Case 18 - 50 year old female with pain following ACL reconstruction
50 year old female with sudden onset knee pain several months after ACL reconstruction.
- The reconstructed anterior cruciate ligament appears intact. Additionally, the position of the femoral and tibial tunnel's appears appropriate.
- The appearance of the tibial tunnel, however, is abnormal; a large cystic lesion is seen extending from the inferior tibial tunnel into the pretibial soft tissues.
- This is compatible with a tibial tunnel cyst, a less common complication of ACL reconstruction.
- Did you also see this fluid signal posterior to the knee? Let's try to better localize that fluid on axial images. This fluid, which extends through the posteromedial soft tissues looks like it originates between the gastrocnemius and semimebranosus tendons, the characteristic location for a Baker cyst. Instead of being well-encapsulated, however, this fluid is ill-defined, dissecting through the soft tissues. This appearance is compatible with a RUPTURED BAKER CYST, and likely accounts for the patient's acute knee pain.
Accession: CL0061
Study description: MR JOINT LOWER KNEE-LT
Case discussion: