Posterior compartment syndrome following ruptured Baker's cyst.

Petros, David P.; Hanley, James F.; Gilbreath, Patricia; Toon, Robert D.

doi:10.1136/ard.49.11.944

Cited by 35 publications

(15 citation statements)

References 6 publications

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“…Irreversible changes are known to occur after only eight to 12 hours of increased compartment pressure, making early diagnosis essential. A history of pain associated with the clinical findings of paraesthesias, weakness, swelling, and increased pain with passive stretching should alert the doctor to the possible diagnosis [15]. In our cases, Homan' s sign was negative and there was no sign or symptom including fever, warmth, erythema, paraesthesias or weakness except swelling and pain.…”

Section: Discussionmentioning

confidence: 61%

Ruptured Baker and #8217;s Cyst in Juvenile Idiopathic Arthritis: A Report of Three Patients

Gülgün¹,

Bilginer²,

Düzova³

et al. 2012

Ann Paediatr Rheum

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Popliteal cysts occur commonly both in normal and arthritic knees. Most cysts are formed by distension of the medially situated semimembranosus bursa. Herein, we describe three children with juvenile idiopathic arthritis and ruptured popliteal cysts which produced leg complaints. Ultrasound and magnetic resonance imaging were performed in the diagnosis of all cases for better evaluation of the anatomic characteristics of the cysts. In all cases, pain and swelling reduced and t hen disappeared with conservative management. In children with juvenile idiopathic arthritis who present with calf pain and swelling of leg, ruptured Baker' s cyst should be considered in the diagnosis.

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Section: Discussionmentioning

confidence: 61%

Ruptured Baker and #8217;s Cyst in Juvenile Idiopathic Arthritis: A Report of Three Patients

Gülgün¹,

Bilginer²,

Düzova³

et al. 2012

Ann Paediatr Rheum

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“…40 Combinations of these are most frequently encountered in the development of compartment syndrome secondary to a ruptured cyst. 38,39 As the cyst expands, it can potentially dissect between the gastrocnemius and soleus muscles or between the medial and lateral heads of the gastrocnemius muscle, and ultimately rupture. Cyst rupture often mimics thrombophlebitic symptoms, including swelling and pain of the affected limb.…”

Section: Discussionmentioning

confidence: 99%

“…A popliteal cyst may be comorbid with a number of these conditions, including communication of the cyst with an adventitial cyst of the popliteal artery, 35 development of a synovial sarcoma within the cyst, 36,37 and also rupture of the cyst, resulting in the acute development of a compartment syndrome. 38,39 It is crucial that the true cause of compression be identified because it directly affects treatment options.…”

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confidence: 99%

Compression syndromes of the popliteal neurovascular bundle due to Baker cyst

Sánchez

Conkling

Labropoulos

2011

Journal of Vascular Surgery

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Background: The purpose of this study was to perform a comprehensive search of the literature for all studies, case reports, and series describing Baker cyst compression of the neurovascular bundle in the popliteal fossa and index their findings according to the structures compressed. Method: Case reports and series obtained after a thorough MEDLINE search were indexed according to compressed structures. Patient demographics, main findings, method of diagnosis, cyst size, outcomes, and follow-up were recorded for each publication. Results: Signs and symptoms related to popliteal vein and tibial nerve compression were the most frequent presentation of symptomatic Baker cysts, due to the anatomic vulnerability of these structures within the popliteal fossa and their relative sensitivity to compression. Patients with tibial nerve entrapment demonstrated gastrocnemius muscle atrophy, paresthesias, and pain. Those with popliteal vein compression experienced swelling, pain, and rarely, venous thromboembolism. Isolated arterial compression, presenting with intermittent claudication, is a rare occurrence because it is a relatively stiff-walled vessel, has a higher pressure, and is located deep in the popliteal fossa. Combinations of these compression syndromes are most frequently encountered in the context of cyst rupture and resulting compartment syndrome. Conclusions: Baker cyst is an important pathology for the differential diagnosis of popliteal neurovascular compression phenomena. It has a wide spectrum of presentation, therefore requiring accurate diagnosis for proper patient management. Because Baker cyst is by definition a chronic disorder, long-term follow-up is necessary to monitor patient recovery and prevent recurrence. ( J Vasc Surg 2011;54:1821-9.)

