破裂的貝克氏囊腫

RUPTURED BAKER'S CYST

陳名聖(Ming-Shern Chen) ； 張政彥(Cheng-Yen Chang) ； 鄧木火(Michael Mu Huo Teng) ； 張遵(Tsuen Chang)

《中華放射線醫學雜誌》 12卷2期 (1987/06) Pp. 99-106

摘要

貝克氏囊腫（Baker's cyst）好發於病人有慢性關節積水之膝部後面，通常與受傷、退行性變化或發炎過程有關。破裂的囊腫會分割至腓腸部肌肉，造成疼痛腫脹併有陽性的Homans癥候，這些症狀很類似血栓靜脈炎。關節攝影術用來評估破裂的貝克氏囊腫是一個非常有用的工具。從1983到1986年間，我們一共有75位膝關節滑膜疾病之病例，其中8位是破裂貝克氏囊腫的病例；這些例子除1例外都接受了關節攝影而得到確定的診斷。其中兩例於双重對比膝關節攝影後立即以電腦斷層攝影作更進一步的評估。在道7位病例中，5位是有確定的類風濕性關節炎診斷，一位痛風性關節炎，而另一位則是結核性關節炎。全部的病人都曾主訴小腿肌肉疼痛腫脹，其中5位有局部發熱和皮膚變紅的情形，2位併有陽性的Homans癥候。本文目的是強調貝克氏囊腫破裂可引起類似血栓靜脈炎的症狀，並且提出這種病患之關節攝影及電腦斷層關節攝影之發現。

並列摘要

Baker's cysts (popliteal synovial cysts) commonly occur in patients with a chronic knee joint effusion which may relate with trauma, degenerative change or an inflammatory process. Ruptured cysts that dissect into the calf can produce painful swelling with a positive Homans' sign that simulates acute thrombophlebitis. Arthrography is a very useful tool for evaluating a dissecting Baker's cyst. From 19831986 we reviewed 75 cases of synovial disease of knee and encountered 8 cases of ruptured Baker's cysts. 7 patients were diagnosed by arthrography, and two of them had been evaluated with computed tomography immediately after double contrast knee arthrography. In these series of 7 cases, five of them are documented with rheumatoid arthritis, one is goutyarthritis and the other one is tuberculous arthritis. All patients had complaints of painful swelling of calf, 5 of them had local heat and redness, and 2 had positive Hornans' sign. In tnis article we present the arthrographic and CT findings of our cases for the references to those doctors in the related fields.