Compression syndromes of the popliteal neurovascular bundle. Popliteal fossa, also known as the popliteal space, is located behind the knee joint. Total excision with the pseudocapsule is the treatment method. The needle was directed posteriorly with a 2030degree sign angle.
In this article, we shall look at the anatomy of the popliteal fossa its borders, contents and clinical correlations. There is a wide variety of lesions that can be identified in the popliteal fossa, ranging. The space is extremely dynamic, allowing for its neurovascular contents to move during the extreme range of motion produced by knee flexion and extension. Pronunciation of popliteal fossa with 2 audio pronunciations, 1 meaning, 10 translations and more for popliteal fossa. Chronic expanding hematoma in the popliteal fossa after.
Friction massage friction of the popliteal fossa is provided for the purpose of relieving pain related to circulatory disorders by improving venous flow in the lower legs. As it gives passage for primary vessels and nerves from the thigh to the leg, this fossa has great anatomical significance. Wusu, md, natalie casemyr, md, mostafa abousayed, md, malcolm r. The division of the sciatic nerve in the popliteal fossa. The posterior tibial nerve continues to run in the direction of the main trunk, at the center of the fossa. Any information contained in this pdf file is automatically generated from digital. The popliteal fossa is a diamond shaped area located on the posterior aspect of the knee. Popliteal fossa definition of popliteal fossa by the. The popliteal fossa syndrome is a pain syndrome of unknown cause or etiology. Hayder the popliteal fossa is a diamondshaped hollow on the back of the knee joint. These conditions, which may be common throughout the arterial system or exclusive to the popliteal artery, include atherosclerosis, popliteal artery aneurysm, arterial embolus, trauma, popliteal artery entrapment syndrome, and cystic adventitial disease. Popliteal fossa orthopaedicsone articles orthopaedicsone. Structures within the popliteal fossa include from superficial to deep tibial nerve. Boundaries of the popliteal fossa, posterior view of the right.
Rupture or dissection of the cyst causes extravasation of fluid into the calf, which can result in. A cystic mass in the popliteal fossa and its differential. Supine with leg abducted and externally rotated transducer. Femoral nerve block with selective tibial nerve block. Popliteal fossa definition of popliteal fossa by medical.
Popliteal fossa pathology encompasses relatively common entities such as baker cysts to eh uncommon, such as popliteal fossa entrapment and soft tissue masses. Histopathologic examination revealed an aneurysmal venous wall with no evident inflammatory or degenerative changes. In the floor adductor magnus and vastus lateralis lies. Entrapment neuropathies of the knee, leg, ankle, and foot are often underdiagnosed, as the results of clinical examination and electrophysiologic evaluation are not always reliable. A strain of one or more of the distal hamstring tendons is the most likely culprit.
Transverse at the base of the popliteal fossa 4 5cm above popliteal crease needle. Subparaneural versus circumferential extraneural injection. The most common mode of presentation is pulmonary embolism, which occurs in 70% to 80% of reported cases of pva and is sometimes accompanied by a mass or pain in the popliteal fossa. Softtissue popliteal masses can be evaluated using physical examinations and imaging studies, such as computed tomography ct or magnetic resonance imaging mri. Subparaneural versus circumferential extraneural injection at. The retained knife blade is a seldomreported injury with the majority of cases involving the head, neck and thoracic regions. Mar 24, 2006 a rare case of chondrolipoma of the right popliteal fossa in a 24. Detailed familiarity of the operative procedure is necessary, however, to avoid complications.
Popliteal fossa is a diamondshaped hollow found on the rear side of the knee joint. A strain of the tendinous origins of one of the gastrocnemius heads may also be at fault. May 11, 2020 the popliteal fossa is a diamondshaped depression located posterior to the knee joint. Pierces the deep fascia and drains into the popliteal vein. Soft tissue sarcomas of the popliteal fossa are rare, account. Back of thigh and popliteal fossa it extends from lower part of gluteal region to back of knee joint up to popliteal fossa. Upon entering the popliteal fossa, the two nerve com ponents, peroneal and tibial, finally diverge from each other, hav ing never mixed their fibers. We present a case of a 63yearold male who presented with a retained knife blade in the popliteal fossa. Thorough understanding of the appearance and location of the popliteal fossa masses one can reach a specific differential diagnosis in the majority of cases. Popliteal fossa syndrome advanced therapy institute. The level of division of the sn sheath into tn and cpn above the knee was measured in 28 cadaver leg specimens.
