ARRS 2022 Abstracts

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E1160. Differential Diagnosis of Posterior Knee Pain
Authors
  1. Dyan Flores; The Ottawa Hospital
  2. Timothy Murray; St. Paul's Hospital, University of British Columbia
  3. Darra Murphy; St. Paul's Hospital, University of British Columbia
  4. Mark Cresswell; St. Paul's Hospital, University of British Columbia
Background
Posterior knee pain is a relatively less common patient complaint compared to other forms of knee pain, making accurate diagnosis fraught with difficulty. The differential diagnosis can be broad, ranging from common causes, such as ligament and meniscal tears, to less common etiologies such as benign tumors (i.e., schwannoma). A precise understanding of posterior knee anatomy, physical examination, and differential diagnosis is needed to accurately evaluate posterior knee pain. This education exhibit provides an overview of anatomy, pertinent history and physical examination, and imaging features when evaluating posterior knee pain.

Educational Goals / Teaching Points
The objectives of this educational exhibit are to review osseous and soft tissue anatomy of the posterior knee and popliteal fossa; briefly discuss distinguishing clinical and physical findings in various disorders presenting with posterior knee pain; and discuss the differential diagnosis and corresponding imaging findings of posterior knee pain.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
The key anatomic issues in this exhibit include: Anatomy (bones and articular surfaces [including posterior capsular area] and soft tissues [ligaments, tendons, muscles, and nerves]); clinical examination (distinguishing symptoms and physical findings); and differential diagnosis and imaging of soft tissues (posterior cruciate ligament), posterolateral corner (fibular collateral ligament, popliteus tendon, popliteofibular ligament), menisci muscles (gastrocnemius, popliteus, hamstrings), vasculature (popliteal artery entrapment, cystic adventitial disease, deep venous thrombosis), nerves (sciatic nerve, common peroneal, tibial nerve), and bursae and synovial recesses (Baker’s cyst, subgastrocnemius bursa).

Conclusion
There are broad differential diagnoses for causes of posterior knee pain. The radiologist needs a precise understanding of anatomy, clinical findings and physical examination, and the differential diagnosis for accurate image interpretation and reporting of patients with posterior knee pain.