What Is Baker's Cyst - Symptoms & Treatment
Medically Reviewed By : Dr K. Hari Chandana
MBBS, MS ORTHOPAEDICS
( Fellowship in Trauma, Fellowship in Pain Management )
Introduction
The name Baker’s cyst was first coined by Dr. Morrent Baker. Anatomically, the name popliteal synovial cyst derives from its location, which is on the popliteal fossa, the back of the knee.
A little sac filled with vital fluid, called the bursa, helps the knee operate quite smoothly without causing much friction. In certain conditions, there is an excess of fluid inside the bursa, which can cause bursitis, an inflammation of the bursa.
There can be numerous etiologies for cyst formation; however, the most common ones are osteoarthritis, rheumatoid arthritis, gout, anterior cruciate ligament (ACL) tears, and meniscus tears, which are C-shaped cartilage that can be torn due to an abrupt injury to the knee.
Baker’s Cyst Causes
The most common cause of baker’s cyst is
- Inflammatory conditions like osteoarthritis or rheumatoid arthritis
- Meniscus or a cartilage tear
- Knee injury, which causes swelling in the knee
These are the types of conditions that cause your joints to produce excessive fluid, which is the cause that leads to the formation of the popliteal cyst
Types of the cysts
Let’s discuss the classification of the cyst. There are two types of cysts: There are two types of cysts.
- Primary Cyst: In a primary type of cyst, there is no underlying disease that causes the cyst or an anomaly in the knee.
- Secondary Cyst: In the secondary type of cyst, there is an underlying disease that causes the cyst, or there is some anomaly in the knee.
Depending on the size of the cyst, the symptoms and treatment can vary to some extent. However, the baseline treatment remains the same.
Baker’s cyst is commonly seen in adults, especially in inflammatory conditions like osteoarthritis and rheumatoid arthritis, and is symptomatic compared to the asymptomatic manifestation seen in children.
Signs and symptoms
Both subjective and objective symptoms and signs might be present, but they can differ from person to person.
Let’s discuss the popliteal cyst symptoms and indicators.
- Swelling : When there is a popliteal cyst that is filled with fluid, swelling is quite prominent on the posterior aspect of the knee. The swelling can vary in size depending on the size of the popliteal cyst.
- Discomfort : A vague pain is noted around the knee region. The pain can be typically dull. In the case of a popliteal cyst rupture, there could be excruciating pain.
- Stiffness : There could be marked stiffness, which can lead to a limited range of motion. The patient may be unable to fully flex the knees because of the swelling, stiffness, and limited range of motion.
- Discolouration : In extreme cases, there could be discoloration and blot clots. In such cases, visiting the doctor becomes necessary.
- Fatigue : Some may also experience generalized fatigue.
Diagnosis and Treatment
If your doctor suspects that you have a frozen shoulder, they’ll likely begin by physically examining your shoulder. This examination helps identify how limited your range of motion is and how severe your pain is.
Sometimes, your doctor may recommend imaging tests, such as X-rays or an MRI, to help diagnose the condition.
The treatment for a frozen shoulder often involves physical therapy, which might include exercises to help stretch and strengthen the shoulder joint. Painkiller medications may also be helpful in this condition.
WHEN TO SEE A DOCTOR
Considering the nature of a symptomatic popliteal cyst, most of the time the patient may not know that they have one. However, in cases of discoloration or excruciating pain, which could be because of the rupture of the cyst, one must visit the physician.
Even if the patient sees an unusual bulge or swelling on the back of the knee, they must visit the physician and follow that advice.
Complications
There are several complications of a popliteal cyst that are usually seen quite rarely.
However, the most common complication of a baker’s cyst is its rupture
Baker’s cyst rupture
Since it is a cyst and is filled with fluid, there is a possibility that it can rupture.
If the baker’s cyst ruptures, there’s a tendency for it to cause pain and swelling because there will be a leakage of fluid that may go into your calf muscles, leading to pain and discomfort.
Diagnosis of baker's cyst
Consulting a specialist becomes of high importance in such conditions where there is a chance of serious complications. Your doctor will want you to provide a detailed account of your symptoms to obtain a complete medical history, and he or she will ask you in-depth questions about your symptoms, like the onset, duration, and progress of the disease.
Along with that, the physician may also perform an examination and ask you to do some imaging tests.
The imaging test could be:
- X-ray : The medical professional might look for abnormalities in the bone structures, although the cyst is soft tissue and cannot be seen on an X-ray. Arthritis can display indications that include the narrowing of the space between joints.
- MRI: A technique of determining if the prominence on the posterior aspect of the knee is solid or is stuffed with fluid using sound waves .
- Ultrasound: This test provides a clear image of soft tissues and may help to understand the diagnosis in more detail.
Treatment of baker’s cyst
The treatment is further divided into
- Surgical
- Non-surgical
Arthroscopy is a component of surgical treatment.
While you are under anesthesia, your doctor will make several tiny incisions to implant an arthroscope, which is a tiny camera inserted into your knee joint. Your doctor will use the images from the camera to direct tiny surgical equipment.
Non-surgical treatment
This could include
- OBSERVATION: At times, the physician will merely keep you under close observation of the cyst to see whether it increases in size or causes any discomfort. There could also be some form of physical therapy given after the surgery.
- ACTIVITY MODIFICATION: Any vigorous activity, especially vigorous walking or running, might exacerbate the medical condition.
- NSAIDs (Non-steroidal anti-inflammatory drugs): Drugs such as ibuprofen and naproxen may help alleviate or manage the pain and swelling.
- ASPIRATION: Where a medical professional may drain the cyst of additional fluid, that may be contributing to the patient's discomfort.
- Corticosteroid injections may help reduce pain and swelling.
The prognosis regarding Baker’s cyst is fair, and it’s not something serious. Considering appropriate medication and services, a full recovery can be achieved in 3–4 weeks.
Removal of the baker’s cyst
This can depend on the size of the cyst and the symptoms it causes. Your healthcare provider may drain the fluid from the cyst to prevent its rupture.
In extreme cases, arthroscopic surgery may be performed by your healthcare provider to prevent further complications.
Self-Care in Baker’s Cyst
There are certain measures that you need to take from your end when you are diagnosed with baker’s cyst
- Exercise: When we talk about exercise in Baker's cyst, it doesn't mean heavy or strenuous exercise. It means gentle exercise that can help strengthen the muscle. These exercise include seated hamstring stretches, wall squatting, and side-stepping.
- Ice pack: In this cases of swelling, apply an ice pack to the affected area. It will help calm down the swelling.
- Rest : Adequate amounts of rest are important whenever you are diagnosed with Baker's cyst because heavy activity could cause the cyst, leading to further complications.
- Compression bandage: This is frequently used to reduce the swelling brought on Baker's cyst.