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Vascular/Cardiac » Peripheral Vascular
Baker's cyst
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Author(s) :
S. Manohar, MD, DMRD
 
Presentation A 39 year old woman presents with acute pain and redness of left lower limb. She was referred for a venous Doppler study with clinical diagnosis of deep vein thrombosis.
 
 
 
Caption: Photograph of the symptomatic left lower limb
Description: The symptomatic lower limb demonstrates redness and swelling suggesting a clinical diagnosis of deep vein thrombosis.
 
 
 
Caption: Sagittal scan of the popliteal fossa and calf
Description: This scan shows evidence of fluid tracking between the deep fascia and the belly of gastrocnemius muscle. The fluid also is seen to have echoes. This suggests the presence of a Bakers cyst which has ruptured.
 
 
 
Caption: Sagittal scan.
Description: The fluid is also seen communicating with the gastrocnemius –semi membranosus bursa. This is a boomerang shaped bursa and is comprised of a superficial portion, a deep portion and a neck.
 
 
 
Caption: Color Doppler scan of the popliteal vessels
Description: The popliteal artery and vein appear normal on color Doppler. The other vessels of the symptomatic lower limb were normal.
 
 
 
Caption: Transverse scan in the upper calf region
Description: The fluid containing boomerang shaped bursa is noted again in this image.
 
 
 
Caption: Sagittal scan in the region of left popliteal fossa
Description: This image demonstrates well the communication of the fluid with the bursa.
 
Differential Diagnosis Ruptured Baker's cyst, deep venous thrombosis [clinical differential]
 
Final Diagnosis Ruptured Baker's cyst
 
Discussion This case has been illustrated to demonstrate that a Baker`s cyst may rupture resulting in a clinical appearance of pseudothrombophlebitis. An ultrasound can easily distinguish between the two entities.
 
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