Baker’s cyst

Overview of Baker’s cyst:

In another term popliteal cyst distend bursa or herniation of synovial membrane through the posterior part of capsule of the knee or escape of fluid through normal communication of bursa with the knee. It fill with synovial inside the knee joint. (Semimembranosus or medial gastrocnemius bursa)

It is most common in adult aged 35 to 70years and children aged 4 to 7 years.[3]

It is named after the surgeon who first described it, William Morrant Baker.

Indian epidemiology then other

Causes of Baker’s cyst:

A lubricating fluid called synovial fluid helps your leg swing smoothly and reduces friction between the moving parts of your knee.

But sometimes the knee produces too much synovial fluid, resulting in buildup of fluid in an area on the back of your knee (popliteal bursa), causing a Baker’s cyst. This can happen because of:

• Inflammation of the knee joint, such as occurs with various types of arthritis
• A knee injury, such as a cartilage tear

It is usually arise from almost any form of knee arthritis or cartilage particularly a meniscus tear.

Bakers cyst arise between the tendons of the medial head of the gastrocnemius and the semimembranosus muscles.

The synovial sac of the knee joint can, under certain circumstances, produce a posterior bulge, into the popliteal space,[2]

Classification of Baker’s cyst:

• Primary Baker’s cyst:

  Idiopathic Bakers cyst. It usually develops in younger people and children.

• Secondary Baker’s cyst:

  Most common type. Develop if there is underlying problem within the knee, such as arthritis (Osteoarthritis and rheumatoid arthritis). Or a tear in the meniscal cartilage that lines the inside of the knee joint or an infection within the knee joint.[3]

Risk factors of Baker’s cyst

• Past knee injuries or cartilage tears.
• Osteoarthritis—wear and tear of cartilage between bones.
• Inflammatory diseases, such as rheumatoid arthritis and gout.
• Previous knee surgery. (4)

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Pathophysiology of Baker’s cyst

• A Baker’s cyst is an enlarged bursa that is normally located between the medial head of the gastrocnemius and a capsular reflection of the semimembranosus, named oblique popliteal ligament.
• The two requirements for a cyst formation are the anatomical communication and a chronic effusion.
• Knee joint effusions may replete the gastrocnemius-semimembranosus bursa with synovial fluid and if the fluid outflow is hindered by a unidirectional mechanism, the gastrocnemius-semimembranosus bursa enlarges giving rise to a pseudo cystic cavity, referred to as a Baker’s cyst. (5)

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Sign & Symptoms of Baker’s cyst:

• Swelling behind knee
• Pain may increase if cyst breaks open
• Knee stiffness and tightness especially when stranding up.[3]
• Sensation of clicking or locking of your knee.[3]
• Swelling of calf
• Rupture of a Bakers cyst may also cause bruising below the medial malleolus of the ankle. [2]

Clinical examination of Baker’s cyst

• 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.
• A Baker cyst is a fluid-filled growth behind the knee. It causes a bulge and a feeling of tightness.
• Also called a popliteal cyst, a Baker cyst sometime causes pain.
• The pain can get worse when with activity or when fully straightening or bending the knee. (6)

Diagnosis of Baker’s cyst:

• In General, Based on Physical Examination and clinical sign and symptoms of the patient.
• Moreover, A Baker’s cyst is easier to see from behind with the patient standing with knees fully extended.
• It is most easily palpated (felt) with the knee partially flexed.
• Transillumination test: Positive [3]
• In detail, If the lumps grows quickly or have night pain, severe pain, fever need more test to make sure other type of tumors [3]
• Besides this, 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.
• Lastly, An MRI mage can reveal presence of a Baker’s cyst.

Differential Diagnosis Baker’s cysts 

• Lipomas
• Vascular mass
• Benign soft tissue tumor
• Thrombophlebitis
• Peripheral nerve sheath tumor [3]

Complications are what happen after you have a disease. They are the negative consequences of the disease process.

Investigation of Baker’s cyst i.e.:

• Ultrasonography or MRI
• MRI shows high signal intensity homogenous cystic mass[3]

Treatment of Baker’s cyst:

• Baker’s cyst usually require no treatment unless they are symptomatic.
• It is very rare that the symptoms are actually coming from the cyst. In most cases, there is another disorder in the knee (e.g. arthritis, meniscal (cartilage) tear, etc.) that is causing the problem.
• Initial treatment should direct at correcting the source of the increased fluid production. Additionally, Often rest and leg elevation are all that is needed.
• If necessary, the cyst can aspirate to reduce its size, then injected with a corticosteroid to reduce inflammation.
• Surgical excision is reserve for cysts that cause a great amount of discomfort to the patient.

Ruptured cyst

• A ruptured cyst is treating with rest, leg elevation, and injection of a corticosteroid into the knee.
• Baker’s cysts in children, unlike in older people, nearly always disappear with time, and rarely require excision.
• Ice pack therapy may sometimes an effective way of controlling the pain related to Baker’s cyst, Heat is also commonly using.
• A knee brace can offer support giving the feeling of stability in the joint.[2]
• Supportive care/ Support stockings
• Physiotherapy
• Ice therapy
• Fluid Aspiration
• Steroid injection
• Surgical removal

Prevention of Baker’s cyst

• Wearing proper footwear.
• Using the balls of your feet to turn instead of your knees.
• Warming up properly before you exercise and cooling down afterward.
• Stopping immediately when you get a knee injury.(7)

Homeopathic Treatment of Baker’s cyst:

Homeopathy treats the person as a whole. It means that homeopathic treatment focuses on the patient as a person, as well as his pathological condition. The homeopathic medicines selected after a full individualizing examination and case-analysis.

which includes

• The medical history of the patient,
• Physical and mental constitution,
• Family history,
• Presenting symptoms,
• Underlying pathology,
• Possible causative factors etc.

