Popliteal artery pseudoaneurysm

Case contributed by Dr Hamdy Mohammed Ibrahim

Presentation

Chronic limping and claudication with difficult control of knee movement. MRI knee was requested.

Patient Data

Age: 60 years
Gender: Male
MRI

Signal void, lobulated cystic lesion in the popliteal fossa connected to the popliteal artery with associated extensive muscular and subcutaneous oedema.  Moderate knee joint effusion.

 

On the MRI a popliteal fossa lesion with signal void alerts us to perform a colour Doppler ultrasound examination.  This revealed a high flow popliteal artery aneurysm. CTA was urgently requested.

Contrast filled aneurysmal sac in the popliteal fossa communicated anteriorly with the popliteal artery via a narrow curved short neck. No leakage of contrast out of the sac.  No thrombosis and or arterial branches originating from it.

Incidentally the liver is cirrhotic.  Splenectomy. Contrast filled oesophageal varices with mesenteric and retroperitoneal edema.

Case Discussion

The usual imaging requested for a patient with knee pain is MRI to examine ligaments and menisci as well as articular cartilage and other extra-articular structure. Popliteal fossa lesions rarely cause alarming knee pain

The most common cystic lesion seen in the popliteal fossa is a Baker's cyst with aneurysms (both true and false) being uncommon. Endovascular coiling is the treatment of choice. 

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Case information

rID: 53518
Case created: 22nd May 2017
Last edited: 30th May 2017
Inclusion in quiz mode: Included

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