Bakers Cyst: A Case Report and its clinical significance

Soumitra Trivedi,Dhyanesh Kumar Sharma,Abu Ubaida Siddiqui,Bikash Chandra Satapathy,Manisha Barnwal Sinha

doi:10.7439/ijbr.v6i1.1575

Abstract

The Bakers or Popliteal cyst is a bursa seen between medial head Gastrocnemius and Semimembranosus. This bursa when present usually communicates with the cavity of Knee joint, most of the times being asymptomatic. They can occur due to any intra-articular pathology including bony inflammation, cartilaginous lesions, meniscal or ligament tear, etc. The symptomatic cases are mainly leading to pressure effects due to anatomical vulnerability of surrounding structures. Symptoms related to Popliteal vein compression and Tibial nerve entrapment are the most common clinical presentations. Although, Bakers cyst is a chronic disorder and after treatment also requires follow up to prevent relapses, it causes difficulty in differential diagnosis while presenting in acute state. Ultrasonographic examination and Magnetic Resonance Imaging are important tool to avoid misdiagnosis and inappropriate treatment. Surgical resection of the cyst is rarely indicated when intra-articular pathology cannot be diagnosed or its treatment is not responding.

Highlights

There are six normal bursae around the Popliteal area, out of which Bakers’s cyst is the most commonly formed cyst around Knee joint
It is commonly presented in clinics by patients above 50 years with complaint of knee pathology especially those affecting the dynamics of synovial fluid such as arthritis, meniscal tear and rarely gout[2][5]
The pressure of the developing cyst can lead to compression of one or more components of neurovascular bundle which can manifest as Tibial or Sciatic neuropathy, Gastrocnemius muscle atrophy[8][9][10] true thrombophlebitic or Psuedothrombophlebitic syndrome[11][12] and rarely claudication of the lower limb[13]

Summary

1.Introduction

There are six normal bursae around the Popliteal area, out of which Bakers’s cyst is the most commonly formed cyst around Knee joint. Baker’s cyst communicates with the cavity of knee joint in more than 50% of the cases seen in adults[4] It is commonly presented in clinics by patients above 50 years with complaint of knee pathology especially those affecting the dynamics of synovial fluid such as arthritis, meniscal tear and rarely gout[2][5]. During the routine dissection classes of first year MBBS students, it was noted that a thick fascial ballooning existed on the back of popliteal fossa on postero-medial side This swelling typically presented between the medial head of gastrocnemius and semimembranosus with its base attached to deeper aspect. On further dissection, this cystic swelling was noted to be in continuation with the capsule of knee joint. On opening the cavity of the cyst it was noted to be in continuity with the joint cavity

Findings

3.Discussion

4.Conclusion