Baker's cysts are rare cause of peripheral nerve entrapment and only a few cases of tibial nerve entrapment resulting from the popliteal cyst in the calf muscle have been reported in the literature. We present a case of rheumatoid arthritis complicated by a Baker's cyst with a tibial nerve entrapment. It is important to diagnose a Baker's cyst early and to differentiate it from thrombophlebitis, a popliteal aneurysm, tumor or muscle tear to effect optimal therapy and to obviate a potential neuropathy. Prompt recognition of these cases may save the patients unnecessary procedures and delay in treatment.
Arthritis, Rheumatoid/diagnosis ; Arthritis, Rheumatoid/complications ; Biopsy, Needle ; Case Report ; Electromyography ; Female ; Follow-Up Studies ; Human ; Magnetic Resonance Imaging ; Middle Age ; Popliteal Cyst/surgery ; Popliteal Cyst/diagnosis ; Popliteal Cyst/complications+ACo- ; Tibial Neuropathy/etiology+ACo- ; Tibial Neuropathy/diagnosis ; Treatment Outcome

Schwannoma is the most common benign tumor of peripheral nerves and usually appears on the trunk, head and neck, or extremities. A mass arising at popliteal fossa can be misdiagnosed as a popliteal cyst. We report on a rare case of a popliteal schwannoma mimicking a popliteal cyst in a 39-year-old female who showed a clinical presentation similar to that of a popliteal cyst. Diagnosis was delayed until ultrasonographic evaluation was performed due to its anatomical location, the same as that of a popliteal cyst. We describe the clinical significance and ultrasonographic findings of the schwannoma for initial differential diagnosis from a popliteal cyst.
Adult ; Diagnosis ; Diagnosis, Differential ; Extremities ; Female ; Head ; Humans ; Neck ; Neurilemmoma* ; Peripheral Nerves ; Popliteal Cyst* ; Ultrasonography

Degenerative disc disease of the lumbar spine caused leg pain with associated calf weakness and atrophy. However, an unusual case of leg pain and calf atrophy due to neural compression is reported. We reported a rare case of a Baker's cyst causing common peroneal nerve and tibial nerve entrapment neuropathy. Initially, after arthroscopic menisectomy and cyst decompression, Baker's cyst was recurred and then open excision was done. Until 1 year after surgery, the cyst was not recurred, increased muscle bulk was noted and EMG showed improved findings. But she continued to complain of lower leg weakness and sole paresthesia owing to delayed diagnosis and cyst decompression.
Atrophy ; Decompression ; Delayed Diagnosis ; Leg ; Paresthesia ; Peroneal Nerve* ; Popliteal Cyst* ; Spine ; Tibial Nerve*

Popliteal cyst is a common peri-knee cyst, also known as a Baker's cyst. With the current development of popliteal cysts, the pathogenesis is mainly due to increased pressure in the knee joint caused by various reasons, leading to a fluid-filled sac that can form behind the knee as a result of enlargement of the gastrocnemius-semimembranosus bursa. The current diagnostic methods include X-ray computed, ultrasound, and magnetic resonance. Among them, magnetic resonance imaging is considered the gold standard for the diagnosis of popliteal cysts. There are various treatments, including conservative treatment, traditional surgical resection and arthroscopic surgery. In recent years, the focus of the treatment of popliteal cysts has gradually shifted from the simple removal of cysts to arthroscopic treatment of intra-articular lesions and the treatment of joint-cyst communication, and achieved a good effect. However, there are still controversies about the most effective treatment, and the best surgery method is still uncertained. It is hoped that high quality prospective studies will be able to directly compare different surgery methods, so as to select the best treatment for popliteal cyst. This article reviews past literature research and describes in detail the epidemiology, pathological mechanism, clinical manifestations and signs, auxiliary examination, diagnosis and differential diagnosis and clinical treatment of popliteal cysts. Different diagnosis methods and treatment methods are compared and summarized to provide basis for clinical diagnosis and treatment.
Arthroscopy ; Bursa, Synovial ; Humans ; Knee Joint ; Popliteal Cyst ; diagnosis ; therapy ; Prospective Studies

Here, we describe a popliteal mass that was initially misdiagnosed as a simple popliteal cyst, which finally turned out to be osteochondrolipoma. A 63-year-old housewife presented with sustained knee pain in association with a palpable mass on the popliteal fossa. The mass was in the posteromedial area and soft, non-tender, non-movable in the posteromedial area. Using plain radiography, the mass appeared as a round, soft tissue density lesion containing bony fragments. We performed an ultrasound-guided needle biopsy in conjunction with magnetic resonance imaging, followed by an open excisional biopsy. Microscopically, histological sections showed a lipoma with cartilaginous and osseous differentiation, finally diagnosed as osteochondrolipoma. In conclusion, popliteal masses are not always simple cysts, and the evaluation of masses in the popliteal fossa is always necessary.
Female ; Humans ; Lipoma/complications/*diagnosis ; Middle Aged ; Osteochondroma/complications/*diagnosis ; Popliteal Cyst/etiology ; Soft Tissue Neoplasms/complications/*diagnosis

