Baker's cyst: overview of symptoms and key treatments

Inflammations localized in the joint of the lower extremities can provoke the formation of a neoplasm in the popliteal tissues, which is commonly called a Baker's cyst. Clinical manifestations of the neoplasm can be traced only after the cyst reaches a certain size, at which nerves and blood vessels are compressed.

Identification and approval of the diagnosis is carried out based on the results of laboratory and instrumental studies. Often the pathology is recorded in the fair sex, but it can also be observed in men.

What is a Baker's cyst?

Baker's cyst is a pathological neoplasm that involves the accumulation of varying volumes of fluid in the synovial sac, which is localized on the back of the knee joint.

The morphological signs of the existing pathology allow us to assert the benign nature of the formation, without classifying it as a cancerous tumor.

Popliteal synovial cysts most often occur when the patient has an intra-articular disease, such as osteoarthritis. The formation can have a different size (from 2 mm or more) and occurs at any age.

Diet

Diet for sore joints

• Efficacy: therapeutic effect after 2-3 months
• Terms: 2-6 months
• Cost of products: 1700-1800 rubles. in Week

Nutrition should be complete and rational, while the menu should include foods that strengthen bones and joints. It is recommended to include the following products in your diet:

• Fatty fish.
• Vegetables, greens.
• Lactic acid products.
• Bran.
• Nuts.
• Jelly, jelly, marmalade.

In general, nutrition should be rational and not lead to excess weight gain, since extra pounds have a bad effect on the joints of the legs.

Baker's cyst symptoms

According to average statistical data, Baker's cyst is accompanied by the manifestation of a symptomatic picture of meniscal or chondral disorder, which usually includes:

• pain localized in the knee or popliteal fossa, occurring both when performing various types of loads and in a calm state;
• extraneous clicks, crunches inside the joint;
• feeling of stiffness when moving.

The actual symptoms of a Baker's cyst, as such, appear extremely rarely and are often associated with progressive growth and an increase in the size of the tumor (from 3 cm in diameter). These include:

• pain;
• swelling of the arteries of the popliteal region;
• loss of joint functionality due to mechanical blocking of its mobility.

When a Baker cyst reaches a noticeable size, it can be noted that the formation often has a hard structure when the knee is fully extended and softer when the leg is bent. This phenomenon is called “Foucher's sign” and is observed in a situation where the cyst is compressed between muscle tissue.

It is also worth paying attention to the fact that patients with this diagnosis may experience signs and general symptoms of thrombophlebitis, which include pain and mild swelling of the lower extremities.

Reasons for development

Popliteal bursitis is characterized by various etiologies. Doctors associate the development of the pathology in question with previously suffered arthritis (usually of rheumatoid origin) and severe gonarthrosis. The causes of Becker's cyst in 1948 were even associated with brucellosis . It was also confirmed that neoplasms can form against the background of pigmented villous synovitis, chronic microdamage to the joints.

The relationship between popliteal protrusion and other pathological processes occurring inside the joint has been proven. They are degenerative-dystrophic or rheumatic in nature and lead to the development of chronic synovitis. It is recognized as a predisposing factor to the development of popliteal hernia. The condition contributes to increased intra-articular pressure.

Attention! At the stage of consultation with a doctor, you need to report all injuries to your legs, especially recent ones.

Many orthopedists and rheumatologists say that popliteal bursitis never occurs in people who do not have a history of any type of knee injury.

Pathogenesis of Baker's cyst

The pathogenesis of Baker's cyst under the knee is based on the non-standard anatomical location of the articular tissues, as well as the popliteal fossa.

Statistics show that in more than 40% of cases, when examining healthy people of different ages and genders, there is an intertendinous mucous bursa between the tendons of their muscular frame of the knee joint, which is not a pathology, but is considered an acceptable deviation from the norm.

The progression of joint inflammation and the formation of fluid in the joint tissues lead to an increase in the size of the cyst. The presence of a valve mechanism allows liquid to leak into its cavity, but does not allow reverse flow to occur.

Baker's cyst classification

Baker's cyst has several variations in manifestation and development, which makes it possible to classify cases according to their location in the popliteal fossa and distinguish two types:

• typical - located between the muscles of the knee joint;
• atypical – posterolateral cyst.

In addition, it is worth noting that Professor Raushing’s research made it possible to prove the existence of two forms of cysts:

• symptomatic – is a symptom of a pathogenic joint disease;
• idiopathic - a cyst in which no pathological articular processes are detected.

Diagnostics

The following examination methods allow us to identify the presence of this neoplasm and prescribe an accurate diagnosis:

1. MRI – allows you to examine the popliteal joint and tissue structure from all sides. The most suitable method to detect the disease even at the earliest, asymptomatic stage;
2. Ultrasound of the knee joint and adjacent areas;
3. Arthroscopy is a closed (minimally invasive) operation. An incision is made in the examination area through which a microcamera is inserted.

X-ray is an inappropriate method of examination, since it cannot detect a Becker cyst.

Diagnosis of Baker's cyst

Clarification of the clinical picture is realized using methods such as:

• laboratory blood test (clinical and biochemical analysis;
• instrumental research methods.

The process of diagnosing Baker's cyst involves a differential approach that excludes the possibility of such pathologies as:

• popliteal artery aneurysm;
• soft tissue tumor;
• meniscal cyst;
• hematoma of various origins;
• thromboembolism;
• seroma.

In order to confirm existing symptoms, instrumental research methods such as:

• radiograph;
• arthrography;
• ultrasonography;
• Magnetic resonance imaging.

Let's look at each of the methods used in more detail.

X-ray examination

X-ray studies are indicated for use in the initial stages of assessing the patient’s condition, since they can be used to identify other pathological processes accompanied by the presence of popliteal neoplasms. Among these diseases:

• arthritis of various groups;
• free bodies of cartilage and bone type.

