Ruptured Baker's Cyst and Thrombophlebitis

To the Editor.—  The article entitled "Ruptured Baker's Cyst Simulating Acute Thrombophlebitis" (240:1517, 1978) serves to heighten my suspicion of a possible ruptured Baker's cyst when considering the condition of a patient with an apparent clinical picture of thrombophlebitis. However, in the past two years I have had three patients with a similar clinical picture, and in all three the diagnosis of ruptured Baker's cyst and concomitant thrombophlebitis existed. These diagnoses were established and confirmed using phlebograms and arthrograms.Therefore, I would encourage the use of both arthrograms and phlebograms in such patients instead of having the diagnosis of ruptured Baker's cyst established without the secure elimination of the diagnosis of thrombophlebitis and its potentially disastrous sequelae. In all three of these patients the thrombophlebitis was treated in the conventional manner, and the ruptured Baker's cyst did not require surgery.I suspect that the Baker's cysts compress the venous return