Thursday, May 19, 2011

Baker Cyst

Baker cyst is also called a popliteal cyst formation caused by the distension liquid fluidly gastrocnemio-exchange membrane. It is one of the formations encountered popliteal area.
Arthritis is the most common condition associated with Baker cyst.Although the prevalence of cysts in patients with inflammatory arthritis is higher than in those with osteoarthritis, osteoarthritis is more common than inflammatory arthritis.Cysts can occur in many forms around the knee. A cyst is defined as a closed cavity, or a bag covered with epithelium. May contain fluid or semisolid material, can be normal or abnormal, and can occur in soft tissue or bone. The masses must be differentiated from benign or malignant cystic lesions.
Determination of treatment depends on the individual patient and diagnosis. Noninterventional treatment, including limitation of activity and aspiration of the cyst, with or without steroid injection is a staple. Surgical therapy should not be the first option and not necessary in most cases.
Baker cyst pathogenesisA Baker's cyst is a ganglion cyst located posterior medial femoral condyle, between the tendons of the medial head of Gastrocnemius muscle and semimembranosus. Communicate often with joint capsule posteromediala front knee. Baker cyst is an extension of the knee joint, lined with synovium. They vary in size from 1-40 cm.Baker cyst may serve as a protective mechanism for the knee.Intrinsic intra-articular disorders cause joint effusion. Knee effusion cyst Baker is forced to reduce the pressure of the joint destructive potential.
His ball-valve mechanism theory proposed in which effusion is pumped from the knee joint cyst Baker and fibrin acts as a one-way valve that blocks fluid in the joint return. In Bunsen valve mechanism, proposed enlarged cyst Baker exert mass effect on the communication between cyst and joint, effusion incarcerated.Blocked fluid is resorbed by the semi-permeable membrane, leaving behind concentrated fibrin. This theory explains the difficulty thick cyst content aspiration.
Causes and risk factors:Baker cyst is thought to form by:Cyst primary idiopathic valvular connection with the joint.Memebranele bands synovial folds and valves are seen in all cases. Scarring and irritation cause these folds in primary cysts.Bands may be remnants of synovial tissue and joint cavity interposed between scholarship. Idiopathic cysts are seen in younger patients without symptoms. Their content is viscous.Secondary or symptomatic cysts, which communicate freely with the knee and contains synovial fluid of normal viscosity. Cyst occurs secondary joint disorders: osteoarthritis, rheumatoid arthritis, psoriatic arthritis, synovitis, meniscal tears and Chondromalacia of the patella.
Signs and symptomsBaker cyst is asymptomatic and symptomatic in young to older people with associated arthropathy. Clinical manifestations include palpation a painless or slightly painful popliteal mass. These symptoms may be associated intra-articular.Possible complications include cyst Baker: pseudotromboflebita, deep vein thrombosis, pulmonary embolism, hemorrhage, cyst rupture, infection, posterior compartment syndrome, calcified body incarceration. The most common complication is rupture or dissection of the cyst fluid in gastrocnemius muscle pseudoflebitic syndrome that mimics the symptoms of deep vein thrombosis. The incidence of fracture is 10%.
Due to the anatomical location of the cyst is a risk factor for deep vein thrombosis. Posterior compartment syndrome caused by trauma. Rarely, rupture of the cyst increases pressure in the rear compartment of the leg. Infected cyst is rare. Patients with fever, leukocytosis and elevated erythrocyte sedimentation rate.Calcified corpora may result from trauma by osteochondral fractures, arthropathy by surface disintegration, osteoarthritis, infection and neurogenic or condromatoza joint synovium. Distal migration of this body supports the diagnosis of cyst dissected.
Diagnosis of cyst BakerImaging Studies:Scanning scintigraphy radionuclide injected into the joint to visualize the cyst, rupture or crack and leak fluid or its dissection.Radiography detects soft tissue mass, calcifications Internal Displacement of atherosclerotic popliteal artery and impaired bone cyst printrun adjacent sea.Ultrasonography is helpful in assessing popliteal mass. The method is quick, easy, and it radiates not cheap. Determine if the table is purely cystic or complex structure with soft structure. Color Doppler study excludes the possibility of enlarged arteries, an aneurysm or cystic degeneration of adventicei.The differential diagnosis is made with the following conditions: deep vein thrombosis, arterial aneurysm, cystic degeneration adventiciala, benign or malignant tumor, lymph node cyst, meniscal cyst, traumatic fracture of the gastrocnemius.
TreatmentBaker cyst treatment is conservative and includes the use of steroids antiinflaamtorii, ice and reducing weight on the affected joint, joint disease associated with correction. Internal abnormalities of the knee can be treated by therapeutic arthroscopy. Total arthroplasty is reserved for severe osteoarthritis.Radioactive Sinoviorteza is used to treat inflammatory arthritis and hemophilia. Prior to this treatment should be performed to exclude a artrografie a Baker's cyst ruptured.

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