Updated: 10/10/2016

Popliteal Cyst in Children

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Introduction
  • Common soft tissue mass in children
    • most often not associated with meniscal tears 
      • unlike in the adult population
  • 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 q
  • Operative 
    • excision
      • indications
        • only if cyst causes significant discomfort 
        • failure of spontaneous resolution 
 

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(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? Review Topic | Tested Concept

QID: 80
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CT with intravenous contrast

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(13/1860)

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Bone scan

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Radical excision

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(10/1860)

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Arthroscopic resection

1%

(11/1860)

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Observation

97%

(1813/1860)

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