AB0767 Comparison of Inraarticular and Intracyst Corticosteroid Injections in the Treatment of Baker's Cyst with Ultrasonographic Follow-Up

We report a rare case of a “giant Baker’s cyst-related rheumatoid arthritis (RA)” with 95 × 26 mm dimensions originating from the semimembranosus tendon. The patient presented with chronic pain and a palpable mass behind his left calf located between the posteriosuperior aspect of the popliteal fossa and the distal third of the calf. In MRI cystic lesion which was located in soft tissue at the posterior of gastrocnemius, extensive synovial pannus inside and degeneration of medial meniscus posterior horn were observed. Arthroscopic joint debridement and partial excision of the cyst via biomechanical valve excision were performed. The patient continued his follow-up visits at Rheumatology Department and there was no recurrence of cyst-related symptoms in 1-year follow-up. Similar cases were reported in the literature previously. However, as far as we know, a giant Baker’s cyst-related RA, which was treated as described, has not yet been presented.

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Natural course of Baker’s cysts in a total knee arthroplasty population

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967120s00286 ◽

2020 ◽

Vol 8 (5_suppl4) ◽

pp. 2325967120S0028

Author(s):

Hagen Hommel ◽

Sebastian Kopf

Keyword(s):

Total Knee Arthroplasty ◽

Knee Arthroplasty ◽

Natural Course ◽

Cyst Size ◽

Baker’S Cyst ◽

Baker's Cyst ◽

Adjacent Structures ◽

Total Knee ◽

The Mean

Aims and Objectives: Baker’s cysts are known to be a source of discomfort and pain due to pressure on adjacent structures. They are not uncommon in patients eligible for total knee arthroplasty (TKA). Since there is a paucity of medium-term studies that assess the natural course of Baker’s cyst following TKA, in this study we report the one- and five-year outcomes of patients to elucidate the state of their Baker’s cyst following TKA. Materials and Methods: In this prospective case series, 102 TKA patients were included. All patients who received surgery had a diagnosis of primary osteoarthritis and had preoperatively presented with a Baker’s cyst. Sonography was performed to evaluate the existence and the gross size of the cyst before TKA, and sonography was repeated at one and five years after TKA. Symptoms potentially attributable to the Baker’s cyst were recorded at each assessment. In addition, the five-year assessment included a sonographic assessment of the anterior aspect of the knee to identify joint effusion. Results: Ninety-one patients were available for the five-year assessment (with an 89% follow-up rate). After one and five years, Baker’s cyst was still present in 87 (85%) and 30 (33%) patients, respectively. Of those patients who retained a Baker’s cyst at one-year follow up, 31 patients (36%) had sustained popliteal symptoms. Of those patients who continued to have a Baker’s cyst at five years, 17 patients (56.7%) were still symptomatic. The probability of entering remission was dependent on the size of the Baker’s cyst at baseline (odds ratio, 1.41; p = 0.025). The mean preoperative cyst size was 14.5 cm2. At one and five years postoperatively, the mean cyst size was 10.6 cm2 and 9.9 cm2, respectively. At five years, no association between cyst size and popliteal symptoms was found. Conclusion: Five years after TKA, the majority of the Baker’s cysts that were present at baseline had gone into remission. The probability of going into remission was dependent on the size of the Baker’s cyst at baseline.

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The fate of Baker’s cysts at mid-term follow-up after total knee arthroplasty

The Bone & Joint Journal ◽

10.1302/0301-620x.102b1.bjj-2019-0273.r2 ◽

2020 ◽

Vol 102-B (1) ◽

pp. 132-136

Author(s):

Hagen Hommel ◽

Roland Becker ◽

Peter Fennema ◽

Sebastian Kopf

Keyword(s):

