Rupture of a Baker cyst provokes serious impaired motor activity in the lower extremities. Individuals experience severe pain and burning. The rupture of the cystic capsule leads to an increase in pressure, which is provoked by injuries, excessive physical exertion, inflammation or degenerative processes in the knee joint.
general information
In pathological conditions such as trauma, deforming arthrosis, high mobility of the knee joint, arthritis, inflammatory or traumatic damage to the meniscus, fluid accumulation in the joint cavity is possible. If it becomes a lot, then there is a protrusion in the popliteal fossa in the form of a ball, which was called Baker's cyst. It is named after the English doctor who first described the disease in the nineteenth century. This is a benign formation in the knee joint. A cyst forms on the back of the knee and is noticeable when the lower limb is straightened. On palpation, the cyst moves, and when the legs are bent, it disappears. It can form in both joints, its size varies from a millimeter to ten centimeters.
How does the gap appear?
The gap occurs infrequently, but leads to significant complications. The growth of the tumor causes severe pain, it becomes difficult to bend the lower limb and, as a result, movements are limited, which leads to muscle atrophy. Volumetric formation compresses muscles, blood vessels and nerves. As a result, varicose veins develop. Upon reaching large sizes and under the influence of provoking factors, the cystic capsule ruptures. Liquid flows out of it and edema occurs. The individual experiences acute pain. In the affected area of the dermis is red, the temperature of the skin rises. If you do not immediately take appropriate measures, then the pain syndrome becomes very strong, and the edema is very extensive. The patient loses the ability to move his leg. Then there is a fever, aches in the affected area and other more serious consequences. Cyst rupture involves complex treatment in a hospital setting.
Symptoms of Baker's Cyst
With the disease, the following clinical picture is observed:
- swelling occurs in the knee fossa;
- there is a tingling sensation, numbness in the tissues located nearby, this indicates that the cyst puts pressure on the nerves;
- when flexing a sick lower limb, pain occurs;
- blood circulation is disturbed, since there is constant pressure on the blood vessels, in connection with this, the risk of thrombus formation and blockage of the vessel increases.
In some, this disease proceeds without any symptoms. In the initial stage of cyst formation, it does not cause inconvenience or pain. If the size of the cyst is small or it is deep, the individual experiences slight discomfort in the knee area, manifested by pulling pain. In order to avoid inconvenience, a person consciously tries to reduce natural extension and flexion, which provokes contracture and muscle atrophy. Without appropriate therapy, the size of the cyst increases, swelling, discomfort and heaviness in the knee joint are formed. At this stage, the doctor can detect it by palpation. A small seal will be felt in the popliteal fossa. Further growth contributes to the compression of blood vessels and nerve endings, provoking the development of thrombosis and varicose veins. One of the most dangerous complications is rupture of a Baker's cyst of the knee joint. The liquid contained in it enters the muscles surrounding the tumor and provokes:
- sharp severe pain;
- edema;
- redness of the dermis in the area of the knee fossa;
- temperature rise.
Complications of Baker's Cyst
In some patients, due to anatomical features, the knee joint bag communicates with the joint cavity. With inflammatory processes or abnormal abnormalities, synovitis occurs in it, i.e., inflammation of the synovial membrane. The result is increased fluid production. After some time, the protrusion becomes an isolated cavity (cyst) and is connected to the joint by small ducts. Directly, it does not harm the body of the individual. The threat is severe consequences:
- Rupture of a baker's cyst of the knee joint. The contents flowing out of it cause edema.
- Compression of the nerve endings contributes to the occurrence of osteomyelitis and soft tissue necrosis.
- Compression of the veins of the lower leg provokes deep vein thrombosis and thrombophlebitis. A blood clot leads to the death of a person.
- Suppuration. In this process, the joint is affected and purulent arthritis occurs.
In order to avoid negative consequences, you should contact a health care institution if you yourself have discovered:
- violation of the flexion function of the knee joint;
- there is a protrusion in the fossa under the knee.
