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E1165. Ominous Musculoskeletal Cysts
Authors
  1. Lawrence Wang; Atlantic Health System - Morristown Medical Center
  2. Frank Chen; Atlantic Health System - Morristown Medical Center
  3. Paul Schulze; Atlantic Health System - Morristown Medical Center
Background
While cysts are typically considered benign entities in most parts of the body, cysts in joints or soft tissues can often be ominous for underlying pathology. In joints such as the shoulder and knee, paralabral or parameniscal cysts are indications of underlying tears of the labrum/meniscus. If large enough, paralabral cysts can even impinge on nerves that innervate rotator cuff muscles and cause denervation. In soft tissues, cysts can sometimes represent tumors such as a sarcoma. This exhibit aims to present cases of soft tissue and juxta-articular cystic lesions that represent underlying pathology and ultimately required surgical intervention ranging from minimal to radical.

Educational Goals / Teaching Points
This exhibit will present multiple cases of various cystic musculoskeletal lesions and will include annotated radiologic images and a discussion of the underlying pathology, including epidemiology, pathophysiology, and treatment options.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Original MRI images will be displayed for each case, which includes: • Parameniscal cyst with underlying meniscal tear • Paralabral cyst with underlying labral tear and resultant nerve entrapment and muscle denervation • Synovial sarcoma in the knee • Myxoid liposarcoma in the ankle • Extraskeletal myxoid chondrosarcoma in the distal arm • Myxofibrosarcoma in the distal leg

Conclusion
Cysts in the joint and soft tissues should be evaluated closely when encountered as they can be a sign of more serious underlying pathology.