Baker's cyst (cyst) is a fluid reservoir that is felt in the popliteal fossa, i.e. on the posterior side of the knee joint. It most often occurs in people who overload the knee joint, it can affect athletes who train intensively as well as overweight and obese people, although it can also occur in some people with joint diseases, e.g. gout or RA. What are the causes and symptoms of a Baker's cyst? How is treatment and rehabilitation going? When is surgery necessary?

Baker's cystis a reservoir with synovial fluid, palpable by skin integuments in the popliteal fossa. Baker's cysts are formed by fluid accumulated in the gastrocnemius bursa in the area of ​​the back of the knee joint of the knee joint. Often the synovial fluid becomes "trapped" in the fluid reservoir, it goes there via a valve mechanism, which means that it cannot return to the joint.

The popliteal cystis one ganglion. Classified as harmless, it is often spontaneously absorbed.

Baker's cyst - causes

The formation of a popliteal cyst in adults is associated with degenerative changes in the joint or inflammatory diseases. In children, the causes of its formation are unclear. However, there are many risk factors. One of them is overload and injuries of the knee joint, which is why physically active people (e.g. athletes) as well as overweight and obese people who overload their knee joints are most vulnerable to the development of Baker's cyst.

The probability of a Baker's cyst is also high in people with:

  • joint diseases (e.g. rheumatoid arthritis, gout)
  • inflammation of the knee joint
  • osteoarthritis of the knee
  • with a history of meniscus damage

Baker's cyst - symptoms

  • noticeable fluid reservoir in the knee trough
  • redness and warming of the skin around the cyst
  • swelling of the knee joint
  • obstructed bending of the leg at the knee (full bend cannot be performed)
  • pain during complete extension of the knee joint
  • knee pain, which increases with prolonged walking
  • may be the result of pressure on the blood vessels and nerves in its vicinity
  • symptoms of numbness in the calf that may appear after rupture and the spilling of the cyst contents into the surrounding tissue.

Baker's cyst - diagnosis

Symptoms and an interview with the patient are usually sufficient to make a diagnosis. In case of doubt, an ultrasound scan is performed. Often an asymptomatic Baker's cyst is visualized on MRI of the knee to diagnose another problem.

According to an expertbow. Tomasz Szymański - orthopedist from the Carolina Medical Center in Warsaw

Baker's cyst is an example of a ganglion, a gallic cyst located in the popliteal fossa at the site of the gastrocnemius bursa. It most often occurs in two age groups: in children 4-7 years of age and in adults over 35 years of age

There are many possible causes of this fluid reservoir, but the most common is overloading the joint with overproduction of synovial fluid. The increased amount of fluid causes more pressure in the joint, which pushes the fluid into the gastrocnemius bursa, preventing it from returning to the joint, which is a valve mechanism.

The popliteal cyst tends to atrophy spontaneously, like most ganglions. Limb sparing, high pose, cooling, as well as anti-inflammatory drugs often help. Rehabilitation may be helpful.

In some cases, the cyst ruptures, and then we observe swelling and redness of the calf as well as pain and palpation of the muscles of the posterior part of the lower leg. Quite characteristic symptoms can easily lead to a correct diagnosis, but to confirm it, I recommend performing an imaging test - ultrasound or magnetic resonance imaging. It is worth taking X-ray pictures, which are the basis of diagnostics and can give us further information.

Baker's cyst, especially in adults, is a symptom, not a disease in itself. A recurring problem requires an MRI to diagnose a diseased structure that can cause synovitis, irritation of other structures, overproduction of fluid and, consequently, a popliteal cyst. Sometimes cyst puncture, fluid evacuation and steroid injection are performed, usually under ultrasound control, so as not to damage important structures nearby. However, this procedure is often associated with the risk of recurrence of symptoms.

Patients with recurrent popliteal cyst problem, after exhausting the less invasive treatment methods, are qualified for surgical treatment, always based on MRI. The operation consists in arthroscopy of the knee joint, working out damaged structures and opening the cyst gates, aalso its cleansing and removal of the hypertrophied synovial membrane. Magnetic resonance imaging allows to differentiate a cyst with similarly progressing, much more dangerous diseases; such as deep vein thrombosis, proliferative changes such as sarcoma or popliteal aneurysm.

Baker's cyst - treatment and rehabilitation

  • In the early stage of development, when the cyst is of a small size, there are no pain symptoms, and there is no restriction of mobility and loss of function of the knee joint, exercise should be limited and the knee joint should be relieved.
  • Anti-inflammatory drugs (NSAIDs)
  • You can also use physiotherapeutic treatments (iontophoresis, cryotherapy, magnetic field, laser therapy and ultrasounds), as well as fascial therapy treatments - FM therapy (Fascial Manipulation), strengthening exercises, massages and kinesiotaping (dynamic taping) .
  • In more severe cases, it may be necessary to puncture the cyst and suck out the fluid remaining in it (puncture) and inject a steroid to alleviate the inflammation. Unfortunately, a single cyst puncture often doesn't work.
  • If treatment does not lead to a lasting improvement or the cyst under the knee is large in size, your doctor may decide to have a knee arthroscopy. This is a procedure in which the cyst is removed. It is performed under spinal anesthesia, i.e. the patient is anesthetized from the waist down. Hospitalization takes 1-2 days.
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Category:

Spine, bones, joints