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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

Ganglion cyst of the proximal tibiofibular joint. The coronal fat saturated proton density weighted image shows a ganglion cyst (white arrow) emerging with a short neck (black arrow) from the proximal tibiofibular joint (T tibia, F fibula)
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Fig2: Ganglion cyst of the proximal tibiofibular joint. The coronal fat saturated proton density weighted image shows a ganglion cyst (white arrow) emerging with a short neck (black arrow) from the proximal tibiofibular joint (T tibia, F fibula)

Mentions: The proximal tibiofibular joint (PTFJ) synovial cyst is believed to represent a joint capsule herniation, due to increased intra-articular pressure [14–16]. On T1-weighted and T2-weighted MR sequences the lesion appears as a homogeneous often fusiform fluid collection in contact with the proximal tibiofibular joint, while a communicating neck leading from the cyst into the PTFJ is sometimes also illustrated [14–16]. Increased signal intensity on T2-weighted images of the peroneally innervated anterior compartment musculature may be present in cases of common peroneal nerve impingement. Erosion of adjacent bone may also be seen in cases of large cysts. Differential diagnosis from soft tissue and nerve sheath tumours with myxomatous or cystic degeneration may be required (Fig. 2).Fig. 2


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)

Ganglion cyst of the proximal tibiofibular joint. The coronal fat saturated proton density weighted image shows a ganglion cyst (white arrow) emerging with a short neck (black arrow) from the proximal tibiofibular joint (T tibia, F fibula)
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

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

Fig2: Ganglion cyst of the proximal tibiofibular joint. The coronal fat saturated proton density weighted image shows a ganglion cyst (white arrow) emerging with a short neck (black arrow) from the proximal tibiofibular joint (T tibia, F fibula)
Mentions: The proximal tibiofibular joint (PTFJ) synovial cyst is believed to represent a joint capsule herniation, due to increased intra-articular pressure [14–16]. On T1-weighted and T2-weighted MR sequences the lesion appears as a homogeneous often fusiform fluid collection in contact with the proximal tibiofibular joint, while a communicating neck leading from the cyst into the PTFJ is sometimes also illustrated [14–16]. Increased signal intensity on T2-weighted images of the peroneally innervated anterior compartment musculature may be present in cases of common peroneal nerve impingement. Erosion of adjacent bone may also be seen in cases of large cysts. Differential diagnosis from soft tissue and nerve sheath tumours with myxomatous or cystic degeneration may be required (Fig. 2).Fig. 2

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