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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↗

PubMed2005

The popliteal cyst.

A popliteal cyst, originally called Baker's cyst, is a synovial fluid-filled mass located in the popliteal fossa. The most common synovial popliteal cyst is considered to be a distension of the bursa located beneath the medial head of the gastrocnemius muscle. Usually, in an adult patient, an underlying intra-articular disorder is present. In children, the cyst can be isolated and the knee joint normal. The anatomy, etiopathogenesis, clinical presentation, differential diagnosis, imaging and treatment modalities of the popliteal cyst are presented. The authors try to answer some questions dealing with this condition. Is the cyst isolated, can it be treated as such, is its origin always well-defined and does surgical excision provide a permanent cure?

Diagnostic Imaging↗

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↗

PubMed2006

Multilobulated popliteal cyst after a failed total knee arthroplasty.

Popliteal cyst is a rare finding after total knee arthroplasty (TKA), but when present, it might indicate a malfunction of the TKA related to generation of wear-particles, or loosening. We present a case of a multilobulated popliteal cyst developing in a patient 8 years after primary TKA. The cyst was associated with a mechanical prosthetic loosening. The primary complaint of the patient was pain in the posterior region of the knee. A two-stage procedure consisting of cyst excision at first, followed after 5 months by a revision TKA was performed. Intraoperatively, a darkish, multilobulated cyst with a well-defined thick wall filled with fluid containing polyethylene debris, communicating with the knee joint was found. After 3 years of follow-up, the patient was satisfied and walked without the support of a cane. The patient presented a satisfactory knee range of motion. Clinical, radiological and ultrasound investigations ruled out popliteal cyst recurrence. A dissecting popliteal cyst associated with a failed TKA should be excised because it contains polyethylene debris that constitutes an induced factor for prosthetic loosening. A two-stage procedure with quite a long time in-between, as presented in this paper, can be a useful alternative to manage such a problem, in particular in very old patients associated with other medical problems.

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↗