Severe calf pain with evidence of Baker's Cyst in the MRI

Patient

Q: I have been having severe calf pain for several weeks. I went to the doctor several times who performed an MRI and said that it was a Baker's cyst and not a DVT. Recently the pain moved to my thigh and now I'm having pain in my back; could his diagnosis be incorrect? It's been a week since the last MRI.

Doctor

A:   .Once that DVT was ruled out then, the most common mass that may produce pain and numbness in the popliteal fossa (the region behind the knee) is the Baker cyst, 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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