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20-September-2008 10:21:21 - Baker's cyst Baker's cyst Classification and external resources ICD-10 M71.2 ICD-9 727.51 DiseasesDB 1224 MedlinePlus 001222 eMedicine radio/72 A Baker's cyst, otherwise known as a popliteal cyst, is a benign swelling found behind the knee joint. It is named after the surgeon who first described it, Dr. William Morrant Baker 1838-1896.1 Contents 1 Etiology 2 Diagnosis 3 Treatment 4 Symptomatic relief 4.1 Cryotherapy 4.2 Medication 4.3 Heat 4.4 Bracing 4.5 Rest and specific exercise 5 References 6 Footnotes 7 External links Etiology In adults, Baker's cysts usually arise from almost any form of knee arthritis and cartilage particularly the meniscus tear. Baker's cysts can be associated with Lyme disease. Baker's cysts in children do not point to underlying joint disease. Baker's cysts arise between the tendons of the medial head of the gastrocnemius and the semimembranosus muscles. They are posterior to the medial femoral condyle. The synovial sack of the knee joint can, under certain circumstances, produce a posterior bulge, into the popliteal space, the space behind the knee. When this bulge becomes large enough, it becomes palpable and cystic. Most Baker's cysts maintain this direct communication with the synovial cavity of the knee, but sometimes, the new cyst pinches off. A Baker's cyst can rupture and produce acute pain behind the knee and in the calf and swelling of the calf muscles. Diagnosis Diagnosis is by examination. They are easier to see from behind with the patient standing with knees fully extended and then most easily felt with the knee partially flexed. Diagnosis is confirmed by ultrasonography, although if needed and there is no suspicion of a popliteal artery aneurysm then aspiration of synovial fluid from the cyst may be undertaken with care. An MRI image can reveal presence of a Baker's cyst. A burst cyst can cause calf pain, swelling and redness that may mimic thrombophlebitis or a potentially life-threatening deep vein thrombosis DVT which may need to be excluded by urgent blood tests and ultrasonography. Although an infrequent occurrence, a Baker's cyst can compress vascular structures and cause leg edema and a true DVT. Treatment Baker's cysts usually require no treatment unless they are symptomatic. Often rest and leg elevation are all that is needed. If necessary, the cyst can be aspirated to reduce its size, then injected with a corticosteroid to reduce inflammation. Surgical excision is reserved for cysts that cause a great amount of discomfort to the patient. A ruptured cyst is treated with rest, leg elevation, and injection of a corticosteroid into the knee. Recently, prolotherapy in use at the Mayo Clinic since 2005 has shown encouraging results as an effective way to treat Baker's cysts and other types of musculoskeletal conditions.23 Baker's cysts in children, unlike in older people, nearly always disappear with time, and rarely require excision. Symptomatic relief Cryotherapy Ice pack therapy is believed to be an effective way of controlling the pain caused by Baker's cyst.citation needed Ice must not be applied directly onto the skin but be separated by a thin cloth. Alternatively, cooling packs may be used, but the total application time for any product is for no more than 15 minutes at a time. Medication Medications bought at pharmacies may be used to help soothe pain. Painkillers with paracetamol, a.k.a. tylenol acetaminophen, or with the additional anti-inflammatory action such as ibuprofen or naproxen, may be used. Stronger non-steroidal anti-inflammatory drugs may be required by prescription from one's general practitioner. Heat Heat is also a recognised treatment.citation needed The application of a heating pad on a low setting for 10-20 minutes may relieve some pain, but only if instructions are followed carefully. Bracing A knee brace can offer support, but relieve pain by stimulating nerve fibre,citation needed giving the feel of stability in the joint. If only support is necessary, a simple elastic bandage is recommended; however, braces compress the back of the knee, where it is most tender, and can cause pain. Rest and specific exercise Many activities can put strain on the knee, and cause pain in the case of Baker's cyst. Avoiding activities such as squatting, kneeling, heavy lifting, climbing, and even running can help prevent pain. Despite this, some