Speech bubble sign

Case contributed by Ian Bickle
Diagnosis almost certain

Presentation

Long standing lump behind the back of the knee. Baker's cyst?

Patient Data

Age: 45 years
Gender: Female
ultrasound

4.3cm well defined hypoechoic cystic 'bubble shaped' lesion with a tight narrow neck arising from the synovial space of the posterior aspect of the knee joint.

No internal Doppler flow.

Case Discussion

This is the classical appearance of a Baker's cyst with the shape that of a speech bubble. 

The neck is at the deepest part of the cyst.   The content may contain internal echoes.

 

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