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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.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.

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

Hoffa’s fat pad ganglion cysts: the sagittal (a) and axial (b) fat saturated proton density weighted images in two different patients demonstrate a multiloculated septated cystic lesion (asterisks) within the Hoffa’s fat pad. Ganglion cyst of the suprapatellar bursa: the sagittal (a) and axial (b) fat saturated T2-weighted images show a lobulated cystic lesion (arrows) in the suprapatellar bursa
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Fig5: Hoffa’s fat pad ganglion cysts: the sagittal (a) and axial (b) fat saturated proton density weighted images in two different patients demonstrate a multiloculated septated cystic lesion (asterisks) within the Hoffa’s fat pad. Ganglion cyst of the suprapatellar bursa: the sagittal (a) and axial (b) fat saturated T2-weighted images show a lobulated cystic lesion (arrows) in the suprapatellar bursa

Mentions: They are quite uncommon cystic lesions and typically arise from the cruciate ligaments, most commonly from the anterior cruciate ligament (ACL) [9, 11, 17, 18] In MRI part of the lesion is interspersed within the ACL fibres and it may extend anteriorly towards the Hoffa’s fat pad or posteriorly towards the femoral intercondylar fossa [1, 2, 19]. Rarely it may be demonstrated between the ACL and posterior cruciate ligament (PCL). PCL ganglia have a more typical appearance and present as well-defined multilocular cysts adjacent to and along the dorsal PCL surface [1, 2, 8, 9]. Differential diagnosis should be made from a posteromedial meniscal cyst extending centrally within the joint predominantly posterior to the PCL. Ganglia within Hoffa’s fat pad or in the suprapatellar recess-bursa usually appear as well-defined multilocular cysts and are most commonly encountered anterior to the anterior horn of the lateral meniscus [6, 8, 19]. An intrahoffatic lesion or a synovial lesion such as haemangioma or synovial sarcoma may be misinterpreted as a ganglion cyst within the fat pad and contrast-enhanced MRI is warranted in such cases for differential diagnosis (Figs. 3, 4 and 5).Fig. 3


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)

Hoffa’s fat pad ganglion cysts: the sagittal (a) and axial (b) fat saturated proton density weighted images in two different patients demonstrate a multiloculated septated cystic lesion (asterisks) within the Hoffa’s fat pad. Ganglion cyst of the suprapatellar bursa: the sagittal (a) and axial (b) fat saturated T2-weighted images show a lobulated cystic lesion (arrows) in the suprapatellar bursa
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

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

Fig5: Hoffa’s fat pad ganglion cysts: the sagittal (a) and axial (b) fat saturated proton density weighted images in two different patients demonstrate a multiloculated septated cystic lesion (asterisks) within the Hoffa’s fat pad. Ganglion cyst of the suprapatellar bursa: the sagittal (a) and axial (b) fat saturated T2-weighted images show a lobulated cystic lesion (arrows) in the suprapatellar bursa
Mentions: They are quite uncommon cystic lesions and typically arise from the cruciate ligaments, most commonly from the anterior cruciate ligament (ACL) [9, 11, 17, 18] In MRI part of the lesion is interspersed within the ACL fibres and it may extend anteriorly towards the Hoffa’s fat pad or posteriorly towards the femoral intercondylar fossa [1, 2, 19]. Rarely it may be demonstrated between the ACL and posterior cruciate ligament (PCL). PCL ganglia have a more typical appearance and present as well-defined multilocular cysts adjacent to and along the dorsal PCL surface [1, 2, 8, 9]. Differential diagnosis should be made from a posteromedial meniscal cyst extending centrally within the joint predominantly posterior to the PCL. Ganglia within Hoffa’s fat pad or in the suprapatellar recess-bursa usually appear as well-defined multilocular cysts and are most commonly encountered anterior to the anterior horn of the lateral meniscus [6, 8, 19]. An intrahoffatic lesion or a synovial lesion such as haemangioma or synovial sarcoma may be misinterpreted as a ganglion cyst within the fat pad and contrast-enhanced MRI is warranted in such cases for differential diagnosis (Figs. 3, 4 and 5).Fig. 3

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.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.

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