Updated: 6/14/2021

Popliteal Cyst in Children

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  • summary
    • Popliteal Cysts are common soft tissue masses in children that unlike the adult population, are most often not associated with meniscal tears. 
    • Diagnosis is suspected clinically with a palpable mass in the popliteal fossa that transilluminates. MRI can confirm the diagnosis of a cystic lesion. 
    • Treatment is observation as the majority of lesions spontaneously resolve. 
  • Etiology
    • Pathoanatomy
      • popliteal cysts usually are located
        • between muscles of
          • semimembranosus
          • medial head of gastrocnemius
        • from herniated posterior knee joint capsule synovium
  • Anatomy
    • Muscles posterior to medial knee capsule
      • semimembranosus
      • medial head of gastrocnemius
  • Presentation
    • Symptoms
      • usually asymptomatic
    • Physical exam
      • located in popliteal fossa
        • usually located medially and distal to knee crease
          • most pronounced with knee extended
      • mass will transilluminate
  • Imaging
    • Radiographs
      • are normal
    • Ultrasound
      • consistent with cystic lesion
    • MRI
      • show fluid filled cyst
  • Treatment
    • Nonoperative
      • observation
        • indications
          • mainstay of treatment
            • with majority of cases resolving spontaneously
    • Operative
      • excision
        • indications
          • only if cyst causes significant discomfort
          • failure of spontaneous resolution

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Questions (1)

(OBQ05.44) A 10-year-old boy presents with a mobile, soft, and painless mass over the posteromedial aspect of his knee. MRI demonstrates a simple cyst. What is the most appropriate next step in treatment?

QID: 80
1

CT with intravenous contrast

1%

(13/1997)

2

Bone scan

0%

(5/1997)

3

Radical excision

1%

(10/1997)

4

Arthroscopic resection

1%

(11/1997)

5

Observation

98%

(1949/1997)

L 1 D

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Evidence (2)
EXPERT COMMENTS (3)
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