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Scientific Reports Aug 2021Worldwide, knee osteoarthritis (KOA) accounts for 2.2% of total years lived with disability. There is a low correlation between joint tissue damage and pain intensity.... (Observational Study)
Observational Study
Worldwide, knee osteoarthritis (KOA) accounts for 2.2% of total years lived with disability. There is a low correlation between joint tissue damage and pain intensity. Periarticular structures may be involved and cannot be identified in X-rays. To describe the main ultrasonography (USG) changes in symptomatic patients with primary KOA; to correlate the number of USG findings with KOA severity assessed by Kellgren and Lawrence (K&L) radiological scores, with pain intensity measured by a visual analogue scale (VAS) and with functioning scores assessed with the Timed up and go test (TUG) and Western Ontario and McMaster Universities (WOMAC) questionnaire. 100 patients with primary symptomatic KOA were assessed with X-ray and USG. Quantitative and qualitative analyses were evaluated in a systematic manner. The most frequent findings were joint effusion, pes anserinus bursitis, quadriceps tendon enthesopathy, popliteal cyst, iliotibial band tendinitis and patellar tendinitis. Pearson's correlation analysis demonstrated a significant moderate positive association between VAS scores and the number of USG findings (r = 0.36; p < 0.0001). The number of USG findings was different between K&L grades I and III (p = 0.041), I and IV (p < 0.001), and II and IV (p = 0.001, analysis of variance with Bonferroni correction). There was significant association between number of USG findings and TUG (r = 0.18; p = 0.014) and WOMAC scores for pain (r = 0.16; p < 0.029) and physical function domains (r = 0.16; p < 0.028). The most frequent USG finding was joint effusion. Periarticular structures should be explored as potential sources of pain and disability.
Topics: Aged; Arthralgia; Bursitis; Cross-Sectional Studies; Female; Humans; Knee Joint; Male; Middle Aged; Osteoarthritis, Knee; Prospective Studies; Radiography; Surveys and Questionnaires; Ultrasonography; Visual Analog Scale
PubMed: 34400659
DOI: 10.1038/s41598-021-95419-3 -
Praxis 2022CME Rheumatology 26: Rheumatological Cases Special rheumatological cases are illustrated using various examples. On the one hand we present differential diagnoses and...
CME Rheumatology 26: Rheumatological Cases Special rheumatological cases are illustrated using various examples. On the one hand we present differential diagnoses and causes of a "Baker's cyst", on the other hand a case of involvement of the cervical spine in rheumatoid arthritis. Usually, the medical history and precise clinical examination will lead us in the right diagnostic direction. Further clarifications such as laboratory analyses or imaging procedures are used in a targeted manner, taking into account the clinic.
Topics: Arthritis, Rheumatoid; Diagnosis, Differential; Humans; Physical Examination; Popliteal Cyst; Rheumatology
PubMed: 35611484
DOI: 10.1024/1661-8157/a003885 -
Acta Parasitologica Jun 2023Intra-abdominal and pelvic seeding of hepatic cystic echinococcosis to various organs is a known feature of the disease. Dissemination into distal extremities is...
INTRODUCTION
Intra-abdominal and pelvic seeding of hepatic cystic echinococcosis to various organs is a known feature of the disease. Dissemination into distal extremities is uncommon and in this report, we present a case of disseminated cystic echinococcosis extending toward the right popliteal fossa.
CASE PRESENTATION
A 68-year-old male presented with swelling in the right upper leg and discomfort in the right popliteal region. Work-up revealed various cystic mass lesions of different sizes within the liver, intra-abdominal cavity, right inguinal region, right femoral region, and right popliteal fossa. Diagnosis of hepatic cystic echinococcosis was made and the patient was started on medical therapy.
DISCUSSION
Hepatic cysts can be easily observed with ultrasonography and the WHO-Informal Working Group on Echinococcosis (WHO-IWGE) classification system is commonly used to further classify cysts. The work-up of the disseminated disease involves further radiological modalities such as computerized tomography and magnetic resonance imaging. Management includes medical therapy, percutaneous drainage, or surgery depending on hepatic cyst localization and the presence of dissemination.
CONCLUSION
Extrahepatic dissemination of cystic echinococcosis is commonly encountered in endemic areas. Rarely, hepatic cysts can spread beyond the abdomen towards the distal extremities. Therefore, cystic echinococcosis should be included in the differential diagnosis in endemic areas where patients present with cystic masses.
Topics: Male; Humans; Aged; Echinococcosis; Echinococcosis, Hepatic; Abdomen; Cysts
PubMed: 36995509
DOI: 10.1007/s11686-023-00669-y -
Journal of Orthopaedic Surgery and... Sep 2023As a common disease in orthopedic clinics, popliteal cysts often coexist with intra-articular lesions. Compared with traditional open surgery, arthroscopic treatment of...
