Original Author: Oliver Jones

Last Updated: April 6, 2018

THE POPLITEAL FOSSA Revisions: 26

Contents

1 Borders
2 Contents
3 Clinical Relevance: Swelling in the Popliteal Fossa
3.1 Baker’s Cyst
3.2 Popliteal Aneurysm
3.3 Other Causes

The popliteal fossa is a diamond shaped area found on the posterior side of the knee. It is
the main path in which structures move from the thigh to the leg.

In any anatomical area such as this, it is important to look at the borders, contents, and
any clinical relevance.

Borders
The popliteal fossa is diamond shaped, with four borders. These borders are formed by
the muscles in the posterior compartment of the leg and thigh:

• Superomedial border – semimembranosus.

• Superolateral border – biceps femoris.

• Inferomedial border – medial head of the gastrocnemius.

• Inferolateral border – lateral head of the gastrocnemius and plantaris.

The popliteal fossa also has a floor and a roof. The floor of the popliteal fossa is formed by
the posterior surface of the knee joint capsule, and by the posterior surface of the femur.
The roof is made of up two layers; popliteal fascia and skin. The popliteal fascia is
continuous with the fascia lata of the leg.
 Fig 1 – The borders of the popliteal fossa are formed by the muscles of the thigh and leg.

Contents
The popliteal fossa is the main conduit for neurovascular structures entering and leaving
the leg. Its contents are (medial to lateral):

• Popliteal artery

• Popliteal vein

• Tibial nerve

• Common fibular nerve

The tibial and common fibular nerves are the most superficial of the contents of the
popliteal fossa. They are both branches of the sciatic nerve. The common fibular nerve
follows the biceps femoris tendon, running along the lateral margin of the popliteal fossa.

The small saphenous vein pierces the popliteal fascia of the popliteal fossa to enter the
diamond, and empty into the popliteal vein.

In the popliteal fossa, the deepest structure is the popliteal artery. It is a continuation of
the femoral artery, and travels into the leg to supply it with blood.
 Fig 2 – The contents of the popliteal fossa.

Clinical Relevance: Swelling in the Popliteal

Fossa
The appearance of a mass in the popliteal fossa has many differential diagnoses.
The two major causes are baker’s cyst and aneurysm of the popliteal artery.

Baker’s Cyst
A baker’s cyst (or popliteal cyst) refers to the
inflammation and swelling of the
semimembranosus bursa – a fluid filled sac found
in the knee joint. The usually arise in conjunction
with arthritis of the knee (rheumatoid or
osteoarthritis). Whilst it usually self-resolves, the
cyst can rupture and produce symptoms similar to
deep vein thrombosis.

Popliteal Aneurysm
 An aneurysm is a dilation of an artery, which is
greater than 50% of the normal diameter. The
popliteal fascia (the roof of the popliteal fossa) is
tough and non-extensible, and so an aneurysm of
the popliteal artery has consequences for the other
contents of the popliteal fossa.

The tibial nerve is particularly susceptible to

compression from the popliteal artery. The major
features of tibial nerve compression are:
Fig 3 – MRI Scan of a Baker’s cyst.

• Weakened or absent plantar flexion

• Paraesthesia of the foot and posterolateral leg

An aneurysm of the popliteal artery can be detected by an obvious palpable

pulsation in the popliteal fossa. An arterial bruit may be heard on auscultation.

Other Causes
Rarer causes of a popliteal mass include deep vein thrombosis, adventitial cyst of
the popliteal artery and various neoplasms (such as rhabdomyosarcoma).

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