CARE OF ORTHOPEDIC

PATIENTS WITH
BAKER CYSTS
Made by :Mr. Eduard Francis Q. Luayon
  General Objectives
 At the end of my case presentation, the learners shall be able to acquire
enough knowledge regarding Baker's cyst and conduct a comprehensive case
study of illness/condition, and to provide a holistic care to patients diagnosed
with Baker's cyst through effective nursing care to the client by putting to use the
knowledge we have acquired.

 Specific Objectives
LEARNING Within an hour, the listeners will be able to:
OBJECTIVES  Define the terms and concepts related to the case of Baker's cyst.
 Identify the developmental data of the patient.
 Determine the disease process of Baker's cyst through its pathophysiology.
 Recognize the relevance of drug to the patient by obtaining familiarity and doing
drug studies on various medications.
 Present medications and its indications to be given to the patient with Baker's
cyst.
 Discuss the implications of the laboratory results of the patient with Baker's cyst.
 Create efficient nursing care plan based on actual high-risk of health need.
INTRODUCTION
WHAT IS BAKER CYSTS ?
 A Baker's cyst is a fluid-filled cyst that causes a bulge
and a feeling of tightness behind your knee. The pain
can get worse when you fully flex or extend your knee
or when you're active. A Baker's cyst, also called a
popliteal cyst, is usually the result of a problem with
your knee joint, such as arthritis or a cartilage tear.
Both conditions can cause your knee to produce too
much fluid, which can lead to a Baker's cyst. Although a
Baker's cyst may cause swelling and make you
uncomfortable, treating the probable underlying
problem usually provides relief
 In the mid-1800s, Dr. William Morrant Baker concluded that these
popliteal cysts resulted from fluid flowing out from a damaged
knee joint. When structures in or around the joint are damaged,
your knee produces extra fluid that can only flow one way so it
forms a cyst on the back of your knee.
CLASSIFICATIONS OF BAKER
CYSTS
 Primary Baker cyst it may develop just behind an
otherwise healthy knee joint. This type of cyst is
sometimes referred to as a primary or idiopathic
Baker's cyst. It usually develops in younger people and
in children. It is thought that in this type of Baker's cyst
there is a connection between the knee joint and the
popliteal bursa behind the knee. This means that
synovial fluid from inside the joint can pass into the
popliteal bursa and a Baker's cyst can form.
 Secondary Baker Cyst. It can develop if there is an underlying
problem within the knee, such as arthritis or a tear in the meniscal
cartilage that lines the inside of the knee joint. This type of Baker's
cyst is the most common. It is sometimes referred to as a
secondary Baker's cyst. In a secondary Baker's cyst, the underlying
problem within the knee joint causes too much synovial fluid to be
produced within the joint. As a result of this, the pressure inside
the knee increases. This has the effect of stretching the joint
capsule. The joint capsule bulges out into the back of the knee,
forming the Baker's cyst that is filled with synovial fluid
  The knee is made of bone, tendons, and cartilage. The
tendons and cartilage need lubrication, which they get
from synovial fluid – it helps the legs move smoothly
and reduces friction. There are various pouches, called
CAUSES OF bursae, in each knee, through which the synovial fluid
BAKER circulates.
CYSTS  Between the popliteal bursa – a pouch at the back of
the knee – and the knee joint, there is a valve-like
system that regulates the flow of synovial fluid.
  If the knee produces too much synovial fluid, there can be an accumulation of it in the
popliteal bursa.This can be caused by an inflammation of the knee joint, usually due to an
underlying condition, such as:
 Gout – levels of uric acid in the blood rise until the level becomes excessive (hyperuricemia),
causing urate crystals to build up around the joints. This causes inflammation and severe
pain.
 Hemophilia – an inherited medical condition where the blood does not clot properly,
CAUSES OF leading to internal bleeding and joint damage.
 Lupus – an autoimmune disease where the body’s immune system attacks normal, healthy
BAKER tissue.
 Osteoarthritis – a form of arthritis caused by inflammation, breakdown, and the eventual
CYSTS loss of cartilage in the joints – the cartilage wears down over time.
 Psoriasis – some patients also experience pain and inflammation in their joints.
 Reactive arthritis – a chronic (long-term) type of arthritis with inflamed joints,
inflammation of the eyes, and inflammation of the genital, urinary, or gastrointestinal
system.
 Rheumatoid arthritis – an inflammatory form of arthritis.
 Septic arthritis – joint inflammation caused by a bacterial infection.
 Injury – injury or trauma to the knee, such as a cartilage tear, can lead to a Baker’s cyst; they
are common among athletes
 You may not feel any pain with a popliteal cyst. In some cases, you
may not notice it at all. If you do experience symptoms, they might
include:

