Article Abstract:
Popliteal cysts are enlargements of the bursae (fluid-containing lubricating sacs), which are present under the muscles and tendons that attach to the knee joint. Most of these cysts involve the bursa that lies under the hamstrings muscles at the back of the knee. These cysts are particularly associated with knee disorders in which synovial fluid (the fluid present in joints) is increased. Less common, and difficult to distinguish from these posterior cysts, are the cysts present at the lateral (outside) portion of the knee joint. This report describes the symptoms and treatment in two cases of ruptured lateral popliteal cysts. The first case involved a 68-year-old man with rheumatoid arthritis who had recently had the knee joints aspirated and had received steroid injections. The left leg was red, swollen, and tender from below the lateral knee to the ankle. Although both types of cysts were present, the symptoms were attributed to rupture of the lateral cyst. Inflammatory cells were isolated from the cyst, and the patient developed a fever even though antibiotics were given. Open surgery was then performed, and a cavity connecting the lateral cyst to the knee joint synovial space was found. After surgery, fluid drainage continued until a steroid drug was injected. The second patient was a 66-year-old woman with rheumatoid arthritis who developed a red, warm, painful swelling below the front-lateral portion of the knee. Yellow fluid stained with blood was drained from the area, and no bacteria were present. This was diagnosed as leakage of synovial fluid. The patient improved quickly once the swelling was aspirated and a steroid was injected. These cases are described so as to facilitate recognition and appropriate treatment of this somewhat infrequent problem. (Consumer Summary produced by Reliance Medical Information, Inc.)
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Article Abstract:
Rheumatoid arthritis (RA), an inflammatory joint disease, is characterized by swelling, stiffness, hypertrophy (enlargement) of the cartilage, and pain. Pain in the area of the lung in patients with RA usually results from the pericardial or pleural cavities, which surround the heart and lungs, respectively. A case is described of a 61-year-old woman with RA, who complained of anterior chest pain. The pain had been present for six months and was worsened with deep breathing in and coughing. The tissue overlying the manubriosternal joint, located in the breastbone, was shown to be tender and swollen, and X-rays revealed synovitis, inflammation and deterioration of the joint. A corticosteroid drug, triamcinolone, was injected into the joint and symptoms resolved over the following week. Synovitis of the manubriosternal joint is common but seldom apparent, because the joint is normally immobile. This case shows that synovitis of the manubriosternal joint can produce symptoms, which can then be treated by injection of steroid drugs directly into the joint. (Consumer Summary produced by Reliance Medical Information, Inc.)
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Article Abstract:
Stress fractures of the pubic ramus may be more common than thought among patients with rheumatoid arthritis (RA). RA is an inflammatory disease that affects the joints. The pubic ramus, or pubic bone, is part of the hip bone. Among 22 female RA patients who had a stress fracture of the public ramus, all had signs of osteoporosis. Eighty-six percent had experienced pain in their lower back, groin or hip before their diagnosis. Some had experienced a gradual onset of symptoms, and others had had a sudden onset. Fourteen percent had not experienced any type of pain before their diagnosis. Eight-six percent had been receiving regular treatment with prednisolone. Of the 16 women who had an X-ray taken of their spine, 63% also had a crush fracture of the vertebrae of their spine.
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