Puncture of the Baker cyst
The puncture of a Baker’s cyst is a frequently used method of treating the disease. The treating physician inserts a needle into the Baker cyst and removes the fluid it contains. However, the withdrawal of the fluid alone rarely has the promised effect, as the inflammation responsible for the cyst is still present and a renewed filling of the cyst is therefore likely.
There are several possibilities which can prevent the recurrence of the cyst. For example, there is the possibility that anti-inflammatory drugs taken orally can treat the inflammation in the knee joint. The second possibility is to flush the previously drained cyst with cortisone.
Cortisone is anti-inflammatory and can thus also prevent the cyst from recurring. A bandage which is placed around the knee joint after the puncture can also ensure the success of the puncture. The puncture of a Baker’s cyst is not without risks and should only be performed after a detailed medical consultation.
The puncture itself should not be understood as a healing measure but as a symptom-relieving intervention. The Baker’s cyst is usually congenital in children and can reach the size of a hen’s egg. Above a certain size, children are eventually restricted in their freedom of movement and feel pain, especially when bending the knee joint.
A puncture can be used to prevent the cyst from becoming trapped. Depending on the age of the child, the minimally invasive procedure can be carried out under local anaesthesia or under a short anaesthetic, as the children should lie still and not find the procedure frightening. A suitable puncture needle is used to puncture above the palpable cyst and the fluid content is sucked out with a syringe.
As the contents of the cyst have now been removed, the discomfort, especially a restriction and entrapment in the flexion of the knee, rapidly diminishes, but a renewed development of a cyst is still very likely. Therefore it is necessary to treat the causative disease. While in adults, a Baker’s cyst usually develops due to a degenerative joint disease, Baker’s cysts in children often develop without any apparent cause.
In most cases, a weakness of the connective tissue at the affected site favours the development of the cyst in children. Furthermore, inflammatory diseases, which sometimes occur in childhood, can be responsible for the development of a baker’s cyst. Especially when joint effusions occur in the course of an inflammation, the development of a Baker’s cyst is likely to occur in the course of the disease.
An ultrasound diagnosis should be performed to exclude other diseases. The therapy of a Baker’s cyst in a child is less complex than in adults, because the cysts in children often disappear by themselves and therefore often no therapy is necessary. In some cases a puncture of the cyst may be necessary to relieve the joint and to restore a possibly restricted mobility. The surgical removal of the Baker’s cyst in children is rarely necessary.
