Baker's cysts in knees with chronic osteoarthritic pain: A clinical, ultrasonographic, radiographic and scintigraphic evaluation

Department of Nuclear Medicine, Papageorgiou Hospital, and Aristotelian University, Thessaloniki, Greece.
Rheumatology International (Impact Factor: 1.52). 06/2008; 29(2):141-6. DOI: 10.1007/s00296-008-0639-z
Source: PubMed


This study aimed to determine the ultrasonographic prevalence of Baker's cysts in knees with chronic osteoarthritic pain and investigate for cysts correlates and relationships with scintigraphically established synovitis. Consecutive patients with chronic osteoarthritic knee pain underwent clinical examination, X-rays, ultrasonography and early-phase bone scintigraphy. Eighty-nine Baker's cysts were detected in 328 knees with chronic osteoarthritic pain (27%), whereas one cyst was identified among the 54 non-osteoarthritic knees (2%, P<0.001). Baker's cysts were detected in 72/195 (37%) patients with knee osteoarthritis. Abnormal and intense tracer accumulation in early-phase bone scintigraphy were significantly more frequent in osteoarthritic knees with Baker's cysts (97 and 56%, respectively), than in those without (89 and 40%, respectively, P<0.05 for both). Clinical and radiographic variables could not predict the presence of those cysts. Baker's cysts are a common ultrasonographic finding in knees with chronic osteoarthritic pain and are associated with synovial inflammation and its grade.

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    • "Hill and colleagues reported 43.2% prevalence of popliteal cysts in knees with moderate or larger effusions, compared with 22.7% in those with little or no effusion, and the presence of popliteal cysts was not associated with knee pain [10]. Chatzopoulos et al. reported that popliteal cysts are a common finding in the knee among subjects with chronic OA pain [32]. These studies did not distinguish weight-bearing from non-weight-bearing pain, which are two distinct constructs of WOMAC pain [16]. "
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    ABSTRACT: The role of popliteal cysts and subgastrocnemius bursitis in knee joint homeostasis is uncertain. The aim of this study is to describe cross-sectional associations between popliteal cysts, subgastrocnemius bursitis, knee symptoms and structural abnormalities in older adults. A cross-sectional sample of 900 randomly-selected subjects (mean age 63 years, 48% female) were studied. Knee pain, stiffness and dysfunction were assessed by self-administered Western Ontario McMaster Osteoarthritis Index (WOMAC) questionnaire. Radiographic knee osteophyte and joint space narrowing (JSN) were recorded. Magnetic resonance imaging (MRI) was utilized to assess popliteal cysts, subgastrocnemius bursitis, cartilage defects and bone marrow lesions (BMLs). Popliteal cysts were present in 11.7% and subgastrocnemius bursitis in 12.7% of subjects. Subgastrocnemius bursitis was more common in those with popliteal cyst (36.2% versus 9.7%, P <0.01). In multivariable analyses, popliteal cysts were significantly associated with increased osteophytes in both medial and lateral tibiofemoral compartments while subgastrocnemius bursitis was associated with increased osteophytes and JSN in the medial tibiofemoral compartment. Both were significantly associated with cartilage defects in all compartments, and with BMLs in the medial tibiofemoral compartment. Furthermore, both popliteal cysts and subgastrocnemius bursitis were significantly associated with increased weight-bearing knee pain but these associations became non-significant after adjustment for cartilage defects and BMLs. Popliteal cysts and subgastrocnemius bursitis are associated with increased symptoms as well as radiographic and MRI-detected joint structural abnormalities. Longitudinal data will help resolve if they are a consequence or a cause of knee joint abnormalities.
    Arthritis research & therapy 03/2014; 16(2):R59. DOI:10.1186/ar4496 · 3.75 Impact Factor
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    • "Fluid-equivalent lesions of the knee joint consist of a variety of pathologies ranging from benign intra-articular fluid collections to those associated with inflammatory or degenerative arthritis, infection and malignancy [1-4]. These pathologies have historically been detected by arthrography [5] and ultrasound [6], and are often seen on routine magnetic resonance imaging (MRI) scans. MRI has emerged as the technique of choice for characterizing the nature of these lesions, which show fluid-equivalent hypointensity on T1-weighted images and hyperintensity on T2-weighted images. "
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    ABSTRACT: The purpose of the present study was to determine the prevalence of cystic lesions and cyst-like bursitides in subjects with frequent knee pain and to assess their relation to radiographic osteoarthritis (OA) severity; to describe bilaterality and size fluctuation of the lesions over 6 months; and to assess relations between the prevalence of synovium-lined lesions communicating with the joint capsule and severity of magnetic resonance imaging (MRI)-detected effusion and synovitis. One hundred and sixty-three subjects (total 319 knees) aged 35 to 65 with chronic, frequent knee pain were included. Imaging with 3 Tesla MRI was performed at baseline and 6-month follow-up with the same protocols as those used in the Osteoarthritis Initiative. Severity of radiographic OA was assessed using the Kellgren-Lawrence grade (0 to 4). Severity of effusion and synovitis was graded 0 to 3 based on the Whole Organ Magnetic Resonance Imaging Score system. The associations of cysts and cyst-like bursitides and severity of radiographic OA, MRI-detected effusion and synovitis were analyzed using logistic regression controlling for clustering by person. The Wilcoxon signed-rank test was used to determine whether there was a significant change in the size of lesions between baseline and follow-up. At least one lesion (any type) was present in 222 (70%) knees. The most prevalent lesions were popliteal cysts (40%, 128/319), followed by subgastrocnemius bursitis (15%, 49/319) and proximal tibiofibular joint cysts (8%, 26/319). Bilateral lesions were seen in 49% of the subjects. Only popliteal cysts and subgastrocnemius bursitis showed a significant change in size (P < 0.001). No trend was observed between prevalence of any of the cyst-like lesions analyzed and the increasing radiographic OA severity. Increasing prevalence of subgastrocnemius bursitis was associated with increasing severity of effusion (P = 0.0072) and synovitis (P = 0.0033). None of the cyst-like lesions analyzed seems to be a marker of radiographic OA severity in knees with chronic frequent pain. Subgastrocnemius bursitis may be used as a marker of effusion/synovitis severity. Bilateral cyst-like lesions are relatively commonly observed in people with chronic knee pain.
    Arthritis research & therapy 09/2010; 12(5):R172. DOI:10.1186/ar3132 · 3.75 Impact Factor
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    ABSTRACT: Die Schulterarthroskopie ist ein verbreitetes Therapieverfahren und erlaubt die Behandlung einer Vielzahl von Schulterpathologien. Die Werte für Morbidität und Komplikationsraten sind niedrig. Wir berichten über eine arthroskopieportalassoziierte Synovialzyste 8 Wochen nach arthroskopischem Débridement einer irreparablen Rotatorenmanschettenruptur. Die offene Exzision zeigte eine 2 × 2 × 1 cm messende Synovialzyste im Bereich des lateralen Arthroskopieportals. Dies ist der erste in der Literatur beschriebene Fall einer arthroskopieportalassoziierten Synovialzyste nach Schulterarthroskopie.
    Arthroskopie 11/2011; 24(4). DOI:10.1007/s00142-011-0658-8
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