Ann Rehabil Med.  2014 Dec;38(6):843-846. 10.5535/arm.2014.38.6.843.

Ruptured Popliteal Cyst Diagnosed by Ultrasound Before Evaluation for Deep Vein Thrombosis

• Kim JS
• Lim SH
• Hong BY
• Park SY

• KMID: 2267096
• DOI: http://doi.org/10.5535/arm.2014.38.6.843

Abstract

Most popliteal cysts are asymptomatic. However, cysts may rupture, resulting in pain and swelling of the leg that could also arise from other diseases, including deep vein thrombosis, lymphedema, cellulitis, and tear of a muscle or tendon. Therefore, it is difficult to diagnose a ruptured popliteal cyst based on only a patient's history and physical examination. Musculoskeletal ultrasound has been regarded as a diagnostic tool for ruptured popliteal cyst. Here, we describe a patient who was rapidly diagnosed as ruptured popliteal cyst by ultrasonography. Therefore, ultrasound could be used to distinguish a ruptured popliteal cyst from other diseases in patients with painful swollen legs before evaluation for deep vein thrombosis.

Keyword

Calf pain; Complicated popliteal cyst; Ultrasonography

MeSH Terms

Cellulitis
Humans
Leg
Lymphedema
Physical Examination
Popliteal Cyst*
Rupture
Tendons
Ultrasonography*
Venous Thrombosis*

Figure

• 

  Fig. 1 Physical examination of unilateral leg swelling accompanied by slight redness and warmth was noted in the patient's left leg.

• 

  Fig. 2 Ultrasonography images. (A) Panoramic image of the longitudinal sweep of the medial aspect of calf shows fluid collection (rhomboid) behind medial head of the gastrocnemius muscle (MHG). (B) Transverse 12-5 MHz ultrasound image over the proximal medial calf shows the fluid collection separated into two compartments. (C) Transverse 12-5 MHz ultrasound image over the popliteal fossa shows the different components of a typical popliteal cyst: the base '1', the neck '2', and the body '3' located between the tendon of the semimembranosus (SM) and the tendon of the MHG.

• 

  Fig. 3 Initially a 10 mL of dark red-colored liquid was drained from the calf.

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