Semin Musculoskelet Radiol 2024; 28(03): 248-256
DOI: 10.1055/s-0044-1779652
Review Article

Neoplastic and Non-neoplastic Soft Tissue Lesions Around the Knee

1   Clinica di Radiologia EOC IIMSI, Lugano, Switzerland
2   Ospedale Evangelico Betania, Napoli, Italy
,
Marco Curti
1   Clinica di Radiologia EOC IIMSI, Lugano, Switzerland
,
Tiziana Robba
3   Dipartimento di Radiologia, Azienda Ospedaliera Città della Salute e della Scienza, Centro Traumatologico Ortopedico, Torino, Italy
,
Filippo Del Grande
1   Clinica di Radiologia EOC IIMSI, Lugano, Switzerland
› Author Affiliations

Abstract

Neoplastic and non-neoplastic soft tissue masses around the knee are often incidental findings. Most of these lesions are benign with typical imaging characteristics that allow a confident diagnosis. However, some of these incidental neoplastic masses are characterized by morbidity and potential mortality. This review highlights the typical aspects of these lesions, facilitating a correct diagnosis.



Publication History

Article published online:
20 May 2024

© 2024. Thieme. All rights reserved.

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  • References

  • 1 Perdikakis E, Skiadas V. MRI characteristics of cysts and “cyst-like” lesions in and around the knee: what the radiologist needs to know. Insights Imaging 2013; 4 (03) 257-272
  • 2 Beaman FD, Peterson JJ. MR imaging of cysts, ganglia, and bursae about the knee. Radiol Clin North Am 2007; 45 (06) 969-982 , vi
  • 3 Papaioannou I, Pantazidou G, Mousafeiris VK, Ntourantonis D, Repantis T. Proximal tibiofibular joint ganglion cyst: a rare cause of calf pain. Cureus 2023; 15 (04) e37810
  • 4 Telischak NA, Wu JS, Eisenberg RL. Cysts and cystic-appearing lesions of the knee: a pictorial essay. Indian J Radiol Imaging 2014; 24 (02) 182-191
  • 5 McCarthy CL, McNally EG. The MRI appearance of cystic lesions around the knee. Skeletal Radiol 2004; 33 (04) 187-209
  • 6 Chatra PS. Bursae around the knee joints. Indian J Radiol Imaging 2012; 22 (01) 27-30
  • 7 De Maeseneer M, Shahabpour M, Pouders C. MRI spectrum of medial collateral ligament injuries and pitfalls in diagnosis. JBR-BTR 2010; 93 (02) 97-103
  • 8 Marra MD, Crema MD, Chung M. et al. MRI features of cystic lesions around the knee. Knee 2008; 15 (06) 423-438
  • 9 Kim JY, Jung SA, Sung MS, Park YH, Kang YK. Extra-articular soft tissue ganglion cyst around the knee: focus on the associated findings. Eur Radiol 2004; 14 (01) 106-111
  • 10 Drosos GI, Pozo JL. Large extrasynovial intracapsular ganglia of the knee: a report of 3 cases. Arthroscopy 2005; 21 (11) 1362-1365
  • 11 Krudwig WK, Schulte KK, Heinemann C. Intra-articular ganglion cysts of the knee joint: a report of 85 cases and review of the literature. Knee Surg Sports Traumatol Arthrosc 2004; 12 (02) 123-129
  • 12 Guermazi A, Hayashi D, Roemer FW. et al. Cyst-like lesions of the knee joint and their relation to incident knee pain and development of radiographic osteoarthritis: the MOST study. Osteoarthritis Cartilage 2010; 18 (11) 1386-1392
