Patients with arthritis of the knee may occasionally have a dissecting popliteal cyst simulating other pathological conditions.
In a group of seven such patients, described at the annual meeting in Denver of the American Rheumatism Association, five had symptoms suggesting deep vein thrombophlebitis; the 6th appeared to have acute synovitis; and the 7th, a 55-year-old man with a cyst dissecting upward into the thigh, had symptoms suggesting sciatic neuritis.
Acute dissection of the cysts resulted in chronic rheumatoid calf cysts in 2 of these 7 patients. Nevertheless, all patients had excellent symptomatic responses to therapy that included intra-articular injections of corticosteroids, commented P. Kahler Hench, MD, Scripps Clinic and Research Foundation, La Jolla, California.
The possibility of a dissecting popliteal cyst should be considered early in patients with arthritis and calf inflammation of unknown etiology.Swelling, tenderness, and inflammation associated with a positive Homans' sign (usually