant, fails to perforate and involute. In such cases, MRI reveals a focal fluid accumulation anterior to the distal part of femur, separated from the knee joint by a thin intact suprapatellar plica [1, 2, 6–9]. MR signal may be heterogeneous in chronic post-traumatic bursitis and differential diagnosis from pigmented villonodular synovitis (PVNS), haemangioma or synovial sarcoma should be made. Loose bodies and free osteochondral fragments may be present within this bursa, if it communicates with the knee joint (Fig. 14).Fig. 14

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