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Ruptured Baker’s cyst
Tun Hing Lui
A 62 year old man presented with sudden onset of pain, erythema, and swelling of the right calf. Ultrasound confirmed a ruptured Baker’s cyst and excluded deep vein thrombosis (DVT). He was treated with ultrasound guided aspiration. Baker’s cyst arises between the medial head of the gastrocnemius and the semimembranosus muscles. Fluid from the ruptured cyst drains into this plane and causes medial calf swelling. Patients may stand with the knee and ankle flexed to relax the gastrocnemius. The fluid causes inflammation of the surrounding tissue. Exclusion of DVT avoids unnecessary anticoagulation treatment, which can cause bleeding and posterior compartment syndrome in these patients. Baker’s cyst is usually managed by elevation of the leg, local heating, and non-steroidal anti-inflammatory drugs.
Patient consent obtained.
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