The reliability of the clinical examination for detecting <scp>B</scp>aker's cyst in asymptomatic fossa

Akgül, Özgür; Guldeste, Zuhal; Özgöçmen, Salih

doi:10.1111/1756-185x.12095

Cited by 9 publications

(5 citation statements)

References 35 publications

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“…A total of five patients in this group (0.7%) had a ruptured Baker’s cyst on USS. The prevalence of Baker’s cysts is higher in this study compared to other studies, with the prevalence of Baker’s cysts reported between 7% and 30% 14–23 (see Table 3). Patients in these studies were predominantly Rheumatology patients or patients with knee pain assessing the diagnosis and management of knee OA.…”

Section: Discussioncontrasting

confidence: 71%

“…Baker's cysts are benign, synovial-lined cysts arising from the posterior knee joint and are a consequence of underlying knee joint OA. 14 On imaging, they characteristically extend into the popliteal fossa from the knee joint, between the medial head of the gastrocnemius and semimembranosus muscles. 1 The most common clinical finding is a smooth swelling behind the knee that may or may not be painful.…”

Section: Discussionmentioning

confidence: 99%

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Ultrasound for suspected Baker’s cyst: A test of limited clinical value?

2023

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Introduction: Patients with posterior knee swellings are commonly encountered in clinical practice with the vast majority referred for an ultrasound scan to assess for a clinically suspected Baker’s cyst. Aims: Our aim was to determine the incidence of different pathologies in patients investigated for a posterior knee swelling of a clinically suspected Baker’s cyst using ultrasound. We also wanted to investigate the incidence of significant pathologies in the popliteal fossa to assess whether the ultrasound scan findings influenced patient management. Methodology: Retrospective analysis was performed on all patients who underwent an ultrasound scan for a suspected Baker’s cyst or posterior knee swelling at our institution, between January 2017 and December 2018. Patient demographics, ultrasound findings, further imaging investigations and histopathology were recorded. Patient records were followed up for a minimum period of 3 years after ultrasound. Results: A total of 680 patients had a posterior knee ultrasound scan. Of that, 51% (347/680) had a Baker’s cyst and 40% (273/680) had a normal ultrasound scan. Sixty (9%) patients had other abnormalities identified within the popliteal fossa. Four patients had significant findings on ultrasound that required a change of management. No malignancies identified. Conclusion: This study confirms the high incidence of Baker’s cysts in patients presenting with a posterior knee swelling. In the absence of red flag symptoms, ultrasound of the posterior knee for a clinically suspected Baker’s cyst is of limited clinical value.

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Section: Discussioncontrasting

confidence: 71%

Section: Discussionmentioning

confidence: 99%

Ultrasound for suspected Baker’s cyst: A test of limited clinical value?

2023

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“…59 In the B-mode, BC appear as fluid-filled swellings on the posterior side of the knee (Figure 5B). 60 In addition, during a 2-year follow-up, ultrasound evidence of BC has been shown to predict the clinical and radiological progression of KOA. 61 Hoffa Fat Pad One function of the Hoffa Fat Pad (HFP) is to absorb impulsive actions generated through the knee joint, whereas it loses proper stress-strain behavior under mechanical loads in KOA conditions.…”

Section: Osteophytesmentioning

confidence: 99%

“…In the B‐mode, BC appear as fluid‐filled swellings on the posterior side of the knee (Figure 5B). 60 In addition, during a 2‐year follow‐up, ultrasound evidence of BC has been shown to predict the clinical and radiological progression of KOA 61 …”

Section: Structural Findingsmentioning

confidence: 99%

An Update on Clinical Utility of Musculoskeletal Ultrasonography in Knee Osteoarthritis

Liu

Zhang

et al. 2023

J of Ultrasound Medicine

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In knee osteoarthritis (KOA), timely and accurate assessment of the severity is essential to help orthopedic surgeons determine the most appropriate therapeutic strategies and evaluate disease outcomes and responses for corresponding treatments. In KOA, musculoskeletal ultrasonography (MSUS) could effectively help detect various abnormalities, including synovitis, osteophytes, and cartilage damage. Further, MSUS could be used to monitor the response to different therapies in KOA, to guide local diagnostic and therapeutic procedures. In the future, applications based on continuously evolving US tools could enhance the clinical utility of MSUS in KOA.

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“…BC has demonstrated a longitudinal association with the radiological and clinical progression of osteoarthritis [ 8 ] and may therefore be considered a predictor of osteoarthritis [ 9 ] and a modifiable treatment target [ 10 ]. Early diagnosis of BC may prevent further complications connected with the direct compression or ruptures to the surrounding tissues [ 11 ]. However, it may be a challenging task for physicians to differentiate BC from other musculoskeletal disorders in or near the popliteal fossa, such as synovial and bone tumor, meniscal cyst and ganglion cyst, which share similar symptoms and signs [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Diagnostic accuracy of ultrasound for the assessment of Baker’s cysts: a meta-analysis

Liu

Li²,

Weng³

et al. 2022

J Orthop Surg Res

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Background Baker’s cyst is the most common cystic disease of the knee, and a fast and accurate diagnosis of Baker’s cyst is essential for a better management. Ultrasound is a rapid, portable, widely available, inexpensive and noninvasive imaging modality. However, the diagnostic accuracy of ultrasound on Baker’s cyst still remains undetermined. We conducted the first meta-analysis to comprehensively assess the accuracy of ultrasound for the detection of Baker’s cyst. Methods PubMed, Embase and Web of Science were searched from inception to July 14, 2022, without language restrictions. Studies providing cross-tabulations of ultrasound versus pathology (gold standard) or MRI (standard imaging technique) for diagnosis of Baker’s cyst were included. Indicators for the diagnostic accuracy of ultrasound, including sensitivity, specificity and area under the curve, were calculated using a bivariate model. Sensitivity analysis was conducted to evaluate the heterogeneity and robustness of the results. Results A total of 13 studies with 1,011 subjects (mean age 32.2 years; men 53.5%) met the inclusion criteria. The pooled sensitivity, specificity and area under the curve of ultrasound for diagnosis of Baker’s cyst, compared with pathology, were 0.97 (95% confidence intervals: 0.73–1.00), 1.00 (0.98–1.00) and 1.00 (0.99–1.00), respectively. The pooled estimates of ultrasound versus MRI were 0.94 (0.87–0.98) for sensitivity, 1.00 (0.83–1.00) for specificity and 0.97 (0.95–0.98) for area under the curve. Sensitivity analysis did not change the results materially. Conclusion Ultrasound shows excellent diagnostic accuracy for the assessment of Baker’s cyst and provides similar diagnostic information (absent or present) compared to MRI. Because of its advantages of low cost, portability and accessibility, ultrasound is likely to be a choice of imaging technique for screening Baker’s cyst in clinical and population settings as well as in follow-ups.

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The reliability of the clinical examination for detecting Baker's cyst in asymptomatic fossa

Abstract: This study demonstrates that many patients may have BCs without any symptoms at the popliteal fossa and clinical examination of the popliteal fossa could not accurately detect BC. US examination of the popliteal fossa should be performed to detect BCs and this may recover the diagnosis.

Cited by 9 publications

References 35 publications

Ultrasound for suspected Baker’s cyst: A test of limited clinical value?

Ultrasound for suspected Baker’s cyst: A test of limited clinical value?

An Update on Clinical Utility of Musculoskeletal Ultrasonography in Knee Osteoarthritis

Diagnostic accuracy of ultrasound for the assessment of Baker’s cysts: a meta-analysis

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