What are the  mild to severe pain

 stiffness
symptoms of
 limited range of motion
a baker cyst?  swelling behind the knee and calf
 bruising on the knee and calf
 rupturing of the cyst
  Individuals with the following conditions are at greater risk of
Risk Factors developing a Baker’s cyst:
for a Baker’s  Torn meniscus
 Knee arthritis (including rheumatoid arthritis and osteoarthritis)
Cyst
 Knee joint injury
  In rare cases, a Baker cyst may cause complications. The cyst may
enlarge, which may cause redness and swelling. The cyst may also
rupture, causing warmth, redness, and pain in your calf.
 The symptoms may be the same as a blood clot in the veins of the
What are legs. Your healthcare provider may need imaging tests of your leg to
make sure you don’t have a clot. Rupture can also lead to its own
possible complications, such as:
complications  Trapping of a tibial nerve. This causes calf pain and numbness behind
the leg. It can be treated with arthrocentesis and steroid injections.
of a Baker  Blockage of the popliteal artery. This causes pain and lack of blood
cyst? flow to the leg. It can also be treated with arthrocentesis and steroid
injections.
 Compartment syndrome. This causes intense pain and problems
moving the foot or toes. Compartment syndrome is a medical
emergency. It needs immediate surgery. It can lead to permanent
muscle damage if not treated right away.
 A Baker's cyst can often be diagnosed with a physical exam.
However, because some of the signs and symptoms of a Baker's cyst
mimic those of more-serious conditions, such as a blood clot,
aneurysm or tumor, your doctor may order noninvasive imaging
Diagnosis tests, including:
 Ultrasound
 X-ray
 Magnetic resonance imaging (MRI)
 Often, your healthcare provider will suggest that you start with a
nonsurgical treatment of your Baker’s cyst. These are generally
things you can do at home and on your own that can improve your
symptoms.

Nonsurgical  Nonsurgical treatment options can include the RICE method:

