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Interstitial nephritis

Alternative Names: Tubulointerstitial nephritis; Nephritis – interstitial; Acute interstitial (allergic) nephritis

Definition:
Interstitial nephritis (or Tubulo-interstitial nephritis) is a form of nephritis affecting the interstitium of the kidneys surrounding the tubules  in which the spaces between the kidney tubules become swollen (inflamed).The inflammation can affect the kidneys’ function, including their ability to filter waste.
This disease can be either acute, meaning it occurs suddenly, or chronic, meaning it is ongoing and eventually ends in kidney failure.

click  to see the pictures

Acute interstitial nephritis is a kidney disorder in which the kidneys become unable to filter waste materials and fluid properly. This is a potentially serious condition that requires care from your doctor.

In chronic interstitial nephritis the kidney becomes small and granular with thickening of arteries and arterioles and proliferation of interstitial tissue. There may be functional abnormalities, such as urea retention, hematuria, and casts.

Symptoms:
Interstitial nephritis can cause mild to severe kidney problems, including acute kidney failure. In about half of cases, people will have decreased urine output and other signs of acute kidney failure.

Symptoms of this condition may include:

•Blood in the urine
•Fever
•Increased or decreased urine output
•Mental status changes (drowsiness, confusion, coma)
•Nausea, vomiting
•Rash
•Swelling of the body, any area
•Weight gain (from retaining fluid)

Causes:
Interstitial nephritis may be temporary (acute) or it may be long-lasting ( chronic) and get worse over time.

The following can cause interstitial nephritis:

•Allergic reaction to a drug (acute interstitial allergic nephritis)
•Analgesic nephropathy
•Long-term use of medications such as acetaminophen (Tylenol), aspirin, and nonsteroidal anti-inflammatory drugs (NSAIDS). This is called analgesic nephropathy
•Side effect of certain antibiotics (penicillin, ampicillin, methicillin, sulfonamide medications, and others)
•Side effect of medications such as NSAIDs, furosemide, and thiazide diuretics

The acute form of interstitial nephritis is common. It is most often caused by side effects of certain drugs. This disorder may be more severe and more likely to lead to chronic or permanent kidney damage in elderly people.

Complications:
Metabolic acidosis can occur because the kidneys aren’t able to remove enough acid. The disorder can lead to acute or chronic kidney failure or end-stage kidney disease.

Diagnosis:
At times there are no symptoms of this disease, but when they do occur they are widely varied and can occur rapidly or gradually.  When caused by an allergic reaction, the symptoms of acute tubulointerstitial nephritis are fever (27% of patients), rash (15% of patients),  and enlarged kidneys. Some people experience dysuria, and lower back pain. In chronic tubulointerstitial nephritis the patient can experience symptoms such as nausea, vomiting, fatigue, and weight loss. Other conditions that may develop include hyperkalemia, metabolic acidosis, and kidney failure.

Blood tests:
About 23% of patients have eosinophilia.

Urinary findings:
Urinary findings include:
*Eosinophiluria: sensitivity is 67% and specificity is 83%.  The sensitivity is higher in patients with interstitial nephritis induced by methicillin or when the Hansel’s stain is used.

*Isosthenuria.

*Hematuria

*Sterile pyuria: white blood cells and no bacteria

Gallium scan
The sensitivity of an abnormal gallium scan has been reported to range from 60% to 100%.

Treatment:
Treatment focuses on the cause of the problem. Avoiding medications that lead to this condition may relieve the symptoms quickly.

Nutrition therapy consists of adequate fluid intake, which can require several liters of extra fluid.

Limiting salt and fluid in the diet can improve swelling and high blood pressure. Limiting protein in the diet can help control the buildup of waste products in the blood (azotemia) that can lead to symptoms of acute kidney failure.

If dialysis is necessary, it usually is required for only a short time.
Corticosteroids or anti-inflammatory medications can help in some cases.

Prognosis:
The kidneys are the only body system that are directly affected by tubulointerstitial nephritis. Kidney function is usually reduced; the kidneys can be just slightly dysfunctional, or fail completely.