exercises can help relieve pain, and a physiotherapist may instruct on stretching and strengthening the quadriceps and/or the patellar ligament. References Hellmann, DB 2005. Chapter 20: Arthritis Musculoskeletal Disorders, in Tierney LM, Jr., McPhee SJ, Papadakis MA: Current Medical Diagnosis Treatment, 44th ion, Philadelphia, PA: F. A. Davis Company. ISBN 0-07-145323-7. Joint Healing.com-Baker's Cyst Footnotes ^ William Morrant Baker. Who Named It. ^ Alternative treatments. Dealing with chronic pain 2005. Mayo Clinic health letter English ed. 23 4: 1-3. PMID 15864836. ^ March Darrow. Prolotherapy: Living Pain Free. Protex Press. ISBN 0971450323. External links Baker's cyst at GPnotebook v d e Diseases of the musculoskeletal system and connective tissue M, 710-739 Arthropathies Arthritis Septic arthritis - Reactive arthritis - Rheumatoid arthritis - Psoriatic arthritis - Felty syndrome - Juvenile idiopathic arthritis - Still's disease - crystal Gout, Chondrocalcinosis - Osteoarthritis Heberden's node, Bouchard's nodes - Monoarthritis/Polyarthritis Specific joints shoulder Winged scapula - elbow Cubitus valgus, Cubitus varus - hand Wrist drop, Boutonniere deformity, Swan neck deformity hip Protrusio acetabuli, Coxa valga, Coxa vara - leg Foot drop, Flat feet, Club foot, Unequal leg length - patella Luxating patella, Chondromalacia patellae - foot Bunion/hallux valgus, Hallux varus, Hallux rigidus, Hammer toe general terms Valgus deformity, Varus deformity Other Hemarthrosis - Arthralgia - Osteophyte - Hypermobility Systemic CT disorders vasculitis: Arteritis Polyarteritis nodosa, Takayasu's arteritis, Temporal arteritis - arterioles/capillaries Wegener's granulomatosis, Kawasaki disease, Churg-Strauss syndrome, Microscopic polyangiitis hypersensitivity/autoimmune: Hypersensitivity vasculitis - Goodpasture's syndrome - Systemic lupus erythematosus Drug-induced - Dermatomyositis Juvenile dermatomyositis - Polymyositis - Scleroderma - Sjögren's syndrome - Behçet's disease - Polymyalgia rheumatica - Eosinophilic fasciitis Dorsopathies spinal curvature Kyphosis, Lordosis, Scoliosis - Scheuermann's disease - Spondylolysis - Torticollis - Spondylolisthesis Spondylopathies Ankylosing spondylitis, Spondylosis, Spinal stenosis - Schmorl's nodes - Degenerative disc disease - Coccydynia - Back pain Radiculopathy, Neck pain, Sciatica, Low back pain Soft tissue disorders Muscle Myositis Pyomyositis - Myositis ossificans Fibrodysplasia ossificans progressiva Synovium and tendon Synovitis/Tenosynovitis Calcific tendinitis, Stenosing tenosynovitis, Trigger finger, DeQuervain's syndrome - Irritable hip - Ganglion cyst Bursa Bursitis Olecranon, Prepatellar, Trochanteric - Baker's cyst Fascia/fibroblastic Fasciitis Plantar fasciitis, Nodular fasciitis, Necrotizing fasciitis - Dupuytren's contracture - Fibromatosis Shoulder lesions Adhesive capsulitis - Rotator cuff tear - Subacromial bursitis Enthesis Enthesopathies Iliotibial band syndrome, Achilles tendinitis, Patellar tendinitis, Golfer's elbow, Tennis elbow, Metatarsalgia, Bone spur, Tendinitis Other, NEC Muscle weakness - Rheumatism - Myalgia - Neuralgia - Neuritis - Panniculitis - Fibromyalgia Osteopathies disorders of bone density and structure: Osteoporosis - Osteomalacia - continuity of bone Pseudarthrosis, Stress fracture - Monostotic fibrous dysplasia - Skeletal fluorosis - Aneurysmal bone cyst - Hyperostosis - Osteosclerosis Osteomyelitis - Avascular necrosis - Paget's disease of bone - Algoneurodystrophy - Osteolysis - Infantile cortical hyperostosis Chondropathies Juvenile osteochondrosis Legg-Calvé-Perthes syndrome, Osgood-Schlatter disease, Köhler disease, Sever's disease - Osteochondritis - Tietze's syndrome - Relapsing polychondritis See also congenital Retrieved from http://en..org/wiki/Baker%27s_cyst Categories: Surgery | Musculoskeletal disordersHidden categories: All articles with statements | Articles with statements since February 2007 Views Article Discussion this page History Personal tools Log in / create account Navigation Main page Contents Featured content Current events Random article Search Go Search Interaction Community portal Recent changes Contact Donate to Help Toolbox What links here Related changes Upload file Special pages Printable version Permanent link Cite this page Languages Deutsch Norsk bokmål Polski Português This page was last modified on 8 July 2008, at 02:17
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