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September 29, 1978

Ruptured Baker's Cyst Simulating Acute Thrombophlebitis

Author Affiliations

From the Department of Radiology, The Medical College of Wisconsin, Milwaukee County Medical Complex, Milwaukee.

JAMA. 1978;240(14):1517-1518. doi:10.1001/jama.1978.03290140059028

POPLITEAL synovial cysts (Baker's cysts) commonly occur in patients with a chronic knee-joint effusion whether related to trauma, degenerative change, or an inflammatory process.1 -3 Ruptured cysts that dissect into the calf can produce severe pain that simulates thrombophlebitis.

Arthrography is a useful tool for diagnosing extrameniscal lesions of the knee joint. We have recently encountered three patients with ruptured Baker's cysts initially suspected of having thrombophlebitis. Each complained of pain and swelling in the calf, ankle, or knee. None had a history of rheumatoid arthritis or meniscal cartilage tear. In each instance, arthrography was delayed because of a failure to recognize the existence of a knee-joint problem.

Report of Cases 

Case 1.—  A 22-year-old woman had two episodes of acute swelling and pain in the left ankle and calf within two weeks. She had experienced intermittent knee swelling for the past eight years. Because of persistent pain and