Rheumatology International

, Volume 29, Issue 2, pp 141–146 | Cite as

Baker’s cysts in knees with chronic osteoarthritic pain: a clinical, ultrasonographic, radiographic and scintigraphic evaluation

  • Dimitrios Chatzopoulos
  • Efstratios Moralidis
  • Pavlos Markou
  • Vassilios Makris
  • Georgios Arsos
Original Article


This study aimed to determine the ultrasonographic prevalence of Baker’s cysts in knees with chronic osteoarthritic pain and investigate for cysts correlates and relationships with scintigraphically established synovitis. Consecutive patients with chronic osteoarthritic knee pain underwent clinical examination, X-rays, ultrasonography and early-phase bone scintigraphy. Eighty-nine Baker’s cysts were detected in 328 knees with chronic osteoarthritic pain (27%), whereas one cyst was identified among the 54 non-osteoarthritic knees (2%, P < 0.001). Baker’s cysts were detected in 72/195 (37%) patients with knee osteoarthritis. Abnormal and intense tracer accumulation in early-phase bone scintigraphy were significantly more frequent in osteoarthritic knees with Baker’s cysts (97 and 56%, respectively), than in those without (89 and 40%, respectively, P < 0.05 for both). Clinical and radiographic variables could not predict the presence of those cysts. Baker’s cysts are a common ultrasonographic finding in knees with chronic osteoarthritic pain and are associated with synovial inflammation and its grade.


