71/77. Coccidiomycosis presenting as a popliteal cyst. Coccidiomycosis is a fungal infection that primarily causes pulmonary disease. Extrapulmonary dissemination can occur to the musculoskeletal system with the knee joint most frequently involved. This case report describes a patient with coccidiomycosis whose initial presentation was of a popliteal cyst. The need for aggressive surgical and antibiotic treatment to eradicate this infection is discussed. Coccidiomycosis should be considered in a differential diagnosis of patients with popliteal cysts without other obvious etiologies. ( info) |
72/77. lipoma arborescens of the knee. lipoma arborescens is a rare intra-articular lesion, characterised by diffuse replacement of the subsynovial tissue by mature fat cells, producing prominent villous transformation of the synovium. The aetiology of this benign condition is unknown. We describe six cases involving the knee, discussing the symptoms, diagnosis and treatment. ( info) |
73/77. Epstein-Barr (EB) monoarthritis leading to ruptured Baker's cyst. We report a case of Epstein-Barr (EB) infection that presented as an acute monoarthritis of the knee. This formed a Baker's cyst which ruptured into the gastrocnemius. The peripheral and synovial white blood counts were dominated by neutrophils. After repeated aspirations, spontaneous resolution occurred. ( info) |
74/77. Posterior tibial neuropathy from ruptured Baker's cyst. OBJECTIVES: To increase awareness of entrapment neuropathy caused by rupture of Baker's cyst. methods: A patient with psoriatic arthritis, ruptured Baker's cyst, and entrapment neuropathy is reported and the literature on this complication is reviewed. RESULTS: Nerve entrapment caused by rupture of Baker's cyst is rare. Neurological examination and demonstration of Baker's cyst by color Doppler Duplex Ultrasound (CDDU) help in making the diagnosis. Nerve Conduction Study (NCS) may confirm the diagnosis of posterior tibial nerve entrapment. CONCLUSIONS: Peripheral nerve entrapment should be considered in patients with Baker's cysts and loss of sensation along the plantar aspect of the foot or other neurological symptoms or findings. ( info) |
75/77. Superficial venous thrombosis presenting as a painful popliteal fossa mass in a child. We report an unusual case of superficial venous thrombosis in a cyanotic 12-year-old child who had undergone recent appendectomy. Although compression, color Doppler, and duplex ultrasound techniques remain the keys to the diagnosis of venous thrombosis, SieScape sonography was beneficial in demonstrating the extent of the thrombi and their location along a superficial thrombosed vein. ( info) |
76/77. Nerve entrapment by a firmly wrapped Baker cyst. Baker's cysts as a clinical entity are among the most infrequent cause of peripheral nerve entrapment and usually produce a strong positive pressure within the knee resulting in the rupture of the joint capsule. An unusual case with muscular and sensorial weakness due to compression of the peroneal nerve around the fibular head by a Baker cyst is presented in this article. Clinical and electromyographical findings shown peroneal nerve entrapments in the popliteal fossa. peroneal nerve decompression by synevectomy resulted in clinical and electromyographical improvement. ( info) |
| Two cases of isolated symptomatic ganglia and one case of a combined asymptomatic ganglion arising from the posterior cruciate ligament (PCL) are reported. One patient was a 29-year-old male who complained of posteromedial radiating knee pain. The medial McMurray test was positive. A cystic mass, 1.5 cm in diameter, arising from the femoral insertion of the PCL was removed piece-by-piece. The second case involved a 29-year-old female who complained of medial knee pain and limitation of flexion. MR scans detected a soft mass around the PCL. This was found to be a ganglion cyst surrounding the PCL, measuring 30 mm by 25 mm; it was excised using a power shaver. The third patient was a 17-year-old male who had knee pain due to a large medial synovial plica. Two small cystic masses were present on the intermediate portion of the PCL, but they seemed to be asymptomatic because of their small size. Whether or not a ganglion produces symptoms is determined by its size and location. Intra-articular ganglia can be cured by piecemeal resection and do not recur. ( info) |