The etiology and clinical manifestation of Baker's cyst: a musculoskeletal ultrasound study

陳 玉秀(Yu-Hsiu Chen), 陳 相成(Hsiang-Cheng Chen), 周 雨青(Yu-Ching Chou), 朱 士傑(Shi-Jye Chu), 郭 三元(San-Yuan Kao), 劉 峰誠(Feng-Cheng Liu), 盧 俊吉(Chun-Chi Lu), 張 棋楨(Chi-Ching Chang)

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: Patients with rheumatic disease have a higher risk of developing Baker's cysts. The aim of this study is to determine the etiology of a Baker's cyst and clinical manifestation. Method and Material: This is a retrospective review study using the musculoskeletal ultrasonography (MUS) database from June 2006 to June 2010. The relationship between the etiology of a Baker's cyst and its clinical manifestation, including gender, size of cyst, symptoms, physical examination, and complication, were analyzed using Pearson correlation coefficient, Student's t test, one-way ANOVA and multiple logistic regression. Results: We identified 301 Baker's cysts in 257 patients. The prevalence of bilateral cysts was 5.9-27.3% across its different etiologies. We found that the most common cause of Baker's cyst was osteoarthritis (53.5%), while the most common cause of a ruptured Baker's cyst was Rheumatoid Arthritis (RA) in women (47%) and gout in men (35%). Both grading of effusion and Kellgren and Lawrence(KL) grade were positive related to the size of a Baker's cyst. The mean size of palpable cyst was 7.95±0.53 cm and that of non-palpable cyst was 2.65±0.11 cm (p<0.001). The size of Baker's cyst (cm) was correlated with cyst rupture with odds ratio (OR): 2.58, confidence interval (CI): 1.69-3.95 (p<0.001). Conclusion: The etiology of a Baker's cyst was different between the sexes. For early detection, MUS should be performed in patients with advanced KL grade or knee effusions. In addition, patients with a Baker's cyst on one knee, an imaging study should be performed on the contralateral side.目的:風濕性疾病患者得到貝克氏囊腫的風險較高。這項研究的目的是為了瞭解貝克囊腫的病因和其臨床表現之關聯性。方法:這是一項回顧性研究,使用2006年6月至2010年6月的肌肉骨骼超音波資料庫。分析了貝克氏囊腫的病因與臨床表現(包括性別,症狀,身體檢查,囊腫大小和併發症)統計資料分析使用Pearson相關係數,Student's t檢驗,one-way ANOVA和多因素回歸測試。結果:我們在257名患者中發現了301個貝克氏囊腫。不同病因造成之雙側膝蓋囊腫之患病率為5.9-27.3%。我們發現造成貝克氏囊腫最常見的原因是退化性關節炎(53.5%),而貝克氏囊腫破裂的最常見原因於女性是類風濕性關節炎(47%)於男性則是痛風(35%)。關節積液分級,Kellgren and Lawrence(KL)分級均與貝克氏囊腫大小呈正相關。可摸到的囊腫的平均大小為7.95±0.53公分,摸不到的囊腫的平均大小為2.65±0.11公分(p <0.001)。貝克氏囊腫的大小(公分)與囊腫破裂呈正相關,Odds Ratio為:2.58,信賴區間(CI):1.69-3.95(p <0.001)結論:引發貝克氏囊腫的病因在兩性之間是不同的。骨骼肌肉超音波應用在患有較嚴重的KL grade或膝關節積液的患者有助於早期診斷貝克氏囊腫,而如果病人在一側膝蓋發現貝克氏囊腫,則應在其對側膝蓋進行影像學檢查。
Original languageEnglish
Pages (from-to)18-24
Number of pages7
JournalFormosan Journal of Rheumatology
Volume32
Issue number1
DOIs
Publication statusPublished - Sep 1 2018

Keywords

  • Musculoskeletal ultrasonography
  • Baker's cyst
  • Osteoarthritis
  • Gout
  • Pyrophosphatearthropathy
  • Rheumatoid arthritis
  • Systemic lupus erythematosus
  • Spondyloarthropathy
  • 肌肉骨骼超聲檢查
  • 貝克氏囊腫
  • 退化性關節炎
  • 痛風
  • 焦磷酸鹽關節病
  • 類風濕性關節炎
  • 紅斑性狼瘡
  • 脊椎關節病變

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