Bakers Cyst 727.51

synonyms: Bakers cyst, popliteal cyst

Bakers Cyst ICD-9

• 727.51 (synovial cyst of popliteal space)

Bakers Cyst Etiology / Epidemiology / Natural History

• Common synovial cyst in the knee

Bakers Cyst Anatomy

• Generally located between the semimembranosus and medial head of the gastrocnemius.
• The popliteal bursa communicates with the knee joint and can become cystic with synovitis, arthritis, meniscal tears or trauma which increase the jiont fluid in the knee.

Bakers Cyst Clinical Evaluation

• Swelling of fullness in the popliteal fossa . Often have posterior knee pain and tenderness.
• Cysts often change in size
• Large cysts may track into the calf. Acute rupture of large cysts may cause severe calf pain and swelling similar to a DVT.
• Document neurovascular exam, especially in large cysts which have potential to compress the neurovascular structures in the popliteal space.

Bakers Cyst Diagnositc Tests

• A/P and lateral views of the knee are generally normal or demonstrate arthritic changes. Evaluate for calcifications in the cyst.
• MRI: demonstrates increased signal on T1 and T2 weighted images.

Bakers Cyst Classification / Treatment

• Asymptomatic cysts or minimally symptomatic cysts can be observed. Symptomatic cysts are best treated with treatment of the underlying cause (meniscal tear, arthritis). Cyst aspiration generally not recommended due to proximity of neurovascular structures, high recurrence rate and limited ability to aspirate gelatinous cyst fluid.
• Cysts associated with meniscal tears generally respond well to knee arthroscopy with meniscal repair or partial excision.
• Cysts associated with advanced arthritis generally respond well to TKA.
• Cyst excision rarely indicated.
• Ruptured Popliteal Cyst: NSAIDs, activity modifications, elevation

Bakers Cyst Associated InjuriesBakers Cyst / Differential Diagnosis

• DVT
• Exertional compartment syndrome
• Gastrocnemius strain or tear
• Tumor
• Arthritis
• Superficial phlebitis
• Ganglia of the cruciate ligaments: may limit flexion and extention. (Deutsh A, Arthroscopy 1994;10:219), (Brown MF, Arthroscopy 1990;6:322).

Bakers Cyst Complications

• Cyst rupture

Bakers Cyst Follow-up Care

• As indicated for underlying pathology (meniscal tear, arthritis)

Bakers Cyst Review References