Popliteal cystic disease - diagnotic images

James S.T. Yao
Northwestern University Medical School
Chicago, Illinois

Characteristic diagnostic images can be seen in arteriograms of young adults suspected to have popliteal artery adventitial cystic disease. These include the filling defect (Figure 1) or Scimitar sign (Figure 2). Infusion CT scan can also aid the diagnosis. This is characterized by circumferential cystic appearance (Figure 3). At surgery, a cystic structure is noted in the adventitia of the popliteal artery (Figure 4). Figure 5 shows the artery after the completion of removal of the cystic structure.

Figure 1: Arteriogram reveals a subtle decrease of contrast density of the popliteal artery.

Figure 2: The eccentric stenosis seen in arteriogram and often referred to as “scimitar sign.”

Figure 3: Circumferential adventitial cyst as defined by computed tomography scan (left). Right side is normal.

Figure 4 : Using the posterior approach, a cystic structure is found in the adventitia of the popliteal artery.

Figure 5: Appearance of the popliteal artery after complete removal of the adventitial cyst.

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