Contents gluteal region and posterior thigh by james pickering, phd is from the course lower limb anatomy. The popliteal vein forms from the posterior and anterior tibial veins and ascends through the popliteal fossa to the opening in adductor magnus alongside the popliteal artery where it becomes the femoral vein. We studied the level of division of the sn in the popliteal fossa and its relationship to the common epineural sheath of the sn. Case report popliteal cyst filled with hematoma at. Popliteal cysts baker cysts are a relatively common finding in patients aged 50 years, presenting with knee pain or knee pathologies that disturb the synovial fluid dynamics, including arthritis, most commonly, 1 meniscal tears, or rarely, gout. Important nerves and vessels pass from the thigh to the leg by traversing through this fossa and the muscles of the thigh and the leg form its boundaries. Softtissue popliteal masses can be evaluated using physical examinations and imaging studies, such as computed tomography ct or. Popliteal fossa, also known as the popliteal space, is located. Considerable overlap exists in the presentation of these entities, yet the clinical course and treatment vary considerably. Popliteal vein aneurysm presenting as a popliteal mass.
Its relationship to the popliteal artery changes as the vein ascends, but it is always between the popliteal artery and tibial nerve. Popliteal fossa definition of popliteal fossa by the free. It lies in between laterally lateral intermuscular septum and medially posterior intermuscular compartment which is incomplete. Popliteal lymph nodes few nodes just under the deep fascia embedded in the fatty connective tissue of popliteal fossa, close to the popliteal vessels drain the deep tissues of the leg, foot and knee joint efferents to the deep inguinal ln dr. Like other flexion surfaces of large joints groin, armpit, cubital fossa and essentially the anterior part of the neck, it is an area where blood vessels and nerves pass. Effects of friction massage of the popliteal fossa on. The popliteal fossa is a shallow depression located at the back of the knee joint. Eleven patients with chondrolipoma including lipoma with cartilaginous metaplasia, including my case, have been reported in japan. Chondrolipoma of the popliteal fossa and japanese reports.
Jul 14, 2015 a cystic mass arising in the popliteal fossa can be either a meniscal cyst, a synovial cyst bakers cyst, or a ganglionic cyst. This fossa is an important anatomical region because it provides passage for main vessels and nerves from the thigh to the leg. The bones of the popliteal fossa are the femur and the tibia. The overall success rate of the block at 30 minutes, using ultrasound guidance, ranges from 60% to 100%. Musculoskeletal and vascular pathology of the popliteal fossa.
Any information contained in this pdf file is automatically generated from. It is the main path by which vessels and nerves pass between the thigh and the leg. Thirtyfour patients undergoing ankle or foot surgery were enrolled in this study. The ultrasound probe should be held transversely to the thigh to gain a shortaxis view of the nerves and vessels figures 6 and 7. Thorough understanding of the appearance and location of the popliteal fossa masses one can reach a specific differential diagnosis in the majority of. The sn was invariably formed of independent trunks. The purpose of this study is to verify the effects of enhancing the venous flow based on measuring the blood flow velocity of the popliteal vein before and after providing friction to the patients. Mr imaging of entrapment neuropathies of the lower. A cystic mass arising in the popliteal fossa can be either a meniscal cyst, a synovial cyst bakers cyst, or a ganglionic cyst. A rare case of chondrolipoma of the right popliteal fossa in a 24. Laterally it is bounded by the biceps femoris above, and by the plantaris and the lateral head of the gastrocnemius below.