BACKGROUND
As a common disease in orthopedic clinics, popliteal cysts often coexist with intra-articular lesions. Compared with traditional open surgery, arthroscopic treatment of popliteal cysts is less traumatic, and intra-articular lesions can be treated. The 'one-way valve' mechanism of the popliteal cyst can be removed by expanding the communication between the articular cavity and the cyst to avoid cyst recurrence. In terms of arthroscopic techniques, the comparison of clinical effects between the double posteromedial portal (DPP) and single posteromedial portal (SPP) has rarely been studied. The purpose of this retrospective study was to compare the clinical effects of DPP and SPP.
METHODS
A total of 46 consecutive patients with symptomatic popliteal cysts who underwent arthroscopic treatment were included in this study and followed for approximately 1 year. All patients were divided into two groups according to the arthroscopic portals (DPP group and SPP group). The cyst size, Lysholm score and Rauschening-Lindgren (R-L) grade were evaluated before the operation for all patients, and the intra-articular lesions, operative time and complications were recorded after operation. At the last follow-up, the Lysholm score and R-L grade were recorded, and magnetic resonance imaging was used to evaluate the outcome of the cyst. The clinical data of the two groups was statistically compared and analyzed.
RESULTS
There were no significant differences in preoperative cyst size, Lysholm score or R-L grade between the two groups (P > 0.05). The operation time of the DPP group (67.52 ± 18.23 min) was longer than that of the SPP group (55.95 ± 16.40 min) (P = 0.030), but the recurrence rate of cysts in the DPP group (0%) was obviously lower than that in the SPP group (19.0%) (P = 0.046). There were no significant differences in the Lysholm score, R-L grade or complication rate between the two groups at the last follow-up (P > 0.05).
CONCLUSION
Arthroscopic treatment of popliteal cysts using double posteromedial portals was a safe and effective surgical method.
TRIAL REGISTRATION
ChiCTR, ChiCTR2200060115. Registered 19 May 2022, https://www.chictr.org.cn/showproj.html?proj=133199.
Topics: Humans; Popliteal Cyst; Retrospective Studies; Cysts; Joints; Ambulatory Care Facilities
PubMed: 37667310
DOI: 10.1186/s13018-023-04132-6 -
Journal of Visualized Experiments : JoVE Nov 2022Unicompartmental knee arthroplasty (UKA) is an established treatment option for anteromedial osteoarthritis, and popliteal cysts are a common finding in the knee among...
Unicompartmental knee arthroplasty (UKA) is an established treatment option for anteromedial osteoarthritis, and popliteal cysts are a common finding in the knee among patients with chronic osteoarthritis pain. The two are so closely related that popliteal cysts are commonly discovered during the unicompartmental knee arthroplasty preoperative examination. However, only a few reports exist on the management and outcome of popliteal cysts in the patients receiving UKA for knee osteoarthritis (OA) and popliteal cysts. As such, it is crucial to evaluate different treatment strategies and their management of popliteal cysts. In this paper, we evaluate a surgical strategy for patients with knee anteromedial osteoarthritis and symptomatic popliteal cysts. These patients were treated with UKA and internal drainage of the popliteal cyst. The results shown here, spanning 1-year post-operation follow-up, demonstrated that UKA and internal drainage is an effective surgical protocol for treating anteromedial osteoarthritis with symptomatic popliteal cysts.
Topics: Humans; Popliteal Cyst; Knee Joint; Osteoarthritis, Knee; Chronic Pain
PubMed: 36504231
DOI: 10.3791/64725 -
Panminerva Medica Mar 2024
Topics: Humans; Popliteal Cyst; Treatment Outcome
PubMed: 37439788
DOI: 10.23736/S0031-0808.23.04932-7 -
Medical Science Monitor : International... Apr 2024BACKGROUND A popliteal cyst, often perceived as benign, poses potential harm and symptoms. This study focused on arthroscopic treatment through the posterior knee portal...
BACKGROUND A popliteal cyst, often perceived as benign, poses potential harm and symptoms. This study focused on arthroscopic treatment through the posterior knee portal at our medical center, aiming to assess its efficacy, safety, and long-term outcomes compared to traditional methods. MATERIAL AND METHODS A retrospective analysis of 20 patients (9 males and 11 females) with symptomatic popliteal cysts (January 2020 to December 2022) undergoing arthroscopic treatment via the posterior knee portal was conducted. Data on demographics, clinical presentation, preoperative imaging, surgical techniques, intraoperative findings, and postoperative Rauschning and Lindgren scores were collected and analyzed. RESULTS With a mean follow-up of 13.6 months (range: 12 to 36 months), all patients had associated intra-articular lesions and were treated. Degenerative cartilage damage was most common (65.0% of cases). The Rauschning and Lindgren score significantly improved after surgery (P<0.05), with no recurrence evident on MRI in any patients. CONCLUSIONS Arthroscopic treatment through the posterior knee portal has good potential for popliteal cyst management. This minimally invasive approach offers benefits such as direct visualization, precise cyst excision, and concurrent treatment of intra-articular pathologies.
