bakers cysts

Question 1

what is vouchers sign?

Answer 1

On examination, the lump will be most apparent when the patient stands with their knees fully extended.

The lump will get smaller or disappear when the knee is flexed to 45 degrees (Foucher’s sign).

Question 2

why might someone with a bakers cyst get oedema?

Answer 2

Oedema may occur if the cyst compresses the venous drainage of the leg.

Question 3

how will a ruptured bakers cyst present? and what is a complication to be aware of?

Answer 3

Ruptured Baker’s cyst causes inflammation in the surrounding tissues and calf muscle, presenting with:

Pain
Swelling
Erythema
A ruptured Baker’s cyst can rarely cause compartment syndrome.

Question 4

what is a key differential to exclude with bakers cysts?

Answer 4

A critical differential diagnosis of a ruptured Baker’s cyst is a deep vein thrombosis (DVT).

Question 5

what are differential for a lump in the popliteal fossa?

Answer 5

Deep vein thrombosis 
Abscess
Popliteal artery aneurysm
Ganglion cyst
Lipoma
Varicose veins
Tumour

Question 6

what is the cause of bakers cysts?

Answer 6

Baker’s cysts are usually secondary to degenerative changes in the knee joint. They can be associated with:

Meniscal tears (an important underlying cause)
Osteoarthritis
Knee injuries
Inflammatory arthritis (e.g., rheumatoid arthritis)

Question 7

how might a patient with a bakers cyst present?

Answer 7

Pain or discomfort 
Fullness
Pressure
A palpable lump or swelling
Restricted range of motion in the knee (with larger cysts)

Question 8

which investigations would you preform to investigate a bakers cyst?

Answer 8

Ultrasound is usually the first-line investigation to confirm the diagnosis. It is also used to rule out a DVT.

MRI can evaluate the cyst further if required, for example, before surgery. They can also demonstrate underlying knee pathology, such as meniscal tears.

Question 9

what are non surgical management of a bakers cyst?

Answer 9

Modified activity to avoid exacerbating symptoms

Analgesia (e.g., NSAIDs)

Physiotherapy

Ultrasound-guided aspiration

Steroid injections

Question 10

what is surgical management of a bakers cyst

Answer 10

involves arthroscopic procedures to treat underlying knee pathology contributing to the cyst, such as degenerative changes or meniscal tears.

Resection of the cyst is difficult, and the cyst is likely to recur, particularly when another knee pathology is present.