title: [Giant Baker's cyst treated with intralessional methotrexate].
abstract: BACKGROUND
  Synovial cyst is composed by a fibrous wall; lining by a thin layer of synovial cells containing synovial fluid, the prototype of these, in the knee is the Baker's cyst, which is located abnormally in the gastrocnemius semimembranous bursa. Baker's cyst prevalence ranges from 5 - 38%. Clinical diagnosis is supported by the presence of increased volume of soft tissues located in the popliteal region.
  
  
  METHODS
  A 74 year-old woman with longstanding active rheumatoid arthritis who developed a large, recurrent Baker's cyst. The Baker's cyst had two flare-ups of pain and soft tissue swelling which eventually limited knee movements; was treated with needle aspiration guided by ultrasound and synovectomy with methotrexate twice. At 18-months follow-up, the patient remains without evidence of recurrence.
  
  
  CONCLUSIONS
  Local infiltration of methotrexate represents an alternative therapy for those refractory Baker's cyst with partial response to conventional treatment, where the surgical procedure carries a high risk.
authors: Departamento de Radiología e Imagen. Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México D.F., Mexico.
authors: Fritz
authors: F
authors: Hofmann-González
authors: Cristina
authors: C
authors: Hernández-Díaz
authors: Carla
authors: C
authors: Solano-Ávila
authors: Alberto Gabriel
authors: AG
authors: López-Reyes
authors: Angélica
authors: A
authors: Peña-Ayala
authors: Carlos
authors: C
authors: Pineda-Villaseñor
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D015552:Injections, Intralesional; D008727:Methotrexate / Q000008:administration & dosage*; D011151:Popliteal Cyst / Q000188:drug therapy* / Q000473:pathology
chemical_list: D008727:Methotrexate
keywords: Baker's cyst; methotrexate; rheumatoid arthritis; synovectomy; ultrasound