Clinical Manifestations of Synovial Cysts
THE VESTERN Jourx.4 of Medicine Refer to: Burt TB, MacCarter DK, Gelman MI, et al: Clinical manifestations of synovial cysts. West J Med 133:99-104, Aug 1980 Clinical Manifestations of Synovial Cysts TODD B. BURT, MD; DARYL K. MacCARTER, MD; MARTIN 1. GELMAN, MD, and CECIL 0. SAMUELSON, MD, Salt Lake City Although synovial cysts are most commonly associated with rhaumatoid arthritis and osteoarthritis, they may occur in many other conditions. The clinical manifestations of these cysts are numerous and may result from pressure, dissection or acute rupture. Vascular phenomena occur when pop- liteal cysts compress vessels, and result in venous stasis with subsequent lower extremity edema or thrombophlebitis. Rarely, popliteal cysts may cause arterial compromise with intermittent claudication. Neurological sequelae in- clude pain, paresthesia, sensory loss, and muscle weakness or atrophy. When synovial cysts occur as mass lesions they may mimic popliteal aneurysms or hematomas, adenopathy, tumors or even inguinal hernias. Cutaneous joint fistulas, septic arthritis or osteomyelitis, and spinal cord and bladder compres- sion are examples of other infrequent complications. Awareness of the heter- ogeneous manifestations of synovial cysts may enable clinicians to avoid unnecessary diagnostic studies and delay in appropriate management. Ar- thrography remains the definitive diagnostic procedure of choice, although ultrasound testing may be useful. SYNOVIAL CYSTS are fluid-filled spaces lined by in 1877, resulting in the common eponym Baker synovial membrane and arise from diarthrodial cysts, for popliteal cysts.2 Subsequently, synovial joints, bursae and tendon sheaths. The first pub- cysts have been described in numerous locations lished report of a synovial cyst was made by although the knees, shoulders and wrists remain Adams, an Irish surgeon, in 1840.1 He described the most frequently involved areas.
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