Nonoperative management of lower extremity claudication caused by a Baker's cyst: case report and review of the literature

Vascular. 2005 Jul-Aug;13(4):244-7. doi: 10.1258/rsmvasc.13.4.244.

Abstract

A Baker's or popliteal cyst is a synovial cyst in the popliteal fossa arising from the knee joint. The majority of patients develop a popliteal mass that is asymptomatic, but in a small percentage of patients, complications and symptoms occur; these may not only encompass the popliteal veins and arteries but may also include cyst leakage, infection, hemorrhage, and compartment syndrome. Severe lower limb ischemia caused by a Baker's cyst is extremely rare, having been reported only six times since 1960; all patients were treated with surgical intervention. We report the case of a 29-year-old male presenting with right calf claudication caused by a Baker's cyst. The patient was managed nonoperatively with nonsteroidal anti-inflammatory agents, proper exercises, and close observation. His claudication improved progressively and had completely disappeared at 12 months of follow-up. A repeat duplex arterial study showed that increased blood flow to the right foot and the right ankle/brachial index improved to 0.97 from 0.67. Repeat ultrasonography demonstrated that the size of the cyst decreased from 4.5 x 1.5 cm to 2.8 x 0.9 cm. The patient had been followed for 20 months and remained asymptomatic in the last 8 months. We will continue to follow the patient to evaluate the long-term outcome. In summary, our own data and literature review suggest that the limb ischemia caused by Baker's cyst may be a transient condition and can be managed nonoperatively in selected patients.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use*
  • Constriction, Pathologic
  • Humans
  • Intermittent Claudication / diagnosis
  • Intermittent Claudication / drug therapy*
  • Intermittent Claudication / etiology
  • Knee Joint / pathology
  • Magnetic Resonance Imaging
  • Male
  • Popliteal Cyst / complications*
  • Popliteal Cyst / diagnosis
  • Treatment Outcome

Substances

  • Anti-Inflammatory Agents, Non-Steroidal