Acute Synovial Rupture in Scleroderma

Abstract

Sattar MA, Al-Sughye AA, Leven H. Acute synovial rupture in scleroderma. Scand J Rheumatology 1988; 17:119-122.

Popliteal cysts, described during the last century by Adams of Dublin and Mourant Baker of London are abnormal distensions of the gastrocnemius-semimembranosus bursa, which usually communicates with the synovial cavity of the knee joint in protrusions from the knee joint itself. It is characteristically seen in rheumatoid arthritis, although it can also occur with synovial effusions from other causes, degenerative arthrosis, gout, meniscal tears, psoriatic arthritis, Reiter's syndrome, gonococcal arthritis and pyrophosphate arthropathy (1).

Asymptomatic popliteal bursae found at routine arthrography are considered to be of no clinical significance. In case of rupture of these bursae, pain behind and below the knee can be of slow, sudden, or even of dramatic onset, usually extending down into the calf. Secondary venous compression often occurs, with a positive Homan's sign and tenderness in the calf simulating thrombophlebitis (2) and/or deep venous thrombosis (DVT), whereas chronic dissection or leakage may lead to the formation of a chronic calf cyst (Baker's cyst) which may extend as far as to the ankle.

We report here a patient with scleroderma who developed acute synovial rupture, hitherto an unreported feature and/or complication of the disease.