What is Bakerís Cyst?
Pre-existing conditions like rheumatoid arthritis, osteoarthritis, cartilage tear and other knee conditions predispose to the development of a Bakerís cyst.
Flexion or extension or movement in the knee causes pain at the back of the knee. The cyst usually communicates with the knee joint by a valve-like mechanism and this helps the presence of fluid that contributes to the formation of the cyst.
In case of rupture of a Bakerís cyst swelling, severe pain and bruising are seen at the back of the knee and calf region.
Usually Bakerís cyst resolves on itís own. But in case of large and painful swelling treating underlying conditions like arthritis or cartilage tear helps in resolution of the Bakerís cyst.
Symptoms of a Bakerís Cyst
- Swelling/ tightness on the back of the knee
- Pain at the back of the knee on movement of the knee
- Stiffness of the knee joint
- Reduced range of movement in the joint due to pain and bulging on the back of the joint
- If the cyst ruptures - Swelling, excruciating pain, bruising on the back of the knee and calf can occur
Diagnosis and Treatment for Bakerís CystDiagnosis of a Bakerís cyst is mainly with physical examination and history of development of symptoms like sudden pain and swelling at the back of the knee or after a trauma to the knee.
It is important to rule out other conditions like deep vein thrombosis or tumors which can present with similar symptoms. For this purpose certain investigations like Ultrasound knee, trans-illumination of the swelling, plain X-rays of the knee.
Ultrasound and Magnetic Resonance Imaging (MRI) are best for its diagnosis and of the two MRI has become the modern imaging modality of choice for its diagnosis.
Treatment of a Bakerís cyst usually depends upon the size and itís presentation. Small cysts, which are asymptomatic usually resolve on their own. In case the cyst is large and painful, treating the underlying cause like arthritis is helpful. Non-steroidal anti-inflammatory drugs and rest are useful in this situation.
If the pain is still persistent, then injecting corticosteroids into the swelling is helpful to reduce pain. Aspiration of fluid from the cyst is also useful in reducing the pain.
Physical therapy with icing, compression wrap and strengthening exercises are useful in improving the knee function. It is advised to use a crutch for walking in order to reduce strain on the affected knee.
In case of recurrent Bakerís cyst or a painful cyst, arthroscopic surgery for removal of the cyst is indicated. Maintaining an optimal weight can reduce the risk of recurrence of a Bakerís cyst.