  • 13 Papp DF, Khanna AJ, McCarthy EF, Carrino JA, Farber AJ, Frassica FJ. Magnetic resonance imaging of soft-tissue tumors: determinate and indeterminate lesions. J Bone Joint Surg Am 2007; 89 (Suppl. 03) 103-115
  • 14 Panwar J, Mathew A, Thomas BP. Cystic lesions of peripheral nerves: are we missing the diagnosis of the intraneural ganglion cyst?. World J Radiol 2017; 9 (05) 230-244
  • 15 Spinner RJ, Carmichael SW, Wang H, Parisi TJ, Skinner JA, Amrami KK. Patterns of intraneural ganglion cyst descent. Clin Anat 2008; 21 (03) 233-245
  • 16 Becton JL, Young HH. Cysts of semilunar cartilage of the knee. Arch Surg 1965; 90 (05) 708-712
  • 17 Barrie HJ. The pathogenesis and significance of menisceal cysts. J Bone Joint Surg Br 1979; 61-B (02) 184-189
  • 18 Campbell SE, Sanders TG, Morrison WB. MR imaging of meniscal cysts: incidence, location, and clinical significance. AJR Am J Roentgenol 2001; 177 (02) 409-413
  • 19 De Smet AA, Graf BK, del Rio AM. Association of parameniscal cysts with underlying meniscal tears as identified on MRI and arthroscopy. AJR Am J Roentgenol 2011; 196 (02) W180–W186
  • 20 Wyss JF, Foye PM, Stitik TP. An infected, extruded lateral meniscal cyst as a cause of knee symptoms. Am J Phys Med Rehabil 2010; 89 (03) 175-176
  • 21 Jackson DW, Schaefer RK. Cyclops syndrome: loss of extension following intra-articular anterior cruciate ligament reconstruction. Arthroscopy 1990; 6 (03) 171-178
  • 22 Recht MP, Piraino DW, Cohen MAH, Parker RD, Bergfeld JA. Localized anterior arthrofibrosis (cyclops lesion) after reconstruction of the anterior cruciate ligament: MR imaging findings. AJR Am J Roentgenol 1995; 165 (02) 383-385
  • 23 Kambhampati SBS, Gollamudi S, Shanmugasundaram S, Josyula VVS. Cyclops lesions of the knee: a narrative review of the literature. Orthop J Sports Med 2020; 8 (08) 2325967120945671
  • 24 Chianca V, Chalian M, Harder D, Del Grande F. Imaging of spine infections. Semin Musculoskelet Radiol 2022; 26 (04) 387-395
  • 25 Dalbeth N, Choi HK, Joosten LAB. et al. Gout. Nat Rev Dis Primers 2019; 5 (01) 69
  • 26 Rodas G, Pedret C, Català J, Soler R, Orozco L, Cusi M. Intratendinous gouty tophus mimics patellar tendonitis in an athlete. J Clin Ultrasound 2013; 41 (03) 178-182
  • 27 Chhana A, Dalbeth N. The gouty tophus: a review. Curr Rheumatol Rep 2015; 17 (03) 19
  • 28 Ko KH, Hsu YC, Lee HS, Lee CH, Huang GS. Tophaceous gout of the knee: revisiting MRI patterns in 30 patients. J Clin Rheumatol 2010; 16 (05) 209-214
  • 29 Evenski AJ, Stensby JD, Rosas S, Emory CL. Diagnostic imaging and management of common intra-articular and peri-articular soft tissue tumors and tumorlike conditions of the knee. J Knee Surg 2019; 32 (04) 322-330
  • 30 Colberg RE, Henderson RG. Diagnosis and treatment of gouty tophi in the patellar tendon using ultrasound-guided needle barbotage: a case presentation. PM R 2017; 9 (09) 938-942
  • 31 Yu JS, Chung C, Recht M, Dailiana T, Jurdi R. MR imaging of tophaceous gout. AJR Am J Roentgenol 1997; 168 (02) 523-527
