Large cysts in lower leg originating in the knee occurring in patients with rheumatoid arthritis

Abstract

Four patients are presented with rheumatoid arthritis who have had long term steroid therapy with unusual cysts in the posterior aspect of the lower portion of the leg connected with the joint cavity. The diagnosis may be confused with thrombophlebitis of the leg veins.Arthrograms clarify the diagnosis. The mechanism formation of these cysts is unclear, but may be due partly to weakening of the connective tissue by prolonged steroid therapy. The cysts disappear and recur with remission and exacerbation of the rheumatoid process. Surgical excision of the cysts relieves the discomfort but recurrence is frequent.Es presentate quatro patientes con arthritis rheumatoide, tractate a longe vista con therapie steroide e exhibiente cystes inusual in le aspect0 posterior del parte inferior del gambas. Le cystes es connectite con le cavitate articular del genu. Le diagnose es facile a confunder con thrombophlebitis del venas del gamba. Arthrogrammas servi a clarificar le diagnose. Le mechanism0 del formation de iste cystes non es clar, sed il es pos sibile que il se tracta de un debilitation del tissus conjunctive in consequentia del prolongate therapia con steroides. Le cystes dispare e recurre con remissiones e exacerbationes del process0 rheumatoide. Le excision chirurgic del cystes allevia le disconforto, sed recurentias es frequente.

Popliteal Cysts and Their Relation to the Gastrocnemio-Semimembranosus Bursa: Studies on the Surgical and Functional Anatomy

“…Most /JIIW<ilt!J, hewever, apart from a radical excision of the cyst, advocate closure of the communication (Bond 1890, Kirmisson 1892, Hawkes 1899, Hemet 1900, Wilson et al 1938, Edmunds & Hebble 1939, Meyerding & van Demark 1943, Haggart 1943, Kuhn & Hemphill 1944, Sachs & Rubinstein 1946, Orr 1951, Saegesser 1956, Kirpila & Ripatti 1958, Beatty 1959, Harvey & Corcos 1960, Colombo 1965, Bryan et al 1967, Borellini et aI. 1971, Justis 1971, Solomon & Berman 1972, Goldstein & Dickerson 1974.…”

“…In some larger reviews the results of histopathological examination of excised popliteal cysts have been reported (Hammer 1920, Haggart 1938, Wilson et al 1938, Buck et al 1943, Kuhn & Hemphill 1944, Burleson et al 1956, Kirpila & Ripatti 1958, Harvey & Corcos 1960, Hoffman 1963, Myles 1971, Reinhardt 1972), but no consistent histological features have been described upon which a clinically relevant classification could be based or conclusions drawn regarding their pathogenesis.…”

“…In the literature numerous accounts bear witness to the propensity of popliteal cysts to recur following surgical excision (Lewin 1952, Burleson et al 1956, Beatty 1959, Harvey & Corcos 1960, Hoffman 1963, Bryan et al 1967, Hooper & Brookler 1971, Myles 1971, Pinder 1973, Vahvanen 1973, Meire et al 1974, particularly after their removal in children (Malloch 1970, Dinham 1975. In a recent clinical and arthrographic follow-up study Rauschning & Lindgren (1979) found 40 recurrences and 15 postoperative complications following 41 routine operations on such cysts.…”

Popliteal Cysts (Baker's Cysts) in Adults: I.Clinical and Roentgenological Results of Operative Excision

“…It is the experience of many surgeons that popliteal cysts frequently reappear after operation (Harvey & Corcos 1960, Childress 1970, Vahvanen 1973, while others consider the excision more beneficial (Haggart 1943, Meyerding & van Demark 1943, Burleson et al 1956). Since we have observed several recurrences following routine excisions of popliteal cysts, we considered it of interest to re-examine a series of patients in this respect.…”

Popliteal Cysts (Baker's Cysts) in Adults:II. Capsuloplasty With and Without a Pedicle Graft

“…Recurrences following conventional surgical treatment are frequent (Harvey & Corcos 1960, Vahvanen 1973, Meire et al 1974. In a recent clinical and radiographic follow-up examination of 41 routinely excised popliteal cysts, 15 postoperative complications and 40 recurrences were found (Rauschning & Lindgren 1979).…”