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1. Baker's cyst: Scenario: Management of Baker's cyst

Baker's cyst: Scenario: Management of Baker's cyst Scenario: Management | Management | Baker's cyst | CKS | NICE Search CKS… Menu Scenario: Management Baker's cyst: Scenario: Management of Baker's cyst Last revised in May 2020 Scenario: Management of Baker's cyst From birth onwards. Management in children Admit to paediatrics or accident and emergency for urgent assessment if any red flags indicating a serious (such as deep vein thrombosis) are identified in assessment. Consider referral (...) : To a paediatric orthopaedic surgeon, if symptomatic or the cyst is very large. To a paediatric rheumatologist or paediatrician, if an underlying condition (such as inflammatory joint disease) is suspected. To a paediatric orthopaedic surgeon or paediatrician, if diagnosis is unclear. If no underlying disease is suspected, and the diagnosis is confirmed on ultrasound scan, reassure the child (and the parents or carers) that primary Baker's cysts usually resolve without treatment. Basis for recommendation

2018 NICE Clinical Knowledge Summaries

2. Baker's cyst: How should I assess a person with a suspected Baker's cyst?

Baker's cyst: How should I assess a person with a suspected Baker's cyst? Diagnosis | Diagnosis | Baker's cyst | CKS | NICE Search CKS… Menu Diagnosis Baker's cyst: How should I assess a person with a suspected Baker's cyst? Last revised in May 2020 How should I assess a person with a suspected Baker's cyst? Take a history, asking about: Symptoms such as swelling and pain. An asymptomatic swelling behind the knee may be the only feature. In children, Baker’s cysts are often found incidentally (...) — the child or parent may report seeing or feeling a lump behind the knee. In adults, non-specific posterior knee pain and a feeling of tightness are common. Pain may be due to the cyst itself or the underlying cause (for example osteoarthritis or soft tissue injury). Symptoms may be aggravated by walking (as fluid passes between the knee joint and the cyst). Range of movement may be restricted by larger cysts. Possible underlying causes. Symptoms related to a Baker's cyst may be indistinguishable from

2018 NICE Clinical Knowledge Summaries

3. Ganglion cyst

Ganglion cyst Ganglion cyst - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Ganglion cyst Last reviewed: February 2019 Last updated: February 2019 Summary Most common benign lesion of the hand/wrist. Typically, insidious onset with no predisposing conditions. Usually only a cosmetic problem but local pain and neurovascular compression may occur. Conservative management usually suffices if no neurovascular compromise (...) . Aspiration of dorsal cysts can be therapeutic and diagnostic. Surgical excision has a higher rate of resolution but recurrence is possible. No reported malignant transformation. Definition Ganglion cysts are smooth, soft, benign masses that are usually located on the wrist (dorsal or volar aspect) with one or more communicating stalks into the wrist joint or surrounding structures. They can be single or multi-loculated and are filled with viscous, sticky, mucinous fluid. History and exam subcutaneous

2019 BMJ Best Practice

4. Scrotal pain and swelling: Scenario: Epididymal cyst/spermatocele

Scrotal pain and swelling: Scenario: Epididymal cyst/spermatocele Scenario: Epididymal cyst/spermatocele | Management | Scrotal pain and swelling | CKS | NICE Search CKS… Menu Scenario: Epididymal cyst/spermatocele Scrotal pain and swelling: Scenario: Epididymal cyst/spermatocele Last revised in August 2019 Scenario: Epididymal cyst/spermatocele How should I manage a man with epididymal cysts/spermatoceles? If confident of the diagnosis: Reassure the man that epididymal cysts/spermatoceles

