title: Multiple rheumatoid bursal cysts that were finally effectively treated by combining surgical resection and sclerotherapy.
abstract: A 71-year-old male who had been diagnosed with rheumatoid arthritis 3 years previously developed multiple subcutaneous cysts on his buttock, elbow, knee, hand and back. The diameters of the cysts were 10-15 cm. The characteristic fluid and pathology of the cysts led to the diagnosis of multiple rheumatoid bursal cyst (MRBC). The patient was keen to treat the cyst on his buttock as it hampered his sitting position. However, it resisted several kinds of sclerotherapies, including absolute alcohol, OK-432, minocycline and dexamethasone. When the cyst grew further, it was resected surgically; however, the cyst recurred immediately. It was finally brought under control by injecting it with OK-432. The thick cyst wall, which resisted the various sclerotherapies, was removed surgically, and a new capsule developed inside the cavity; adding a sclerotant to newly made thin capsule made us possible to treat this resistant large bursal cyst.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Juntendo University School of Medicine, 2-1-1 Hongo Bunkyo-ku, Tokyo 113 8421, Japan. ayhayasi@juntendo.ac.jp
authors.forename: Ayato
authors.initials: A
authors.lastname: Hayashi
authors.forename: Takashi
authors.initials: T
authors.lastname: Matsumura
authors.forename: Masakazu
authors.initials: M
authors.lastname: Komoto
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Horiguchi
authors.forename: Yuzo
authors.initials: Y
authors.lastname: Komuro
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Mizuno
mesh_terms: D000368:Aged; D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000175:diagnosis; D002061:Bursa, Synovial; D003560:Cysts / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D005500:Follow-Up Studies; D006801:Humans; D007719:Knee Joint; D008297:Male; D019637:Orthopedic Procedures / Q000379:methods*; D015911:Sclerotherapy / Q000379:methods*