MRI characteristics of cysts and “cyst-like” lesions in and around the knee: what the radiologist needs to know

Evangelos Perdikakis & Vasilios Skiadas


Given the fact that magnetic resonance imaging (MRI) is being performed more frequently for assessment of the knee joint (e.g. post-traumatic, in sport injuries, in rheumatological disorders, in oncological imaging), the number of incidental cystic and “cyst-like” lesions in and around the knee joint found on routine knee MRI scans has also increased [1–4]. The vast majority of these lesions are benign, ranging from benign cysts to complications of underlying diseases and many of them demonstrate characteristic features on MRI, thus allowing a confident diagnosis to be made [1–6]. Knowledge of the common anatomical locations and appearances of bursae, recesses, cysts and ganglia is necessary so that radiologists do not misinterpret these benign entities as soft-tissue tumours [1–8]. It is of paramount importance for the radiologist to be aware of the MRI features because understanding the spectrum of appearances of the various benign cystic lesions is vital for optimal patient management. This article is intended to be a comprehensive pictorial review of the most common and uncommon benign cystic and “cyst-like” lesions in and around the knee joint. For easier classification purposes, benign cysts were subdivided into categories as following: (1) synovial cysts,  (2) ganglion cysts, (3) meniscal cysts and (4) intraosseous cysts. Similarly, “cyst-like” lesions were subclassified into the following: (1) normal knee bursae, (2) normal knee recesses and (3) miscellaneous cyst-like lesions.


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