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Mandy, 50, has a history of OA in her knees and an ACL tear in her left knee many years ago. She has a concern for posterior left knee pain with hyperflexion over the last few weeks. Upon physical exam, you palpate a fullness in the posterior knee as you move her LLE from extension to flexion. The leg is not warm or erythematous.
a. What is the most likely diagnosis? Provide your rationale.
Bakers Cyst - this is a popliteal cyst that results in swelling behind the knee. It is particularly noticeable when the patient is standing and the knee is fully extended and becomes softer when the knee is bent at a 45-degree angle. These cysts develop when synovial fluid production increases due to an injury such as a meniscal tear or conditions affecting the joint like osteoarthritis or rheumatoid arthritis.
b. What diagnostic modality would you utilize to confirm your diagnosis? Provide your rationale.
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