2020 NICE Clinical Knowledge Summaries

5. Ovarian cysts

Ovarian cysts Ovarian cysts - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Ovarian cysts Last reviewed: February 2019 Last updated: September 2018 Summary A fluid-filled sac in the ovarian tissue. The cyst may be unilocular or multilocular. The causes may be physiological, infectious, benign neoplastic, malignant neoplastic, or metastatic. The most important step in management is assessing the risk of malignancy (...) . Oral contraceptives do not hasten or influence regression of benign ovarian cysts. Asymptomatic post-menopausal women with simple unilocular ovarian cysts <10 cm in diameter and cancer antigen (CA)-125 <35 U/mL can be managed conservatively with serial ultrasonography. Ultrasonography can provide a morphology index score that is useful in determining likelihood of malignancy. Definition Ovarian cyst is a surgical, imaging, or examination finding of an enlarged, fluid-filled ovary or portion

2018 BMJ Best Practice

6. Bartholin's cyst

Bartholin's cyst Bartholin's cyst - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Bartholin's cyst Last reviewed: February 2019 Last updated: March 2018 Summary Non-infectious occlusion of the distal Bartholin's duct, with resultant retention of secretions. Diagnosed on clinical exam. The classic appearance is a medially protruding cystic structure at the inferior aspect of the labia majora, in the 5 or 7 o'clock (...) position, crossed by the labium minus. Identified in about 2% of women presenting for gynaecological care in the US, and most common in women of reproductive age. In post-menopausal women with a vulval mass, malignancy should be considered. A Bartholin's gland abscess may result from polymicrobial non-gonorrhoeal infection of the cyst fluid or, less commonly, from primary infection of the gland or duct. Treatment of a cyst can be conservative or surgical and depends on size, symptoms, presence

2018 BMJ Best Practice

7. Popliteal cyst

Popliteal cyst Popliteal cyst - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Popliteal cyst Last reviewed: February 2019 Last updated: March 2018 Summary Common accumulation of synovial fluid that is usually the result of a knee joint abnormality, such as arthritis or a cartilage tear. May present with swelling or pain behind the knee, but most cases are asymptomatic. May rupture, leading to severe pain and calf (...) swelling. Usually only conservative treatment is required. Large symptomatic cysts that do not resolve may require drainage. Definition Popliteal cyst, also known as Baker's cyst, is the result of an accumulation of joint synovial fluid outside the knee joint that forms behind the knee. This occurs via increased intrasynovial pressure and causes the synovial capsule to bulge at an area where there is a lack of external anatomical support. Labropoulos N, Shifrin DA, Paxinos O. New insights

2018 BMJ Best Practice

8. Ganglion cyst

Ganglion cyst Ganglion cyst - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Ganglion cyst Last reviewed: February 2019 Last updated: February 2019 Summary Most common benign lesion of the hand/wrist. Typically, insidious onset with no predisposing conditions. Usually only a cosmetic problem but local pain and neurovascular compression may occur. Conservative management usually suffices if no neurovascular compromise (...) . Aspiration of dorsal cysts can be therapeutic and diagnostic. Surgical excision has a higher rate of resolution but recurrence is possible. No reported malignant transformation. Definition Ganglion cysts are smooth, soft, benign masses that are usually located on the wrist (dorsal or volar aspect) with one or more communicating stalks into the wrist joint or surrounding structures. They can be single or multi-loculated and are filled with viscous, sticky, mucinous fluid. History and exam subcutaneous

2018 BMJ Best Practice

16. Pancreatic Cyst.

Pancreatic Cyst. New 2019 ACR Appropriateness Criteria ® 1 Pancreatic Cyst American College of Radiology ACR Appropriateness Criteria ® Pancreatic Cyst Variant 1: Incidentally detected pancreatic cyst less than or equal to 2.5 cm in size. Initial evaluation. Procedure Appropriateness Category Relative Radiation Level MRI abdomen without and with IV contrast with MRCP Usually Appropriate O CT abdomen with IV contrast multiphase May Be Appropriate ??? ? MRI abdomen without IV contrast with MRCP (...) May Be Appropriate O CT abdomen without and with IV contrast Usually Not Appropriate ??? CT abdomen without IV contrast Usually Not Appropriate ???? US abdomen endoscopic Usually Not Appropriate O Variant 2: Incidentally detected pancreatic cyst greater than 2.5 cm in size. No high-risk stigmata or worrisome features. Initial evaluation. Procedure Appropriateness Category Relative Radiation Level MRI abdomen without and with IV contrast with MRCP Usually Appropriate O CT abdomen with IV contrast

