Akagi Ryuichiro, Saisu Takashi, Segawa Yuko, Sasho Takahisa, Moriya Hideshige, Takahashi Kazuhisa, Kamegaya Makoto
Department of Orthopaedic Surgery, Chiba Children's Hospital, Chiba, Japan.
J Pediatr Orthop. 2013 Apr-May;33(3):262-8. doi: 10.1097/BPO.0b013e318281e9bf.
Cystic mass lesions in the popliteal area, called popliteal cysts or Baker's cysts, are usually minimally symptomatic and not related to intra-articular morbidity in the pediatric population. Although multiple studies have described cases of spontaneous resolution over a period of several months to a few years, others still consider surgical treatment necessary. Furthermore, no previous studies have used magnetic resonance imaging (MRI) to confirm the disappearance of popliteal cysts. In this retrospective study, we reviewed records of patients with popliteal cysts to investigate the natural history of this disease.
The medical records of patients with popliteal cysts followed for at least 12 months were retrospectively reviewed. The patient set comprised of 17 knees in 15 males and 3 knees in 2 females. Mean age was 5.6±2.0 years (range, 1.8 to 11.4 y) at their initial visit to the clinic, and mean follow-up period was 53.1±31.6 months (range, 12.6 to 147.8 mo). MRI findings were reviewed for the 16 knees in 13 patients who had undergone MRI. Symptoms and clinical course were extracted from the medical records of all the study subjects and analyzed.
Although 6 knees (30%) had histories of pain in the popliteal area, no patient complained of pain at their initial visit. Seventeen cysts (85%) naturally decreased in size or disappeared on clinical examination and/or ultrasound. Cysts confined to either the gastrocnemio-semimembranosus bursa or the subgastrocnemius bursa according to the MRI findings were classified as type I, and cysts which occupied both bursae were classified as type II. Eight knees received MRI examination more than once, and complete disappearance was confirmed in 5 of these knees. All type II cysts converted to type I, and all cysts which completely disappeared were type I before disappearance.
The MRI findings in our study population confirmed that popliteal cysts in pediatric populations can be expected to completely resolve in due course without treatment.
Therapeutic study Level IV (Case series).
腘窝区域的囊性肿物，称为腘窝囊肿或贝克囊肿，在儿童群体中通常症状轻微，与关节内病变无关。尽管多项研究描述了在数月至数年时间内囊肿自然消退的病例，但其他研究仍认为手术治疗是必要的。此外，以前没有研究使用磁共振成像（MRI）来证实腘窝囊肿的消失。在这项回顾性研究中，我们回顾了腘窝囊肿患者的记录，以调查这种疾病的自然病程。
对随访至少12个月的腘窝囊肿患者的病历进行回顾性分析。患者组包括15名男性的17个膝关节和2名女性的3个膝关节。初次就诊时的平均年龄为5.6±2.0岁（范围1.8至11.4岁），平均随访期为53.1±31.6个月（范围12.6至147.8个月）。对13例接受MRI检查的患者的16个膝关节的MRI结果进行了回顾。从所有研究对象的病历中提取症状和临床病程并进行分析。
尽管6个膝关节（30%）有腘窝区疼痛史，但初次就诊时无患者主诉疼痛。17个囊肿（85%）在临床检查和/或超声检查中自然缩小或消失。根据MRI结果，局限于腓肠肌-半膜肌滑囊或腓肠肌下滑囊的囊肿分类为I型，占据两个滑囊的囊肿分类为II型。8个膝关节接受了不止一次的MRI检查，其中5个膝关节证实囊肿完全消失。所有II型囊肿均转变为I型，所有完全消失的囊肿在消失前均为I型。
我们研究人群的MRI结果证实，儿童腘窝囊肿有望在未经治疗的情况下在适当的时候完全消退。
治疗性研究IV级（病例系列）。
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