Total Knee Arthroplasty ◽

Knee Arthroplasty ◽

Case Series ◽

Short Term ◽

Cyst Size ◽

Baker’S Cyst ◽

Baker's Cyst ◽

Total Knee ◽

The Mean

Aims We report the natural course of Baker’s cysts following total knee arthroplasty (TKA) at short- and mid-term follow-up. Methods In this prospective case series, 105 TKA patients were included. All patients who received surgery had a diagnosis of primary osteoarthritis and had preoperatively presented with a Baker’s cyst. Sonography and MRI were performed to evaluate the existence and the gross size of the cyst before TKA, and sonography was repeated at a mean follow-up time of 1.0 years (0.8 to 1.3; short-term) and 4.9 years (4.0 to 5.6; mid-term) after TKA. Symptoms potentially attributable to the Baker’s cyst were recorded at each assessment. Results At the one-year follow-up analysis, 102 patients were available. Of those, 91 patients were available for the 4.9-year assessment (with an 86.7% follow-up rate (91/105)). At the short- and mid-term follow-up, a Baker’s cyst was still present in 87 (85.3%) and 30 (33.0%) patients, respectively. Of those patients who retained a Baker’s cyst at the short-term follow-up, 31 patients (35.6%) had popliteal symptoms. Of those patients who continued to have a Baker’s cyst at the mid-term follow-up, 17 patients (56.7%) were still symptomatic. The mean preoperative cyst size was 14.5 cm2 (13.1 to 15.8). At the short- and mid-term follow-up, the mean cyst size was 9.7 cm2 (8.3 to 11.0) and 10.4 cm2 (9.8 to 11.4), respectively. A significant association was found between the size of the cyst at peroperatively and the probability of resolution, with lesions smaller than the median having an 83.7% (36/43) probability of resolution, and larger lesions having a 52.1% (25/48) probability of resolution (p < 0.001). At the mid-term follow-up, no association between cyst size and popliteal symptoms was found. Conclusion At a mean follow-up of 4.9 years (4.0 to 5.6) after TKA, the majority (67.0%, 61/91) of the Baker’s cysts that were present preoperatively had disappeared. The probability of cyst resolution was dependent on the size of the Baker’s cyst at baseline, with an 83.7% (36/43) probability of resolution for smaller cysts and 52.1% (25/48) probability for larger cysts. Cite this article: Bone Joint J. 2020;102-B(1):132–136

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Ultrasound guided percutaneous treatment and follow-up of Baker's cyst in knee osteoarthritis

European Journal of Radiology ◽

10.1016/j.ejrad.2012.05.015 ◽

2012 ◽

Vol 81 (11) ◽

pp. 3466-3471 ◽

Cited By ~ 20

Author(s):

Mert Köroğlu ◽

Mehmet Çallıoğlu ◽

Hüseyin Naim Eriş ◽

Mustafa Kayan ◽

Meltem Çetin ◽

...

Keyword(s):

Knee Osteoarthritis ◽

Percutaneous Treatment ◽

Ultrasound Guided ◽

Baker’S Cyst ◽

Baker's Cyst

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Baker’s cyst in children: conservative management versus surgical excision according to clinical and imaging criteria

Annals of Pediatric Surgery ◽

10.1186/s43159-021-00071-1 ◽

2021 ◽

Vol 17 (1) ◽

Author(s):

Mohammed A. Mansour ◽

Mohammed A. Shehata ◽

Mohammed M. Shalaby ◽

Mohammed A. Arafa ◽

Hisham A. Almetaher

Keyword(s):

Conservative Management ◽

Surgical Excision ◽

Popliteal Cyst ◽

First Year ◽

Baker’S Cyst ◽

X Ray ◽

Persistent Symptoms ◽

Baker's Cyst ◽

The Mean

Abstract Background Pediatric patients rarely exhibit Baker’s cysts. This study was conducted on 15 cases (9 males, 6 females) presented with Baker (popliteal) cyst in the last 2 years (from September 2017 to September 2019). The mean age was 8.5 years. The aim of this study was to present our experience in management of these cases based on clinical and imaging criteria. Plain x-ray and knee ultrasonography were routinely done for all cases. If the size of the cyst was less than or equal to 3 cm by ultrasonography, with no or minimal pain, the patients were managed conservatively and were scheduled to followed up visits after 3 months, 6 months, and after 12 months for clinical assessment of symptoms and sonographic size of the cyst. Surgical excision of the Baker’s cyst was considered if the size of the cyst was more than 3 cm with persistent of pain. Results Seven cases had cysts less than 3 cm by ultrasonography and were managed conservatively. In five out of these seven cases, the cysts disappeared with no recurrence within the first year of follow-up. In two cases, the cysts increased in size with increase in pain. These two cases were subjected to surgical excision after 1 year of follow-up. The remaining eight cases had cysts more than 3 cm and were managed by surgical excision. Out of the ten cases which were managed by surgical excision, recurrence occurred in 3 cases within the first post-operative year (after 4 months, 7 months, and 8 months) consecutively. Conclusions The management of Baker’s cysts in children is debatable, with no definite protocol. In this current study, we conclude that surgical excision of large Baker’s cysts (more than 3 cm) with persistent symptoms is crucial providing meticulous dissection without rupture of the cyst and proper closure of the pedicle which connects the cyst with the knee joint, while conservative management and follow-up is effective in small Baker’s cysts (less than 3 cm) with no recurrence.

