Chronicle-Express.

com The Chronicle-Express Wednesday, April 11, 2012

B7

YOUR GOOD HEALTH

Bakers cyst can recur unless underlying cause is found
By the faculty of Harvard Medical School

Question: I have a Baker's cyst in my right knee. I've had it drained twice, but it keeps coming back. Are there any other treatments for it besides draining? Is there an operation that can x it once and for all? Answer: Your situation is fairly common. A Baker's cyst (also called a popliteal cyst) is a uid-lled sac that can develop in the popliteal space, the hollow at the back of the knee joint. Baker's cysts are named for William Morrant Baker, a 19th-century surgeon who rst described the condition. The cyst is lled with synovial uid, a viscous material that lubricates the knee joint. Synovial uid reduces friction between the various parts of all your joints, including your knee, which needs lubrication to ex and extend smoothly. Although there are several ways to treat a Baker's cyst, surgery is an uncommon choice. Whatever the treatment, however, the cyst will often recur if the underlying cause hasn't been corrected. A Baker's cyst can be caused by an injury to the knee, such as a tear in a meniscus. Damage to the cartilage from conditions such as rheumatoid arthritis or osteoarthritis can also lead to Baker's cysts. These conditions may cause the synovial cells lining the knee joint to pro-

duce excess uid. If the uid bulges into the popliteal space, a cyst can develop. The excess uid can also cause the whole knee to become swollen. A Baker's cyst is often found incidentally during a physical exam or an ultrasound performed for other reasons. It may cause no symptoms at all. It may be a painless bulge at the back of the knee. But it can also cause pain, swelling and joint stiffness. Sometimes the bulge is so large that it's hard to fully bend or straighten the leg. Baker's cysts aren't dangerous, and they may go away on their own. But occasionally they burst. If that happens, synovial uid can leak into your calf below, causing pain and swelling. These symptoms are similar to the symptoms associated with having a blood clot in your calf. This is called deep vein thrombosis (DVT), and it is a common problem. Most of these clots develop because blood ow in the calf is slow. This is usually as a result of inactivity. DVT is a serious condition that requires immediate treatment. That's why it's important to nd the source of the problem right away. (A painless Doppler ultrasound can usually identify a DVT in the calf.) If your Baker's cyst causes discom-

troublesome, MRI imaging may be done to detect an underlying meniscal tear or other possible cause of increased joint uid and cyst formation. While you're considering your options, protect your knee by doing gentle (nonweight-bearing) range-of-motion and musclestrengthening exercises. Strength or resistance training, which typically employs equipment such as weight machines, free weights, and resistance bands or tubing, protects

against bone loss and builds muscle. It also improves your body's ratio of lean muscle mass to fat, improving your overall health. Consult your doctor or a physical therapist to set up a program that's right for you. You'll probably want to scale back on activities such as jogging, tennis or golf. And try to lower the stress on your knee by maintaining a healthy body weight. With common sense and the help of your doctor, you should be able to cook up a program to control your Baker's cyst.

fort or interferes recurs and remains with your daily activities, there are Seneca Lake Terrace 3670 PreEmption Rd., Geneva 315-789-4162 several things you Visit us on the Internet at www.senecalaketerrace.com can do. To bring 24 hour security Deliciously prepared restaurant style down swelling, meals served All housekeeping, laundry and linen apply a cold pack provided to the area or use a Dynamic activities program Beauty Salon, Ice Cream Parlor, Chapel compression wrap. Outdoor Gardens and enclosed patios To reduce inam Caregivers available Come see why so many have chosen mation, take an Seneca Lake Terrace over-the-counter We offer beautifully designed private nonsteroidal antiapartments in a neighborhood setting. inammatory drug such as ibuprofen (Motrin, Advil, others). Because stress on the knee joint can increase inammation, rest your leg and keep it elevated whenever you can. When you're up and about, use a cane or crutch. Sometimes, as in your case, a Baker's cyst needs to be drained. Your doctor may want to inject cortisone into your knee joint at the same time, to quell inammation. If, despite these treatments, the cyst

Copyright 2012 the President and Fellows of Harvard College. Developed by Harvard Health Publications (www.health.harvard.edu). Distributed by Universal Uclick for UFS. Submit questions to harvard_adviser@hms. harvard.edu.

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