Baker's cyst
The content of the article:
- Baker's cyst of the knee joint - what is it?
- Reasons for the appearance of a hernia of the popliteal fossa
- Symptoms
- Diagnostics
- Differential diagnosis
-
How to treat Baker's cyst of the knee
- Treatment of Baker's cyst without surgery
- Surgery
- Prevention
- Video
Baker's cyst (Becker, popliteal fossa) is an accumulation of joint fluid in a stretched intertendinous bag located in the popliteal region. It is formed in various diseases of the knee joint. It is a benign neoplasm that occurs at any age, but more often in older people. In many cases, it is asymptomatic. Complaints usually appear with its significant size and the development of complications. There are various options for treating pathology: conservative and operative.
Baker's cyst develops in the popliteal fossa mainly due to injury or excessive stress on the knee joint
Baker's cyst of the knee joint - what is it?
Behind the knee are the tendons of the calf and semi-membranous muscles. Between them, in half of healthy people, there is an intertendinous bag, which is a variant of normal development. The mechanism of formation of Baker's cyst depends on the presence or absence of the connection of this bag with the knee joint.
| Connection between the joint cavity and the interarticular tendon bursa | Formation option |
| There is a message | The onset of an inflammatory process in the joint, accompanied by excessive production of synovial fluid, leads to its entry into the inter-articular bag. The latter is stretched, and, in fact, a popliteal hernia, or cyst, is formed. This is how most of the fluid cavities in this area are formed. |
| Missing message |
Some cystic formations have no connection with the articular cavity, they exist in isolation. In this case, excess fluid accumulation in the mucous bag located between the muscle tendons is caused by its primary inflammation. This process is called bursitis. |
Reasons for the appearance of a hernia of the popliteal fossa
The reasons underlying the formation of a neoplasm may be inflammation, traumatic injuries, degenerative changes in the intra-articular structures of the knee joint. These include:
- trauma (meniscus damage, cartilage ruptures, subluxations, bruises, etc.);
- deforming arthrosis;
- arthritis (tuberculous, rheumatoid, etc.);
- lesions in psoriasis, amyloidosis, sarcoidosis.
Overweight, especially in the elderly, systematic stress on the joint in people involved in sports, performing heavy physical work, carrying severity, are considered factors provoking the development of pathology.
Symptoms
Clinical manifestations in the knee area largely depend on the size of the cystic formation. With a small diameter of formation, complaints may be absent. Growth leads to compression of the surrounding tissues and the appearance of:
- tumors in the popliteal fossa;
- pain, bloating sensation, discomfort in the popliteal region;
- swelling of the back of the knee;
- limiting the amount of motion in the knee;
- difficulty walking;
- atrophy of the muscles of the leg and foot;
- decreased sensitivity in the leg and foot;
- violations of blood flow in the vessels of the lower leg and foot.
Serious complications develop if left untreated.
| Complication type | Symptoms |
| The gap | The contents of the cystic cavity flow down through the intermuscular spaces, leading to the development of a non-infectious inflammatory process. It is manifested by pain, swelling, redness and itching of the skin of the lower leg, an increase in local and sometimes general temperature. |
| Deep vein thrombosis of the lower leg |
It occurs as a result of compression of the popliteal vein: bursting pain in the affected limb, swelling of the leg and foot, cyanosis of the skin, local temperature increase. |
| Deep vein thrombophlebitis of the lower leg | It occurs as a result of thrombosis against the background of inflammation of the vein wall, accompanied by pain in the thrombosed vein, fever, chills, swelling of the limb. |
| Compression of the nerve (peroneal, tibial, femoral) |
On defeat Peroneal nerve: impaired extension of the foot and toes, impaired sensitivity of the anterolateral surface of the lower leg, rear of the foot, pain on the outer surface of the lower leg and foot; Tibial nerve: disorder of the downward flexion of the foot and impaired movement in the fingers, impaired tactile and pain sensitivity along the back of the leg, on the sole; Femoral nerve: dullness of sensations, weakening of the skin sensitivity of the medial edge of the knee, lower leg, foot and pain, aggravated by extension of the lower leg. |
| Formation of calcifications (local deposition of calcium salts) | The formation of calcification occurs due to chondromatosis (degeneration of the synovial membrane into cartilaginous tissue) with subsequent calcification. This leads to persistent, i.e. persistent, pain in the knee joint. |
In the absence of timely adequate therapy for deep vein thrombosis of the leg, thrombus separation and migration are possible, leading to the development of such a formidable complication as pulmonary embolism.
Diagnostics
Diagnosis of a hernia of the popliteal region is carried out on the basis of a study of the patient's complaints, examination and additional examination methods, which include:
- X-ray of the knee joint in direct projection;
- ultrasound procedure;
- axial slices (in a plane perpendicular to the midline of the body) computed tomography;
- Magnetic resonance imaging.
In ultrasound examination, a cystic formation on the monitor of the apparatus and a photo usually looks like an elongated formation with clear even contours and a dense capsule.
In particularly difficult cases, arthroscopy of the knee joint is possible. This manipulation is carried out by introducing a special optical device, an arthroscope, into the joint through a micro-incision.
Diagnosis of Baker's cyst is usually straightforward
Differential diagnosis
A hernia of the popliteal fossa should be distinguished from diseases with similar symptoms.
| Disease | Characteristic signs |
| Popliteal hematoma (limited collection of blood when a vessel ruptures) | A hematoma is almost always preceded by a joint injury; it is characterized by: one-sided appearance, lack of communication with the joint cavity, usually intermuscular arrangement. |
| Lipoma (fatty tumor, wen) | Formation of a soft consistency, painless on palpation, mobile, slow-growing and often asymptomatic. |
| Popliteal artery aneurysm (bulging of the wall) | Tumor-like pulsating formation, with significant size accompanied by impaired blood circulation: swelling, pain, cold extremity, pallor of the skin, decreased sensitivity, numbness. |
| Malignant tumor (synovial sarcoma) | Formation of various consistencies without clear boundaries, inactive, painful, limiting the mobility of the limb in the knee joint. |
How to treat Baker's cyst of the knee
Therapeutic tactics for the popliteal fossa cyst is possible both conservative and operative. Small asymptomatic formations of the popliteal region can be simply observed over time. In some cases, they gradually decrease in size on their own and pass.
Treatment of Baker's cyst without surgery
The cyst is punctured with a large-diameter hollow needle with suction of the contents and subsequent injection of corticosteroid drugs (hydrocortisone, etc.) into the cavity. Conservative tactics rarely lead to the disappearance of the pathology, recurrence often occurs.
When the cystic cavity is infected, antibacterial and anti-inflammatory drugs, physiotherapy procedures are prescribed.
Surgery
Operation is a radical method of treatment. It is necessary for:
- rapid growth;
- significant popliteal hernia;
- the occurrence of complications;
- ineffectiveness of conservative therapy.
The doctor performs excision of the cyst under local anesthesia: the place of its connection with the articular cavity is stitched, bandaged, and the formation removed. After the operation, wearing a tight bandage and temporary limitation of the load is indicated.
There is an endoscopic removal technique using an arthroscope. It allows you to reduce the invasiveness of surgery. Performing additional coagulation of the anastomosis between the popliteal hernia and the joint cavity during the operation prevents the development of relapse, improves long-term results of therapy.
Prevention
To prevent the formation of Baker's cysts, it is necessary to treat the concomitant intra-articular pathology, dose the load, and normalize body weight.
Video
We offer for viewing a video on the topic of the article.
Anna Kozlova Medical journalist About the author
Education: Rostov State Medical University, specialty "General Medicine".
The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
