Related Experiment Videos
[Baker's cyst in osteoarticular tuberculosis of the knee joint]
H W Krawzak1, F G Scherf, J Bong
1Chirurgische Klinik, Ruhr-Universität Bochum, Marienhospital Herne.
Insights
A Baker cyst in the knee, initially suspected as a common issue, was diagnosed as tuberculosis (TB) of the knee joint. Prompt antituberculosis treatment led to complete healing without lasting damage.
Area of Science:
- Orthopedics
- Infectious Diseases
- Radiology
Background:
- Baker cysts (synovial cysts) can cause knee joint effusions.
- Recurrent effusions after minimal trauma may indicate underlying pathology.
Observation:
- Ultrasound revealed a Baker cyst in a 70-year-old woman with recurrent knee effusions.
- Initial knee joint fluid analysis showed neutrophils; imaging revealed degenerative changes.
Findings:
- Histological examination of synovial tissue showed epithelioid granulomas and Langerhans giant cells.
- Culture of knee fluid identified Mycobacterium tuberculosis, indicating knee joint tuberculosis.
- No pulmonary tuberculosis was detected.
Implications:
- Tuberculosis can present atypically as a Baker cyst with knee effusions.
- Early diagnosis and appropriate antituberculosis treatment are crucial for favorable outcomes.
- Complete healing of knee joint tuberculosis is achievable with standard treatment regimens.
Abstract:
A Baker cyst (synovial cyst) in the right knee-joint was demonstrated by ultrasound in a 70-year-old woman with recurrent knee-joint effusions after minimal trauma to the knee. Radiological examination in two planes showed degenerative changes corresponding to age. Needle puncture of the knee-joint demonstrated numerous neutrophil granulocytes. As the effusion recurred after one week, despite rest and avoidance of weight bearing, arthroscopy with removal of the cyst was indicated. But surprisingly histological examination of synovial tissue revealed epithelioid granulomas and Langerhans giant cells. Culture of fluid obtained on repeat puncture finally grew Mycobacterium tuberculosis. There was no evidence of pulmonary tuberculosis. The knee-joint tuberculosis healed completely without residual damage on antituberculosis treatment, initially 600 mg rifampicin daily, 300 mg isoniazid daily and 2.5 g pyrazinamide daily for 3 months, followed by rifampicin and isoniazid for a further 6 months.