整形２４

【臨床症状】60代　膝痛精査

【問題】画像所見と診断名は？

13246_2016_03_14_MR_Image001
13246_2016_03_14_MR_Image002
13246_2016_03_14_MR_Image003
13246_2016_03_14_MR_Image004
13246_2016_03_14_MR_Image005
13246_2016_03_14_MR_Image006
13246_2016_03_14_MR_Image007
13246_2016_03_14_MR_Image008
13246_2016_03_14_MR_Image009
13246_2016_03_14_MR_Image010
13246_2016_03_14_MR_Image011
13246_2016_03_14_MR_Image012
13246_2016_03_14_MR_Image013
13246_2016_03_14_MR_Image014
13246_2016_03_14_MR_Image015
13246_2016_03_14_MR_Image016
13246_2016_03_14_MR_Image017
13246_2016_03_14_MR_Image018
13246_2016_03_14_MR_Image019
13246_2016_03_14_MR_Image020
13246_2016_03_14_MR_Image021
13246_2016_03_14_MR_Image022
13246_2016_03_14_MR_Image023
13246_2016_03_14_MR_Image024
13246_2016_03_14_MR_Image025
13246_2016_03_14_MR_Image026
13246_2016_03_14_MR_Image027
13246_2016_03_14_MR_Image028
13246_2016_03_14_MR_Image029
13246_2016_03_14_MR_Image030
13246_2016_03_14_MR_Image031
13246_2016_03_14_MR_Image032
13246_2016_03_14_MR_Image033
13246_2016_03_14_MR_Image034
13246_2016_03_14_MR_Image035
13246_2016_03_14_MR_Image036
13246_2016_03_14_MR_Image037
13246_2016_03_14_MR_Image038
13246_2016_03_14_MR_Image039
13246_2016_03_14_MR_Image040
13246_2016_03_14_MR_Image041
13246_2016_03_14_MR_Image042
13246_2016_03_14_MR_Image043
13246_2016_03_14_MR_Image044
13246_2016_03_14_MR_Image045
13246_2016_03_14_MR_Image046
13246_2016_03_14_MR_Image047
13246_2016_03_14_MR_Image048
13246_2016_03_14_MR_Image049
13246_2016_03_14_MR_Image050
13246_2016_03_14_MR_Image051
13246_2016_03_14_MR_Image052
13246_2016_03_14_MR_Image053
13246_2016_03_14_MR_Image054
13246_2016_03_14_MR_Image055
13246_2016_03_14_MR_Image056
13246_2016_03_14_MR_Image057
13246_2016_03_14_MR_Image058
13246_2016_03_14_MR_Image059
13246_2016_03_14_MR_Image060
13246_2016_03_14_MR_Image081
13246_2016_03_14_MR_Image082
13246_2016_03_14_MR_Image083
13246_2016_03_14_MR_Image084
13246_2016_03_14_MR_Image085
13246_2016_03_14_MR_Image086
13246_2016_03_14_MR_Image087
13246_2016_03_14_MR_Image088
13246_2016_03_14_MR_Image089
13246_2016_03_14_MR_Image090
13246_2016_03_14_MR_Image091
13246_2016_03_14_MR_Image092
13246_2016_03_14_MR_Image093
13246_2016_03_14_MR_Image094
13246_2016_03_14_MR_Image095
13246_2016_03_14_MR_Image096
13246_2016_03_14_MR_Image097
13246_2016_03_14_MR_Image098
13246_2016_03_14_MR_Image099
13246_2016_03_14_MR_Image100
13246_2016_03_14_MR_Image101
13246_2016_03_14_MR_Image102
13246_2016_03_14_MR_Image103
13246_2016_03_14_MR_Image104
13246_2016_03_14_MR_Image080
13246_2016_03_14_MR_Image079
13246_2016_03_14_MR_Image078
13246_2016_03_14_MR_Image077
13246_2016_03_14_MR_Image076
13246_2016_03_14_MR_Image075
13246_2016_03_14_MR_Image074
13246_2016_03_14_MR_Image073
13246_2016_03_14_MR_Image072
13246_2016_03_14_MR_Image071
13246_2016_03_14_MR_Image070
13246_2016_03_14_MR_Image069
13246_2016_03_14_MR_Image068
13246_2016_03_14_MR_Image067
13246_2016_03_14_MR_Image066
13246_2016_03_14_MR_Image065
13246_2016_03_14_MR_Image064
13246_2016_03_14_MR_Image063
13246_2016_03_14_MR_Image062
13246_2016_03_14_MR_Image061
 

※ T2*、プロトン強調、脂肪抑制の矢状断、T2*の冠状断、脂肪抑制の横断像の順に表示

    ▶答えはこちら
    • 膝窩部に境界明瞭な嚢胞性病変を認める
    • 発生部位からBaker嚢胞（膝窩嚢胞）が最も考えられる
    • 他、大腿骨内顆寄りに小さな骨挫傷あり
    上段左からT2スター、プロトン強調、下段左から脂肪抑制の矢状断、脂肪抑制の横断像

    【Baker嚢胞】

    ・Baker嚢胞は腓腹筋内側頭と半膜様筋腱の間にある滑液包に液体貯留を来した状態

    ・中年以降に好発するが、若年者でも見られる

    ・基本的に無症状だが、何らかの原因で下腿へ破裂をする事があり、その場合は腫脹と痛みが出る事もある

    ・MRIでは横断像にて、膝窩部の内側で腓腹筋内側頭と半膜様筋腱の間にコンマ状に嚢胞病変が入り込んでいるのが特徴的とされている

    骨軟部疾患の画像診断 第2版 を引用改変