Baker’s Cyst Explained: Causes, Diagnosis, and Treatment скачать в хорошем качестве

Baker’s Cyst Explained: Causes, Diagnosis, and Treatment

Join this channel to support the channel    / @nabilebraheim   Baker's cyst, sometimes called popliteal cyst, is a benign swelling found behind the knee. It can be a large cyst or a small cyst. The cyst lies posterior to the medial femoral condyle and is connected to the knee joint through a valvular opening. Knee effusion or swelling from intra-articular pathology allows the fluid to go through the valve into the cyst in one direction, and that direction is usually behind the knee. Sometimes the patient complains about swelling behind the knee, and that alerts the clinician to the possibility of having a problem inside the knee itself. The cyst is located between the semimembranosus and the medial gastrocnemius muscle. This cyst is usually located at or below the joint line. Diagnosis: The patient usually has swelling behind the knee with pain, fullness, and tenderness. The presence of knee effusion, which is excessive fluid inside the knee, will create fluid pressure that allows unidirectional passage of the fluid from the knee joint through the valve into the cyst. Baker's cyst is easier to see with the knee fully extended. The diagnosis is usually confirmed by an MRI that will show the associated intra-articular pathology. Ultrasound is helpful. The cyst will be located medial to the blood vessels. Ultrasound can be important, especially if the cyst is found to be outside of its typical normal position. What causes the cyst? The two most common causes are knee arthritis and meniscal tear, especially the medial meniscus. Tears of the posterior horn of the meniscus that extend to the capsule may cause an effect or one-way valve to develop between the knee joint and the bursa that lies between the gastrocnemius and semimembranosus. If the cyst is present in an atypical location, consider a tumor as part of the differential diagnosis. Baker's cyst is a fluid-filled cyst and not a solid tumor. The cyst should transilluminate. Treatment of a painful large cyst: Ice, compression wrap, anti-inflammatory medication, strengthening exercises, aspiration of the cyst. Here is a technique of aspiration of the cyst blindly. And here is a technique of aspiration of the cyst under ultrasound. And here is the fluid that was obtained from aspiration of a Baker's cyst. And here is a picture of the back of the knee after aspiration of the cyst. Excision of the cyst: The occurrence of Baker's cyst is common if the intra-articular pathology continues. The best treatment is arthroscopy and debridement of intra-articular pathology. The occurrence of the cyst is common following its removal, and therefore, the main treatment of Baker's cyst should be directed towards treating the intra-articular pathology, usually a meniscal tear or arthritis. The cyst may burst, causing calf pain and swelling. Rule out deep venous thrombosis or thrombophlebitis. Popliteal cyst in children: Common soft tissue mass at the back of the knee. Occurs more in boys. It transilluminates, usually asymptomatic, and it is not a tumor. The cyst may not be intra-articular and may not have a connection to the knee joint. It is usually not associated with a meniscal tear. Surgery is rarely indicated. The cyst is usually treated by observation. A spontaneous resolution of the cyst can occur in 10 to 20 months. In difficult cases, aspiration of the cyst may be indicated. The cyst may respond to aspiration and steroid injection because it is not connected to the knee joint. Quizzes 1. Where is a Baker’s cyst typically located? Answer: Posterior to the medial femoral condyle A. Anterior to the patella B. Posterior to the lateral femoral condyle C. Posterior to the medial femoral condyle D. Inside the tibial plateau Explanation: Baker’s cyst forms behind the knee, specifically behind the medial femoral condyle. 2. The fluid inside the cyst typically flows in which direction? Answer: From the knee joint into the cyst A. From cyst into lymph nodes B. From ankle to the cyst C. From the knee joint into the cyst D. From the cyst into cartilage Explanation: Due to knee effusion, fluid enters the cyst in a one-way direction. 3. Which imaging study best confirms the diagnosis and associated pathology? Answer: MRI A. X-ray B. CT scan C. MRI D. Bone scan Explanation: MRI shows the cyst and any associated meniscal tear or arthritis. 4. Which meniscus is most often involved in Baker’s cyst formation? Answer: Medial meniscus A. Lateral meniscus B. Anterior meniscus C. Medial meniscus D. Posterior meniscus Explanation: Tears in the posterior horn of the medial meniscus are frequently involved. 5. What are the two most common causes of Baker’s cysts? Answer: Arthritis and medial meniscus tear A. ACL tear and bursitis B. Gout and patellar tendinitis C. Arthritis and medial meniscus tear D. Infection and fracture Explanation: These pathologies increase intra-articular fluid, pushing fluid into the cyst.