Physical Therapy Program, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO., USA
Received Date: September 24, 2016; Accepted Date: September 26, 2016; Published Date: September 30, 2016
Citation: Canham L, Mintken PE (2016) Large Popliteal Cyst in Patient with Complaint of Posteromedial Knee Pain Int J Phys Med Rehabil 4:I102. doi:10.4172/2329-9096.1000I102
Copyright: © 2016 Canham L, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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The patient was a 44-year-old emergency room physician who presented to a direct access physical therapy clinic with right posteromedial knee pain. The patient had completed rehabilitation following a right partial medial meniscectomy 1 year prior at the same clinic, but continued to have progressively worsening posteromedial knee pain. The patient was considering further arthroscopic surgery to evaluate the medial meniscus following a consult from the orthopaedic surgeon, but sought out direct access physical therapy for a second opinion, as he felt the symptoms were consistent with tendinitis.
Upon evaluation the patient presented with signs and symptoms consistent with medial meniscal pathology, including medial joint line tenderness and a mild effusion. In addition, there were impairments of hip strength, increased pain with toe and heel walking, increased pain during terminal stance phase of gait, and palpable thickening of the posteromedial knee capsule. The possibility of a popliteal cyst was discussed. He underwent 6 physical therapy sessions with little change in symptoms. Being a physician, the patient ordered a magnetic resonance image (MRI) of his right knee, which revealed gross enlargement of a popliteal cyst adjacent to the medial gastrocnemius (Figures 1 and 2). Benign cystic and “cyst-like” lesions in and around the knee joint are common, in which case an MRI is useful to differentiate and diagnose these lesions . Physical examination will miss one half of these cysts, and in older patients there is usually a coexisting problem . Based on the findings, the patient underwent successful removal of the cyst.