Baker's cyst is a non-self-contained disease, its appearance is associated with such abnormalities as osteoarthritis, rheumatoid arthritis, synovitis and others.
Causes of cyst rupture
A cyst is a protrusion that forms on the shell of a synovial bag, which later forms into a closed cavity containing fluid inside. The rupture of Baker's cyst, as well as its appearance, provokes inflammatory, degenerative, traumatic processes occurring in the knee joint, as well as excessive physical exertion and operations on the knee joint. In some cases, it is not possible to determine the exact cause. Sudden rupture of a cyst can occur with the following pathological conditions:
- gonarthritis;
- rheumatoid arthritis;
- gonarthrosis;
- rheumatism.
All of the above factors lead to an increase in pressure in the capsule and thereby contribute to the rupture of Baker’s knee cyst. The patient needs the qualified help of doctors and treatment in a hospital, because as a result of a rupture for a long period, the functions of the knee joint are impaired. A feature of this pathology is that a gap can occur without provocative reasons. Quite rarely, but the cyst may burst during surgery on the popliteal joint. This problem occurs regardless of the age of the individual.
Signs and consequences of rupture of a Baker cyst
As the cyst grows, it begins to put pressure on the nerves and blood vessels, as well as cause discomfort. The arising strong pain creates difficulties when bending the lower limb, muscle tissue atrophies. During the rupture, all the liquid in the capsule flows out and fills the space along the calf muscle and to the ankle. The first thing they pay attention to is a huge swelling in the popliteal fossa. As the fluid flows out, burning and pain increases. The main characteristic signs of a rupture of a Baker cyst are manifested in the form:
- severe swelling under the knee ;
- burning in the lower limb as the effusion spreads;
- hyperemia and local rise in temperature in the place of swelling;
- pain on palpation;
- disturbances in leg movement;
- sudden sharp pain;
- numbness;
- swelling of the leg.
In case of untimely treatment, the individual intensifies pain in the calf muscle and under the knee to such an extent that he loses the ability to move the limb. The aches begin in the affected area, the body temperature rises to 39 degrees. If the fluid that drained from the cyst remained in the interfascial space for a long period, then the lower limb becomes numb, and then loses its sensitivity. If the cyst is of an infectious nature, then the surrounding tissue is infected. Muscle fibers and fascia undergo decay as a result of their infection. In this case, the risk of phlegmon formation is high. Blood flow is disturbed due to compression of nerve endings and blood vessels. In especially severe cases, this leads to thrombosis and further to the death of the individual.
Diagnostics
To make an accurate diagnosis:
- history taking;
- listen to the patient’s complaints;
- examine the individual;
- carry out ultrasound, MRI, CT, radiography;
- biochemical, serological and cytological examination of the contents of the cavity is carried out if necessary, when it is necessary to study the type and origin of the liquid;
- exclude thrombosis of the lower extremities and phlebitis.
For the diagnosis of rupture of Baker's cyst, the most informative method was recognized as ultrasound. The X-ray diffraction pattern makes it possible to assess the condition of soft periarticular tissues, tibia and femur, and in addition, to identify metabolic diseases, as well as joint neoplasms, arthrosis. In children, the diagnosis is very difficult, since they are not able to clearly explain the type of pain. Therefore, parents are advised to carefully examine the area under the knee in case of injury to the knee joint.
Baker Cyst Treatment
To prevent a rupture of a Baker cyst, treatment should be started when the protrusion is small. For this, physiotherapeutic procedures are indicated, as well as physiotherapy exercises. At this stage, you can use herbal recipes. With an increase in the cyst, pain and discomfort appear. In this case, it is recommended to keep the diseased limb several times a day elevated. To reduce pain, ice compresses will help, and if they do not help, the doctor will recommend painkillers, as well as anti-inflammatory and hormonal drugs. Without fail, the doctor will prescribe medications to treat the underlying disease.
