Baker's Cyst -- Need advice

[Heather M.]

Hi everyone.

I'm seeing a new OS tomorrow who specializes in bone and joint infections to try and come up with a diagnosis for my left knee (possible staph infection, possibly forming more scar tissue, who knows).  This will be my fifth medical consult in 8 days.

In the meantime, my 'good' knee is hurting much worse than the bad one that is causing all this fuss in the medical community.  I slipped and twisted the good knee in April, but the MRI came up clear 4 weeks after my fall.  I have lateral swelling that becomes severe during the day, clicking & snapping, and a feeling of instability and sharp pain on weight-bearing.  I also have very painful grinding on any exercises that involve tightening my quads, like leg raises.  If I try to sit or sleep with the knee bent, I develop radiating pain through the whole joint.

Two weeks ago I developed a lump at the back of the knee, and now most of the pain is centered there and on the lateral side.  Sometimes I can feel the pain shooting down into the top of my calf.  I cannot put weight on the leg with my knee locked as the pain is blinding (makes standing interesting, since I can't lock the other leg either).  The pain is always worse after walking or being on my feet, or PT for my other knee.

My OS wants to focus on my operated knee and find out what's wrong before we undertake any other diagnostic adventures.  My PT went on the record saying he thinks I have a torn meniscus, possible loose body, and Baker's cyst.  The four different physicians who examined me last week all dismissed my complaints of pain behind the knee, saying (every one of them) "I wouldn't worry, it's just a Baker's cyst."  

But there is not JUST about it for me.  The thing is killing me.  Last night I was up until 2am, counting my heartbeat in the back of my knee.  I understand what a Baker's cyst is, but what causes them to just appear if my MRI says there's no internal pathology?  Could it just be overuse from being on and off crutches for a year?

And more importantly, how to deal with the pain?  It hurts much worse than my other knee, except when that one is flared up.  The only thing that helps is sitting with frozen vegetables behind my knee...this is getting very old.  Now my fear is getting the left knee fixed and being left with the right one in shambles.  I really can't deal with any more surgeries.

Does anyone have any advice on this?  Any questions for me to ask the new OS tomorrow?  What about treatment options for pain-relieving effect?

Thanks in advance.

Heather

[khaoskat]

Heather:

You could have torn your lateral meniscus.  Not all tears show up on an MRI.

I know that my MRI came back as negative for a torn lateral meniscus, but all the manual tests that my Sports Med Specialist did, came back positive for a torn lateral meniscus.

When my OS did surgery, he found a tear in the Lateral Meniscus, which required it to be removed and not repaired.

[opal]

Heather M.

I had a baker's cyst and yes, it did hurt.  Enough that I ended up in the hosp. with drs. thinking I had a blood clot (had one after a previous scope years ago and they thought it was a repeat of THAT problem because the symptoms can mimic a clot).  Turned out to be a bakers cyst.  Ok, the way it was described to me is that when the knee has an underlying problem (like torn meniscus, etc.) fluid builds up in the knee and can cause the baker's cyst, which unless it is very large, the drs. are reluctant to treat it surgically, cause the back of the knee is very vascular.  (Mine wasn't too big, but enough to cause symptoms).  Until the underlying problem is corrected, surgically or otherwise (in my case, surgically) it won't go away.  The symptoms may not always be constant, they can wax and wane as the fluid fluctuates, but it won't go away.  Look into the underlying condition.  By the way, my cyst was there for 2 years before I had meniscal repair and it is now gone.

MRIs are not foolproof.  The original MRI which showed the cyst did not show a lateral tear!!!  It did, however, indicate a medial tear, which WASN'T there.  Go figure!!  Plenty of ice and anti-inflammatories will help the pain until it can be dealt with  Good luck

[Heather M.]

Thanks to you both for the info.  I am having another MRI tomorrow, though I put no faith in it.  I've had 3 MRI's done, and only one showed damage (my first one--kind of to suck me in, I guess).  Despite having two other 'clean' MRI's, I had surgery each time and there were significant problems found.

I just want to know what's wrong so I know how to fix it.  My PT is almost positive I've torn the cartilage...the hotshot OS I saw yesterday said, are you ready?  "It's just a Baker's cyst."  I had to restrain myself from hurting him.

