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Baker’s Cyst: A Common Knee Problem

A person may have a Baker’s Cyst and never report any symptoms. More often, stiffness and swelling in the back of the knee are reported, causing discomfort and a decrease in activity. It may be possible to feel the cyst underneath the skin. Occasionally, a Baker’s Cyst may rupture, which will result in swelling, bruising and pain behind the knee and calf. Most people find that having a Baker’s Cyst is an annoyance, but not something which needs medical attention.

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 The Poor Misunderstood Baker’s Cyst – Not From Baking!

While it seems tempting to simply have the cyst drained in the hopes of resolving the swelling, the success rate of this treatment can be poor as the bursa will often refill with fluid. More importantly, the underlying problem itself within the knee joint needs to be addressed in order for the cyst to be appropriately reduced in size. While surgery may be indicated in rare circumstances, most non-surgical treatments can be extremely helpful in resolving symptoms from a Baker’s cyst.

 What You Need to Know About Baker’s Cysts: Causes, Symptoms, and Treatment

These cysts are named for the doctor who first described them. In 1854, Dr. William Morrant Baker noted that these popliteal boils resulted from fluid flowing out of a damaged knee joint and into an adjacent space around it (the subcutaneous tissue). When structures within or near your Kneecap become injured -as can happen during sports-related injuries-they produce extra fluid which then collects in this cavity leading to the formation of painful swelling known colloquially as a “Baker’s cyst”.

Articles of Interest

Ask the doctor: How do you treat a Baker's cyst?

A Baker's cyst is often found incidentally during a physical exam or an ultrasound performed for other reasons. It may cause no symptoms at all or just a bulge at the back of the knee, but it can also cause pain, swelling, and joint stiffness. Sometimes the bulge is so large that it's hard to fully bend or straighten the leg.

Baker's Cyst

A Baker's cyst, also known as a popliteal cyst, is caused by fluid distention of the gastrocnemio-semimembranosus bursa and results in a painful synovial-lined fluid sac outside the knee joint due to its communication with the knee cavity. Most often it presents in adults aged 35-70 years. A popliteal cyst is associated with commonly found intra-articular knee disorders, such as osteoarthritis and meniscus tears.

Baker’s cyst on ultrasound: is it worth draining?

Do you need to perform a Baker’s cyst drainage? Generally no. If you perform a Baker’s cyst drainage, it ususally comes back. Drainage is advised for cosmetic reasons or if you develop pain or discomfort at the back of the knee. However, we recommend you have your knee injected to reduce joint swelling and prevent a recurrence.

Baker’s cysts: an early indication of pathology?

Chris Mallac explores the anatomy and pathology of Baker’s cysts, and how clinicians can manage this condition.

Bilateral Baker Cysts

Secondary Baker cysts, on the other hand, arise secondary to pathology in the joint cavity and thus are generally more symptomatic. They are more common in adults. Significant trauma, juvenile idiopathic arthritis, infections (especially Lyme disease), and malignancy have all been associated with secondary cyst formation.

Should I be worried about my Baker’s cyst?

A Bakers cyst is a fluid filled sac that lies at the back of your knee. The cyst communicates with the knee joint and fluid travels from within the knee, into the cyst. It is often an incidental finding on an MRI. Most patients do not have symptoms related to their Baker’s cyst.

What's Behind Your Behind-Your-Knee Pain?

“Most often we see Baker’s cysts when a doctor has suspected a blood clot and orders an ultrasound,” says Jeff Bytomski, DO, a sports medicine specialist with Duke Orthopaedics. “The radiologist reads the scan and discovers a Baker’s cyst instead.” Treating the cyst is not important if there are no symptoms and they rarely cause further problems. Most of the time we tell patients not to worry about it,” he says.

Resources

OrthoInfo

Most Baker’s cysts will improve with nonsurgical treatment that includes changes in activity and anti-inflammatory medications. Some cysts may even go away on their own, with no treatment at all.

Physiopedia

The cyst can exercise pressure on some anatomical structures, in most cases, the affected anatomical structure is the popliteal vein. Which can develop into thrombophlebitis.