Baker's Cyst
Introduction
A popliteal synovial cyst, commonly known as a Baker’s cyst, is a fluid-filled swelling that develops at the posterior aspect (back) of the knee.
- It typically occurs due to an underlying intra-articular pathology (e.g. osteoarthritis, rheumatoid arthritis) or a meniscus (cartilage) tear, which causes the joint to produce excessive synovial fluid.
Symptoms
Patients often report increased discomfort during prolonged standing or when the knee is in hyperflexion. Common symptoms include:
- A visible or palpable lump behind the knee, which may extend into the calf.
- Knee pain
- Stiffness and an inability to fully flex or extend the knee.
Rarely, a Baker’s cyst may rupture, causing synovial fluid to leak into the calf, and present with similar symptoms of a deep vein thrombosis.
- This results in sharp, sudden pain in the knee and significant swelling and redness in the calf, and require immediate medical evaluation.
NOTE: Diagnosis is typically confirmed via physical examination and imaging studies (such as X-ray, ultrasound or MRI) to identify the cyst and its underlying cause.
Management
A Baker’s cyst does not always require direct treatment; it often resolves if the underlying joint condition is managed.
If the cyst is symptomatic, management options include:
- Temporarily avoiding activities that aggravate the knee.
- The RICE Method - Rest, ice, compression and elevation.
- Over-the counter analgesics, such as paracetamol or NSAIDs
- A clinician may use needle aspiration to drain excess fluid or an intra-articular corticosteroid injection to reduce inflammation.
- Surgery intervention is rarely required, but may be considered if all conservative treatments have failed.
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