A miasmatic tendency (predisposition/susceptibility) also often taken into account for the treatment of chronic conditions.

What Homoeopathic doctors do?

A homeopathy doctor tries to treat more than just the presenting symptoms. The focus is usually on what caused the disease condition? Why ‘this patient’ is sick ‘this way’?.

The disease diagnosis is important but in homeopathy, the cause of disease not just probed to the level of bacteria and viruses. Other factors like mental, emotional and physical stress that could predispose a person to illness also looked for. No a days, even modern medicine also considers a large number of diseases as psychosomatic. The correct homeopathy remedy tries to correct this disease predisposition.

The focus is not on curing the disease but to cure the person who is sick, to restore the health. If a disease pathology not very advanced, homeopathy remedies do give a hope for cure but even in incurable cases, the quality of life can greatly improved with homeopathic medicines.

Homeopathic Medicines for Bakers cyst:

The homeopathic remedies (medicines) given below indicate the therapeutic affinity but this is not a complete and definite guide to the homeopathy treatment of this condition. The symptoms listed against each homeopathic remedy may not be directly related to this disease because in homeopathy general symptoms and constitutional indications also taken into account for selecting a remedy.

Homeopathy treats the person as a whole. It means that homeopathic treatment focuses on the patient as a person, as well as his pathological condition. The homeopathic medicines are selected after a full individualizing examination and case-analysis, which includes the medical history of the patient, physical and mental constitution, family history, presenting symptoms, underlying pathology, possible causative factors etc.

A miasmatic tendency (predisposition/susceptibility) is also often taken into account for the treatment of chronic conditions. A homeopathy doctor tries to treat more than just the presenting symptoms. The focus is usually on what caused the disease condition? Why ‘this patient’ is sick ‘this way’.

The disease diagnosis is important but in homeopathy, the cause of disease is not just probed to the level of bacteria and viruses. Other factors like mental, emotional and physical stress that could predispose a person to illness are also looked for. No a days, even modern medicine also considers a large number of diseases as psychosomatic. The correct homeopathy remedy tries to correct this disease predisposition.

The focus is not on curing the disease but to cure the person who is sick, to restore the health. If a disease pathology is not very advanced, homeopathy remedies do give a hope for cure but even in incurable cases, the quality of life can be greatly improved with homeopathic medicines.

The homeopathic remedies (medicines)

given below indicate the therapeutic affinity but this is not a complete and definite guide to the homeopathy treatment of this condition. The symptoms listed against each homeopathic remedy may not be directly related to this disease because in homeopathy general symptoms and constitutional indications are also taken into account for selecting a remedy.

Benzoic acid

• Well indicated medicine for baker cyst. Benzoic Acid is a medicine used to treat a swollen knee due to gout.
• Along with swelling, painful nodes on the knee joint may be present.
• Gouty deposits of joints.
• Pain and swelling in knees.
• Drawing pain in the knees, a cracking sound upon movement also aggravation of the symptoms might indicate the need for this medicine.
• Bunion of great toe.
• Tearing pain in great toe.
• There are cracking sounds in joints on motion.[1]

Calcarea flour

• Well indicated medicine either for ganglia or encysted tumors at the back of the wrist and popliteal fossa.
• Gouty enlargements of the joints.
• Chronic synovitis of knee joint.

Iodum

• Joints inflamed also painful.
• Pain in knee joints at night.
• There occurs white swelling of joints.
• Specifically for acrid sweat from feet.
• Well indicated medicine for baker cyst.[1]

Silicea

• Well indicated medicine for baker cyst.
• Silicea is a natural medicine for housemaid’s knee also swelling when knee pains are tearing in nature.
• Pressure and exercise worsen the pain over the knee.
• The knee is also highly swollen and shining.
• Pain in knee, as if tightly bound, Pain beneath toes.
• Calves are tense also contracted.
• Loss of power in legs.

Mercurius solubis

• Well indicated medicine for baker cyst in knees.
• Contraction of legs and cramps in calves of legs
• There occur dropsical swelling of legs.
• There is great weakness, heaviness and painful weariness in thighs and legs. [1]

• 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 [2]

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References use for Article Baker’s cyst:

[1] https://drkathyramsey.com/services/protocols/bakers-cyst

[2] https://en.wikipedia.org/wiki/Baker%27s_cyst

[3] https://www.slideshare.net/jeabzsiwaporn/bakers-cyst-56272143

[4] https://www.winchesterhospital.org › health-library › article

[5] https://www.physio-pedia.com/Baker%27s_Cyst

[6] https://www.wikidoc.org › index.php › Baker’s_cyst_ph.

[7] https://my.clevelandclinic.org › health › 15183-bakers-cyst

What is Baker’s cyst?

Baker’s cyst is also known as a popliteal cyst, is a type of fluid containing cyst behind knee.

Homeopathic Medicines used by Homeopathic Doctors in treatment of Baker’s cyst?

• Benzoic acid
• Calcarea flour
• Iodum
• Silicea
• Mercurius solubis

What are the symptoms of Baker’s cyst?

• Swelling behind knee
• Pain may increase if cyst breaks open
• Knee stiffness and tightness
• Sensation of clicking or locking of knee
• Swelling of calf
• Rupture of a Bakers cyst may cause bruising

What are the causes of Baker’s cyst?

• Inflammation of the knee joint (arthritis)
• A knee injury (cartilage tear)