2019 American College of Radiology

17. Neck lump: Scenario: Thyroglossal cyst

Neck lump: Scenario: Thyroglossal cyst Scenario: Thyroglossal cyst | Management | Neck lump | CKS | NICE Search CKS… Menu Scenario: Thyroglossal cyst Neck lump: Scenario: Thyroglossal cyst Last revised in January 2016 Scenario: Thyroglossal cyst From age 1 month onwards. Management of a thyroglossal cyst If a thyroglossal cyst is suspected, refer to an ear, nose, and throat specialist or to a thyroid surgeon, depending on local service provision. Basis for recommendation This recommendation

2019 NICE Clinical Knowledge Summaries

18. Meibomian cyst (chalazion)

Meibomian cyst (chalazion) Meibomian cyst (chalazion) | Topics A to Z | CKS | NICE Search CKS… Menu Meibomian cyst (chalazion) Meibomian cyst (chalazion) Last revised in March 2019 A meibomian cyst (also known as a chalazion) is a sterile, chronic, inflammatory granuloma caused by the obstruction of a meibomian gland. Diagnosis Management Background information Meibomian cyst (chalazion): Summary A meibomian cyst (also known as a chalazion) is a sterile, chronic, inflammatory granuloma (...) of the eyelid caused by a foreign body reaction to sebum within a meibomian gland. Meibomian cysts can occur in all age groups (but are thought to be most common in adults) and are a frequent cause of lumps in the eyelid. Pregnant women and people with the following conditions are more at risk of meibomium cysts (and their recurrence): Blepharitis. Seborrhoeic dermatitis. Rosacea. Diabetes mellitus. Elevated serum cholesterol. A meibomian cyst rarely causes serious complications. A meibomian cyst typically

2019 NICE Clinical Knowledge Summaries

19. Ovarian cysts

Ovarian cysts Ovarian cysts - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Ovarian cysts Last reviewed: February 2019 Last updated: September 2018 Summary A fluid-filled sac in the ovarian tissue. The cyst may be unilocular or multilocular. The causes may be physiological, infectious, benign neoplastic, malignant neoplastic, or metastatic. The most important step in management is assessing the risk of malignancy (...) . Oral contraceptives do not hasten or influence regression of benign ovarian cysts. Asymptomatic post-menopausal women with simple unilocular ovarian cysts <10 cm in diameter and cancer antigen (CA)-125 <35 U/mL can be managed conservatively with serial ultrasonography. Ultrasonography can provide a morphology index score that is useful in determining likelihood of malignancy. Definition Ovarian cyst is a surgical, imaging, or examination finding of an enlarged, fluid-filled ovary or portion

2017 BMJ Best Practice

20. Interventions for treating simple bone cysts in the long bones of children. Full Text available with Trip Pro

Interventions for treating simple bone cysts in the long bones of children. Simple bone cysts, also known as a unicameral bone cysts or solitary bone cysts, are the most common type of benign bone lesion in growing children. Cysts may lead to repeated pathological fracture (fracture that occurs in an area of bone weakened by a disease process). Occasionally, these fractures may result in symptomatic malunion. The main goals of treatment are to decrease the risk of pathological fracture, enhance (...) cyst healing and resolve pain. Despite the numerous treatment methods that have been used for simple bone cysts in long bones of children, there is no consensus on the best procedure. This is an update of a Cochrane review first published in 2014.To assess the effects (benefits and harms) of interventions for treating simple bone cysts in the long bones of children, including adolescents.We intended the following main comparisons: invasive (e.g. injections, curettage, surgical fixation) versus non

2017 Cochrane

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