  • 32 Hsu CY, Shih TTF, Huang KM, Chen PQ, Sheu JJ, Li YW. Tophaceous gout of the spine: MR imaging features. Clin Radiol 2002; 57 (10) 919-925
  • 33 Chou H, Chin TY, Peh WCG. Dual-energy CT in gout—a review of current concepts and applications. J Med Radiat Sci 2017; 64 (01) 41-51
  • 34 Fecek C, Carter KR. Pigmented villonodular synovitis. StatPearls. Available at: https://www.ncbi.nlm.nih.gov/books/NBK549850/ . Accessed November 19, 2023
  • 35 Mollon B, Lee A, Busse JW. et al. The effect of surgical synovectomy and radiotherapy on the rate of recurrence of pigmented villonodular synovitis of the knee: an individual patient meta-analysis. Bone Joint J 2015; 97-B (04) 550-557
  • 36 Fałek A, Niemunis-Sawicka J, Wrona K. et al. Pigmented villonodular synovitis. Folia Med Cracov 2018; 58 (04) 93-104
  • 37 Gu HF, Zhang SJ, Zhao C, Chen Y, Bi Q. A comparison of open and arthroscopic surgery for treatment of diffuse pigmented villonodular synovitis of the knee. Knee Surg Sports Traumatol Arthrosc 2014; 22 (11) 2830-2836
  • 38 Aurégan JC, Klouche S, Bohu Y, Lefèvre N, Herman S, Hardy P. Treatment of pigmented villonodular synovitis of the knee. Arthroscopy 2014; 30 (10) 1327-1341
  • 39 Kamath KR, Suresh PK, Nayak UKR, Kotian P, Singh K. Lipoma arborescens of the knee—a case report. J Orthop Res 2023; 2 (03) 100163
  • 40 Sanamandra SK, Ong KO. Lipoma arborescens. Singapore Med J 2014; 55 (01) 5-10 ; quiz 11
  • 41 Plotkin BE, Varma R. Lipoma arborescens of the knee in a 17-year-old man. Radiol Case Rep 2015; 3 (02) 164
  • 42 Vilanova JC, Barceló J, Villalón M, Aldomà J, Delgado E, Zapater I. MR imaging of lipoma arborescens and the associated lesions. Skeletal Radiol 2003; 32 (09) 504-509
  • 43 Murphey MD, Vidal JA, Fanburg-Smith JC, Gajewski DA. Imaging of synovial chondromatosis with radiologic-pathologic correlation. Radiographics 2007; 27 (05) 1465-1488
  • 44 Singh S, Neelakandan K, Sood C, Krishnan J. Disseminated synovial chondromatosis of the knee treated by open radical synovectomy using combined anterior and posterior approaches. J Clin Orthop Trauma 2014; 5 (03) 157-160
  • 45 Villacin AB, Brigham LN, Bullough PG. Primary and secondary synovial chondrometaplasia: histopathologic and clinicoradiologic differences. Hum Pathol 1979; 10 (04) 439-451
  • 46 Kramer J, Recht M, Deely DM. et al. MR appearance of idiopathic synovial osteochondromatosis. J Comput Assist Tomogr 1993; 17 (05) 772-776
  • 47 Ng VY, Louie P, Punt S, Conrad EU. Malignant transformation of synovial chondromatosis: a systematic review. Open Orthop J 2017; 11 (01) 517-524
  • 48 Gazendam AM, Popovic S, Munir S, Parasu N, Wilson D, Ghert M. Synovial sarcoma: a clinical review. Curr Oncol 2021; 28 (03) 1909-1920
  • 49 Jo VY, Fletcher CDM. WHO classification of soft tissue tumours: an update based on the 2013 (4th) edition. Pathology 2014; 46 (02) 95-104
  • 50 Smolle MA, Parry M, Jeys L, Abudu S, Grimer R. Synovial sarcoma: do children do better?. Eur J Surg Oncol 2019; 45 (02) 254-260
