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Occipital Encephalocele in a Newborn: MRI Diagnosis of a Congenital Scalp Mass, Surgical Anatomy, Treatment, and Prognosis

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Executive Clinical Summary A small scalp mass in a newborn can appear deceptively harmless. A dermoid cyst, cephalohematoma, or other superficial lesion may initially seem more likely than a congenital cranial malformation. Yet when a mass is present from birth, lies in the midline occipital region, and is associated with a distinctive ring of coarse hair, the diagnostic question changes completely. The key question is no longer simply, “What is this scalp mass?” It becomes: “Does this mass communicate with the intracranial compartment?” This distinction is critical because an occipital encephalocele represents a congenital defect of the skull through which cerebrospinal fluid (CSF), meninges, and sometimes neural tissue protrude beyond the cranial vault. The composition of the herniated sac, the size and location of the skull defect, the relationship to the cerebellum and brainstem, and the anatomy of the dural venous sinuses can directly influence surgical planning and prognosis. The...
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Baker’s Cyst on Ultrasound and MRI: Imaging Diagnosis, Differential Diagnosis, Treatment, and Prognosis of a Popliteal Synovial Cyst

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Executive Clinical Summary A palpable mass in the popliteal fossa is a common clinical problem, but the correct diagnosis should never be based on location alone. In a 64-year-old woman with known psoriatic arthritis, persistent left knee pain had continued for approximately nine months. Physical examination revealed a palpable, non-tender mass in the popliteal fossa. Musculoskeletal ultrasound demonstrated a large cystic lesion in the characteristic posteromedial location, leading to the diagnosis of a popliteal synovial cyst, or Baker’s cyst . The central radiologic lesson is more important than simply recognizing the cyst. A Baker’s cyst in an adult is often a manifestation of an underlying intra-articular knee disorder rather than an isolated abnormality. Osteoarthritis, meniscal pathology, cartilage abnormalities, joint effusion, synovitis, and inflammatory arthritis may all contribute to cyst formation. Therefore, once a Baker’s cyst is identified, the next question should ...
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