Baker's cyst. Diagnosis and treatment of Becker's cyst at the Sports Clinic.

, cyst, ganglion, synovial hernia are the names of a benign tumor that is localized above the wrist joint. Women get sick more often. In some cases, the formation resolves on its own, without treatment.

Hygroma of the wrist is a round capsule with dense walls, filled with a viscous liquid. Can be located on the outside or on the inside. Transformation into a malignant tumor does not occur. Treatment aims to eliminate the external defect.

Diagnostics

To make an accurate diagnosis, you should consult an orthopedic surgeon. Determining the causes of the disease and treatment methods involves conducting an examination: the doctor must determine the location of the tumor and its size. Of the laboratory tests, only a biopsy will be indicative.

Diagnosis is carried out using:

• MRI or ;
• Ultrasound;
• X-rays;
• If necessary, a puncture of the hygroma is taken.

Synovitis and synovial cysts

Synovitis is an inflammatory disease that affects joint tissue. Its insidiousness lies in the fact that at first the pathology does not reveal itself. Late diagnosis of the disease can lead to serious complications - fluid accumulates in the membrane, the joint increases in size and synovial cysts form. Joints are exposed to physical stress every day, so the formation of inflammatory processes is not uncommon. Synovitis often manifests itself in a chronic form and is dangerous because it provokes pathological processes throughout the body.

Kinds

Synovitis develops in a joint - elbow, ankle, knee or wrist. Usually the disease affects one location, less often - several joints. Several types of synovitis are classified depending on the form and duration of the process:

• Acute - the disease has pronounced symptoms and responds well to treatment. With timely, high-quality medical care, acute synovitis goes away without consequences for the joint.
• Chronic - in this case, synovitis is masked for a long time and does not manifest itself in the form of characteristic symptoms. The disease is dangerous because it leads to the formation of synovial cysts, frequent relapses and remissions, and also changes a person’s usual lifestyle.

Chronic synovitis and the formation of cysts against its background develop against the background of incorrect treatment or the absence of an acute form. Contacting our clinic will allow patients to promptly diagnose the inflammatory disease and prevent the occurrence of associated pathological processes.

Depending on the provoking factor, the following forms of synovitis are distinguished:

• Serous - liquid of a characteristic transparent yellowish color accumulates in the joint;
• Hemorrhagic - the contents contain blood impurities;
• Fibrinous - fibrinogens are found in the fluid;
• Purulent - a dangerous form of synovitis, characterized by the appearance of pathogenic flora in the joint;
• Mixed - involves a combination of several types of liquid.

Causes

The most common cause of the development of synovitis and synovial cysts is mechanical damage as a result of trauma. Sometimes a small blow is enough for the pathological process to start. As a result, microcracks form in the fiber of the articular membrane, which, with regular loads, provoke the accumulation of fluid.

The following associated pathological causes are identified:

• arthritis;
• arthrosis
• bursitis;
• Baker's hernia.

There are a number of indirect reasons that can provoke the development of synovitis and synovial cysts:

• excess body weight;
• autoimmune diseases;
• allergies in the acute stage;
• Metabolic dysfunction.

Synovitis often affects the joints of older people. Natural aging processes in the body trigger degenerative mechanisms and provoke the development of inflammatory diseases.

Symptoms and signs

Acute synovitis is characterized by pronounced symptoms. Typically the patient exhibits the following symptoms:

• pain in the affected area;
• swelling;
• fever;
• decreased joint mobility and impaired motor function.

Which doctor treats

An orthopedist treats synovitis.

Diagnostic methods

The purpose of the initial examination is to check the condition of the joint visually. In order to understand how much fluid has accumulated, as well as to determine the presence of synovial cysts, the patient is prescribed one of the instrumental research methods - MRI or ultrasound.

The causes of the inflammatory process are determined using the following examinations:

• blood test for bacteria;
• general blood analysis;
• puncture.

Treatment methods

The main goal of treating synovitis is to block the source of inflammation. The patient is first prescribed complete rest, which can be achieved by applying a splint or plaster cast to the damaged joint. After studying the tests and examination results, the doctor will decide on further treatment, including a set of measures:

• non-steroidal anti-inflammatory drugs;
• antibiotics;
• corticosteroids;
• getting rid of accumulated fluid;
• physiotherapy;
• massage.

If conservative methods are powerless, the patient is prescribed a surgical operation, which involves partial or complete removal of the inflamed joint membrane.

results

The final result depends on several factors - the speed of seeking medical help, the presence of concomitant pathologies and the causes of inflammation. If measures were taken on time, synovitis goes away without a trace and does not return again.

Rehabilitation and lifestyle restoration

It all depends on the form and severity of the disease. Many patients are prescribed a complex of exercise therapy as a comprehensive measure, which allows them to speed up the recovery process and improve metabolic processes within inflamed tissues. Proper treatment and timely seeking medical help guarantee the patient a complete recovery and return to their normal lifestyle.

