Anesth Pain Med.  2020 Apr;15(2):199-204. 10.17085/apm.2020.15.2.199.

Ultrasound-guided treatment of common peroneal neuropathy caused by Baker’s cyst: a clinical note - A case report -

• Cho H
• Kim DR
• Lee JJ
• Lee SY
• Park YB
• Kim HS
• Shin HY

• KMID: 2500972
• DOI: http://doi.org/10.17085/apm.2020.15.2.199

Abstract

Baker’s cysts are usually located in the posteromedial side of the knee and seldom cause neuropathy. We describe the rare case of a 57-year-old woman with a popliteal cyst who presented with limping gait and pain in her lower leg. She was electronically diagnosed with common peroneal neuropathy and transferred to our pain clinic. On ultrasound examination, about 2.0 × 1.2 cm sized popliteal cyst was found to extend to the fibular head, compressing the common peroneal nerve. Therefore, ultrasound-guided aspiration of the cyst and a common peroneal nerve block were performed. Immediately after the procedure, the pain, dysesthesia, and limping gait were relieved. Although her pain and dysesthesia were relieved, she underwent the surgery because of limping gait. In this case, we found the Baker’s cyst, the cause of the common peroneal neuropathy, and treated it immediately by just simple ultrasound examination and aspiration.

Keyword

Peroneal neuropathies; Popliteal cyst; Ultrasonography

Figure

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  Fig. 1. Ultrasound images of the Baker’s cyst. It follows the uncommon route, which arises from the popliteal space and extends to the fibular head (dagger) posterior to lateral femoral condyle compressing the common peronaeal nerve (asterisk).

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  Fig. 2. An ultrasound image of the aspiration of the Baker’s cyst, which arises from the popliteal space and extends to the fibular head (dagger).

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  Fig. 3. Axial proton density-weighted magnetic resonance imaging with fat suppression of the knee. Cystic lesion (asterisk) compressing the common peroneal nerve (arrowhead) at the level of the fibular head (arrow).

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  Fig. 4. Axial proton density-weighted magnetic resonance imaging with fat suppression of the knee. Increased signal intensity (arrow) in proximal anterior compartment of lower leg.

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  Fig. 5. An ultrasound image of the aspiration of the Baker’s cyst at the second visit.

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  Fig. 6. Pathologic findings of the cyst excised from the knee revealed synovial lining, and the diagnosis was Baker’s cyst (Hematoxylin and eosin stain, ×200)

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