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Medial Fluid Collections around the Knee

The numerous etiologies of medial fluid collections around the knee can be initially differentiated by the location relative to the joint line and the medial collateral ligament bursa.1^,2

The Joint Line

A Baker’s cyst is superior to the joint line and fluid in the pes anserinus bursa is inferior to the joint line. Ganglion cysts are variable in location. The remaining fluid collections are centered at the joint line.

The Medial Collateral Ligament (MCL Bursa)

If a collection is at the level of the joint line, the next question is the location relative to the MCL bursa. The MCL itself can be involved with tears or bursitis. Semimembranous-tibial collateral ligament bursal fluid is posterior to the MCL and comma-shaped. Meniscocapsular separation and meniscal cysts are usually posterior to the MCL bursa, involving the region of the posterior horn medial meniscus.

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