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Baker cyst, also termed popliteal cyst, is the most common mass in the popliteal fossa and results from fluid distension of the gastrocnemio-semimembranosus bursa.
Baker cysts are not uncommon and can be caused by virtually any cause of joint swelling ( arthritis ). The most common form of arthritis associated with Baker cysts is osteoarthritis , also called degenerative arthritis . Baker cysts also can result from cartilage tears (such as a torn meniscus ), rheumatoid arthritis , and other knee problems.
Superficial vein thrombophlebitis may occur spontaneously or as a complication of medical or surgical interventions.
Sterile thrombophlebitis limited to the superficial veins rarely is life threatening, but a thorough diagnostic evaluation is mandatory because many patients with superficial phlebitis also have occult deep vein thrombosis (DVT), which carries very high rates of morbidity and mortality.
Phlebitis should be assumed to involve the deep veins until proven otherwise, because superficial vein thrombophlebitis and deep vein thrombophlebitis share the same pathophysiology, pathogenesis, and risk factors.
Edema, principally unilateral , is the most specific symptom. Massive edema with cyanosis and ischemia (phlegmasia cerulea dolens) is rare.
Leg pain occurs in 50%, but this is entirely nonspecific. Pain can occur on dorsiflexion of the foot (Homans sign).
Tenderness occurs in 75% of patients but is also found in 50% of patients without objectively confirmed DVT
Homan’s sign : Discomfort in the calf muscles on forced dorsiflexion of the foot with the knee straight has been a time-honored sign of DVT. However, this sign is present in less than one third of patients with confirmed DVT
Clinical signs and symptoms of pulmonary embolism as the primary manifestation occur in 10% of patients with confirmed DVT.
The pain and tenderness associated with DVT does not usually correlate with the size, location, or extent of the thrombus.
Warmth or erythema of skin can be present over the area of thrombosis
Wells Clinical Score for DVT* Clinical Parameter Score Score Active cancer (treatment ongoing, or within 6 months or palliative) +1 Paralysis or recent plaster immobilization of the lower extremities +1 Recently bedridden for >3 d or major surgery <4 wk +1 Localized tenderness along the distribution of the deep venous system +1 Entire leg swelling +1 Calf swelling >3 cm compared to the asymptomatic leg +1 Pitting edema (greater in the symptomatic leg) +1 Previous DVT documented +1 Collateral superficial veins (nonvaricose) +1 Alternative diagnosis (as likely or > that of DVT) -2 Total of Above Score High probability > 3 Moderate probability 1 or 2 Low probability < 0
Dorsal dislocation of the proximal base of the second metatarsal ( small arrow ) when the foot is placed in extreme plantar flexion with an axial load ( large arrow ). This dislocation occurs because the base of the second metatarsal extends beyond the horizontal axis.
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