  • 51 Nordemar D, Öberg J, Brosjö O, Skorpil M. Intra-articular synovial sarcomas: incidence and differentiating features from localized pigmented villonodular synovitis. Sarcoma 2015; 2015: 903873
  • 52 Jamshidi K, Yahyazadeh H, Bagherifard A. Unusual presentation of synovial sarcoma as meniscal cyst: a case report. Arch Bone Jt Surg 2015; 3 (04) 296-299
  • 53 Chotel F, Unnithan A, Chandrasekar CR, Parot R, Jeys L, Grimer RJ. Variability in the presentation of synovial sarcoma in children: a plea for greater awareness. J Bone Joint Surg Br 2008; 90 (08) 1090-1096
  • 54 Larbi A, Viala P, Cyteval C. et al. Imaging of tumors and tumor-like lesions of the knee. Diagn Interv Imaging 2016; 97 (7–8): 767-777
  • 55 Blacksin MF, Siegel JR, Benevenia J, Aisner SC. Synovial sarcoma: frequency of nonaggressive MR characteristics. J Comput Assist Tomogr 1997; 21 (05) 785-789
  • 56 Sánchez Reyes JM, Alcaraz Mexia M, Quiñones Tapia D, Aramburu JA. Extensively calcified synovial sarcoma. Skeletal Radiol 1997; 26 (11) 671-673
  • 57 Murphey MD, Gibson MS, Jennings BT, Crespo-Rodríguez AM, Fanburg-Smith J, Gajewski DA. From the archives of the AFIP: Imaging of synovial sarcoma with radiologic-pathologic correlation. Radiographics 2006; 26 (05) 1543-1565
  • 58 Chianca V, Albano D, Messina C. et al. Diffusion tensor imaging in the musculoskeletal and peripheral nerve systems: from experimental to clinical applications. Eur Radiol Exp 2017; 1 (01) 12
  • 59 Kim SM, Seo SW, Lee JY, Sung KS. Surgical outcome of schwannomas arising from major peripheral nerves in the lower limb. Int Orthop 2012; 36 (08) 1721-1725
  • 60 Tagliafico AS, Isaac A, Bignotti B, Rossi F, Zaottini F, Martinoli C. Nerve tumors: what the MSK radiologist should know. Semin Musculoskelet Radiol 2019; 23 (01) 76-84
  • 61 Abreu E, Aubert S, Wavreille G, Gheno R, Canella C, Cotten A. Peripheral tumor and tumor-like neurogenic lesions. Eur J Radiol 2013; 82 (01) 38-50
  • 62 Banks KP. The target sign: extremity. Radiology 2005; 234 (03) 899-900
  • 63 Bhargava R, Parham DM, Lasater OE, Chari RS, Chen G, Fletcher BD. MR imaging differentiation of benign and malignant peripheral nerve sheath tumors: use of the target sign. Pediatr Radiol 1997; 27 (02) 124-129
  • 64 Wasa J, Nishida Y, Tsukushi S. et al. MRI features in the differentiation of malignant peripheral nerve sheath tumors and neurofibromas. AJR Am J Roentgenol 2010; 194 (06) 1568-1574
  • 65 Chianca V, Albano D, Messina C. et al. An update in musculoskeletal tumors: from quantitative imaging to radiomics. Radiol Med (Torino) 2021; 126 (08) 1095-1105
  • 66 Nasir M, Sadiq I, Abdul Fatir C, Mehmood Qadri H. Spontaneous isolated thrombosed true popliteal aneurysm in an eight-year-old child: a rare case report with literature review. Cureus 2022; 14 (08) e28248
  • 67 Verikokos C, Karaolanis G, Doulaptsis M. et al. Giant popliteal artery aneurysm: case report and review of the literature. Case Rep Vasc Med 2014; 2014: 780561
  • 68 Wright LB, Matchett WJ, Cruz CP. et al. Popliteal artery disease: diagnosis and treatment. Radiographics 2004; 24 (02) 467-479