Pain on the backside of the right knee.

Patient

Q: Pain felt in the backside of the Right knee after sitting behind the wheel or in a chair for long periods of time. Very painful when I crouch down to check alignment on a putt. Long walks will aggrevate it. No noticable swelling. No pain when moving the knee cap up down or side to side. Any ideas?

Doctor

A:    Possibly you are experiencing problems with the hamstring muscles and you must do stretching exercises. The other option to rule out would be a Baker’s cyst which is the most common mass in the popliteal fossa (the region behind the knee), also called popliteal cyst. It results from build up or fluid distention of the calf muscles bursa. It usually communicates with the knee joint by way of a slit like opening at the posterior and inner aspect of the knee capsule just superior to the joint line. A Baker cyst may serve as a protective mechanism for the knee, when certain disorders cause joint effusion; this liquid is displaced into the Baker cyst, thus reducing potentially destructive pressure in the joint space. Arthritis is the most common condition associated with Baker cysts, with osteoarthritis probably being the most frequent cause. The treatment of Baker cysts is conservative and includes the use of no steroidal anti-inflammatory medications, ice, and assisted weight bearing, in addition to the correction of underlying intra-articular disorders. Internal derangements of the knee can be treated with therapeutic arthroscopy.

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