| | | |  | | © Reed Group | | |
A Baker's cyst is a swelling of one of the two fluid-filled sacs (anatomic bursae) located behind the knee (popliteal space). Because these two bursae communicate with the knee joint, increased synovial fluid in the knee (resulting from inflammation) can cause the bursae to enlarge and form a Baker's cyst. The Baker's cyst usually affects only one knee.
In adults, 50% of Baker's cysts are associated with knee joint damage, particularly a torn cartilage (meniscus). Other risk factors for Baker's cysts include rheumatoid arthritis and thrombophlebitis.
Incidence and Prevalence: Approximately 50% of Baker's cysts occur in adults; the remainder occurs in children. |
Source: Medical Disability Advisor
| History: Individuals may report pain on the back (posterior) side of the knee. Swelling may be present. Most individuals have no history of knee injury. If the cyst formed secondary to a torn meniscus and resulting knee effusion (swelling), there would be a history of injury. Physical exam: The exam may reveal swelling behind the knee. This swollen area is often painful to the touch (palpation). In more obese patients, even fairly large cysts may not be palpable. Tests: X-rays of the knee joint may show some soft tissue swelling. Magnetic resonance imaging is very useful in evaluating both the cyst and any intra-articular pathology, like a torn meniscus, that may be the primary cause of the cyst. |
Source: Medical Disability Advisor
| Conservative treatment with rest is often all that is necessary. Corticosteroid medication, injected into the cyst or into the knee, often reduces the size of the cyst and relieves associated symptoms. Surgery is indicated in individuals for cysts unresponsive to injection.
Surgical treatment of associated joint pathology, such as meniscectomy for a torn meniscus, may relieve the symptoms without cyst removal. However, if the cyst is secondary to intra-articular pathology, removal of the cyst without treatment of the underlying joint pathology often results in recurrence.
Two similar surgical procedures, the Hughston, Baker, and Mello procedure and the Meyerding and Van Demark procedure, are commonly used to remove (excise) Baker's cysts. The procedures differ primarily in the position of the incision. Both procedures allow joint exposure for additional repairs. |
Source: Medical Disability Advisor
| The prognosis is determined by the type and severity of injury or disease in the knee joint. Some individuals may respond to injection alone. Surgical repair with either procedure provides good results with complete recovery. |
Source: Medical Disability Advisor
| A Baker's cyst may be complicated by thrombophlebitis and associated knee joint pathology such as a torn meniscus. |
Source: Medical Disability Advisor
| Individuals with severe knee pain and swelling whose job requires prolonged standing may need temporary transfer to nonstanding duties. Individuals may need to limit squatting, kneeling, and crawling. If surgery is necessary, temporarily limited weight-bearing may be prescribed and the individual may need to use crutches postoperatively. |
Source: Medical Disability Advisor
| If an individual fails to recover within the expected maximum duration period, the reader may wish to consider the following questions to better understand the specifics of an individual's medical case. Regarding diagnosis:
- Does individual have any risk factors for a Baker's cyst?
-
Does individual have knee pain or swelling?
-
Has individual received adequate diagnostic testing to establish the diagnosis?
-
Were conditions with similar symptoms such as meniscal tear ruled out?
Regarding treatment:
- Did individual respond favorably to conservative treatment? Were injections effective?
-
Was surgery necessary?
Regarding prognosis:
- Does individual have any conditions that may affect recovery?
-
Have any complications developed?
|
Source: Medical Disability Advisor
| Stein, Meryl, and Darren Rosenberg. "Baker's Cyst." Essentials of Physical Medicine and Rehabilitation. Ed. Walter R. Frontera. 1st ed. Philadelphia: Hanley & Belfus, Inc., 2002. 308-310. |
Source: Medical Disability Advisor