Quiste de Baker / Baker's cyst

Fundamento: el quiste de Baker es el tumor de partes blandas más frecuente de la fosa poplítea, su tratamiento puede ser conservador o quirúrgico, este último tanto por vía artroscópica o abierta. Objetivo:profundizar los conocimientos en relación al quiste de Baker en la articulación de la rodilla. Métodos: la búsqueda de la información se realizó en un periodo de tres meses (primero de octubre de 2017 al 31 de diciembre de 2017) y se emplearon las siguientes palabras: popliteal cyst y Baker's cyst, a partir de la información obtenida se realizó una revisión bibliográfica de un total de 316 artículos publicados en las bases de datos PubMed, Hinari, SciELO y Medline mediante el gestor de búsqueda y administrador de referencias EndNote, de ellos se utilizaron 50 citas seleccionadas para realizar la revisión, 45 de ellas de los últimos cinco años, donde se incluyeron cuatro libros. Resultados: se abordan la forma de presentación clínica de esta enfermedad y los estudios de tipo imaginológicos. Se hace referencia al diagnóstico diferencial entre el niño y el adulto; y entre el quiste de Baker y aneurisma de la arteria poplítea. Se describen las modalidades de tratamiento tanto conservador como quirúrgico, en relación a este último se plasman las indicaciones y variedades. Conclusiones: el quiste de Baker es el tumor de partes blandas más frecuente en la fosa poplítea, su presencia ocurre tanto en niños como en adultos y existen diferencias entre estos grupos. En el adulto se debe prestar especial interés con respecto al diagnóstico diferencial con el aneurisma de la arteria poplítea. El tratamiento en el paciente adulto por lo general es quirúrgico, tanto por vía abierta o artroscópica con muy buenos resultados(AU)

Background: Baker's cyst is the most common soft tissue popliteal tumor; treatment may be conservative or surgical by arthroscopy or open ways. Objective: to deep the knowledge about Baker's cyst in the knee joint. Methods: the search of the information was carried out in a period of three months (from October 1st, 2017 to December 31, 2017) and the following words were used: popliteal cyst and Baker's cyst, from the obtained information it was carried out a bibliographical review of a whole of 316 articles published in the databases PubMed, Hinari, SciELO and Medline by means of the information locator EndNote, of them 50 citations were selected to do the review, 45 of them of last five years, where four books were included.Development: important aspects related to clinical picture and imaging investigations were pointed out. Differential diagnosis between Baker's cyst in children and adults, and Baker's cyst and popliteal aneurysm were described. Treatment modalities were stated as well as surgical indications.Conclusions: Baker's cyst is the most common soft tissue popliteal tumor affecting children and adults with cardinal differences. Popliteal aneurysm should be always ruled out. Surgical treatment is usually needed in adults by open procedures or arthroscopy, both methods have good results(AU)

Cisto de Baker: variaçöes sobre o tema / Baker cyst: variations on theme

O cisto poplíteo ou cisto de Backer consiste em um aumento de volume na fossa poplítea produzindo dor local ou na panturrilha, associado a patologia do joelho, mais freqüentemente a artrite reumatóide. Deve ser corretamente diagnosticado, seja pelo médico generalista, seja pelo especialista, principalmente com o objetivo de diferenciá-lo da trombose venosa profunda, com a qual é facilmente confundido quando ocorre sua ruptura para a panturrilha. Nesta situaçäo, a artrografia (às vezes seguida da flebografia convencional ou isotópica) será extremamente útil no diagnóstico diferencial de ambas as patologias, o que determinará a decisäo terapêutica de anticoagular ou näo o paciente. O tratamento conservador, com repouso, aspiraçäo do líquido sinovial articualr e do cisto e infiltraçäo com esteróides de longa açäo, é na maioria dos casos eficaz. A cirurgia com exérese do cisto pode ser necessária, näo esquecendo de tratar a doença subjacente, sem o que poderá ocorrer a recidiva do mesmo

Baker's cysts, pseudothrombophlebitis, pseudo-pseudothrombophlebitis: where do we stand?

The diagnostic approach and therapeutic attitudes to be assumed when facing the dilemma of deep vein thrombosis versus a complicated Baker's cyst remain unclear. We examined our own approach with 16 Baker's cysts [11 presenting with a "thrombophlebitis picture" (TP)] recently diagnosed in our services, and reviewed the literature. All of our patients had an underlying joint disorder and previous knee effusions. The diagnostic approach (i.e., the request or not for venography) was related to the specialty of the physician who saw the patient first. The results of the venography led to anticoagulation treatment in 5 of the 6 patients on whom it was performed, although these patients did not otherwise differ from those with a similar clinical picture in whom no venogram was obtained. Arthrograms performed early after onset of the TP were more likely to reveal cyst rupture. The recent literature does not mention serious venous complications (in particular, pulmonary embolism) in patients in whom only the cyst was treated, without knowledge of possible coexisting venous occlusions. The need to perform venography, the importance of the localisation of the occlusions and the therapeutic consequences are discussed and a proposal is made to study these patients in a systematic way in order to better understand the inter-relationship between complicated popliteal cysts and venous alterations, and to decide the best approach to assume in the future.