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Background
Baker's cyst is a well-known entity that has been extensively described in the literature. 1-3 However, very little has been written about complications of this benign condition and particularly rupture of the cyst leading to the development of compartment syndrome. In this paper we present this extremely rare and interesting case, which, if goes unnoticed or not treated promptly, can lead to potentially catastrophic results causing permanent disability.
Case presentation
A 69-year-old gentleman presented to the Accident & Emergency department with swelling and redness of his left leg. He was generally fit and well and was not receiving any long-term medications (eg, anticoagulants). There was no history of any previous injury to the affected leg with no obvious signs of skin disruption. On physical examination the patient had a diffusely swollen left calf which was quite tense on palpation. There was also redness over entire leg. Initially he was treated on suspicion of cellulitis with oral antibiotics. At the Emergency Department the possibility of deep vein thrombosis (DVT) was ruled out by performing a Doppler ultrasound and blood tests. On the initial ultrasound it was concluded to be a large popliteal cyst measuring 110x47x66 mm. The radiologist could not determine whether the cyst was infective or haemorrhagic. This patient was later referred to the orthopaedic fracture clinic as his symptoms worsened. At this stage he had developed neurological deficit at the common peroneal nerve with an inability to move his big toe and sensory impairment along the distribution of both the deep and superficial peroneal nerves. His calf was swollen and tense but he did not have excessive pain which is classically seen in acute compartment syndrome. The patient was admitted and urgent MRI scan was done which confirmed a ruptured popliteal cyst with extension into the upper two-thirds of the calf and signal characteristics suggested fresh...