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“…26 Five previous cases of a ruptured Baker cyst leading to compartment syndrome have been reported in the literature. 12,16,23,31,38 Acute compartment syndrome is most commonly associated with extremity trauma. However, acute compartment syndromes induced by medication or concurrent diseaseinduced bleeding have been reported in the literature.…”

Section: Discussionmentioning

confidence: 99%

Acute Compartment Syndrome Due to Ruptured Baker Cyst after Nonsurgical Management of an Anterior Cruciate Ligament Tear

et al. 2006

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Acute compartment syndrome is a clinical entity seen most often after extremity trauma. However, acute compartment syndrome can also follow atraumatic bleeding into a closed compartment. 2,19,28,41 This case report describes an occurrence of acute compartment syndrome in the setting of bleeding from a ruptured Baker cyst. Five previous cases of acute compartment syndrome in the setting of a ruptured 12,23,31,38 or dissecting 16 Baker cyst have been reported. This article highlights a sixth case and emphasizes the importance of potential contributing factors such as antithrombotic medications and mechanical factors such as leg curls and venous compression devices. CASE REPORTA 49-year-old man was initially evaluated with a 1-month history of a ruptured left ACL. He was treated with activity modification and gradual range of motion restoration. He began working aggressively on hamstring strengthening exercises using prone leg curls with a roller that contacted on the proximal posterior calf. Three weeks later, he came to the clinic with increased left leg pain and swelling. Examination at that time revealed pain with passive toe dorsiflexion (Homans sign). A duplex ultrasound revealed no evidence of deep venous thrombosis (DVT). He was diagnosed with superficial thrombophlebitis. That day, the patient underwent an MRI study, which confirmed the ACL tear in addition to a tear of the posterior horn of the medial meniscus as well as a ruptured Baker cyst. He was treated with rest, elevation, warm compresses, and scheduled doses of ibuprofen. The patient did well for the next 5 days. At that time, he had an acute increase in pain with increased swelling. A repeat ultrasound was negative for DVT. Compartment pressures were measured and ranged between 15 and 20 mm Hg. A diagnosis of possibly evolving acute compartment syndrome was made, and a venous compression device was placed on the foot (Plexipulse, NuTech, San Antonio, Tex) to assist with venous return and decrease swelling. The patient was discharged home with this device. He came to the emergency department 6 hours later with markedly increased swelling and tense compartments.The patient's medical history was significant for Gilbert syndrome, benign prostatic hypertrophy, and depression. He had no history of coagulation or bleeding problems. Routine medications included fluoxetine (Prozac) 10 mg orally once a day and ibuprofen.Physical examination revealed a healthy-appearing man in moderate pain. On musculoskeletal examination of the left knee, there were posterior fullness, tense swelling of all lower leg compartments, and increased pain with passive flexion and extension of the left ankle. Dorsalis pedis and posterior tibial artery pulses were palpable. On neurologic examination of the affected extremity, there was slightly decreased sensation to light touch in the deep peroneal nerve distribution. Compartment pressures were as follows: superficial posterior, 78 mm Hg; deep posterior, 69 mm Hg; lateral, 79 mm Hg; and anterior, 78 mm Hg-confirming a diagnosis of...

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Posterior compartment syndrome following ruptured Baker's cyst.

Cited by 35 publications

References 6 publications

Ruptured Baker and #8217;s Cyst in Juvenile Idiopathic Arthritis: A Report of Three Patients

Ruptured Baker and #8217;s Cyst in Juvenile Idiopathic Arthritis: A Report of Three Patients

Compression syndromes of the popliteal neurovascular bundle due to Baker cyst

Acute Compartment Syndrome Due to Ruptured Baker Cyst after Nonsurgical Management of an Anterior Cruciate Ligament Tear

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