MRI EVALUATION OF BAKER S CYSTS AND ASSOCIATED INTRA-ARTICULAR PATHOLOGIES IN DIFFERENT AGE GROUPS

Abstract

Introduction: To investigate the association between Baker’s cysts (BCs) and intra-articular pathologies across different age groups using magnetic resonance imaging (MRI). Methods: In this retrospective, single-center study, 476 patients aged ≥18 years who underwent knee MRI for pain were included after applying exclusion criteria. BC-positive (BC+) patients were matched with controls based on age, sex, and knee laterality. Intra-articular pathologies—including meniscal abnormalities, cruciate ligament ruptures, chondromalacia, osteoarthritis, and joint effusion—were evaluated. Binary logistic regression was used to assess associations; interobserver agreement was evaluated using Cohen’s kappa (κ). Results: BCs were identified in 86 patients (18%). Significant associations were observed between BCs and posterior horn abnormalities of the medial meniscus (OR: 1.91, p = 0.018) and joint effusion (OR: 1.75, p = 0.013). In patients aged ≥50 years, chondromalacia (OR: 2.09) and joint effusion (OR: 4.08) showed strong associations with BCs, while osteoarthritis was inversely associated (OR: 0.22, p = 0.001). In patients <50 years, posterior horn abnormalities of the medial meniscus remained the only significant correlate (OR: 3.08, p = 0.003). Interobserver agreement was substantial to almost perfect (κ=0.67–1.00). Conclusion: BCs demonstrate distinct age-specific associations with intra-articular pathology. Recognition of these patterns may improve diagnostic confidence, especially in younger patients, by facilitating the detection of potential coexisting intra-articular pathologies.