Bakers Popliteal Cyst

One of the primary indications for imaging the posterior knee is to confirm the presence of a suspected Baker's cyst (Fig. 12). With sonography, a simple cyst appears anechoic and well-defined, with posterior acoustic enhancement. Complicated cysts may contain internal echoes and septations on ultrasound. Anechoic or hypoechoic fluid beyond the caudal margin of the Baker's cyst on

Baker Cyst
Fig. 10. Patellar tendinopathy. Longitudinal (A) and transverse (B) sonographic images of the patellar tendon show a mildly thickened hypoechoic tendon (large arrows). A small linear in-trasubstance tear was also identified (B, small arrow).

ultrasound indicates leakage of fluid due to cyst rupture [37]. The diagnosis of a Baker's cyst cannot be assured unless a communication is identified with the knee joint between the medial gastrocnemius and semimembranosus tendons. It has been shown that when joint communication is documented by sonogra-phy with a posterior knee cyst, the cyst always represents a Baker's cyst [37].

Baker's cysts have a statistically significant relationship with meniscal tear and degenerative joint disease [38]. Therefore, if a patient has both a suspected Baker's cyst and intra-articular pathology, MRI of the knee should be performed rather than ultrasound. If the clinical question is only whether a cyst is present, however, sonography provides an accurate, cost-effective means for diagnosis.

Patellar Tendinopathy Ultrasound

Fig. 11. Partial tear of the patellar tendon with chronic tendinopathy. Transverse (A) and transverse color Doppler (B) sonographic images of the patellar tendon demonstrate a thickened patellar tendon with diffuse heterogeneity of the tendon (A, large arrows). Small partial thicknesses tear of the distal portion of the patellar tendon 1 cm above its insertion onto the tibial tubercle. This tear is recognized a hypoechoic area extending to the posterior surface of the tendon (A, B, notched arrows).

Fig. 11. Partial tear of the patellar tendon with chronic tendinopathy. Transverse (A) and transverse color Doppler (B) sonographic images of the patellar tendon demonstrate a thickened patellar tendon with diffuse heterogeneity of the tendon (A, large arrows). Small partial thicknesses tear of the distal portion of the patellar tendon 1 cm above its insertion onto the tibial tubercle. This tear is recognized a hypoechoic area extending to the posterior surface of the tendon (A, B, notched arrows).

Baker Cyst

Fig. 12. Popliteal (Baker's) cyst. Transverse (A) and longitudinal (B) sonographic images of the posterior knee demonstrate a small fluid collection (arrows) posterior medial in the location of a baker's cyst. There is no flow within this cyst. (C) Longitudinal image following injection into this cyst show filling of the cyst (arrow). (D) Axial T2-weighted MR image shows the typical location of a Baker's cyst (arrow).

Fig. 12. Popliteal (Baker's) cyst. Transverse (A) and longitudinal (B) sonographic images of the posterior knee demonstrate a small fluid collection (arrows) posterior medial in the location of a baker's cyst. There is no flow within this cyst. (C) Longitudinal image following injection into this cyst show filling of the cyst (arrow). (D) Axial T2-weighted MR image shows the typical location of a Baker's cyst (arrow).

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