Arthrography

Arthrography involves intra-articular injection using a high-contrast agent with mandatory mobilization of the limb. The use of this diagnostic method can improve the effectiveness of x-ray examination.

Ultrasound examination (ultrasound)

Ultrasound examination falls into the category of preliminary diagnostic techniques for Baker's popliteal cyst.

Among the key advantages of the presented method are:

• availability;
• non-invasive;
• safety.

Magnetic resonance imaging (MRI)

MRI is a key diagnostic method in identifying Baker's cysts and differentiating them from other pathological phenomena.

Using MRI, it is possible to fully cover and study the entire existing spectrum of pathological processes.

Baker's cyst treatment

Treatment of Baker's cyst involves the use of both conservative and radical methods based on orthopedic and traumatological treatment.

The key purpose of conservative treatment methods is the implementation of therapeutic measures aimed at eliminating the pathological process. Among the main approaches in the treatment of conservative therapy are such approaches as:

• maximum relief of the load on the affected joint;
• prescription of physiotherapeutic treatment;
• taking a puncture followed by evacuation of the contents of the cyst and administration of specialized drugs.

The determination of the method of therapeutic treatment is determined by such criteria as:

• the degree of inflammation present;
• volume of accumulated liquid;
• the exact location of the pathological cavity.

In order to treat Baker's cyst as effectively as possible, it is recommended to use an integrated approach and combine drug therapy with physical therapy (physical therapy) and other methods.

Drug treatment for Baker's cyst

The use of drugs in the treatment of Baker's cyst is used to enhance the results of conservative methods and can reduce or completely eliminate inflammation inside the joint.

The following groups of drugs may be prescribed as drug treatment:

• NSAIDs (nonsteroidal anti-inflammatory drugs);
• painkillers;
• antispasmodics;
• vitamin and mineral complexes;
• hormonal;
• chondroprotectors.

Particular attention is paid to the group of chondroprotectors that help accelerate regeneration processes. Artracam is considered to be one of the most effective drugs in this group.

IMPORTANT! Drug treatment should be carried out exclusively under the supervision of the attending physician, taking into account the individual characteristics of the clinical picture of a particular patient. Self-medication is unacceptable.

Physical therapy (physical therapy) as a method of treating Baker's cyst

In order to restore the functionality of the knee joint, therapeutic physical education is used as a component of complex treatment.

Performing a number of exercises allows you to speed up the rehabilitation process, the duration of which is determined by the characteristics of the body. Before starting classes, consultation with a treating specialist is required.

Complexes of exercise therapy are based on certain principles and pay special attention to muscle groups such as:

• calf;
• quadriceps;
• gluteal

Among the general recommendations for performing exercises are:

1. Be sure to warm up your muscle fibers before exercising and do quality stretching.
2. Avoid using gymnastic exercises with increased intensity.
3. Limit your loads, making sure to eliminate the possibility of muscle fatigue.
4. Carefully prepare the location of the classes by preparing the necessary clothing, surface and equipment.

Surgical intervention

Radical therapy is used in situations where conservative treatment methods are not effective enough or are not applicable at all in the current situation.

Surgical intervention involves an open operation, the key task of which is to isolate the tumor from the surrounding tissue.

Despite the obviously successful solution to the problem, the result of surgical intervention is not in all cases capable of producing a guaranteed positive result. The recovery period may be complicated.

Possible complications if Baker's cyst is left untreated

Uncontrolled development of a popliteal Baker's cyst can cause a large number of complications, the most likely of which are:

• development of an infectious disease;
• rupture of the cyst membrane;
• forceful effect on the neurovascular bundle, leading to thrombophlebitis.

In rare cases, untreated Baker's cyst under the knee can cause compression of the popliteal vein or even an artery. If a complication of this type is detected, urgent hospitalization and surgical intervention are indicated.

Consequences

A popliteal hernia without timely treatment can lead to complications, including:

• Due to compression of the veins of the leg by the cyst, other complications can develop: thrombosis - the formation of blood clots in the venous cavity, phlebitis - inflammation of the walls of the veins (causing severe pain, a rise in body temperature, discoloration of the limb).
• Disruption of venous outflow from the tissues of the foot and lower leg. The limb begins to swell and its color changes to purple. If such venous stagnation exists for quite a long time, the color of the limb may change to brown, and trophic ulcers may appear on the skin - skin lesions with a constantly weeping surface, which are very difficult and take a long time to treat.
• Impaired blood supply to muscles, tendons and even bones due to compression of them by a space-occupying formation. This can lead not only to constant pain in the limb (including the foot), but also to muscle necrosis, and even osteomyelitis - a very severe inflammation that affects the bones of the lower leg. Osteomyelitis, in turn, can lead to sepsis - blood poisoning;
• The danger of thrombosis and thrombophlebitis is that the blood clot will not always be in one place. It can “peel off” from the wall of the vein (this is called a thromboembolus) and travel through the bloodstream into vital organs, causing, at a minimum, ischemia of some small area of ​​such an organ. The most dangerous consequence of thromboembolism can be blockage of large branches of the pulmonary artery, which quickly leads to death.

Disease prevention

The best treatment for any pathological condition is to prevent its occurrence.

In order to prevent the formation of a Baker's cyst, the following preventive measures should be followed:

• prevention of injuries to the joints of the lower extremities;
• tracking optimal body weight;
• complete cessation of bad habits;
• balanced diet;
• timely treatment of pathological processes found in articular tissues;
• the use of specialized structures to reduce the load on the knee joints.

Having information about what a Baker's cyst is, pathologists can promptly recognize it and begin its treatment, preventing the likelihood of its rupture.