If the patient is diagnosed with lateral rupture of the meniscus and Baker's cyst, then doctors recommend the following treatment:
- sessions of shock wave therapy, their number is determined individually;
- ultrasonic cleaning of the affected knee;
- meniscus tear sclerotherapy.
As a result of this treatment, a significant decrease in the size of the cyst is noted, and in addition, the signs of meniscus rupture disappear. If necessary, the doctor recommends a second course of therapy.
Baker cyst rupture - what to do?
As mentioned above, the lack of treatment creates a risk of rupture of the cyst. The increase in intracavitary pressure is associated with the filling of the cyst with liquid, under the onset of which the tissues burst and all the contents fall into adjacent muscle tissues. In this case, the individual experiences severe pain, hyperemia of the affected tissue and swelling appear. It is important to remember that it is strictly forbidden to do warming when the Baker cyst ruptures with the formation of a new hemioma. As a first aid to prevent swelling and bruising, an ice pack should be applied as quickly as possible. Further, all the actions are performed by the doctor:
- If the complication after the rupture has affected a small part of the calf muscle, then the therapy will focus on the following processes: resorption of the hematoma, removal of the inflammatory process and anesthesia.
- With significant damage and in cases when liquid oozes from the capsule, an operation is required, during which the cyst is excised completely.
Immediately before transporting the patient to the surgical department of the hospital for the treatment of rupture of the Baker's cyst of the knee joint, the affected leg should be bandaged and horizontal. The main task of doctors with a burst capsule of a cyst is as follows:
- anesthetize;
- immobilize;
- relieve inflammation;
- remove puffiness;
- cure the pathology that triggered this process.
Drug treatment
For the treatment of rupture of a Baker’s cyst of the knee joint (photo below) in order to alleviate the patient’s condition, the following main pharmacological groups of medicines are used:
- "Prednisolone", "Diprospan", "Metipred" - corticosteroids. They have decongestant and anti-inflammatory effects.
- "Don", "Arthra" - chondroprotectors, restore the tissue of cartilage.
- "Tramadol", "Analgin" - analgesics, relieve pain.
- "Movalis", "Voltaren", "Celecoxib", "Celebrex" - NSAIDs, remove the inflammatory process and relieve pain.
- Vitamin complex - improves metabolic processes, saturates tissues with vitamins and minerals.
In addition, drugs that increase immunity are used to treat rupture of a Baker's cyst of the knee joint. A syringe is used to aspirate the fluid, then hormonal preparations of a group of steroids are introduced into the cavity, for example, Diprospan, which gives an anti-inflammatory effect. Unfortunately, drug therapy is temporary, and the undesirable consequences of ruptured cysts return again. Therefore, doctors recommend surgical treatment.
Baker Cyst Treatment
There are several methods of treatment with which you can both reduce the size of the cyst and completely get rid of it. If the cyst is small and does not cause inconvenience, then first of all they select therapy for the underlying disease. Physiotherapeutic procedures are carried out directly for the treatment of cysts, and a course of therapeutic gymnastics is also prescribed. In this period, doctors are allowed to use folk remedies.
If the formation is large, then puncture is recommended, as a result of which excess fluid is pumped out. Perform the procedure under local anesthesia. To prevent inflammation, anti-inflammatory and antibacterial drugs are injected into the knee joint. Unfortunately, the fluid may accumulate again. For severe pain, ice compresses, drug therapy (analgesics, NSAIDs, hormones) and the creation of conditions for rest of a sore foot are indicated. In addition, physiotherapeutic procedures are shown: laser, magnetic and bioresonance therapy.
In the absence of timely treatment, there is a danger of rupture of the Baker cyst. This occurs due to an increase in intracavitary pressure due to the filling of the cyst with fluid. The contents of the capsule flows out and spills into the muscle tissue located nearby. There is a sharp pain, swelling and hyperemia. In case of insignificant damage to the calf muscle, the therapy is aimed at analgesia, removal of the inflammatory process and resorption of the hematoma, and for volume injuries, surgical treatment of rupture of a knee joint Baker cyst is shown (photo above).
