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PubMed2001

[Some historical notes on popliteal cysts]

Popliteal cysts, more appropriately those involving the gastrocnemio-semimembranous bursa, are traditionally known as "Baker's cysts", since in 1877 the English surgeon William Morrant Baker published a paper on this topic ("On the formation of synovial cysts in the leg in connection with disease of the knee-joint"). As a matter of facts, some authors described popliteal cysts before Baker. In particular, in 1856 a French physician, E.Foucher, performed a clinical and experimental study on 18 patients, focusing on some important aspects on the semeiology and pathophysiology of popliteal cysts. In 1861, Pietro Antivari, a physician from Friuli, a northeastern region of Italy, graduated at the University of Padova by producing an interesting paper on the popliteal cysts ("Dell'idrope delle borse mucose poplitee con tre osservazioni"). In the present historical note we report in full one out of three cases described by Pietro Antivari.

Journal Article↗

PubMed1984

Compression syndrome of the popliteal vein and artery caused by popliteal cyst.

Popliteal vein compression caused by popliteal cyst was detected in 53-year-old man with venostasis of the lower limb. Deviation of the popliteal artery was also demonstrated by arteriography. The cyst communicating with the knee joint and partly covered by the lining of synovial cells was totally excised without damage to the vein. An analysis revealed hyaluronic acid to be the major component of glycosaminoglycan in the cyst and was 3 or 4 times in excess of that in the synovial fluid. The postoperative course was uneventful and symptoms were almost relieved.

Humans↗

PubMed1985

Popliteal cysts.

Popliteal cysts may be formed by the escape of a synovial effusion into one of the popliteal bursae. There is usually preexisting knee joint pathology. Presenting complaints include pain and swelling in the posterior aspect of the knee. The cyst may dissect into the calf between the muscle planes and produce pressure on draining lymphatics and veins, resulting in lower leg edema. These cysts are often mistakenly treated as deep vein thrombosis.

Bursa, Synovial↗

PubMed1982

Histomorphology of idiopathic and symptomatic popliteal cysts.

Thirty popliteal cysts, classified on the basis of clinical arthrographic findings as 12 idiopathic and 18 symptomatic lesions, were examined by light and scanning microscopy. The histopathology varied considerably and did not allow a valid distinction between the two types of cysts. Nevertheless, careful histopathologic examination of surgically removed popliteal cysts is advisable for exclusion of malignancy and for consideration of the presenting symptom as part of an inflammatory arthritic disorder.

Adolescent↗

PubMed1997

MRI appearance of popliteal cysts in childhood.

Popliteal cysts are soft fluid-filled lesions of synovial origin which result from extrusion of joint fluid into the gastrocnemiosemimembranous bursa. They may occur in any age group, but 22-33 % occur in the first 15 years of life. In this age group they are rarely associated with intraarticular abnormalities and therefore rarely require treatment. This case report shows the magnetic resonance imaging (MRI) appearances of a popliteal cyst in two children.

Child↗

PubMed2002

The imaging spectrum of Baker's (Popliteal) cysts.

Baker's (Popliteal) cysts are frequently encountered on cross-sectional imaging of the knee. These consist of enlarged gastrocnemius semimembranosus bursa which typically communicate with the knee. They may be imaged with a variety of techniques including arthopgraphy, CT, ultrasound and MRI, with the latter two being more commonly used. Examples of bursa imaged with all of the above techniques are demonstrated in the essay, as well as variance of normal appearance and pathological entities including ruptured bursa, abnormally positioned bursa, osteochondromatosis, septic complications of the bursa and pigmented villonodular synovitis.

Diagnosis, Differential↗

PubMed1991

Anterolateral rupture of popliteal cysts in rheumatoid arthritis.

Popliteal cysts occur commonly in both normal and arthritic knees. Most cysts are formed by distension of the medially situated semimembranosus bursa. Popliteus bursa distension occurs uncommonly as a lateral popliteal cyst. Two cases of rupture of lateral cysts which produced symptoms related to the anterolateral lower leg are reported. The difficulty of diagnosing the condition because of this unusual site of inflammation and subsequent management problems are discussed.

Aged↗

PubMed1984

Popliteal masses masquerading as popliteal cysts.

Two popliteal swellings, thought initially to be synovial cysts associated with arthritic knees, were found to be unrelated tumours of serious significance. In the presence of neurological signs or a large cyst in association with a noninflammed knee joint a disease other than a simple synovial cyst should be considered.

