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Review Question - QID 80

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QID 80 (Type "80" in App Search)
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?

CT with intravenous contrast

1%

15/2352

Bone scan

0%

6/2352

Radical excision

1%

12/2352

Arthroscopic resection

1%

15/2352

Observation

97%

2292/2352

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The description of the mass (soft and non-tender, in the posterior knee) in a young patient suggests that this is a popliteal, or Baker’s, cyst. The article by Dinham reviewed the natural history of 120 cases of popliteal cysts in children and reported that, of seventy untreated cysts, fifty-one disappeared spontaneously during a mean period of one year and eight months. The article also noted that those cysts which fail to regress spontaneously may respond to aspiration, but have a high recurrence rate. Given the lack of symptoms and the likelihood of resolution, observation is the first-line treatment for most popliteal cysts.

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