2013, Number 1
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Cir Cir 2013; 81 (1)
Giant Baker´s cyst treated with intralessional methotrexate
Hofman-González F, Hernández-Díaz C, Solano-Ávila C, López-Reyes AG, Peña-Ayala A, Pineda-Villaseñor C
Language: Spanish
References: 20
Page: 64-68
PDF size: 209.11 Kb.
ABSTRACT
Introduction: Synovial cyst is composed by a fibrous wall;
lining by a thin layer of synovial cells containing synovial fluid,
the prototype of these, in the knee is the Baker's cyst, which is
located abnormally in the gastrocnemius semimembranous bursa.
Baker's cyst prevalence ranges from 5 - 38%. Clinical diagnosis
is supported by the presence of increased volume of soft tissues
located in the popliteal region.
Clinical case: A 74 year-old woman with longstanding active
rheumatoid arthritis who developed a large, recurrent Baker's
cyst. The Baker's cyst had two flare-ups of pain and soft tissue
swelling which eventually limited knee movements; was treated
with needle aspiration guided by ultrasound and synovectomy with
methotrexate twice. At 18-months follow-up, the patient remains
without evidence of recurrence.
Conclusions: Local infiltration of methotrexate represents an
alternative therapy for those refractory Baker's cyst with partial
response to conventional treatment, where the surgical procedure
carries a high risk.
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