Aged↗

PubMed1979

Grey scale ultrasonography and arthrography in evaluation of popliteal cysts.

Ultrasonography will reliably detect popliteal cysts of clinically significant size and improvements in ultrasound imaging have enhanced the value of ultrasound in relation to arthrography in the assessment of cyst rupture. Forty-eight knees in 25 patients suspected of having a popliteal cyst were examined by ultrasonography followed immediately by arthrography. Popliteal cysts were demonstrated in 40% (19/48) by ultrasound and in 46% (22/48) by arthrogram. Arthrography detected small cysts not seen with ultrasound, but altrasonic scanning showed cysts which did not fill on arthrography. A ruptured cyst or deep venous thrombosis was suspected in 10 patients. Rupture was confirmed in two patients by arthrography, in both of whom soft tissue changes and attenuation of the distal margin of the cysts were shown by ultrasound.

Cysts↗

PubMed1989

[Double-contrast arthrography in secondary popliteal cysts].

The diagnosis of a popliteal cyst is usually made on the basis of a history of discomfort and pain in the medial portion of the popliteal region, together with the finding of a palpable mass in the popliteal fossa. The clinical diagnosis can be confirmed by knee arthrography, if the cyst communicates with the knee joint; in recent years, however, noninvasive US has also become an important diagnostic aid to the radiologist. The S. Anna Hospital (Ferrara) experience is here reported in the diagnosis of symptomatic popliteal cysts, with no valve mechanism at the connection with the joint cavity. Arthrography was performed on 438 patients with popliteal cysts to determine their extent and size in relation to the symptoms and to the presence of underlying knee pathology; only 76 patients from this group were then submitted to surgery. The authors confirm that popliteal cyst is a frequent occasional finding during knee arthrography which almost completely lacks any clinical relevance in most cases. Moreover, taking arthrographic findings as a starting point, the authors describe the different anatomotopographic patterns of popliteal cysts.

Aged↗

PubMed1979

[Popliteal cysts: unusual form of presentation].

Popliteal cysts are usually associated with abnormalities of the knee joint such as osteoarthritis, chronic inflammation or cartilage tears. 15 patients with popliteal cysts demonstrated by arthrography are described who had no obvious lesion of the knee. They had consulted their physician for symptoms without a clearcut relation to the knee joint, such as tenderness on the external side of the calf, ankle edema or paresthesia in the toes. Standard X-rays and clinical examination of the knee were normal except for tender swelling of the popliteal area. The symptoms improved after injection of triamcinolone into the knee joint. Unexplained symptoms of the lower leg may be due to popliteal cysts even in the absence of obvious knee pathology.

Adult↗

PubMed1991

[Diagnosis of popliteal cysts and their complications].

Popliteal cysts and their complications (rupture, expansion and pseudothrombosis) all of which may simulate deep venous thrombosis of the lower extremity may be diagnosed reliably by ultrasonography. Even small cysts can be detected, their extension can be defined and rupture with leakage of fluid into the surrounding muscles can be diagnosed. Phlebography can be avoided in most cases. Arthrography rarely gives additional information. Ultrasonography of the erect patient is recommended if rupture is suspected.

Adult↗

PubMed1990

Isolated tuberculosis of the popliteal cyst.

We encountered a case of tuberculosis of a popliteal cyst in a 76-year-old man. He visited our department for treatment of the left knee pain which had not responded to treatment over the previous ten months. At first examination, local rubor, swelling and tenderness on a popliteal cyst were noted. Therefore, curettage of the lesion, including resection of the cyst, was performed. Six weeks later, an abscess had formed in the subcutaneous area over the lateral aspect of the knee, which was cleaned out. The abscess recurred in the same area four months later. At the third operation, curettage of the abscess together with a knee joint synovectomy was performed. Upon pathologic examination, a tuberculous lesion of the popliteal cyst and skin were recognised. However, no tuberculous lesion was detected in the synovia of the knee joint. It is generally agreed that it is possible for a popliteal cyst to be infected from synovial tuberculosis of the knee joint. However, in our case, based on the histopathological and clinical observations, the primary tuberculous lesion appeared to have been in the popliteal cyst, which is very rare indeed. Recent developments in preventative medicine and chemotherapy have markedly reduced the incidence of tuberculous arthritis. However tuberculous arthritis is still an important disease in the differential diagnostic of persistent monoarthritis of the knee. Approximately half of the popliteal cyst communicate with the knee joint. However, it is not frequent for tuberculosis to propagate from the knee joint into the popliteal cyst.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

PubMed1996

Popliteal Cysts: Historical Background and Current Knowledge.

