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Baker's cyst
Bakerscystisaswellingonthebackofthekneecausedbythebuild-upoffluidinsidesacscalled bursae.Thesymptomsaremildunlessthecystburstsorextendsdownintothecalfmuscles. CommoncausesofBakerscystincludearthritis,infection,tornkneecartilageandotherknee injuries.Bakerscystisalsoknownasapoplitealcyst. Thekneeisahingejoint,situatedbetweenthethighboneandshinbones.Theentirejointis enclosedinsideatoughcapsulelinedwithamembraneandfilledwithlubricatingsynovialfluid. Extracapsulesorsacsoffluid,knownasbursae,cushionthejointandhelpreducethefriction betweentissuescausedbymovement. Symptoms Bakerscystsmayhavenosymptoms.Ifsymptomsoccur,theycaninclude: Apronouncedsoftlumporswellingonthebackoftheknee Thelumplooksmostobviouswhenthepersonisstanding Asensationofpressureinthebackofthekneejoint Persistentpainoraching Restrictedmobilityofthejoint Asensationoftightnessatthebackofthekneewhenthelegisstraightened.

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A range of causes SomeofthecausesofBakerscystinclude: Injurytraumaorinjurytothekneecancauseabuild-upoffluid(effusion),which triggersBakerscyst. Torn cartilageusuallyaffectingthecartilages(knownasmenisci)thatbolstertheknee jointonbothsides. Arthritisparticularlyrheumatoidarthritisandosteoarthritisofthekneejoint. Infectionlocalinfectioncancausefluidretentionaroundthekneejoint. Unknown causesBakerscystscansometimesdevelopinchildrenfornoapparent reason.

Complications ApersonmaybelessinclinedtoseekmedicalhelpforBakerscystifthesymptomsaremild, whichtheygenerallyare.However,ifleftuntreated,complicationscaninclude: Thecystcontinuestogrow,causingthesymptomstoworsen. Thecystmayextenddownintothecalfmuscles(dissection). Thecystcanburstandcausebruisingontheankleoftheaffectedleg,duetoleakedfluid.

Thesymptomsofcalfdissectionandcystrupturearesimilartothosecausedbyinflammationof veins,whichmaymakediagnosisdifficultanddelaytreatment.Itisimportanttoseekmedical advice,asmoreseriousbutlesscommonproblemsmaypresentinasimilarway.Thesemay includeatumourorpoplitealarteryaneurysm. Diagnosis Bakerscystisdiagnosedusinganumberoftests,including: Physicalexamination Medicalhistory Jointx-raythiswillnotshowthecystbutcanshowthepresenceofarthritisintheknee jointthatmaybecausingtheproblem

Baker'scyst

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Shiningalightthroughthecyst(transillumination)thiscandeterminethatthemassis filledwithfluid Magneticimagingresonance(MRI) Ultrasound.

Treatment Bakerscystsdontalwaysrequireactivetreatmentandsometimeswillonlyrequireobservation overtimebythetreatingdoctor.TreatmentoptionsforBakerscystcaninclude: Treatmentfortheunderlyingcause,suchasmedicationforarthritisorsurgeryfortorn kneecartilage Temporarilyavoidingactivitiesthataggravatethekneejoint Physiotherapyinvolvingicepacks,theuseofcrutchesandexercisestomaintainmobility andstrength Cortisoneinjections Insertinganeedleintothecystanddrainingoffthefluid Inseverecases,surgerytoremovethecystentirely Aconservativeapproachofwatchingandwaitingisrecommendedwithchildrenthe conditioncommonlysubsideswithoutactivetreatment(spontaneously).

Prevention strategies Kneejointsarepronetoinjuryduringsportingactivities.Preventingkneetraumacanreducethe riskofBakerscystdevelopinginthefirstplaceorrecurringaftertreatment.Suggestionsinclude: Warmupthekneejointsandsofttissuebygentlygoingthroughthemotionsofyoursport oractivityandstretchingthemuscles. Wearsupportivefootwearappropriatetoyouractivity. Trytoturnontheballsofyourfeet,ratherthanthroughyourknees. Cooldownaftersportbyperforminggentleandsustainedstretches. Ifyouinjureyourknee,stopyouractivityimmediately,applyicepackstotreatthe swellingandseekmedicaladvice.

Where to get help Yourdoctor Sportsmedicineprofessional Physiotherapist AustralianPhysiotherapyAssociationTel.(03)95349400

Things to remember

Thekneecontainssacsoffluid,calledbursae,thathelptocushionthejointandreduce frictionbetweenthestructuresaroundit. Bakerscystisapronouncedswellingonthebackoftheknee,causedbytheabnormal collectionoffluidinsidethebursae. Treatmentoptionsincludephysiotherapytreatment,drawingoffthefluidwithaneedle, cortisoneinjectionsorsurgerytoremovethecyst

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Baker'scyst

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