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Platelet-rich plasma treatment and follow-up of recurrent Baker’s cyst

Journal of Clinical Medicine Bach Mai Hospital ◽

10.52322/jocmbmh.120.05 ◽

2021 ◽

Vol 120 ◽

Keyword(s):

Plasma Treatment ◽

Platelet Rich Plasma ◽

Baker’S Cyst ◽

Baker's Cyst

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Differentiation between ruptured Baker’s cyst and deep vein thrombosis (DVT)

The Bangkok Medical Journal ◽

10.31524/bkkmedj.2012.09.008 ◽

2012 ◽

Vol 04 (01) ◽

pp. 47-49 ◽

Cited By ~ 1

Author(s):

Tanawat Teerasahakoon ◽

Mayura Boonthathip ◽

Chirotchana Suchato

Keyword(s):

Deep Vein Thrombosis ◽

Baker’S Cyst ◽

Vein Thrombosis ◽

Baker's Cyst ◽

Deep Vein

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Clinical outcomes of pediatric macular edema associated with non-infectious uveitis

Journal of Ophthalmic Inflammation and Infection ◽

10.1186/s12348-021-00236-4 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Anh Hong Nguyen ◽

Bethlehem Mekonnen ◽

Eric Kim ◽

Nisha R. Acharya

Keyword(s):

Visual Acuity ◽

Macular Edema ◽

San Francisco ◽

Pediatric Patients ◽

Proportional Hazards ◽

Cox Proportional Hazards ◽

Study Cohort ◽

Common Diagnosis ◽

Corticosteroid Injections

Abstract Background Macular edema (ME) is the most frequent cause of irreversible visual impairment in patients with uveitis. To date, little data exists about the clinical course of ME in pediatric patients. A retrospective, observational study was performed to examine the visual and macular thickness outcomes of ME associated with chronic, noninfectious uveitis in pediatric patients. Methods Pediatric patients with noninfectious uveitis complicated by ME seen in the University of California San Francisco Health System from 2012 to 2018 were identified using ICD-9 and ICD-10 codes. Data were collected from medical records including demographics, diagnoses, ocular history, OCT imaging findings, complications, and treatments at first encounter and at 3, 6, 9, and 12-month follow-up visits. Cox proportional hazards regression was used to investigate the association between different classes of treatment (steroid drops, steroid injections, oral steroids and other immunosuppressive therapies) and resolution of macular edema. Results The cohort comprised of 21 children (26 eyes) with a mean age of 10.5 years (SD 3.3). Undifferentiated uveitis was the most common diagnosis, affecting 19 eyes (73.1%). The majority of observed macular edema was unilateral (16 patients, 76.2%) and 5 patients had bilateral macular edema. The mean duration of follow-up at UCSF was 35.3 months (SD 25.7). By 12 months, 18 eyes (69.2%) had achieved resolution of ME. The median time to resolution was 3 months (IQR 3–6 months). Median best-corrected visual acuity (BCVA) at baseline was 0.54 logMAR (Snellen 20/69, IQR 20/40 to 20/200). Median BCVA at 12 months was 0.1 logMAR (Snellen 20/25, IQR 20/20 to 20/50) Corticosteroid injections were associated with a 4.0-fold higher rate of macular edema resolution (95% CI 1.3–12.2, P = 0.01). Conclusions Although only 15% of the pediatric patients with uveitis in the study cohort had ME, it is clinically important to conduct OCTs to detect ME in this population. Treatment resulted in 69% of eyes achieving resolution of ME by 12 months, accompanied with improvement in visual acuity. Corticosteroid injections were significantly associated with resolution of macular edema.

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GIANT BAKER'S CYST AND PSEUDOTHROMBOPHLEBITIS IN PATIENTS WITH RHEUMATIC DISEASES: A NEW INSIGHT INTO OLD COMPLICATIONS

Journal of Musculoskeletal Research ◽

10.1142/s0218957713500097 ◽

2013 ◽

Vol 16 (02) ◽

pp. 1350009

Author(s):

Massoud Saghafi ◽

Azita Azarian

Keyword(s):

Rheumatoid Arthritis ◽

Rheumatic Diseases ◽

Imaging Techniques ◽

Cyst Formation ◽

Underlying Disease ◽

Popliteal Cyst ◽

Baker’S Cyst ◽

Baker's Cyst ◽

Study Results ◽

Prevalent Disease

Background: The knee joint is the most common site for cyst formation. Popliteal cyst may become large and its compressive effects produce complications particularly in subacute and chronic rheumatic diseases. Methods: We evaluated predisposing factors, underlying diseases, complications, course and management of giant Baker's cysts in our patients with rheumatic diseases. Patients with popliteal cysts that extended down lower than inferior level of the popliteal fossa, confirmed by imaging techniques were included in this retrospective study. Results: A total of 40 patients had giant Baker's cysts during last 20 years. Rheumatoid arthritis was the most prevalent disease in 21 patients (52.5%). Our cases included a large series of patients with seronegative spondyloarthropathies complicated with giant Baker's cyst in 10 patients (25%). Localized bulging, pain and tenderness of the calf region were observed in 15 patients (37.5%). A total of 25 patients had symptoms and signs similar to thrombophlebitis (62.5%). Rupture of Baker's cyst was detected in 10 patients (25%). A patient had giant Baker's cyst concurrent with thrombophlebitis. Management was mostly conservative including rest and intra-articular depoglucocorticoid injection with satisfactory results. Conclusions: In this study, rheumatoid arthritis was the most prevalent underlying disease and the pseudothrombophlebitis syndrome was the most prevalent presenting feature of patients with giant Baker's cysts.

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