Topics: Male; Female; Humans; Popliteal Cyst; Retrospective Studies; Treatment Outcome; Arthroscopy; Knee Joint
PubMed: 38582959
DOI: 10.12659/MSM.943472 -
Heliyon May 2023Certain types of popliteal cysts do not possess the common pathophysiology of Baker's cysts, such as location or the presence of a one-way valve lesion. The traditional...
UNLABELLED
Certain types of popliteal cysts do not possess the common pathophysiology of Baker's cysts, such as location or the presence of a one-way valve lesion. The traditional arthroscopic approach and excision of such atypical popliteal cysts are difficult because they do not communicate with the knee joint, especially when located behind the popliteal neurovascular structure. In this case report, we introduce a direct posterior endoscopic technique for the excision of atypical popliteal cysts when accessing them through the traditional arthroscopic approach is unfeasible. In this case, the popliteal cyst was not located between the gastrocnemius medial head and the semimembranosus muscle and did not communicate with the knee joint. Passage of the popliteal artery was observed running on the anteromedial side of the popliteal cyst. Therefore, a direct posterior endoscopic approach was decided for the surgical treatment of the popliteal cyst, and the atypical popliteal cyst was successfully excised without any complications. We also describe the possible advantages and pitfalls of the direct posterior endoscopic approach.
CLINICAL RELEVANCE
Direct posterior endoscopic excision using an intra-cystic portal in the prone position is considered a safe and effective treatment method for atypical popliteal cysts.
PubMed: 37153437
DOI: 10.1016/j.heliyon.2023.e15648 -
Medical Science Monitor : International... Apr 2024BACKGROUND This retrospective study of 42 patients with popliteal cysts (or Baker cysts) aimed to compare the effects on duration and outcomes of arthroscopic surgical... (Comparative Study)
Comparative Study
BACKGROUND This retrospective study of 42 patients with popliteal cysts (or Baker cysts) aimed to compare the effects on duration and outcomes of arthroscopic surgical debridement with and without the use of cyst injection with methylene blue (MB). MATERIAL AND METHODS Medical records of patients who underwent conventional arthroscopic surgery (n=20) or arthroscopic surgery after MB injection (n=22) for popliteal cysts between 2018 and 2021 were reviewed. The MB group underwent arthroscopic popliteal cystectomy with MB as the marker, and the control group underwent conventional arthroscopic popliteal cystectomy. Surgical time of cyst resection, postoperative bruising extent, complication rate, and cyst recurrence rate of the 2 groups were compared. RESULTS The MB group had a faster surgical cyst removal time (16.5±1.5 min) than the control group (24.5±1.6 min; P<0.05). The MB group had less postoperative bruising (1 case, 4.5%) than the control group (5 cases, 25%; P<0.05). The surgical results were similar in both groups, with a Lysholm score of 87.23±1.80 in the MB group and 87.23±1.62 (P>0.05) in the control group. CONCLUSIONS This study showed that preoperative injection of MB for popliteal cysts before arthroscopic debridement improved cyst localization and ease and accuracy of surgery and reduced operative time, adjacent tissue damage, postoperative complications, and recurrence rate.
Topics: Humans; Arthroscopy; Popliteal Cyst; Male; Debridement; Retrospective Studies; Female; Middle Aged; Methylene Blue; Treatment Outcome; Adult; Postoperative Complications; Aged
PubMed: 38650310
DOI: 10.12659/MSM.941102 -
Folia Morphologica 2022Primary synovial chondromatosis (PSC) is a rare idiopathic pathology characterised by the formation of osseocartilaginous nodules within synovial joints, tendons, or...
BACKGROUND
Primary synovial chondromatosis (PSC) is a rare idiopathic pathology characterised by the formation of osseocartilaginous nodules within synovial joints, tendons, or bursae. The mineralisation pattern of PSC nodules is poorly understood and has yet to be investigated using elemental analysis. Mapping this pattern could elucidate the progression of the disease.
MATERIALS AND METHODS
Primary synovial chondromatosis nodules discovered during dissection of a formalin fixed donor were analysed. Scanning electron microscopy paired with energy dispersive X-ray spectroscopy (SEM-EDS) was used to quantify calcium and phosphorus levels to distinguish mineralised components from cartilage, indicated by increased carbon and oxygen concentrations.
RESULTS
Nine nodules with average dimensions 1.76 cm × 1.25 cm were identified in the semimembranosus bursa. SEM-EDS demonstrated increased calcium phosphate levels in nodular cores, while outer margins contained primarily carbon and oxygen. Quantification of these elements revealed nodular peripheries to contain 68.0% carbon, 30.2% oxygen, 0.8% calcium, and 1.0% phosphate, while cores were comprised of 38.1% carbon, 42.1% oxygen, 14.1% calcium, and 5.7% phosphate.
CONCLUSIONS
Nodules were found to have mineralised cores embedded within a cartilaginous matrix. This pattern suggests disease progression is facilitated by endochondral ossification, opening the potential for new therapeutic techniques.
Topics: Calcium; Carbon; Chondromatosis, Synovial; Humans; Oxygen; Phosphates
PubMed: 34060645
DOI: 10.5603/FM.a2021.0054