Popliteal cysts were first described in 1840 by Adams, but it is from Baker's writing in 1877 that we derive the commonly used eponymic term "Baker's cyst." Associated intra-articular lesions are very common with popliteal cysts. Ultra-sonography, arthrography, and magnetic resonance imaging have all proved useful in distinguishing popliteal cysts from other cysts and from soft-tissue tumors about the knee, as well as in identifying coexisting intra-articular lesions. Cysts in pediatric patients are generally self-limited and should be treated conservatively. In the adult population, treatment is primarily nonsurgical. Arthroscopic evaluation is indicated if an intra-articular lesion is causing mechanical symptoms or if there is no response to appropriate conservative treatment, such as use of nonsteroidal anti-inflammatory drugs and compression sleeves. Surgical excision is reserved for cases in which this approach has been unsuccessful.

Journal Article↗

PubMed1994

MRI findings of concurrent acute DVT and dissecting popliteal cyst.

A case of concurrent popliteal vein thrombosis and a dissecting popliteal cyst noted on the same MRI exam is described. Pseudothrombophlebitis is a well known entity in which a ruptured or dissecting popliteal cyst clinically mimics thrombophlebitis; the current case can be considered "pseudo-pseudo thrombophlebitis." This case demonstrates the importance of routine review of the venous structures of the posterior fossa for all MRI exams of the knee.

Acute Disease↗

PubMed1992

Ultrasonography in the study of prevalence and clinical evolution of popliteal cysts in children with knee effusions.

The prevalence and clinical evolution of popliteal cysts in children with knee arthritis is not well known. Using ultrasonography, we studied 44 children with clinically detectable knee effusions secondary to juvenile rheumatoid arthritis (n = 35), spondyloarthritis (n = 3) and psoriatic (n = 2), septic (n = 2) and lupus (n = 2) associated arthritis. Popliteal cysts, defined as anechoic or hypoechoic masses measuring at least 1 cm in 2 of 3 dimensions, were identified in 27 children (61%). Of the 30 children with bilateral arthritis, 11 (37%) had bilateral cysts. The size of the cysts ranged from 1 to 40 cm3 (median 3.0 cm3). There was a significant correlation between the presence of a cyst and popliteal pain and the size of the suprapatellar effusion (p less than 0.001) but not the child's age or underlying diagnosis (p greater than 0.05). A cohort of 25/27 children with cysts were followed prospectively with serial sonograms for 18-24 months. The resolution of the cyst followed that of the suprapatellar effusion in those children whose arthritis improved or resolved. Two children (8%) had rupture of the popliteal cysts. Popliteal cysts are readily documented in children with knee effusions using ultrasonography, and their presence and evolution correlates with the size of the suprapatellar effusion.

Adolescent↗

PubMed1978

Calcified bodies in popliteal cysts: a characteristic radiographic appearance.

Calcified bodies in popliteal cysts have a characteristic radiographic appearance which can be confirmed by arthrography. Calcified bodies may arise in the true joint due to trauma, arthropathy resulting in joint destruction, or synovial osteochondromatosis. These calcified loose bodies may pass into a popliteal cyst through posterior joint-bursal communications or can arise in a popliteal cyst by chondrometaplasia. Correct radiographic interpretation will exclude soft tissue tumors and vascular lesions as differential considerations. Management of these patients will be determined by the clinical circumstances since neither popliteal cysts nor synovial osteochondromatosis are necessarily symptomatic.

Adult↗

PubMedDate not supplied

Ultrasound evaluation of popliteal cysts on osteoarthritis of the knee.

Ultrasound (US) examination of the popliteal space is a noninvasive, reliable technique for the assessment of popliteal cysts. In order to determine the prevalence and significance of popliteal cysts in primary osteoarthritis (OA) of the knee, we conducted a prospective clinical, radiographic and US study on 50 patients and 25 controls. Popliteal cysts were demonstrated by US in 29 of 100 (29%) knees of 21 of 500 (42%) patients, 8 of whom (38%) had bilateral cysts. The majority of cysts were small and symptomless. Cyst rupture and the "pseudothrombophlebitis syndrome" occurred in only 2 of 29 (7%) knees. The occurrence of cysts correlated with the presence of knee effusion and the radiologic grade of OA. The results indicate of high incidence of clinically unsuspected popliteal cysts in patients with symptomatic knee OA. OA may be a more common cause of popliteal cysts than generally recognized.

Adult↗