Hematomas caused by surgery or trauma that persist and expand slowly for more than a month are defined as chronic expanding hematomas ceh. The con tents of the popliteal fossa include the popliteal artery, popliteal vein, small saphen ous vein, tibial nerve, the co mmon peron eal ner ve, and the common fibular n erve. Pdf anatomical approach to clinical problems of popliteal fossa. This study proved that friction to the popliteal fossa is effectively sic enhances venous flow by increasing the blood flow velocity in the popliteal vein. Popliteal varicose veins vascular surgery kelmac medical. The popliteal artery is located behind the knee in the popliteal fossa and is a direct extension of the superficial femoral artery after it passes through the adductor hiatus, an opening in the tendinous slip of the great adductor muscle of the thigh. This region can develop many clinical complications in the vascular, nervous, lymphatics, adipose. Lateral approach to the sciatic nerve in the popliteal fossa. Longitudinal panoramic view of the popliteal artery demonstrating a focal. Thus appropriate imaging and analysis is crucial in.
The popliteal fossa sometimes referred to as the hough, 1 or kneepit in analogy to the armpit is a shallow depression located at the back of the knee joint. Compression syndromes of the popliteal neurovascular. Popliteal lymph node dissection for metastases of cutaneous. Fossa poplitea definition of fossa poplitea by medical. This article will discuss the anatomical structure and the contents of the popliteal fossa, followed by.
The popliteal vein forms from the posterior and anterior tibial veins and ascends through the popliteal fossa to the opening in adductor magnus alongside the popliteal artery where it becomes the femoral vein its relationship to the popliteal artery changes as the vein ascends, but it is always between the popliteal artery and tibial nerve. The popliteal artery is a relatively short vascular segment but is affected by a unique set of pathologic conditions. Popliteal fossa, jabir ibn hayyan medical university lower angle. Pseudoaneurysms result from arterial wall disruptions and can be mistaken for ceh. Lateral intraoperative view of the popliteal sarcoma.
They present as swelling in the popliteal fossa due to enlargement of the gastrocnemiussemimembranosus bursa, which lies between these two muscles on the medial side of the fossa slightly distal to the center crease in the back of the knee. Apr 10, 2012 popliteal lymph nodes few nodes just under the deep fascia embedded in the fatty connective tissue of popliteal fossa, close to the popliteal vessels drain the deep tissues of the leg, foot and knee joint efferents to the deep inguinal ln dr. Tibial nerve block performed in the popliteal fossa in close proximity to the popliteal crease avoided complete peroneal motor block and provided similar postoperative analgesia compared to sciatic nerve block when combined with femoral nerve block for patients undergoing total knee arthroplasty. Popliteal fossa synonyms, popliteal fossa pronunciation, popliteal fossa translation, english dictionary definition of popliteal fossa. The popliteal fossa, we looked at the boundaries, the roof, the floor, and we just finished off by looking at the contents of this space. Magnetic resonance imaging mri is useful for the diagnosis.
The popliteal fossa sometimes referred to colloquially as the knee pit, or poplit is a shallow depression located at the back of the knee joint. The back of the thigh and popliteal fossa linkedin slideshare. This is an unusual case of a retained knife blade in the popliteal fossa from an anterior entry wound without vascular nor ligamentous injury. With patients in the supine position, the upper edge of the patella and the groove between the posterior border of the vastus lateralis and the anterior border of the tendon of the biceps femoris were identified. The popliteal fossa borders contents teachmeanatomy. Popliteal synovial cysts, also known as bakers cysts, are a common occurrence in adults and children. Structures within the popliteal fossa include, from superficial to deep tibial nerve. The popliteal artery lies posterior to the femur and anterior to the popliteal vein.
The popliteal fossa is formed in the posterior knee of the biceps femoris muscle superolaterally, the semitendinosus superomedially, and the lateral and medial heads of the gastrocneumius inferiorly. Few nodes just under the deep fascia embedded in the fatty connective tissue of popliteal fossa, close to the popliteal vessels drain the deep tissues of the leg,foot and knee joint efferents to the deep inguinal ln 14. Effects of friction massage of the popliteal fossa on blood. The popliteal fossa or space is a lozengeshaped space, at the back of the kneejoint. The pva was repaired surgically via a posterior approach to the popliteal fossa. The causes of most entrapment neuropathies in the lower.
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