Inujred knee, still pain after a month, possible baker cyst


Q: My girlfriend fell and injured her knee. She thought it would just heal on it's own. After three weeks it seemed to get worse; at least the pain did. So, I took her to the hospital. They did an xray and an ultrasound. They determined it was not a break/fracture and that she didn't have a blood clot. After the injury my girlfriend developed a bump on the back of her knew, which she looked up and figured it was a baker cyst. She mentioned it in the ER and they said they didn't see a baker cyst. They told her she need to see a Orthopedic doctor. She scheduled an appointed and went to see him. He concluded that it was a bad contusion. She forgot to mention the bump on the back of her knee and he never checked. Now, my questions is, would a baker cyst represent a worse injury than a contusion or can a contusion cause a baker cyst? Also, if it's not a baker cyst could it be something else? The doctor also gave her a cortisone shot and told her to do some exercises. She doesn't have insurance. Thanks for the help.

Symptoms:  Pain when she walks and when she bends her leg. Stiffness while trying to bend her knee. Knee bends to a certain point and then too painful to go any further.

A:   Thank you for posting your query on ATD.
A Baker's cyst is a benign swelling in the knee. It usually occurs at the back of the knee and between 2 muscles. One muscle is on the top of the knee and one muscle is below the knee.

The cyst is also benign and does not need much medication. Also, since I cannot confirm that you have a Baker's cyst, I think it is best to try home remedies and general strategies to reduce the swelling. If this is not a Baker's cyst, then it would most likely be a soft tissue injury.

Here are a few things you can try which will help in both cases:
Rest the knee and avoid walking as much as possible. A gentle massage will help as well
Ice the area of the swelling for 15 minutes at a time every hour
Start on Analgesics like Ibuprofen 2 times a day to help you with he swelling.
Try this for 5 days, and feel free to follow up.

All the best and hope this helps you.

Comments / Follow Ups

Patient: Thanks for your reply. Does a contusion reduce the flexibility/mobility of a knee? What about a Bakers Cyst? Her knee can not bend with ease or to the degree of her other knee. Also, How safe is it to continue taking ibprophen and Tylenol for over a month and more until this heals? Thank you for your help.
Doctor: Thank you for the follow up.

It is a little complicated to take NSAIDs for over a month. They have serious side effects and it is better if you start with icing of the knee and hot compresses.

Follow the RICE regimen:
Rest the knee and use a crutch if needed
Ice the knee for 15 mins every hour
Compress using a knee sleeve or a crepe bandage
Elevate the knee to allow blood to flow back to the heart

Also, you are correct in saying that the knee will have restricted movement and this is not something you should
worry about too much. As there is a progressive reduction in the swelling, the movement will become better.

All the best.

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