Lifestyle with synovitis

Experts recommend the following measures for those who have been given a similar diagnosis:

• wearing comfortable shoes;
• refusal of intense physical activity;
• physical education classes;
• rejection of bad habits;
• regular preventive examinations with a doctor.

Follow your doctor's recommendations and live a full life!
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Types of disease

The ganglion of the wrist joint of the hand can be classified:

• Mucosal hygroma - appears as a result of deforming arthrosis, as a result of compression, the growth of connective tissue is a protective reaction of the body;
• Post-traumatic hygroma of the left or right wrist - occurs as a result of damage to the joint;
• Tendon hygroma - develops under the influence of pathological changes in the tendon sheath, causes pain, and interferes with normal movement of the wrist.

What are the causes of Baker's cyst formation?

The main reasons for the formation of this cyst are various inflammatory and metabolic-dystrophic diseases associated with the knee joint (especially due to excessive loads on it), injuries to the knee joint, and degenerative-dystrophic changes in cartilage tissue. Therefore, people most often at risk are those suffering from:

• any joint injuries
• pathological changes (including degenerative) of the menisci
• destruction of articular cartilage
• osteoarthritis
• osteoarthritis
• chronic synovitis
• rheumatoid arthritis
• patellofemoral arthrosis

Very rarely, Baker's cyst is diagnosed in patients without any apparent reason.

Treatment of hygroma / ganglion of the wrist joint

When the disease worsens and discomfort occurs, anti-inflammatory drugs are used.

If the formation increases, if there are restrictions in movement, the hand becomes numb and hurts, you need to contact a surgeon or traumatologist. Surgery may be needed.

Surgical intervention is required if the formation has a cellular structure or its size increases.

During the operation, the hygroma is removed along with the capsule.

The safest and least traumatic removal of hygroma is using a laser. In addition to laser removal, endoscopic excision of hygroma of the wrist joint has proven itself well.

It is important to remember that after removal by any method, relapse may occur.

The operation to remove hygroma is simple, performed under local anesthesia:

• A special needle is inserted into the cyst cavity;
• Liquid contents are removed;
• The cavity is washed with an antiseptic, and an antibiotic can be used.

After removing the hygroma, a bandage is applied for several weeks. Premature removal of the bandage can provoke re-formation of the cyst.

Symptoms

Baker's cyst is a dense, elastic, movable upon palpation and space-occupying formation in the popliteal region. Often it does not manifest itself in any way for many years. Its dimensions usually do not exceed 3 cm, as a result of which the pathology may not always be noticeable visually. The first symptoms are discomfort in the popliteal region; the onset of pain usually occurs after exercise. There may also be cramps, tingling, and numbness in the lower leg. With further growth, it can compress adjacent vessels (popliteal vein) and nerves, leading to disruption of blood flow and innervation of the leg, edema, and thrombosis of the veins of the lower extremity (one of the most dangerous complications). Complicated forms of this disease are cyst dissection or rupture, characterized by acute pain and requiring emergency treatment. That is why you should not underestimate this problem and delay treatment even in the absence of severe symptoms. Dealing with complications of the disease will take much more effort and time.

Forecast

If you promptly seek help from a specialist and promptly remove the lump, then the prognosis for such a ganglion cyst is favorable. In this case, after the rehabilitation period, it is possible to fully restore performance.

However, if left untreated, a ganglion cyst can grow to a large size. Significant neoplasms disrupt the functionality of the affected joint, limiting its motor properties.

In addition, such formations often compress nerve fibers and blood vessels, impairing the nutrition of the limb, causing severe pain and congestion. Such defects require immediate surgical excision.

Self-opening or accidental damage to the cavity allows serous contents to leak out. This process is dangerous due to the development of an inflammatory process.

If an infection gets into the wound, suppuration begins, which can cause blood poisoning. Therefore, here the prognosis is no longer so favorable and everything depends on the time of assistance.

What's happened

A ganglion cyst is a benign tumor-like formation that occurs near tendons or joints. Most often, an oval or round hygroma with synovial fluid inside is observed.

The disease is considered occupational, since the pathology in most cases affects laundresses and pianists who constantly overload their wrists. The resulting defect significantly impairs the functionality of the affected joint.

Small formations resemble peas, while large formations can reach 2.5 cm in diameter. The walls of the capsule consist of dense connective tissue, and the cavity itself is filled with a viscous serous fluid with mucous impurities.

Clinically Relevant Anatomy

A Baker's cyst is an enlarged bursa located between the medial head of the gastrocnemius muscle and the capsular counterpart of the semimembranosus muscle, the oblique popliteal ligament.

