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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

9. 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

10. 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

11. 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

12. 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

13. 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

14. Tolvaptan (Jinarc) - to slow the progression of cyst development and renal insufficiency of autosomal dominant polycystic kidney disease (ADPKD)

Tolvaptan (Jinarc) - to slow the progression of cyst development and renal insufficiency of autosomal dominant polycystic kidney disease (ADPKD) Cost-effectiveness of tolvaptan (Jinarc®) for the treatment of autosomal dominant polycystic kidney disease (ADPKD) The NCPE has issued a recommendation regarding the cost-effectiveness of tolvaptan (Jinarc®). Following assessment of the applicant’s submission, the NCPE recommends that tolvaptan (Jinarc®) not be considered for reimbursement unless cost (...) is for consideration by anyone who has a responsibility for commissioning or providing healthcare, public health or social care services. National Centre for Pharmacoeconomics September 20182 Summary In February 2018, Otsuka submitted a dossier to examine the cost-effectiveness of tolvaptan (Jinarc®) under the High Tech Drug Arrangements for Autosomal Dominant Polycystic Kidney Disease (APKD). ADPKD is an inherited form of kidney disease characterised by the progressive development of numerous renal cysts

2018 Pediatric Endocrine Society

15. Neck lump: Scenario: Branchial cyst

Neck lump: Scenario: Branchial cyst Scenario: Branchial cyst | Management | Neck lump | CKS | NICE Search CKS… Menu Scenario: Branchial cyst Neck lump: Scenario: Branchial cyst Last revised in January 2016 Scenario: Branchial cyst From age 1 month onwards. Management of a branchial cyst If a branchial cyst is suspected, refer to an ear, nose, and throat specialist. Basis for recommendation This recommendation is based on expert opinion in review articles [ ; ; ]. Referral is recommended (...) because branchial cysts may become infected and usually require surgical excision [ ]. It is also important to exclude a cystic metastasis from a papillary thyroid carcinoma or primary pharyngeal squamous cell carcinoma or a metastatic lymph node as these can present similarly, particularly in people of 40 years of age or older [ ; ]. © .

2018 NICE Clinical Knowledge Summaries

16. Baker's cyst: What else might it be?

Baker's cyst: What else might it be? Differential diagnosis | Diagnosis | Baker's cyst | CKS | NICE Search CKS… Menu Differential diagnosis Baker's cyst: What else might it be? Last revised in May 2020 What else might it be? The differential diagnosis of Baker's cyst includes: Deep vein thrombosis — for further information, see the CKS topic on . Superficial thrombophlebitis — for further information, see the CKS topic on . Popliteal artery aneurysm. Popliteal varices. Lipoma. Ganglion cyst (...) . Abscess. Haematoma. Synovial haemangioma. Muscular herniation. Benign or malignant tumours (such as sarcoma, lymphoma or metastases). Basis for recommendation Information on the differential diagnosis of Baker's cyst is based on expert opinion in review articles [ ; ; ; ] [ ; ; ]. © .

2018 NICE Clinical Knowledge Summaries

17. Baker's cyst: Paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs)

Baker's cyst: Paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs) Paracetamol and NSAIDS | Prescribing information | Baker's cyst | CKS | NICE Search CKS… Menu Paracetamol and NSAIDS Baker's cyst: Paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs) Last revised in May 2020 Paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs) For prescribing information on paracetamol and nonsteroidal anti-inflammatory drugs (NSAIDs), see the CKS topics on and . © .

2018 NICE Clinical Knowledge Summaries

18. Baker's cyst

Baker's cyst Baker's cyst | Topics A to Z | CKS | NICE Search CKS… Menu Baker's cyst Baker's cyst Last revised in May 2020 Baker's cysts (also known as popliteal cysts) are not true cysts. They are a distension of the gastrocnemius-semimembranosus bursa behind the knee. Diagnosis Management Prescribing information Background information Baker's cyst: Summary Baker's cysts (also known as popliteal cysts) are not true cysts. They are a distension of the gastrocnemius-semimembranosus bursa behind (...) the knee. Baker's cysts are described as primary or secondary. Primary cysts are not associated with underlying disease of the knee joint and are found mainly in children. Secondary cysts are associated with underlying disease of the knee joint and tend to have a communication between the bursa and the rest of the knee joint. Almost all Baker's cysts in adults are secondary. The prevalence of Baker's cysts varies widely depending on the population studied, the definition of cyst used

2018 NICE Clinical Knowledge Summaries

19. Diagnosis and Management of Pancreatic Cysts

Diagnosis and Management of Pancreatic Cysts 1 © 2018 by the American College of Gastroenterology The American Journal of GASTROENTEROLOGY CLINICAL GUIDELINES INTRODUCTION Pancreatic cysts are oft en detected on abdominal imaging per- formed for non-pancreatic indications. Th eir prevalence in an asymptomatic population is reported from 2.4 to 13.5% with increasing incidence with age ( 1 ). A review of abdominal mag- netic resonance imaging (MRIs) performed for non-pancreatic indications (...) in patients over the age of 70 showed a 40% incidence of incidental pancreatic cysts ( 2 ). Somewhat reassuring is the low prevalence of cysts >2 cm; in 25,195 subjects in fi ve studies the prevalence of cysts >2 cm was only 0.8% ( 3 ). Pancreatic cysts are increasingly being diagnosed because of the use of more abdomi- nal imaging and to the increased quality of that imaging. Th e overall incidence of pancreatic cancer-related mortality is fairly stable; thus, the increasing incidence of cysts is likely

2018 American College of Gastroenterology

20. An Unusual Case of a Large Periapical Cyst Mimicking a Nasopalatine Duct Cyst. (Abstract)

An Unusual Case of a Large Periapical Cyst Mimicking a Nasopalatine Duct Cyst. This article reports on the management of a large median symmetrical lesion of the anterior palate, which was clinically and radiographically diagnosed as an infected nasopalatine duct cyst. However, histopathology demonstrated it to be a radicular cyst of endodontic origin.Copyright © 2020 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

2020 Journal of Endodontics

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