Case study: Baker’s cyst – Injection
A 64-year-old man presented with persistent right knee pain that has been bothering him for the past 6 months. He described a growing discomfort in the anteromedial and posterior regions of his knee, especially when standing. His primary symptoms included morning stiffness and a noticeable decrease in his knee’s range of motion. Notably, there were no previous instances of knee-related trauma or interventions. The pain tended to ease with rest, but he found only minimal relief from NSAIDs.
Physical examination
- Anterior and posterior knee swelling
- No redness
- Visible quadriceps wasting
- Palpable crepitus on flexion and extension of the knee
Ultrasound findings
- Effusion of the suprapatellar recess: Suggestive of joint effusion with minimal synovial thickening
Axial view of the suprapatellar recess showing an effusion.
- Effusion underneath the tibial attachment of the patellar tendon: Suggestive of deep infrapatellar bursitis
Long axis view of the patellar tendon showing effusion underneath its tibial attachment.
Short axis view of the patellar tendon showing effusion underneath its tibial attachment.
- Septated cystic appearance in the posterior knee: Baker’s cyst
Axial view of the posterior knee showing a septated Baker’s cyst.
Diagnosis
The patient was diagnosed with a Baker’s cyst secondary to osteoarthritis of the knee. Baker’s cysts, also known as popliteal cysts, are fluid-filled swellings that develop at the back of the knee, frequently causing stiffness and discomfort. These cysts typically occur as a secondary condition to underlying knee issues (i.e., osteoarthritis or a meniscus tear), prompting the joint to generate excessive synovial fluid. Common symptoms encompass the presence of a lump, knee pain, and stiffness.
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