TITLE: Baker's cyst. A "bump" under the knee.

Historically, the bulky formation in the popliteal region began to be called, firstly, a cyst, although it is not a true cyst, and secondly, the name of a person who did not study the popliteal region as intensively as other joints, and described a similar formation in another, shoulder joint, and not in the knee.In fact, the same name, "Baker's cyst", has two formations that are similar in location and structure. They are a substrate or anatomical object that causes a sensation of a foreign body in the back of the knee joint, has the appearance of a rounded swelling, and can cause pain. Both are called Baker's cyst.The first of these formations is a hernia of the knee joint, or a protrusion of the joint shell. In real life, an analogy for such a bulge may be an old wheel with a camera and a tire. If there is a defect in the tire of such a wheel, then under pressure the inner, more elastic chamber can push into this defect and bulge outwards in the form of a rounded bulge.Why does an orthopedist often encounter this?Arthrosis of the knee joint is the most common. Arthrosis in the period of exacerbation is accompanied by excessive production of articular fluid. There is a lot of it in the knee joint during an exacerbation, it has nowhere to go, it begins to press in different directions and if the pressure persists for a long time, it can push the shell back to where it is less strong. So, the first cause of Baker's popliteal cyst in the form of a herniated knee joint is a long–term exacerbation of arthrosis, which is not treated.The second of these formations is the hypertrophied tendon sac. Normally, it is a thin-walled sleeping bag, the inner lining of which is similar to the lining of the eyelids of the eye, it can be seen by bending the lower eyelid down. This shell is very delicate, constantly produces and sucks in a small amount of viscous lubricant liquid to facilitate the sliding of the walls of this pouch relative to each other. Such pouches are found wherever there is contact with a dense structure, for example, at the intersection of tendons or in a place where the skin lies close to the bone and should move relative to the skin for a significant distance (for example, on the elbow).In cases of injury or excessive load on this pouch, as well as in cases of inflammation in it, its walls swell, thicken, begin to produce a larger amount of fluid than normal, and such a pouch turns into a ball tightly pumped from the inside with a viscous liquid.Why does an orthopedist often encounter this?Hypertophanous tendon sac is formed in athletes as a result of excessive loads on the muscles. Long-term tense muscles cause excessive tension of the tendons, the tendons put more pressure on the sliding apparatus, including on the bags, the wall of the bag is injured and inflamed. So, the second reason for Baker's popliteal cyst in the form of hypertrophy of the tendon sac is prolonged muscle overstrain in athletes.How is the diagnosis established?With a pronounced cyst size, it is visible to the naked eye. A small cyst can be seen on a good ultrasound examination, even better on magnetic resonance imaging (MRI) of the knee joint. With the help of MRI, it is possible to exclude other, more rare causes of formation behind the knee.Is Baker's cyst alone the cause of the swelling behind the knee?Baker's cyst is the most common cause of bulky formation under the knee, but not the only one. It is important to remember that there are rarer, but also more dangerous pathologies in prognostic terms. Therefore, it is important, in case of any suspicion, not to engage in self-diagnosis and self-medication, but to immediately consult an orthopedist.What are the treatment options for Baker's cyst?The treatment option is determined individually. But there are several principles that can be distinguished.Firstly, the elimination of the cause of its formation is the treatment of an exacerbation of arthrosis or a reduction in muscle loads and competent muscle training.Secondly, anti-inflammatory treatment, cyst puncture, observation.Thirdly, in cases of persistent symptoms, radical treatment is cyst removal.What should I do if they found Baker's cyst on my MRI?If you have performed an MRI and the MRI REPORT describes the presence of a Baker cyst, discuss this with your orthopedist. Quite often, the size of the cyst detected on an MRI scan is negligible in order to do something about it and it is nothing more than a normal tendon bag. The MRI specialist is obliged to describe EVERYTHING that he sees in the picture, while the doctor, correlating the patient's complaints, his medical history, clinical manifestations and MRI data, establishes a DIAGNOSIS and, based on the diagnosis, prescribes appropriate treatment.An MRI SCAN is not a DIAGNOSIS.Is a recurrence of popliteal cyst formation possible after its surgical removal?If the reasons that once led to the formation of a protrusion of the joint shell or hypertrophy of the tendon bag have been preserved, then why not form such a protrusion somewhere nearby or hypertrophy to a bag that has not yet been removed nearby? In short, YES, a relapse is possible. Eliminate the cause and there will be no recurrence.Dry residue – to prevent the formation of Baker's cyst, it is necessary to contact a doctor in time for an exacerbation of arthrosis and, if you are an athlete, competently build up the training process, be sure to include stretching after training. 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