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IMAGING FOR RESIDENTS QUIZ Table of Contents  
Ahead of print publication
A female patient with posterior lateral right knee pain and a palpable mass


 Division of Musculoskeletal Radiology, Department of Radiology, Henry Ford Hospital, Detroit, MI, USA

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Date of Submission03-Dec-2020
Date of Decision16-Dec-2020
Date of Acceptance11-Mar-2021
Date of Web Publication02-Jul-2021
 


How to cite this URL:
Soliman SB. A female patient with posterior lateral right knee pain and a palpable mass. J Med Ultrasound [Epub ahead of print] [cited 2021 Oct 26]. Available from: http://www.jmuonline.org/preprintarticle.asp?id=320550





  Section 1 – Quiz Top


Case description

A 65-year-old woman presented to her primary care physician complaining of 2–3 weeks of pain at the back outer aspect of the right knee with an associated slightly mobile and tender mass. The patient denied any history of trauma and stated that the pain worsened during knee flexion. She is retired but remains active with daily short walks and has not engaged in any recent new activities. She also mentioned that the pain was initially a dull achy pain but had now become severe. She had been trying to self-treat with alternating ice and heat with no significant improvement. She had no pertinent medical or surgical history.

On physical examination, there was localized tenderness and swelling at the posterior lateral aspect of the right knee. There was no discoloration of the overly skin. In addition, an approximately 1–2 cm slightly mobile firm mass was felt near the area of the fibular head. Pain was elicited during passive and active knee flexion. The primary care physician suspected bursitis or a ganglion.

The patient was then referred to radiology for a musculoskeletal ultrasound to further evaluate. Radiographs were also obtained.

Sonographic imaging demonstrated a grouping of multiple echogenic foci, at the posterior lateral aspect of the right knee, adjacent to the fibular head [Figure 1]. The radiographs confirmed multiple ill-defined densities adjacent to the fibular head [Figure 2].
Figure 1: Sonographic images of the posterior lateral right knee. (a) Short-axis image and (b), (c and d) long-axis images demonstrate a grouping of multiple echogenic foci (open arrows) along a tendon (T), adjacent to the fibular head (F)

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Figure 2: Anteroposterior (a) and lateral (b) radiographs of the right knee show multiple ill-defined densities (open arrows) adjacent to the fibular head

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  What Is the Diagnosis? Top


Declaration of patient consent

The author certifies that they have obtained all appropriate patient consent forms. In the form, the patient has given her consent for her figures and other clinical information to be reported in the journal. The patient understands that her name and initials will not be published, and due efforts will be made to conceal her identity, but anonymity cannot be guaranteed.

Acknowledgment

All persons who have made substantial contributions to the work reported in the manuscript (e.g., technical help, writing, editing assistance, and general support), but who do not meet the criteria for authorship, are named in the acknowledgments and have given us their written permission to be named. If we have not included an acknowledgment in our manuscript, then that indicates that we have not received substantial contributions from nonauthors.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



Top
Correspondence Address:
Steven B Soliman,
Department of Radiology, Henry Ford Hospital, 2799 West Grand Blvd., Detroit, MI
USA
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Source of Support: None, Conflict of Interest: None



    Figures

  [Figure 1], [Figure 2]



 

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