Given the way I respond to surgery (scar tissue galore) it may not be an option to have my good knee scoped.  I guess I'll have to find a way to live with it, though I have to say I'm baffled as to how a little piece of gristle with no nerves can cause SO MUCH pain!!!

We'll see what the MRI says tomorrow--probably nothing.

Heather

[Brad]

Heather, I had my first surgery to check out the massive Baker's cyst in my right knee.   They went in to remove the cyst and find the problem. I had torn the articular cartilage on the back side of the patella and on the Medial condyle on the femur.  
I then fell three months post op from my second surgery and twisted my left knee.  I have since had flare up' s with that knee and the MRI showed a Meniscal cyst, a  small meniscal tear, a possible tear in the articular cartilage and a baker's cyst.   But I am on a waiting list for a Osteochondral allograft, and I will have to have it done before we think about the left knee.  
If it is causing that much pain, I would personally push strongly for a exploratory scope, if it had been bothering me very long.  Especially at four months.   At first with my left knee, my OS was reluctant  to do an MRI as he again had no physical indication other than the cyst.  He was hoping it was sympathy pain.
Like I said before I had no indication of a tear or damage of any kind on the first MRI.  And although the OS thought I had possibly torn the menicus he had no physical proof through examination.  And it was something else completely.  Of course the right knee was very swollen (added like 3 or 4 inches), I thought the skin was going to ripe.  So it was very hard to do an examination.

Good luck with your MRI.  

[rosewilson]

hi
they say i have a baker cyst and a patlla in stable
problem i feel like you .i wanted to knock my os out too he said if i did a mri on evryone in my waiting room they have a bakers cyst too...back of mind to the moon with you
i have pain in the same area and i can tell you when it rain or if its cold.i start pt next week i like to see a new os but my insurance is messy.good luck to you
rose

[jeerdh]

Hi,

I developed a Baker's Cyst behind my left knee  8-03.  I could not believe the pain and it eventually radiated to my lower back as well.  Both my knees needed full TKR's and I had a left TKR 1-15-04.  Naturally, the Baker's Cyst is gone and the relief is immense.  Just wanted you to know I empathize with the pain you are experiencing.

Jude

[belladaisygirl]

Hello everyone,

New to the boards and just today was diagnosed with a bakers cyst by my orthopedist.  I noticed a bulge a few months ago, but no pain.  Since then I have sort of made  a joke of my "tumor", thinking it was a cramping muscle, something similar to a "charlie horse".  

Well, after reading up on the 'net, I'm now a little afraid of what it means.  I am scheduled for an MRI in about a week to see if there is a tear in the miniscus.  I have never had surgery and always try to avoid it at all costs...

I am an avid runner and cyclist... just wondering if anyone has had a baker's cyst that has ruptured and could give some advice.... does physical exercise "provoke" it to burst?  Has anyone had one drained successfully (without recurrence)?

Now that I think back to my track and soccer days in high school, I think I may have had it then too, but never gave it much thought...

any info would be appreciated!

thanks  

     

[Heather M.]

Here's an article I found today on cysts around the knee area.

Usually there is little point in aspirating a popliteal or Baker's cyst, because unless the underlying problem is addressed, it will just come back.  The concensus seems to be that the pain is not from the cyst itself, but rather from the condition that causes the cyst.

http://www.emedicine.com/orthoped/topic386.htm

Heather

[libertynm]

Thanks for the article, Heather!  That was very informative.

[gkwdcaw]

Hello Everyone:
I was diagnosed back in November 19, 2004. Had no knee problems untill early October. Regular films showed nothing wrong with my knee.  When I had  the MRI and got the report my Doctor booked an appointment to see an orthopeadic surgeon. Saw this doctor on Friday just passed.
Be basically told me that they would not take it out. I have been on short term disabillity since August. First I had sever laryngitis and no voice at all for almost 6 weeks, then I was diagnosed with Hypothyroidism...
Ok will stop rambling.. the just of this is that most doctors really don't think Bakers Cyst need alot of attention. I was told alot of folks had them and they will come and go.  Mine ruptured sometime before the MRI, had alot of pain and then my left leg began to swell.  I have a very high tolerance for pain, if I know it will end, but this pain just keeps on going...after the MRI which said there was a moderate to large bakers cyst that he thought had ruptured and could do so again. I had a doppler ultrasound about 1 month ago and the cyst was not leaking at all.
I am trying physio starting this week, but if that doesn't work the ortho doc I saw in Edmonton says I will just learn to deal with it.
If I wanted plastic surgery, tummy tuck, breast reduction,  that would be no problem, but can't  find anyone to remove the cyst, the only thing that will  cure this problem for good.
Thanks
Fed up with the runaround

