Arthritic Knee Can Cause Bulging Cyst

Q. I was diagnosed as having a Baker’s cyst swelling in the area behind my right knee. I was told that it’s from arthritis I have in the knees, but I have several friends with arthritis who have never had this happen to them. Why me? How is it best treated? - P.G., Pueblo, Colo.

A. What you’re describing doesn’t happen to everyone who has arthritis of the knee, but chronic inflammation of the knee joint is definitely the most common cause for it.

A Baker’s cyst, named after the British surgeon William Baker (1839-1896), is the result of a buildup of fluid whose job it is to bathe and lubricate the cartilage that cushions the upper bone in the leg (femur) and a bone in the lower leg (tibia).

If there’s knee trauma, or inflammation from rheumatoid arthritis or osteoarthritis, the cartilage is damaged in some way. That means that those two bones will tend to grind against each other due to a lack of adequate joint cushioning. The body attempts to deal with such irritation by making more joint fluid. When we get a blister because there’s too much wear on the skin or we get a burn, our bodies create a similar kind of protective fluid.

When there’s an excess amount of joint fluid produced as a result of inflammation, sometimes the joint lining known as the synovial space just can’t neatly contain it all.

What may happen next is that the joint lining balloons out at its weakest point. And that just happens to be into a space in back of the knee. This bulging Baker’s cyst of joint fluid can be quite painful; other times the swelling just gets in the way of being able to normally bend the knee.

The important point to realize about treating these cysts is that they occur because there’s swelling and inflammation at the knee. To simply remove the fluid with a needle won’t cure it, because the fluid will just tend to re-accumulate - that is, unless the knee joint inflammation is dealt with by getting off your feet, using anti-inflammatory pills, and receiving an injection of steroid into the knee joint and the cyst area. If that doesn’t work, sometimes surgery on the cyst and possibly the knee joint is what’s needed to get rid of the cyst once and for all.

Sometimes a Baker’s cyst may rupture, and that’ll cause quite a bit of pain and swelling behind the knee and in the calf. A person with a ruptured Baker’s cyst may have pain and swelling that resembles a leg clot. However, a sonogram of the leg or an MRI can tell the two apart. The other clue is that person would typically have a history of arthritis in that leg and a prior history of a cyst’s swelling in the area behind the knee.

Q. I recently saw an interview with actor Richard Roundtree, in which he revealed that he was diagnosed with breast cancer several years ago. I didn’t think that men get breast cancer. Just how common is it? Do men need mammograms too? - C.T., Eau Claire, Wis.

A. Breast cancer in men does happen, but its pretty rare. In 2000, the American Cancer Society estimates that about 1,300 men will be diagnosed with breast cancer, and 400 men will die from complications of breast cancer. These numbers account for less than 1 percent of the total number of folks who will be diagnosed and who will die from breast cancer this year.

Still, its important to recognize that breast cancer is not just a women’s issue.

In fact, men who are eventually diagnosed with breast cancer don’t have as good a prognosis because by the time a diagnosis of breast cancer is made, the tumor is larger and more advanced. When a man develops a breast lump, he’s probably not thinking that it could be a cancer. Many men are under the false impression that only women get breast cancer, so a lump is brushed off as a “fatty tumor” or “benign cyst or growth.” And men don’t get mammograms, so a man diagnosed with breast cancer may not have the opportunity to catch a tiny tumor too small to be felt on exam.

Still, its important to be aware of risk factors for developing breast cancer, especially one’s family history of cancer. And like women, men should get in the habit of examining their own body for changes. Folks may see their doctor only once a year for general checkups (or even less than that), so self-exams become pretty important.