[Arthrography and ultrasound scanning for the detection of Baker cysts (author's transl)]

Sonography in Differential Diagnosis of Deep Venous Thrombosis of the Leg

The lower extremities of 60 consecutive symptomatic patients were examined first by ultrasound (US) and then by phlebography. Deep venous thrombosis was found in 17 patients by means of venography. A hematoma was detected by US in six legs without thrombosis. A popliteal cyst was observed by US in five cases; one patient had a concurrent deep venous thrombosis. It was concluded that symptomatic patients with a negative phlebography should be examined by US for correct diagnosis and treatment, although US cannot replace phlebography.

Bilateral Baker's cyst as the presenting symptom of paraneoplastic syndrome

Paraneoplastic syndrome is defined as a systemic malignancy producing prostaglandins or other substances that lead to various manifestations, syndromes or diseases. In the following report we present a case of a young patient complaining of bilateral Baker's cysts who ultimately was diagnosed as suffering from gastric lymphoma. Following subtotal gastrectomy the Baker's cysts disappeared with no specific treatment.

Sonography of popliteal masses

Sonography of the popliteal space was performed in 28 patients with a history of a popliteal mass, verified by physical examination in all but 7 patients. The final diagnosis was established by needle biopsy or surgery. Three main types of lesions were found sonographically. A thin-walled echo-free cyst was present in 16 patients. The diagnosis in all of these cases was Baker's cyst. Two patients had a mixed cystic and solid lesion, which was found to be a Baker's cyst, with a loose body in 1 case and a soft-tissue sarcoma with hematoma in the other. Three patients showed solid lesions subsequently diagnosed as an old rupture of the semimembranosus muscle, lipoma, and soft tissue sarcoma. Sonography was normal in the 7 patients without clinical evidence of a popliteal mass. Sonography of popliteal masses is useful to distinguish benign cysts from other lesions.

Evaluation of popliteal cysts and painful calves with ultrasonography: comparison with arthrography

Grey-scale ultrasonography will detect reliably the presence of clinically significant popliteal cysts, fluid collections which do not fill by arthrography, and will frequently demonstrate ruptured cysts and the soft tissue changes resulting from a recent leak. Forty-eight knees, in 25 patients with popliteal and/or calf pain were examined by ultrasonography followed by arthrography. Popliteal cysts were demonstrated in 40% (19/48) by ultrasound and in 46% (22/48) by arthrogram. For comparison between arthrography and ultrasonography chi2 = 8.58 and contingency coefficient, phi = 0.42 (p less than 0.01). Acute cyst rupture was shown in 2 patients (8%) by both arthrography and ultrasound. In a further study ultrasonography demonstrated popliteal cysts with a prevalence of 31% (22/72) in 36 patients with definite or classical rheumatoid arthritis compared with 4% (3/72) in controls closely matched for age and sex. This difference in prevalence between the rheumatoid patients and controls was highly significant chi2 = 17.48, p less than 0.001. Ultrasonography, therefore, will demonstrate noninvasively the presence of popliteal cysts, may assist in the diagnosis of rupture, and furthermore will assist in quantitative, sequential assessment of patients with painful knees and calves.

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.