[stgiles16]

Have you tried just going to a general surgeon? That is who I went to with my second cyst. The first one burst and it was incredibly painful so when another one came up, I had it cut out by a general surgeon. He did it right there in his office with a local anth. Give that a try before you give up.,
good luck
missy

[BleuChick]

So it's pretty much been established that doctors generally "give you the runaround" when it comes to Baker's Cysts. My own GS always dismisses me when I complain about them, and part of me is hesitant to take those complaints elsewhere lest I have to undergo some sort of surgery... (My sister had knee surgery on both knees so I really don't want to go there, having seen what it can be like.)
I have to say that it feels like even the websites that purportedly provide one with information on the condition come off as 'it's just baker's cysts'. A definitive answer is nearly non-existent it would seem. I for one have been dealing with this problem in both of my knees and have suffered a great deal as a result. As a member of a scheme for young people (http://www.intaward.org/IAA/index.aspx)which involves, among other things, a required number of hikes (up to four days each, in less than ideal conditions for my knees- mountain ranges anyone?), I have basically refused to let the pain get the best of me, though my knees will swell at the drop of a hat, and I have done equal amounts of probable damage to both knees (my right knee was the more problematic one, but putting increased pressure on my left knee has left it in a similar state). I'm also paying for it in that the swelling has recently caused substantial pain (dare I even say agony) because of the fact that the veins in my ankles have started to swell (oh so painfully!) subsequent to swelling behind my knees. I'm now beginning to consider the immensely probable eventuality of surgery of some sort, since I'm sure something is banged up really badly in both my knees. Alas.
So now that I've told you all my life story, I'd just like to hear from others who've had experiences with Baker's cysts if the recent developments should be seen as causes for concern. I'm watching for warning signs right now (especially since I have a hike on the 24th of this month!) and last night I was given reason to worry when I woke up with a cramp in my right leg and all day today have had similar cramps in both legs, with pretty bad swelling in both knees. (Haven't even done anything in the past week or more to aggravate them, which means that this is pretty much out of the blue pain and cramps).
Oh, and I was wondering if anyone else have problems stretching their calves because of the pain in their knees when they extend them?
And also, my brother has baker's cysts as well but he works out in the gym religiously and he says that he doesn't have any problems with them anymore because of the strengthened thigh muscles... Any opinions on this?

[AndrewC]

Hi there

I have a large bakers cyst behind my knee that appeared after I injured myself playing football......where I unfortunatley tore my lateral meniscus in a big way. I had surgery to repair it and this cyst developed soon after.
It does cause me an achy pain but I have seen two surgeons about the fact my knee is not 100% fully yet (about 85-90% some days!) and they have both said

Forget the bakers cyst. It is a result of an underlying problem. NOT the cause. We need to scope your knee, fix the problem adn the bakers cyst will dissapear on it's own accord

So in short...I think you should definately see an OS and if required have a scope to see what the cause of teh cyst (s) is.

Good Luck

[Run262]

Andrew,

Did I read your statement right in that you said you developed your cyst AFTER your meniscus repair?

[AndrewC]

Hi Run262

Sorry for the big delay in reply! I only just saw your post...

