One of the biggest fears of parents is when a lump appears on the body of our children, in this case on the knees. We talk about Baker's cyst, let's get to know it.
A Baker's cyst (popliteal cyst) is a fluid-filled pocket that forms behind the knee. This makes your knee feel tense and sore. These cysts are very common and can be caused by anything that inflames your joints, including arthritis.
Generally in young children, other symptoms such as stiffness or local pain are not observed, although in adolescents they do occur. The mass increases in size when the knee is fully extended and disappears when the knee is flexed. The dough is hard, firm and can be sensed by placing a strong light on the dough, showing the presence of liquid material.
It is extremely important to carefully review the knee joint in children, in order to look for signs of sub-dislocation or early osteoarthritis.
The mechanism by which it occurs is not clearly known. It seems to be related to the development of the knee, but unlike the adult, its presence does not reflect any type of alteration in the knee joint.
It can be caused by the distension of bags filled with gelatinous fluid from the tendon sheath in the back of the knee, although it can sometimes originate from the joint itself.
- Swelling appears in the area behind the knee. The swelling is caused by the fluid that forms the cyst and which in turn causes inflammation in the area. This swelling looks like a lump on the back of the knee and is best seen when standing with the knee straight.
- Some tension is detected behind the knee. When fluid builds up in cysts, it puts pressure on the back of your knee. It usually feels like your knee is about to explode, especially when standing with your leg straight; that is, when the skin around the knee is fully stretched and the feeling of tension is felt.
- Control of stiffness around the knee. Stiffness differs from tension in that if your knee is stiff, you will feel a lot of discomfort when bending it. On the contrary, with tension, your knee will feel like a water balloon about to burst. Your knee may feel stiff because the cyst causes the knee muscles and joints to swell, making it stiff.
- Pay attention to any pain you feel in the back of your knee. When the cyst puts pressure on the nerves behind the knee, you will definitely feel pain when you move your knee a lot.
The diagnosis is made when the child is examined, the mother reports that on certain occasions, especially after physical activity, it is larger, when getting up it is small and increases in size during the day. These cysts They are often discovered accidentally by parents, for example after a child's knee bruise.
The best way for parents to see it is with the child lying down and the knee stretched out, showing a prominence in the innermost part of the back of the knee that does not appear in the other healthy knee. In general, physical examination is sufficient to diagnose Baker's cyst.
In case the cyst is large, causes pain or has grown rapidly, it should be studied with an imaging test. Computerized axial tomography (CT) and Nuclear Magnetic Resonance (NMR) will clearly indicate if the cyst has liquid density, define the relationship with the rest of the structures and guide on the thickness of the cyst wall.
In general, an ultrasound is recommended, which confirms the diagnosis and measures the size of the cyst.
The initial treatment is observation, since the cyst generally tends to disappear, the pediatrician must explain to the parents the nature of the lesion and that there is no possibility of malignancy, in research it has been determined that about 80% of cysts disappear within 2 to 3 yearsIn the event that the mass grows significantly, limits the child's activity or begins to present pain, the surgical indication is not open to discussion. It is not recommended to aspirate the cyst or the infiltration with steroids because with these techniques it always tends to reproduce.
If it causes pain in the mobility of the knee, the pediatrician may suggest taking an anti-inflammatory or analgesic to relieve the pain or acute discomfort.
You can read more articles similar to Knee problems in children: Baker's cyst, in the category of Orthopedics and on-site traumatology.