Baker’s cyst – causes, symptoms & therapy

Baker’s cyst

Baker ‘s cyst , named after surgeon WM Baker, is a fluid-filled sac located in the back of the knee. Baker’s cysts usually appear in middle to old age. Children are rarely affected.

What is a Baker’s cyst?

Baker’s cyst, also known as a knee joint ganglion, is a fluid-filled swelling . It is located at the back of the knee. It is caused by an overproduction of synovial fluid. Due to the increased pressure or damage to the knee joint, an effusion forms and a Baker’s cyst develops.

Their size can vary greatly. Not infrequently, it can grow to the size of a fist. This is also the reason why the gelatinous or liquid protuberance can usually be felt easily. It causes a lot of pain, especially in people who are physically active. Because of its appearance, Baker’s cyst is often mistaken for a tumor . This suspicion must be checked and ruled out in any case.

causes

Baker’s cyst results from a disease of the knee joint . So-called internal knee diseases are responsible for such diseases. Inflammation and irritation in the knee joint causes the body to build up more fluid in the joint.

This increased synovial fluid increases the pressure within the knee joint. In order to relieve this pressure in turn, the joint capsule sags. As a result, the Baker’s cyst forms. Baker’s cysts often occur in connection with meniscus damage .

But chronic rheumatism can also be the cause of a Baker’s cyst. In this context, however, a condition for the development of a Baker’s cyst is a diseased knee joint.

When to the doctor?

The presence of a Baker’s cyst is not dangerous to health and does not require immediate medical attention. If the tissue pocket filled with fluid begins to press on the nerve tracts, unpleasant sensory disturbances occur in the feet. A Baker’s cyst can also cause severe knee pain. If you experience discomfort in your lower legs and feet, or if you experience persistent or very severe pain, you should consult a doctor as soon as possible.

There is a chance that the Baker’s cyst will regress. In this case, complaints in the knee and behind the knee should be monitored further. In most cases, a cyst forms again if the actual cause of the disease is not remedied. Likewise, untreated Baker’s cysts increasingly fill with fluid and become very bulging. The knee can no longer be fully bent. Any kind of movement causes pain. In this case, the quality of life is significantly reduced and it is advisable to see a family doctor, orthopedist or surgeon.

If the Baker’s cyst bursts – as a result of a rupture – and fluid leaks into the surrounding tissue, inflammation develops. This escaping fluid and the synovial fluid migrate down to the foot. There, the pressure in the tissue on the blood and nerve tracts continues to increase. Immediate consultation with a surgeon is advisable here, as this accumulation of fluid and the progressive inflammatory process can lead to the loss of the lower leg if left untreated.

symptoms and course

Typical symptoms of Baker’s cyst include recurring pain. The hollow of the knee and the upper calf area are particularly affected.

The fluid-filled Baker’s cyst can usually be felt clearly. Depending on physical activity, their size can vary greatly. The more active the patient, the more pronounced the symptoms. Athletes in particular complain of severe pain during physical activity. In some cases, such as a mild Baker’s cyst, there may well be no symptoms at all of the above symptoms.

Only the knee seems less flexible and there can be a feeling of tension in the back of the knee. However, this does not cause pain. Sometimes the symptoms caused by Baker’s cysts can improve over time.

Especially if the joints are spared, the Baker’s cyst regresses. However, it can return with stress. This often occurs when the cause of the Baker’s cyst is not completely eliminated.

If the Baker’s cyst ruptures, the fluid leaks out and spreads to the surrounding tissue. The pain increases.

Diagnose

The diagnosis of a Baker’s cyst is usually made on the basis of the symptoms and a palpation. It is more difficult to diagnose a very elongated, tubular Baker’s cyst, which also has bleeding. Sometimes the Baker’s cyst closely resembles a tumor. In any case, this should be clarified immediately.

In addition to a detailed examination, there are various methods to substantiate the diagnosis. Although changes in the knee joint can be shown in an X-ray , it is not possible to identify the Baker’s cyst. An ultrasound examination can be used to determine the size and spread. In addition, a magnetic resonance imaging (MRI) is recommended to demonstrate the exact position and connection of the Baker’s cyst to the joint capsule.

complications

Complications from a Baker’s cyst primarily occur when the sac at the back of the knee ruptures. There is a risk of rupture if the Baker’s cyst is too large. The pressure reaches a critical level in relation to the thickness of the cyst wall. If the patient then bends the knee, it is possible that the thinned wall of the cyst is no longer able to counteract the increase in pressure and ruptures. If the Baker’s cyst bursts, this results in the leakage of synovial fluid. This in turn creates inflammation, which is associated with further pain. The leaked synovial fluid penetrates into the muscles of the lower leg due to gravity and can even reach the ankle area in some cases.

The inflammation within the tissue and the associated swelling create pressure that cannot escape. In medicine, this is then referred to as compartment syndrome . This puts pressure on the nerves and the smallest blood vessels. This complication can have serious consequences such as a lower leg amputation . For this reason, prompt surgical intervention is required. If the Baker’s cyst grows massively, blood vessels and nerves can be pinched by its mass, which is noticeable by numbness in the lower leg. There is also a risk of a blood clot (thrombosis) forming.

treatment and therapy

Sometimes it is not necessary to treat the Baker’s cyst. However, if pain occurs, therapy is advisable. Conservative and operative measures are available for this. As a rule, conservative therapy is sufficient, whereby the Baker’s cyst is treated with anti-inflammatory drugs. In particular, non-steroidal drugs such as ibuprofen and diclofenac are used.

The treatment with cortisone has so far been very controversial. However, the active ingredient is often used. The doctor injects the cortisone preparation directly into the knee to stop the inflammation there. Rarely, the contents of the Baker’s cyst are sucked out with a syringe. The remaining shell is then rinsed out with cortisone.

If there is no significant improvement, surgical removal of the Baker’s cyst is recommended. Basically, the removed tissue should be examined. This is the only way to completely rule out malignant tumors. During the surgical removal, care must be taken to ensure that the connection between the joint and the cyst (the pedicle) is severed. If this is not done, the Baker’s cyst can form again.

prevention

The Baker’s cyst can only be prevented to a limited extent. In order to avoid meniscus damage, high-impact sports should be avoided. Sports such as cycling, swimming, targeted gymnastics and aqua aerobics are far more gentle on the joints. They gently support the mobility of the knee joint and maintain it.

In the case of predominantly sedentary activities, for example in the office, the sitting position should be changed regularly. People who work in the field of passenger transport or as truck drivers are recommended to take regular breaks in which a short walk has a relieving effect on the knee joint. Being overweight puts a lot of strain on the joints. In order to prevent Baker’s cysts, existing excess weight should be reduced.

Dorothy Farrar

Hello and welcome to my Health Guide & Encyclopedia! My name is Dorothy Farrar, and I'm the founder and main author of this platform.
My passion for health and wellness started at a young age when I became interested in the connection between the food we eat and the way we feel. This fascination led me to study nutrition and dietetics in college, where I learned about the importance of a balanced diet and the impact of various nutrients on the body.

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