The knee joint cyst is a rounded tumor-shaped formation located in its posterior surface, in the popliteal fossa. Like any cyst, it is a closed cavity filled with a tissue( serous) fluid. Sometimes it is asymptomatic, but in most cases it is accompanied by impaired sensitivity in the lower leg and movements in the knee joint.
The main reasons for the formation of Baker's cyst are negative changes in the knee joint of a traumatic, inflammatory or degenerative nature. In a word, everything that is accompanied by an increase in the volume of synovial fluid. As a matter of fact, the Baker's cyst is not a full-blown tumor;is not accompanied by pathological growth of atypical cells. Rather, it is one of the varieties of bursitis or synovitis.
Our knee joint is surrounded by articular bags or bursa. And one of them is a semi-membranous tendinous bag, which is a fibrous capsule lined inside with a synovial membrane. Approximately in a third or half of individuals this articular sac anatomically communicates with the cavity of the knee joint. As a result of pathological changes in the bag itself or in the joint cavity inflammation of the synovial membrane develops - synovitis, which leads to increased production of synovial fluid.
Further on the surface of the synovial membrane appears a pathological protrusion filled with fluid. In the future, this protrusion takes the form of a closed cavity - Baker's cyst. Although in many cases the cyst can communicate with the cavity of the knee joint by means of a small ankle. The following diseases can cause cyst formation:
- Knee inflammation - gonarthritis
- Degenerative knee changes - gonarthrosis
- Knee joint injuries
- Inflammatory and traumatic meniscus lesions
- Inflammation and damage of the patella and femur joint
- Rheumatism and rheumatoid arthritis.
Thus, Baker's knee cyst is secondary in nature, and develops as a complication of other diseases. Although there are many cases when the exact cause of this pathology remains unclear.
This popliteal cyst is a dense elastic formation that is not welded to surrounding tissues, located shallow under unchanged skin. Dimensions of the cyst may vary depending on the position of the body and movement in the knee joint. Indistinguishable with a bent knee, the cyst is well palpable( probed) during extension. In the vertical position of the body, its dimensions are larger than in the horizontal position. It is located in the medial( near the middle axis of the body) sections of the popliteal fossa, and has the form of a crevice, a crescent, a bird's beak, a bunch of grapes.
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Initially, the symptoms of Baker's cyst are minimal, and it does not cause significant hassle. In the future, as the disease progresses, joint swelling appears, accompanied by a feeling of heaviness and discomfort in the knee. Then there is pain, which is aggravated by bending the leg in the knee. For this reason, the patient can deliberately reduce the flexion-extension amplitude in the knee joint. As a result, this leads to muscle atrophy and to persistent movement restrictions - contractures.
An enlarged cyst can squeeze the venous vessels and the tibial nerve. Nerve compression leads to pain and unpleasant sensations( paresthesias) in the lower leg and in the foot. A violation of venous circulation is the cause of thrombosis and varicose veins of the lower limbs. The breakdown of Baker's cyst is rare. When ruptured, the liquid contents of the cyst along the intermuscular spaces are shifted to the lower leg. The main symptoms are: severe pain, swelling of the lower leg, redness and local skin temperature increase in the edema zone.
In some cases, the cyst can independently disappear without any intervention. Reduce the size of Baker's cyst by yourself, by means of usual pressure. In this case, the contents of the cyst can be located in the cavity of the knee joint. However, a certain time there is a relapse, and the cyst again increases.
Therefore, it is necessary to treat Baker's cyst, which should begin with the elimination of its causes. In this regard, the use of various groups of drugs - anti-inflammatory, immunostimulants, chondroprotectors, and many others, that eliminate the inflammation of the synovial membrane is shown. Evacuation of fluid from the cystic cavity is carried out by puncturing its wall with a sterile needle. The fluid is sucked off with a syringe, after which steroid hormones( Diprospan, Kenalog) are injected into the cavity, which have an anti-inflammatory effect. At the time of exacerbation, the knee is immobilized( immobilized) with a pressure bandage or special orthopedic devices.
Unfortunately, in most cases, conservative treatment has a temporary effect, after which the cyst recurs again with the appearance of the above-described neurological and vascular complications. In such cases, the operation is shown - removal of the cyst. This operation is not very traumatic, and therefore can be carried out under local anesthesia. In the popliteal fossa, in the projection of the cyst, a shallow incision is made. Bare the cyst and separate it from the surrounding tissues. Further, the place where it communicates with the cavity of the knee joint is stitched and bandaged, after which the cystic cavity is cut off and removed. After the operation, the patient undergoes a course of restorative treatment with painkillers, anti-inflammatory drugs, and physiotherapy procedures.