Baker’s cyst Bone scintigraphy Knee Osteoarthritis Ultrasonography 


  1. 1.
    Handy JR (2001) Popliteal cysts in adults: a review. Semin Arthritis Rheum 31:108–118. doi:10.1053/sarh.2001.27659 PubMedCrossRefGoogle Scholar
  2. 2.
    Fritschy D, Fasel J, Imbert J-C, Bianchi S, Verdonk R, Wirth CJ (2006) The popliteal cyst. Knee Surg Sports Traumatol Arthrosc 14:623–628. doi:10.1007/s00167-005-0028-z PubMedCrossRefGoogle Scholar
  3. 3.
    Hill CL, Gale DG, Chaisson CE, Skinner K, Kazis L, Gale ME et al (2001) Knee effusions, popliteal cysts and synovial thickening: association with knee pain in osteoarthritis. J Rheumatol 28:1330–1337PubMedGoogle Scholar
  4. 4.
    Hill CL, Gale DR, Chaisson CE, Skinner K, Kazis L, Gale ME et al (2003) Periarticular lesions detected on magnetic resonance imaging. Prevalence in knees with and without symptoms. Arthritis Rheum 48:2836–2844. doi:10.1002/art.11254 PubMedCrossRefGoogle Scholar
  5. 5.
    Felson DT (2006) Osteoarthritis of the knee. N Engl J Med 354:841–848. doi:10.1056/NEJMcp051726 PubMedCrossRefGoogle Scholar
  6. 6.
    Miller TT, Staron RB, Koenigsberg T, Levin TL, Feldman F (1996) MR imaging of Baker cysts: association with internal derangement, effusion and degenerative arthropathy. Radiology 201:247–250PubMedGoogle Scholar
  7. 7.
    Fam AG, Wilson SR, Holmberg S (1982) Ultrasound evaluation of popliteal cysts on osteoarthritis of the knee. J Rheumatol 9:428–434PubMedGoogle Scholar
  8. 8.
    Tarhan S, Unlu Z, Goktan C (2003) Magnetic resonance imaging and ultrasonographic evaluation of the patients with knee osteoarthritis: a comparative study. Clin Rheumatol 22:181–188. doi:10.1007/s10067-002-0694-x PubMedCrossRefGoogle Scholar
  9. 9.
    de Miguel Mendieta E, Cobo Ibanez T, Uson Jaeger J, Bonilla Hernan G, Martin Mola E (2006) Clinical and ultrasonographic findings related to knee pain in osteoarthritis. Osteoarthr Cartil 14:540–544. doi:10.1016/j.joca.2005.12.012 PubMedCrossRefGoogle Scholar
  10. 10.
    Kornaat PR, Bloem JL, Ceulemans RYT, Riyazi N, Rosendaal FR, Nelissen RG et al (2006) Osteoarthritis of the knee: association between clinical features and MR imaging findings. Radiology 239:811–817. doi:10.1148/radiol.2393050253 PubMedCrossRefGoogle Scholar
  11. 11.
    Phan CM, Link TM, Blumenkrantz G, Dunn TC, Ries MD, Steinbach LS et al (2006) MR imaging findings in the follow-up of patients with different stages of knee osteoarthritis and the correlation with clinical symptoms. Eur Radiol 16:608–618. doi:10.1007/s00330-005-0004-5 PubMedCrossRefGoogle Scholar
  12. 12.
    Hedbom E, Hauselmann HJ (2002) Molecular aspects of pathogenesis in osteoarthritis: the role of inflammation. Cell Mol Life Sci 59:45–53. doi:10.1007/s00018-002-8404-z PubMedCrossRefGoogle Scholar
  13. 13.
    Pearle AD, Scanzello CR, George S, Mandl LA, DiCarlo EF, Peterson M et al (2007) Elevated high-sensitivity C-reactive protein levels are associated with local inflammatory findings in patients with osteoarthritis. Osteoarthr Cartil 15:516–523. doi:10.1016/j.joca.2006.10.010 PubMedCrossRefGoogle Scholar
  14. 14.
    Colamussi P, Prandini N, Cittanti C, Feggi L, Giganti M (2004) Scintigraphy in rheumatic diseases. Best Pract Res Clin Rheumatol 18:909–926. doi:10.1016/j.berh.2004.07.003 PubMedCrossRefGoogle Scholar
  15. 15.
    Fischer M, Mödder G (2002) Radionuclide therapy of inflammatory joint disease. Nucl Med Commun 23:829–831. doi:10.1097/00006231-200209000-00003 PubMedCrossRefGoogle Scholar
  16. 16.
    Naredo E, Cabero F, Palop MJ, Collado P, Cruz A, Crespo M (2005) Ultrasonographic findings in knee osteoarthritis: a comparative study with clinical and radiographic assessment. Osteoarthr Cartil 13:568–574. doi:10.1016/j.joca.2005.02.008 PubMedCrossRefGoogle Scholar
  17. 17.
    Ward EE, Jacobson JA, Fessell DP, Hayes CW, van Holsbeeck M (2001) Sonographic detection of Baker’s cysts: comparison with MR imaging. AJR Am J Roentgenol 176:373–380PubMedGoogle Scholar
  18. 18.
    Altman R, Asch E, Bloch D, Bole G, Borenstein D, Brandt K et al (1986) The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the knee. Arthritis Rheum 29:1039–1049. doi:10.1002/art.1780290816 PubMedCrossRefGoogle Scholar
  19. 19.
    Kellgren J, Lawrence J (1957) Radiological assessment of osteoarthritis. Ann Rheum Dis 16:494–501PubMedCrossRefGoogle Scholar
  20. 20.
    Hermann G, Yeh HC, Lehr-Janus C, Berson BL (1981) Diagnosis of popliteal cyst: double contrast arthrography and sonography. AJR Am J Roentgenol 137:369–372PubMedGoogle Scholar
  21. 21.
    Sansone V, De Ponti A, Paluello GM, Del Maschio A (1995) Popliteal cysts and associated disorders of the knee. Critical review with MRT imaging. Int Orthop 19:275–279. doi:10.1007/BF00181107 PubMedCrossRefGoogle Scholar
  22. 22.
    Tschirch FTC, Schmid MR, Pfirrmann CWA, Romero J, Hodler J, Zanetti M (2003) Prevalence and size of meniscal cysts, ganglionic cysts, synovial cysts of the popliteal space, fluid-filled bursae, and other fluid collections in asymptomatic knees on MR imaging. AJR Am J Roentgenol 180:1431–1436PubMedGoogle Scholar
  23. 23.
    Torreggiani WC, Al-Ismail K, Munk PL, Roche C, Keogh C, Nicolaou S et al (2002) The imaging spectrum of Baker’s (popliteal) cysts. Clin Radiol 57:681–691. doi:10.1053/crad.2001.0917 PubMedCrossRefGoogle Scholar
  24. 24.
    Johnson LL, van Dyk GE, Johnson CA, Bays BM, Gylly SM (1997) The popliteal bursa (Baker’s cyst): an arthroscopic perspective and the epidemiology. Arthroscopy 13:66–72. doi:10.1016/S0749-8063(97)90211-5 PubMedCrossRefGoogle Scholar
  25. 25.
    Goldenberg DL, Egan MS, Cohen AS (1982) Inflammatory synovitis in degenerative joint disease. J Rheumatol 9:204–209PubMedGoogle Scholar
  26. 26.
    Chatzopoulos D, Moralidis E, Pavlou M, Makris V (2008) Yttrium-90 radiation synovectomy in knee osteoarthritis: a prospective assessment at 6 and 12 months. Nucl Med Commun (in press).Google Scholar
  27. 27.
    Scheel AK, Schmidt WA, Hermann K-GA, Bruyn GA, D’Agostino MA, Grassi W et al (2005) Interobserver reliability of rheumatologists performing musculoskeletal ultrasonography: results from a EULAR “Train the trainers” course. Ann Rheum Dis 64:1043–1049. doi:10.1136/ard.2004.030387 PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Dimitrios Chatzopoulos
    • 1
  • Efstratios Moralidis
    • 2
  • Pavlos Markou
    • 3
  • Vassilios Makris
    • 4
  • Georgios Arsos
    • 5
  1. 1.Department of Nuclear MedicinePapageorgiou HospitalThessalonikiGreece
  2. 2.Department of Nuclear MedicineAristotelian University, AHEPA HospitalThessalonikiGreece
  3. 3.Department of Medical PhysicsHealth Care Unit ManagementEdessaGreece
  4. 4.Department of OrthopaedicsAristotelian University, Papageorgiou HospitalThessalonikiGreece
  5. 5.Department of Nuclear MedicineAristotelian University, Hippokration HospitalThessalonikiGreece

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