case_images: PMC11625097_01
case_images: On inspection of right knee, swelling on the supra-patellar aspect of the right knee (red arrow), along with skin discolouration and scarring was noted.
case_images: gr1.jpg
case_images: PMC11625097_01_gr1.jpg
case_images: fig0001
case_images: Upon local examination, there was swelling on the supra-patellar aspect of the right knee, measuring 2.5 cm x 3.2 cm, along with skin discoloration and scarring (Fig. 1).
case_images: X-ray AP view and Lateral view showing normal knee joint with mild soft tissue swelling on the supra-patellar aspect of right knee (red arrow). A-Xray AP view,B-Xray Lateral view.
case_images: gr2.jpg
case_images: PMC11625097_01_gr2.jpg
case_images: fig0002
case_images: A plain X- ray of the right leg was performed in both the lateral and anteroposterior projections, but no significant findings were shown (Fig. 2).
case_images: Ultrasound (USG) grey scale B mode image of right knee joint showing multicystic anechoic lesion with few slow-flow vascular channels (white arrow-lymphatic channels, red arrow-venous channels). A-Grey scale B mode image, B-Grey scale B mode image with color doppler.
case_images: gr3.jpg
case_images: PMC11625097_01_gr3.jpg
case_images: fig0003
case_images: Further evaluation with ultrasound (USG) and colour flow imaging (CFI) revealed a multicystic anechoic mass with a few slow-flow vascular channels (Fig. 3).
case_images: Ultrasound grey scale B mode image of right popliteal fossa showing cystic lesion with internal echoes suggestive of morrant baker cyst (red arrows). A-Grey scale B mode image, B-Grey scale B mode image with color doppler.
case_images: gr4.jpg
case_images: PMC11625097_01_gr4.jpg
case_images: fig0004
case_images: USG also showed showing well defined cystic lesion with internal echoes suggestive of morrant baker cyst in right popliteal fossa (Fig. 4).
case_images: Magnetic Resonance Imaging (MRI) showing multiple, dilated, tortuous serpentine Proton Density Fat Saturated (PDFS) hyperintensity along vastus medialis muscle with hypertrophy of the muscle (red arrow). A-MRI PDFS axial section, B-MRI PDFS sagittal section C-MRI PDFS coronal section.
case_images: gr5.jpg
case_images: PMC11625097_01_gr5.jpg
case_images: fig0005
case_images: A multiplanar, multisequence MRI of the knee was performed which showed multiple heterogeneously enhancing dilated, tortuous, tubular, serpentine PD/STIR/T2 hyperintense signal vascular channels seen in the visualized portion of vastus medialis (Fig. 5), vastus lateralis (Fig. 5) and vastus intermedialis muscle, intermuscular plane and suprapatellar bursa region and fluid levels were seen in few of the lesions, in the inferior aspect of the thigh.
case_images: Magnetic Resonance (MRI) showing multiple, dilated, tortuous serpentine Proton Density Fat Saturated (PDFS) hyperintensity along vastus lateralis muscle with hypertrophy of the muscle (red arrow). A-MRI PDFS axial section, B-MRI PDFS sagittal section C-MRI PDFS coronal section.
case_images: gr6.jpg
case_images: PMC11625097_01_gr6.jpg
case_images: fig0006
case_images: The patient was diagnosed with VLM involving the vastus medialis, vastus lateralis, vastus intermedialis muscles, intermuscular plane, and supra-patellar bursa region, along with a Morrant Baker cyst (Fig. 6 and Fig. 7).