8/2/2023 0 Comments Compartments of leg mriA ruptured Baker’s cyst with extension in the posterolateral direction is a benign entity and can ultimately lead to a clinical picture identical to that of a DVT. The presence of a beak-like extension between the medial gastrocnemius head and semimembranosus tendon is a key feature in distinguishing a Baker’s cyst from a DVT. Complicated Baker’s cysts may demonstrate wall thickening, hemorrhage, loose bodies, and intracystic debris which make diagnosis difficult and tend to be misinterpreted for a sinister lesion. T2-W hyperintense fluid within the intermuscular fat planes in addition to a Baker’s cyst indicates rupture with leakage. Features typically demonstrate a high T2-weighted (T2W) signal intensity (SI) mass in the gastrocnemius/semimembranosus bursa. When Doppler flow is present, or there are solid components, further imaging with MRI is usually indicated. There is a lack of Doppler flow unless an infective or inflammatory process has occurred. This has a “talk bubble” configuration in the transverse plane. US can demonstrate a neck arising from the medial head of gastrocnemius-semimembranosus tendon interspace. In some instances, an intrinsic anechoic speckling is demonstrated. US is good at delineating a fluid-filled popliteal mass with posterior acoustic enhancement. Fluid tracking down the intramuscular fat planes indicates recent leakage. Underlying complications or arthropathy in the knee can affect the morphology of the Baker’s cyst and can mimic a more aggressive lesion. They are located posteriorly the knee as a fluid filled sac with a neck arising from the interspace between the medial head of gastrocnemius muscle and the semimembranosus tendon. The cyst contains synovial fluid, which is typically gelatinous in consistency. Classically, Baker’s cysts are described as fluid-filled cystic lesions that do not contain a true synovial lining. Of particular importance is that dual pathology of both a baker’s cyst and DVT has been reported in up to 3% of cases as a result of enlargement and compression. The prevalence rates of these cysts have been reported to range up to 49% on US when performing a DVT scan of the lower extremity. Patients usually present with fullness in the popliteal fossa which can mimic the symptoms of a DVT. In the adult population, they are often associated with knee joint pathology, posterior knee pain, knee stiffness, and popliteal fossa swelling. Synovial cysts and popliteal cysts, also known as Baker’s cysts, are commonly encountered non- vascular popliteal masses identified on the ultrasound (US) and magnetic resonance imaging (MRI). Export to PPT MUSCULOSKELETAL Baker’s cyst
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