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

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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Radiation Diagnostic Techniques for Dynamically Controling the Efficiency of Laser-Induced Thermotherapy for Baker’s Cyst

Journal of radiology and nuclear medicine ◽

10.20862/0042-4676-2019-100-4-222-228 ◽

2019 ◽

Vol 100 (4) ◽

pp. 222-228

Author(s):

S. A. Chernyad’ev ◽

V. B. Aretinskiy ◽

N. I. Sivkova ◽

A. V. Zhilyakov ◽

N. Yu. Korobova ◽

...

Keyword(s):

Cyst Formation ◽

Diagnostic Techniques ◽

Current Level ◽

Popliteal Cyst ◽

Resonance Imaging ◽

Baker’S Cyst ◽

Medicine Development ◽

Baker's Cyst ◽

Asymptomatic Patients ◽

Surgical Treatments

A popliteal cyst or Baker’s cyst is easily distinguished from other cystic or solid tumors on the magnetic resonance imaging sections. At the current level of medicine development, many options have been developed for medical and surgical treatments for popliteal cysts; however, there are still disputes on their validity and efficiency. In addition, there is no consensus on the etiology and pathogenesis of the disease. MRI is known to show similar intraarticular changes in asymptomatic patients and articular syndrome patients, which could suggest that intraarticular pathological changes played a secondary role in a number of cases of Baker’s cyst formation. Under these conditions, laser-induced thermotherapy is considered by the authors to be justified. Its main goal is to coagulate the wall of the tissue cyst, which subsequently leads to obliteration of its anastomosis and cavity. Ultrasound control is used to visualize and ensure the safety of manipulation. This paper describes a case of MRI for diagnosing a popliteal cyst and monitoring the efficiency of laser-induced thermotherapy.

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Popliteal cyst simulating a Baker's cyst in a patient with Rheumatoid Arthritis: a case presentation

Reumatología Clínica (English Edition) ◽

10.1016/s2173-5743(11)70026-0 ◽

2011 ◽

Vol 7 (2) ◽

pp. 137-138

Author(s):

Concepción Chalmeta Verdejo ◽

Juan José Alegre Sancho ◽

José Andrés Román Ivorra ◽

José Ivorra Cortes

Keyword(s):

Rheumatoid Arthritis ◽

Popliteal Cyst ◽

Baker’S Cyst ◽

Case Presentation ◽

Baker's Cyst

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Popliteal Cyst (Baker's Cyst)

Atlas of Clinical Vascular Medicine ◽

10.1002/9781118618189.ch50 ◽

2013 ◽

pp. 100-101

Author(s):

Bruce L. Mintz

Keyword(s):

Popliteal Cyst ◽

Baker’S Cyst ◽

Baker's Cyst

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Leukocyte-rich platelet-rich plasma application in post-traumatic osteoarthritis with popliteal cyst: a case report

Regenerative Medicine ◽

10.2217/rme-2020-0021 ◽

2020 ◽

Vol 15 (6) ◽

pp. 1695-1702

Author(s):

Bo Song ◽

Peter Chia Yeh ◽

Prathap Jayaram

Keyword(s):

Platelet Rich Plasma ◽

Corticosteroid Injection ◽

Cruciate Ligament ◽

Symptom Relief ◽

Basketball Player ◽

Popliteal Cyst ◽

Baker’S Cyst ◽

Baker's Cyst ◽

Patient Reported ◽

Post Traumatic

Aim: To describe the successful treatment of a Baker’s cyst in the setting of post-traumatic osteoarthritis using ultrasound-guided injection of platelet-rich plasma. Setting: Outpatient sports clinic. Patient: 29-year old male basketball player. Case description: The patient presented with 2-months history of right knee pain, 17 months after undergoing right knee anterior cruciate ligament reconstruction surgery. Exam revealed medial joint line and medial collateral ligament tenderness with posterior knee swelling. After aspiration, a corticosteroid injection was administered with temporary symptom relief. Diagnostic ultrasound examination confirmed the Baker’s cyst. The patient then underwent two serial leukocyte-rich platelet-rich plasma injections into his right knee. Results: The patient reported complete resolution of pain and cyst size. Conclusion: Leukocyte-rich platelet-rich plasma may be considered as a treatment option for patients with Baker’s cysts in the setting of post-traumatic osteoarthritis.

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Giant Baker’s Cyst Associated with Rheumatoid Arthritis

Case Reports in Orthopedics ◽

10.1155/2017/4293104 ◽

2017 ◽

Vol 2017 ◽

pp. 1-4 ◽

Cited By ~ 2

Author(s):

Levent Adiyeke ◽

Emre Bılgın ◽

Tahir Mutlu Duymus ◽

İsmail Emre Ketencı ◽

Meriç Ugurlar

Keyword(s):

Rheumatoid Arthritis ◽

Rare Case ◽

Medial Meniscus ◽

Popliteal Fossa ◽

Baker’S Cyst ◽

Palpable Mass ◽

Baker's Cyst ◽

Semimembranosus Tendon ◽

Left Calf

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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Baker's Cyst in a Patient with Rheumatoid Arthritis

New England Journal of Medicine ◽

10.1056/nejmicm0709049 ◽

2009 ◽

Vol 361 (11) ◽

pp. 1098-1098 ◽

Cited By ~ 1

Author(s):

Catherine Bakewell ◽

Carin Dugowson

Keyword(s):

Rheumatoid Arthritis ◽

Baker’S Cyst ◽

Baker's Cyst

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A Rare Case Report of Infected Baker’s (Popliteal) Cyst

Surgical Case Reports ◽

10.31487/j.scr.2020.05.02 ◽

2020 ◽

pp. 1-4

Author(s):

Salieha Zaheer ◽

Elizabeth Towner ◽

Hassan Baiz ◽

Pierre Morris ◽

Rehana Siddique ◽

...