Yes..thats right...I developed the cyst after my repair...though it could apparently be from fluid trapped in this area after the meniscus was healed up..... although I have been told the more likely scenario is that the meniscus still has a small tear in it

I hope and pray this is not the case though....
Good Luck

[kelly19819]

hi all i am 23 and have suffered with knee problems for 14 years this year i have hyper mobile joints and osgood shaltters in both my knees. a week ago i had what my doctor suspected was a dvt blood clot on my left thigh. how ever tests with the dvt nurses and doctors showed that it wasnt a dvt but in fact a burst bakers cyst that had caused my calf to swell up and go hard cos of the fluid and that out of the cyst i had no idea i had one and all i did was strighten my leg the night before when it burst. my os has got me using a tens machine to try and ease the pain unfortunatley there isup too 10 months waiting list for one.the reaso i am using one is on the same leg a lump type swelling had been found on my ankle and i have had to have been put in a plaster cast on that ankle for 4 weeks and i am not alowed to put weight through it. but hte pain i am still getting in my calf and the burning is very uncomforable so i kno how you are felling

[jillsibley]

   hi ,can someone please tell me if they have pain like cramp in the calves of there legs, I have been told that I have bakers cyst in the knees, can someone please help?




Thanks jill, London

[floryed]

All,

I got a baker's cyst after ortho surgery.  It started as plica sydrome on my right medial/inside part of the knee.  Plica syndrome is an oveworked tendon that gets shredded and hardens.  I had NO swelling, or issues other than burning some burning on the inner part of the knee, or where the two knees meet when you put your legs together, but very close to the skin as you could feel the heat after a good ride/repetitive motion of 10 miles, as I'm a cyclist and runner.  Prior to this, I could ride 100 miles in a day.  Anyway, I went to see the best sports surgeons in Chicago, and I was told that I needed surgery.  I should have rested it for a few months, but I wanted to get it taken care of.  Anyway, the surgery was to scrape the hardened stuff off, and check the rest of the knee.  There was NOTHING else wrong with my knee.  In fact, the doctor said that it was in great shape.  Went to therapy, and then started riding slowly.  I was good for about 6 months, and then I started to get pain in the back of my knee with swelling...a baker's cyst.  This was the first time my knee ever swelled.  It got worse the more I rode, and it eventually swelled the whole knee.  I stopped the riding but the swelling was so bad that it burst.  I know it broke in the back where the cyst was the biggest.  Back to the doctor, he sent me for more therapy.  By the way; all the swelling was gone in the knee right after the cyst broke, all the fluid went into my calf where it was sore for a month.  After two months of therapy, my calf went down, and my knee looked okay. 

I started back riding and would have pain on the inner part of the knee.  I went back to the surgeon and told him, and he said not to worry, and to just keep working it.  I kept working it, and it swelled again.  I stopped before it got too bad.  The swelling went down on it's own, but I was left with the baker's cyst.  I went back to the surgeon, and he said not to worry, and to push it.

I started riding again, only this time I had no pain, but the cyst was there.  The cyst got bigger and bigger.  I went to see the surgeons in Chicago again telling them I thought that I had a meniscus tear.  Went for MRI, and nothing.  They decided that I probably had a tear, so they did ortho surgery again.  They found NOTHING wrong with my knee, except for the baker's cyst.  They made the drain hole bigger as they said the fluid was getting stuck, and couldn't drain back into the knee, so that's why it kept getting bigger.

It's been 7 weeks since the surgery, and the cyst is still there, but much smaller.  I got a steroid injection yesterday, and was told that in two weeks I can start riding very easily.  If the cyst starts hurting, or gets bigger, than they will have to remove it.

My original question to them is; if there's nothing wrong with my knee, and they did the surgery to prove it, than why did I/do I have a backer's cyst?  The doctor told me it was because I am a fanatic about riding, but what I think is this;  When I had the first ortho surgery, it stretch the knee capsule.  Now that capsule is stretched, and getting in the way of tendons, muscles, etc., and it is causing inflamation, and pain, and because it is stretched, it is easy to build up fluid in part of the stretched capsule and form a baker's cyst.  Now the only way to get rid of it, is to have them cut out the cyst, or effectively remove the hanging/stretched capsule.

Of course the surgeons won't admit to this, and I'm no professional, but what else could it be?  If my knee is good, than what else?  Any thoughts?

[kristianfraser]

I have had a similar situation to you.  Did you get it figured out?  I just had surgery to remove a cyst behind my knee on September 7, 2012, now nearly 3 months later I have a new bigger cyst on the side of me knee near the hamstring tendon.