 Resting your leg whenever possible.
treatment.  Applying ice to your knee.
 Using compression wraps on your knee to decrease the amount of
joint swelling.
 Elevating your knee while you are resting.
 Even though surgery is rarely used to treat a Baker’s cyst, there are
some cases where surgery might be recommended. Surgery may be
Surgical used to repair the source of your knee damage.
 Your provider might suggest a surgical option to you if:
treatment.  Your knee pain is severe.
 You’re unable to move your knee well (limited range of motion).
  In many cases, your provider will treat the cause of your condition
in order to fix your Baker’s cyst. This might involve surgery for a
knee injury or to correct damage to your knee. In other cases, your
provider might focus on the cyst itself. Surgical options for Baker’s
cysts can include:
 Cyst draining: Your healthcare provider can drain the fluid out of
Surgical the cyst with a needle.
treatment.  Arthroscopic Knee Surgery: This procedure can be used to both
diagnose and correct knee damage. Your surgeon will make a
small cut in your knee and insert a device called an arthroscope (a
flexible tool with a camera on the end). This is also called knee
scoping.
 Knee Osteotomy: In this procedure, your surgeon cuts part of the
bone in order to correct damage to your knee. This surgery can be
an option for those with arthritis knee pain.
ANATOMY AND PHYSIOLOGY
SKELETAL SYSTEM
 The skeletal system includes all of the bones and joints in the
body. Each bone is a complex living organ that is made up of many
cells, protein fibers, and minerals. The skeleton acts as a scaffold
by providing support and protection for the soft tissues that make
up the rest of the body.
 The skeletal system also provides attachment points for muscles
to allow movements at the joints. New blood cells are produced by
the red bone marrow inside of our bones. Bones act as the body’s
warehouse for calcium, iron, and energy in the form of fat. Finally,
the skeleton grows throughout childhood and provides a
framework for the rest of the body to grow along with it.
  Besides contributing to body shape and form, our bones perform several
important body functions.
 Support. Bones, the “steel girders” and “reinforced concrete” of the body,
form the internal framework that supports the body and cradle its soft
organs; the bones of the legs act as pillars to support the body trunk when
we stand, and the rib cage supports the thoracic wall.
Functions of  Protection. Bones protect soft body organs; for example, the fused bones
of the skull provide a snug enclosure for the brain, the vertebrae surround
the Skeletal the spinal cord, and the rib cage helps protect the vital organs of the thorax.
System  Movement. Skeletal muscles, attached to bones by tendons, use the bones
as levers to move the body and its parts.
 Storage. Fat is stored in the internal cavities of bones; bone itself serves as
a storehouse for minerals, the most important of which are calcium and
phosphorus; because most of the body’s calcium is deposited in the bones
as calcium salts, the bones are a convenient place to get more calcium ions
for the blood as they are used up.
 Blood cell formation. Blood cell formation, or hematopoiesis, occurs within
the marrow cavities of certain bones.
Anatomy of  The skeleton is subdivided into two divisions: the axial skeleton,
the Skeletal the bones that form the longitudinal axis of the body, and the
appendicular skeleton, the bones of the limbs and girdles.
System
  The adult skeleton is composed of 206 bones and there are two basic types
of osseous, or bone, tissue: compact bone and spongy bone, and are
classified into four groups according to shape: long, short, flat, and irregular.
 Compact bone. Compact bone is dense and looks smooth and
homogeneous.
 Spongy bone. Spongy bone is composed of long, needle-like pieces of bone
and lots of open space.
Classification  Long bones. Long bones are typically longer than they are wide; as a rule,
of Bones they have a shaft with heads at both ends, and are mostly compact bone.
 Short bones. Short bones are generally cube-shaped and mostly contains
spongy bone; sesamoid bones, which form within tendons, are a special
type of short bone.
 Flat bones. Flat bones are thin, flattened, and usually curved; they have two
thin layers of compact bone sandwiching a layer of spongy bone between
them.
 Irregular bones. Bones that do not fit one of the preceding categories are
called irregular bones.
Bones of the  The lower limbs carry the total body weight when we are erect;
hence, it is not surprising that the bones forming the three
Lower Limbs segments of the lower limbs (thigh, leg, and foot) are much
thicker and stronger than the comparable bones of the upper
limb.
 Thigh
 The femur, or thigh bone, is the only bone in the thigh; it is the heaviest,
strongest bone in the body.
 Parts. Its proximal end has a ball-like head, a neck, and greater and lesser
trochanters (separated anteriorly by the intertrochanteric line and
posteriorly by the intertrochanteric crest).
 Gluteal tuberosity. These markings and the gluteal tuberosity, located on
the shaft, all serve as sites for muscle attachment.
 Head. The head of the femur articulates with the acetabulum of the hip bone
in a deep, secure socket.
 Neck. However, the neck of the femur is a common fracture site, especially
in old age.
 Lateral and medial condyles. Distally on the femur are the lateral and
medial condyles, which articulate with the tibia below; posteriorly these
condyles are separated by the deep intercondylar fossa.
 Patellar surface. Anteriorly on the distal femur is the smooth patellar
surface, which forms a joint with the patella, or kneecap.
 Leg
 Connected along their length by an interosseous membrane, two bones, the
tibia and fibula, form the skeleton of the leg.
 Tibia. The tibia, or shinbone, is larger and more medial; at the proximal end, the
medial and lateral condyles articulate with the distal end of the femur to form
the knee joint.
 Tibial tuberosity. The patellar (kneecap) ligament attaches to the tibial
tuberosity, a roughened area on the anterior tibial surface.
 Medial malleolus. Distally, a process called medial malleolus forms the inner
bulge of the ankle.
 Anterior border. The anterior surface of the tibia is a sharp ridge, the anterior
border, that is unprotected by the muscles; thus, it is easily felt beneath the skin.
 Fibula. The fibula, which lies along the tibia and forms joints with it both
proximally and distally, is thin and sticklike; the fibula has no part in forming the
knee joint.
 Lateral malleolus. Its distal end, the lateral malleolus, forms the outer part of
the ankle.