Baker's Cyst Filled with Hematoma at the Lower Calf

Abstract

Baker's cyst is a distension of the gastrocnemius-semimembranosus bursa of the knee, which communicates with the posterior portion of the joint capsule. Baker's cyst is commonly located in the inferomedial or superficial layers of the knee joint and rarely extends laterally or proximally. Complications of Baker's cysts are dissection, rupture, pseudothrombophlebitis, leg ischemia, nerve entrapment, and compartment syndrome. However, hematomas in the Baker's cyst have not been reported in Korea. We report a rare case of hematoma in the Baker's cyst with subfascial extension into the calf. The hematoma was demonstrated by magnetic resonance imaging and removed by mass excision.

Compartment syndrome secondary to Baker's cyst rupture: A case report and up-to-date review

“…However, MRI provides detailed information with a better demonstration of fluid within calf fascia. [189]…”

“…Baker's cyst is a distention or enlargement of the gastrocnemius-semimembranosus bursa (GSB) toward popliteal fossa. [1] Communication through a capsular opening between the knee joint cavity and GSB is a common anatomic variant in a normal joint [Figure 1]. Handy reported that Baker's cyst may be found in 5%–32% of symptomatic knees in a review article.…”

“…Although Baker's cyst usually remains asymptomatic, it may produce knee pain or stiffness with a palpable lump at the posterior aspect of the knee. [134] However, it may cause various complications such as neurovascular entrapment owing to mass effect, infection, cyst rupture, and compartment syndrome. Compartment syndrome secondary to Baker's cyst rupture is a rare complication with few published cases in the literature [Table 1].…”

Unusual Presentation of Popliteal Cyst on Magnetic Resonance Imaging

“…The popliteal cyst in this case showed low signal intensity on T1-weighted images and heterogeneous intermediate signal intensity on T2-weighted images. Thus far, pigmented villonodular synovitis, hematoma, and infection have been reported in cases of popliteal cyst with unusual appearance on MRI [6, 7]. Unless the connection between the cyst and the subgastrocnemius bursa can be identified on MRI, malignant tumour, aneurysm, or benign solid tumour should be considered [8].…”

“…Unless the connection between the cyst and the subgastrocnemius bursa can be identified on MRI, malignant tumour, aneurysm, or benign solid tumour should be considered [8]. In all previous cases with unusual signal intensities inside the popliteal cyst, open resection was performed for diagnosis and treatment [6, 7]. The unusual presentation of the popliteal cyst on preoperative MRI was due to necrotic synovial villi inside the cyst.…”