Baker cyst is an enlargement of the gastrocnemius-semimembranosus bursa. Neuropathy can occur due to either direct compression from the cyst itself or indirectly after cyst rupture. We report a unique case of a 49-year-old man with left sole pain and paresthesia who was diagnosed with posterior tibial neuropathy at the lower calf area, which was found to be caused by a ruptured Baker cyst. The patient's symptoms resembled those of lumbosacral radiculopathy and tarsal tunnel syndrome. Posterior tibial neuropathy from direct pressure of ruptured Baker cyst at the calf level has not been previously reported. Ruptured Baker cyst with resultant compression of the posterior tibial nerve at the lower leg should be included in the differential diagnosis of patients who complain of calf and sole pain. Electrodiagnostic examination and imaging studies such as ultrasonography or magnetic resonance imaging should be considered in the differential diagnosis of isolated paresthesia of the lower leg.
Diagnosis, Differential ; Humans ; Leg ; Magnetic Resonance Imaging ; Nerve Compression Syndromes ; Paresthesia ; Popliteal Cyst ; Radiculopathy ; Rupture ; Tarsal Tunnel Syndrome ; Tibial Nerve ; Tibial Neuropathy

PURPOSE: The purpose of this study is to evaluate the cost effectiveness of Computed Tomography (CT) in diagnosis of leg swelling, Now that the public health insurance became applicable since last year. METHOD: Nineteen patients who had difficulty in diagnosing the causes of leg swelling in physical examination and two patients for follow up underwent CT according to the protocol used since November 1999. RESULT: Eight patients showed deep vein thrombosis including two patients for follow up. Three patients showed compatible findings with lymphedema. Other causes appear to be originated from soft tissue; intramuscular hematoma in two, popliteal cyst rupture in two, multiple abscess in three and unknown origin in one patient. CONCLLUSION: The value of CT screening in the diagnosis of swollen leg should be reconsidered with the lowered cost to the patients.
Abscess ; Cost-Benefit Analysis ; Diagnosis* ; Follow-Up Studies ; Hematoma ; Humans ; Insurance* ; Leg* ; Lymphedema ; Mass Screening ; Physical Examination ; Popliteal Cyst ; Public Health* ; Rupture ; Venous Thrombosis

OBJECTIVE: Ultrasonography (USG) of joints has a unique position for the diagnosis of joint diseases. Bone surface, cartilage, periarticular soft tissue and their pathologic changes can be assessed by USG. This study was aimed to compare the radiographic and ultrasonographic findings in osteoarthritis (OA) of the knee joint and to evaluate the usefulness of each modality to evaluate the disease early and determine the severity of the arthritis. METHODS: Fifty osteoarthritis patients classified by the American College of Rheumatology (ACR) clinical criteria from December 2002 to April 2003 were included in the study. Routine radiography (standing anteroposterior, lateral, skyline view) and systemic USG examination of both knee were performed. We compared the incidence of the radiographic and ultrasonographic abnormality related to the pathologic change of the knee OA and suggesting the severity of the OA which would help to decide the therapeutic modality. RESULTS: In patient with knee OA, plain radiography showed abnormal findings in 37/50 (74%) patients, but USG showed at least five abnormal findings in all 50 patients. The abnormal findings detected only by plain radiography were subchondral sclerosis and subchondral cyst (14% and 4% each). But, the thinning of cartilage (94%), Baker's cyst (94%), cartilage degeneration (54%), meniscal protrusion (44%), meniscal tear (34%), meniscal cyst (32%), and the pannus (22%) were detected only by USG. Among the findings shared by both method, joint space narrowing was detected better by plain radiography than USG, but fluid accumulation, spur, meniscal calcification and osteochondroma were detected more frequently by USG. CONCLUSION: USG is more sensitive to find the pathologic changes related to the knee OA and to diagnose OA than the plain radiography. But each of the plain radiography and USG have their own unique value for the evaluation of OA in the knee. So the USG supplements the plain radiography in the examination of the knee OA.
Arthritis ; Bone Cysts ; Cartilage ; Diagnosis ; Humans ; Incidence ; Joint Diseases ; Joints ; Knee Joint ; Knee* ; Osteoarthritis ; Osteoarthritis, Knee* ; Osteochondroma ; Popliteal Cyst ; Radiography* ; Rheumatology ; Sclerosis ; Ultrasonography*