KNEE ARTHRITIS - Arthritic swelling and Baker's Cysts :

Baker's Cyst -- Need advice - - Posted by hmaxwell (Heather M.), 23 July 2002

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
Posted by khaoskat (khaoskat), 24 July 2002

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.

Posted by opal (opal), 25 July 2002

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
Posted by hmaxwell (Heather M.), 25 July 2002

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
Posted by badowns83 (Brad), 26 July 2002

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.  
Posted by rosewilson (rosewilson), 5 October 2003

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
Posted by jeerdh (jeerdh), 6 May 2004

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
Posted by belladaisygirl (belladaisygirl), 10 September 2004

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  

     
Posted by hmaxwell (Heather M.), 12 September 2004

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
Posted by libertynm (libertynm), 23 December 2004

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

Much aloha,
Nesanet

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