Keyword(s):

Venous Thrombosis ◽

Deep Venous Thrombosis ◽

Good Condition ◽

Joint Fluid ◽

Popliteal Cyst ◽

Baker’S Cyst ◽

Streptococcus Anginosus ◽

Baker's Cyst ◽

Limited Range Of Motion ◽

The Right

A popliteal cyst, otherwise known as a Baker’s cyst, is a fluid-filled sac that forms behind the knee between the medial head of the gastrocnemius and the semimembranosus muscles. These cysts have a high prevalence in the adult population and are frequently associated with a variety of degenerative conditions of the knee, which complicates the diagnosis. Our patient is an elderly male initially evaluated for a deep venous thrombosis. Further evaluation revealed a baker’s cyst abscess, which was diagnosed on imaging and confirmed post-operatively. A culture growth of the abscess was obtained that grew Streptococcus anginosus. The patient presented with right leg swelling, erythema and knee pain. His physical exam showed significant effusion of the right knee, with tenderness to palpation of the right posterior knee and a limited range of motion with flexion. The venous duplex was negative for deep venous thrombosis (DVT) and the patient continued to experience significant pain with ambulation. A knee aspiration was done with purulent joint fluid sent for culture. A computed tomography (CT) scan without contrast of his right leg revealed a Baker’s cyst abscess within a collection of fluid. The patient was taken to the operating room (OR) with a diagnosis of right septic knee and popliteal cyst abscess where arthroscopic irrigation and debridement with extensive synovectomy of the right knee was performed. Aspiration cultures were positive for Streptococcus anginosus, which has a unique ability to promote abscesses formation. Patient tolerated the procedure well and was discharged from the hospital in good condition with instructions to take Rocephin IV for six weeks. The patient ambulated without difficulty and showed significant improvement after 2 months.

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Impact of a new coronavirus infection on the clinical course of immunoinflammatory rheumatic diseases

HERALD of North-Western State Medical University named after I I Mechnikov ◽

10.17816/mechnikov72269 ◽

2021 ◽

Vol 13 (2) ◽

pp. 39-47

Author(s):

Vadim I. Mazurov ◽

Irina B. Belyaeva ◽

Lubov E. Sarantseva ◽

Anton L. Chudinov ◽

Roman A. Bashkinov ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Viral Infection ◽

Rheumatic Diseases ◽

Biological Therapy ◽

Clinical Course ◽

Underlying Disease ◽

Clinical Rheumatology ◽

Undifferentiated Arthritis ◽

Saint Petersburg ◽

Coronavirus Infection

BACKGROUND: The COVID-19 pandemic poses a particular threat to patients suffering from immunoinflammatory rheumatic diseases. New coronavirus infection has been found to be accompanied by the development of a wide range of extrapulmonary clinical and laboratory manifestations, which are characteristic of a number of immunoinflammatory rheumatic diseases. AIM: To evaluate the features of the clinical course of immunoinflammatory rheumatic diseases in patients who underwent new coronavirus infection. MATERIALS AND METHODS: The clinical course of immunoinflammatory rheumatic diseases was analyzed in 324 patients who underwent new coronavirus infection from March 2020 to February 2021 and were treated at the Clinical Rheumatology Hospital No. 25, Saint Petersburg, for exacerbation of the underlying disease. RESULTS: Analysis showed that the risk factors for severe new coronavirus infection in patients with immunoinflammatory rheumatic diseases were: age over 60, comorbidities, use of prednisolone in a dose greater than 12,5 mg, and ESR values 40 mm/hour before the development of new coronavirus infection. There was no effect of immunosuppressive and biological therapy on the severity of the course of viral infection. There was no effect of immunosuppressive therapy and biological therapy on the severity of the course of viral infection in patients with immunoinflammatory rheumatic diseases. The development of the postinfectious syndrome was observed in 1/4 of patients, which was characterized by the formation of postinfectious arthritis in 3,6% of patients, transformation of undifferentiated arthritis into various rheumatic diseases in 49% of patients (more often into early rheumatoid arthritis), as well as exacerbation of the underlying disease in 83,4% of patients with an advanced stage of rheumatoid arthritis. In patients with mixed connective tissue disease, there was a significant increase in immunologic activity due to antinuclear factor (up to a maximum of 1:163 840). Clinical cases of the development of arthritis associated with viral infection and the debut of rheumatoid arthritis after an new coronavirus infection are presented. CONCLUSIONS: New coronavirus infection in the cohort of patients with immunoinflammatory rheumatic diseases observed in the Clinical Rheumatology Hospital No. 25, Saint Petersburg, proceeded in the variant of medium severity in half of patients, initiated the development of lung lesions in 68,6% of patients, arthritis associated with viral infection in 3,6% of patients, immunoinflammatory rheumatic diseases which transformed from undifferentiated arthritis in 49% of cases and exacerbation of the main disease in an overwhelming number of patients. Patients with immunoinflammatory rheumatic diseases have a high risk of adverse outcome of new coronavirus infection, especially in cases of unstable course of the disease or exacerbation of this group of diseases.

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