A 73-year-old woman with well-controlled rheumatoid arthritis presented to the outpatient clinic with a 4-day history of swelling and pain in both lower legs. She had no recent trauma. Her vital signs were normal. A physical examination revealed no signs of inflammation, but Homan's sign was positive bilaterally, and her C-reactive protein and D-dimer levels were elevated. Contrast-enhanced computed tomography revealed a low-density area with a light edge and high-density core between the soleus and medial gastrocnemius muscles in both legs (Picture 1, arrows; Picture 2, circled), but no signs of deep vein thrombosis (DVT), confirming a diagnosis of bilateral ruptured Baker's cysts. Ruptured Baker's cysts may cause inflammation, swelling, and pain in the lower leg, resembling DVT (1). Following rupture, the mass in the popliteal fossa may disappear, and there may be no significant local physical or imaging findings (2). Most cases are self-limiting and respond to leg elevation and local heat application.
Picture 1.
Picture 2.
The patient provided informed consent for the publication of this image and the accompanying text.
The authors state that they have no Conflict of Interest (COI).
References
- 1.Herman AM, Marzo JM. Popliteal cysts: a current review. Orthopedics 37: e678-e684, 2014. [DOI] [PubMed] [Google Scholar]
- 2.Mizumoto J. The crescent sign of ruptured Baker's cyst. J Gen Fam Med 20: 215-216, 2019. [DOI] [PMC free article] [PubMed] [Google Scholar]