For the formation of a cyst, two conditions must be met - anatomical connection and chronic joint effusion. Joint effusion in the knee can fill the gastrocnemius and semimembranosus bursae with synovial fluid and, if fluid drainage is obstructed by a unidirectional mechanism, the gastrocnemius and semimembranosus bursa enlarges, creating a pseudocystic cavity called a Baker's cyst.

Clinical manifestations

The symptoms of the pathology depend on the diameter of the hygroma. Minor defects are asymptomatic, causing only aesthetic discomfort. As the pathogenic process progresses, the synovial bursa stretches excessively, causing severe pain.

Complications after removal of a dental cyst

Compliance with the rules and recommendations during the rehabilitation period after removal of a dental cyst helps prevent the development of a number of complications.

When small blood vessels or nerve fibers are compressed, the patient notices the following symptoms:

• Tingling or numbness of the skin.
• Neurological pain.
• Stagnation phenomena.

If the knee joint is affected, then walking and running cause discomfort. In advanced cases, venous outflow is disrupted, causing swelling of the affected area, blue discoloration of the epidermis, and limited mobility of the limb.

How dangerous is a Baker's cyst?

The main danger of Baker's cyst (in the absence of timely and effective treatment) is associated with its complications, which can manifest themselves:

• its rupture (the most common complication, characteristic of almost 10% of patients with this disease) - in this case, the synovial fluid of the cyst penetrates into the nearby calf muscle, filling the space between its fascia, which contributes to the formation of edema in the lower leg, which is often accompanied by general discomfort with pain , local hyperthermia and skin redness;
• deposition of calcium salts in the cyst - with more noticeable pressure of the compacted formation on the surrounding tissues;
• impaired venous circulation - the presence of a cyst often interferes with normal venous outflow in the lower leg, which, in turn, leads to the development of thrombophlebitis and thrombosis in the veins of the lower leg (which can be complicated by life-threatening pulmonary embolism);
• varicose veins located under the skin of the leg;
• compression of the tibial nerve - due to which the patient begins to experience a feeling of numbness or tingling (sometimes just weakness) in the lower leg;
• necrosis – due to compression of soft tissues;
• osteomyelitis - due to compression of the bone and its further suppuration.

Prevention

All prevention of ganglion cysts comes down to avoiding damage to joints and tendons. This is especially true for people whose activities involve constant monotonous movements.

Athletes, pianists, salespeople, and hairdressers should rest regularly so that their joints are not overloaded. In addition, it is important to treat bursitis and other inflammatory pathologies in a timely manner to prevent the disease from becoming chronic.

A ganglion cyst often occurs near a joint or tendon. The wrist is most often affected.

A benign neoplasm does not threaten the patient’s health and does not degenerate into a cancerous tumor, but it can cause severe discomfort, therefore, if a strange lump appears on the body, you should immediately visit a traumatologist.

Treatment methods

Asymptomatic, accidentally discovered cysts do not need to be treated, but their dynamic monitoring is necessary.

Urgent surgery is indicated for:

• compression of the roots of the cauda equina with lower paraparesis (weakness in the legs);
• sensory disorders in the anogenital zone;
• functional pelvic disorders.

In other cases, treatment of spinal cysts begins with conservative measures. Of course, they do not eliminate cysts, but they often help to significantly reduce their clinical manifestations. Prescribed:

• short-term bed rest;
• non-steroidal and steroidal anti-inflammatory drugs;
• vasoactive agents;
• diuretics;
• physiotherapy;
• epidural administration of corticosteroid hormones;
• some manual therapy techniques;
• reflexology;
• Exercise therapy.

If there is no effect from conservative treatment within 4-6 months, especially if the cyst is larger than 1.5 cm, surgical treatment is indicated. If it is contraindicated, stereotactic radiotherapy is performed. Precise focusing of beam energy allows the cyst to be affected without damaging the spinal cord tissue. This contributes to the desolation and scarring of the pathological cavity.

In modern neurosurgical centers, minimally invasive interventions are performed for cysts using endoscopic, microsurgical techniques, laser and cryosurgical technologies. According to indications, lightweight, durable, fully biocompatible implants made of polymeric materials and alloys are used to ensure maximum and long-term preservation of spinal functions.

To eliminate spinal cysts and release nerve structures from compression, the following is carried out:

• percutaneous cyst aspiration. Under the control of neuronavigation, the cyst is punctured and fluid is sucked out of it. To reduce the risk of relapse, drugs are injected into it to promote gluing of its walls and obliteration (emptying) of the cavity;
• Radical excision of the cyst is a more reliable way to prevent future relapse. The neuronavigation system allows you to make a short, no more than 3 cm, incision to access the cyst exactly in the area of ​​its projection. Next, the muscles and ligaments on the way to it are moved apart and gently fixed. The work uses an operating microscope with 8x magnification to ensure removal of all components of the cyst and preservation of healthy structures.