pseudothrombophlebitis 5 424 163 38.1 26 6.1 5 1.2 230 2 3 66.4 51 80 2 3 2 2 1 2012 23 3 261-265 pseudothrombophlebitis 1 2011 7 11 30 2010 2 5 47
Fig. 1 Ultrasonography showed a low echoic cyst in the popliteal fossa of the patient with a Baker s cyst. Fig. 2 Ultrasonography showed the subfascial echo-free space in the mid calf of the patient with a ruptured Baker s cyst. 2004 2009 5 5 SSD-5000 ProSound α6 7.5 MHz 4 13 MHz 3.5 MHz 2 6 MHz Fig. 1 Fig. 2 424 163 38.1 26 6.1 5 1.2 230 CT MRI 2 3 66.4 51 80 2 3 2 2 1 Fig. 3 MRI 1 Fig. 4 2 Table 1 1840 Adams 1877 William Morrant Baker 48
a b Fig. 3 Subcutaneous bleeding around the ankle joint in a patient with a ruptured Baker s cyst (a, b). a b Fig. 4 MRI. T2 weighed MRI showed a high intensity cyst of the knee joint (a) and a subfascial high intensity space of the mid calf (b) in the patient with a ruptured Baker s cyst. Table 1 Case Age Sex Symptoms Calf muscle tenderness Knee pain OA DVT Diagnosis Therapy 1 54 male leg swelling, pain, edema + + (5 days ago) US NSAID 2 51 male leg swelling, pain, edema + + (8 days ago) US, MRI NSAID 3 80 female leg swelling, subcutaneous bleeding + US NSAID 4 80 female leg swelling, pain + US NSAID 5 67 female leg swelling + US NSAID OA, osteoarthritis; DVT, deep vein thrombosis; US, ultrasonography; MRI, magnetic resonance imaging; NSAID, non-steroidal anti-inflammatory drug 49
3 pseudothrombophlebitis 1 54.4 58.1 29.0 14.5 6.5 4.8 4 Langsfeld 20 3.1 5 38.1 1.2 3 1 2 6 6 CT MRI MRI 7 8 Fig. 3 pseudopseudothrombophlebitis 2 9 3 10 1 Katz RS, Zizic TM, Arnold WP, et al: The pseudothrombophlebitis syndrome. Medicine (Baltimore) 1977; 56: 151-164 2 Sato O, Kondoh K, Iyori K, et al: Midcalf ultrasonography for the diagnosis of ruptured Baker s cysts. Surg Today 2001; 31: 410-413 3 Baker WM: On the formation of synovial cysts in the leg in connection with disease of knee-joint. Saint Bartholomew Hospital Reports 1877; 13: 244-261 4 50
2009; 20: 227-233 5 Langsfeld M, Matteson B, Johnson W, et al: Baker s cysts mimicking the symptoms of deep vein thrombosis: diagnosis with venous duplex scanning. J Vasc Surg 1997; 25: 658-662 6 Drescher MJ, Smally AJ: Thrombophlebitis and pseudothrombophlebitis in the ED. Am J Emerg Med 1997; 15: 683-685 7 2001; 35: 383-386 8 Baker 2004; 23: 44-46 9 Prescott SM, Pearl JE, Tikoff G: Pseudo-pseudothrombophlebitis : ruptured popliteal cyst with deep venous thrombophlebitis. N Engl J Med 1978; 299: 1192-1193 10 Simpson FG, Robinson PJ, Bark M, et al: Prospective study of thrombophlebitis and pseudothrombophlebitis. Lancet 1980; 1: 331-333 Abstract The Diagnosis and Treatment of Ruptured Baker s Cyst Harunobu Matsumoto, Eisuke Yamamoto, Chiaki Kamiya, Emi Miura, Tadashi Kitaoka, Kota Yamamoto, Juno Deguchi, and Osamu Sato Department of Vascular Surgery, Saitama Medical Center, Saitama Medical University Key words: Deep vein thrombosis, Baker s cyst, ruptured Baker s cyst, Pseudothrombophlebitis, Ultrasonographic examination Ruptured Baker s cyst is sometimes called pseudothrombophlebitis because it is physically indistinguishable from acute deep vein thrombosis. The purpose of this study was to determine the incidence and characteristics of ruptured Baker s cysts. The hospital records of 424 patients who were referred to our department with swollen legs during last 5 years were reviewed retrospectively. Deep vein thrombosis was found in 163 cases (38.1%), lymphedema in 26 cases (6.1%), and ruptured Baker s cysts in 5 cases (1.2%: 2 men, 3 women; mean age 66.4 years). In the cases of ruptured Baker s cysts, there were preceding knee pain in 2 cases, the history of osteoarthritis in 3 cases, leg edema in 2 cases, calf muscle tenderness in 2 cases, and subcutaneous bleeding of the foot in one case. Ultrasonography in all these cases revealed an easily detectable echo-free space behind the calf muscles. All of the cases were treated conservatively by non-steroidal anti-inflammatory drugs without anticoagulation. In conclusion, Ruptured Baker s cyst may mimic the presentation of acute deep vein thrombosis and is reliably diagnosed by ultrasonography. Jpn J Phlebol 2012; 23 (3): 261-265 51