Surgical intervention
The operation is shown in the following cases:
- large cyst;
- unsuccessful conservative treatment;
- compression of nearby nerve endings and blood vessels;
- loss of motor ability of the lower limb.
During the operation, the doctor makes an incision, separates the capsule of the cyst from the surrounding tissues, then sutures the duct, which connects the joint to the cyst, and cuts off the abnormal formation. After these manipulations, sutures and a bandage soaked in antiseptics. Sutures are usually removed after seven or ten days. The classic way to remove a cyst using a surgical scalpel is shown with repeated fluid accumulation in the cavity. Another way to excise and remove the cystic capsule is arthroscopy.
It is carried out under local anesthesia. Through a small incision, a special device is introduced, which sucks the liquid and injects hormonal substances to relieve the inflammatory process. Next, an elastic bandage is applied to the diseased limb in accordance with all the rules to prevent swelling below the site of application of the bandage. After removing the stitches, the doctor resolves minor physical exertion on the knee joint. Physiotherapeutic treatment improves trophism, healing, and blood supply to affected tissues. For these purposes, do mud wraps, as well as bioresonance, magnetic and paraffin therapy.
Treatment with folk remedies
At the initial stages of the disease and in order to prevent the growth and rupture of Baker cysts, the use of alternative medicine methods in consultation with the attending doctor is permissible in the treatment. Compresses from:
- Burdock and celandine. Pre-plant raw materials, taken in equal parts, are crushed.
- Mix aloe and lemon juice with Streptocide tablets.
- Sunflower oil. Better to use unrefined.
- Tincture of a golden mustache.
The above mentioned means impregnate tissue or gauze, apply to the affected area of the knee, cover with polyethylene, wrap it with a warm cloth and leave it overnight.
The dangerous effects of ruptured cysts
Rupture of a Baker's cyst of the knee joint leads to a number of complications, therefore, if this happens, the help of specialists and medical intervention are mandatory. Enlarged cysts do not pass unnoticed for an individual, since mobility in the knee worsens, and a pain syndrome occurs. After some time, muscles atrophy in the affected lower limb.
Compression of blood vessels and nerve endings provokes a violation of blood supply and leads to their death. , , . , . . . . , , . , , .
Preventive measures
To prevent cyst rupture, it is advisable to adhere to the following recommendations:
- Conduct therapy in the early stages. This will help prevent cyst growth and relapse without resorting to surgery.
- Limit stress on the affected knee joint.
- Correct body weight, adhere to a healthy diet.
- In the diet include a large number of fresh vegetables and herbs.
- Timely treat bruises and injuries.
- Physical activity should be agreed with the attending doctor. Do not perform squats, jumping.
- Try to exclude weight lifting.
- In case of discomfort in the knee area, cancel all physical exercises and visit a doctor.
- If the existing cyst is small, then when playing sports or performing physical work, an orthosis should be worn.
To prevent the formation of cysts in children, the following recommendations should be observed:
- do not supercool the joints;
- Before doing the exercises, do a warm-up to warm up the ligaments and muscles, and you need to finish with stretching exercises;
- give preference to comfortable athletic shoes when playing sports;
- for any knee injury, consult a doctor.
Instead of a conclusion
The knee joint regularly makes active movements when walking and rising. Various morphological and physiological changes in the knee joint provoke complications, for example, a rupture of a Baker cyst (ICD-10 M66.0) This is a fairly common situation in those individuals who experience constant severe physical overload, do not pay attention to pain, taking them for a banal stretch ligaments. In the cyst, there is no growth of atypical cells, therefore it refers to benign formations and is an isolated capsule. Its location is the popliteal region.
In young people and children, it forms as a complication after injuries, and in the older generation, against the background of existing chronic pathologies of a dystrophic and inflammatory nature. In order to avoid the serious consequences of a rupture of a Baker cyst, one should not delay the treatment and seek qualified help in a timely manner. It is important to remember that at risk are individuals with frequent knee injuries and athletes.