In chronic tubulointerstitial nephritis, the most serious long-term effect is kidney failure. When the proximal tube is injured, sodium, potassium, bicarbonate, uric acid, and phosphate reabsorption may be reduced or changed, resulting in low bicarbonate, known as metabolic acidosis, low potassium, low uric acid known as hypouricemia, and low phosphate known as hypophosphatemia. Damage to the distal tubule may cause loss of urine-concentrating ability and polyuria.

In most cases of acute tubulointerstitial nephritis, the function of the kidneys will return after the harmful drug is not taken anymore, or when the underlying disease is cured by treatment. If the illness is caused by an allergic reaction, a corticosteroid may speed the recovery kidney function; however, this is often not the case.

Chronic tubulointerstitial nephritis has no cure. Some patients may require dialysis. Eventually, a kidney transplant may be needed.

Prevention:
In many cases, the disorder can’t be prevented. Avoiding or reducing your use of medications that can cause this condition can help reduce your risk.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose

Resources:
http://en.wikipedia.org/wiki/Interstitial_nephritis
http://www.nlm.nih.gov/medlineplus/ency/article/000464.htm
http://www.empowher.com/condition/acute-interstitial-nephritis
http://medical-dictionary.thefreedictionary.com/chronic+nephritis
http://www.humpath.com/spip.php?article2778&id_document=113#documents_portfolio

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Epididymo-Orchitis and Orchitis

Definition:
Epididymo-orchitis occurs when the testicle (or testis) and epididymis (the coiled tube that lies above and behind the testicle and stores and carries sperm) become infected. Bacteria are usually to blame although the infection may be due to a virus or rarely a parasite such as schistosomiasis, or a fungus.
You may click to see the picture
When infection develops, these two structures become inflamed and swollen, the scrotum feels tender and is red on the side affected. The symptoms usually start after a few hours, and when severe can cause fever and great pain.

CLICK & SEE

Symptoms:
Epididymo-orchitis symptoms may develop suddenly  it  includes:

*Testicular swelling on one or both sides

*Pain ranging from mild to severe

*Tenderness in one or both testicles, which may last for weeks

*Nausea

*Fever

*Discharge from penis

*Blood in the ejaculate

The terms “testicle pain” and “groin pain” are sometimes used interchangeably. But groin pain occurs in the fold of skin between the thigh and abdomen — not in the testicle. The causes of groin pain are different from the causes of testicle pain.

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A number of conditions can cause testicular pain, and some of the conditions require immediate treatment. One such condition involves twisting of the spermatic cord (testicular torsion), which may cause pain similar to that caused by orchitis. Your doctor can perform tests to determine which condition is causing your pain.

Causes:
The bacteria that cause epididymo-orchitis may get to the testis and epididymis in different ways. In younger men, the bacteria have usually travelled from the penis, having been passed on during sex.

In older men, prostatitis (infection of the prostate gland) or urinary infection is usually to blame. Epididymo-orchitis can also follow any medical procedure involving the urinary tract, such as catheterisation of the bladder or a cystoscopy.

Rarely, the infection arrives from the bloodstream, such as when the micro-organism responsible is tuberculosis (TB) which travels from a source of infection elsewhere in the body. Years ago, before the introduction of immunisation, infection with the mumps virus was a common cause of epididymo-orchitis.

Orchitis can be either bacterial or viral.

Bacterial orchitis
Most often, bacterial orchitis is the result of epididymitis, an inflammation of the coiled tube that connects the vas deferens and the testicle. The vas deferens carries sperm from your testicles. When inflammation in the epididymis spreads to the testicle, the resulting condition is known as epididymo-orchitis.

Epididymitis usually is caused by an infection of the urethra or bladder that spreads to the epididymis. Often the cause of the infection is a sexually transmitted disease (STD), particularly gonorrhea or chlamydia. Other causes of infection may be related to having been born with abnormalities in your urinary tract or having had a catheter or medical instruments inserted into your penis.

Viral orchitis:
Most cases of viral orchitis are the result of mumps. About one-third of males who contract the mumps after puberty develop orchitis during their course of the mumps, usually four to six days after onset.

Risk Factors:
Several factors may contribute to developing orchitis. For nonsexually transmitted orchitis, they include:

#Not being immunized against mumps

#Being older than 45

#Having recurring urinary tract infections

#Having surgery that involves the genitals or urinary tract, because of the risk of infection

#Being born with an abnormality in the urinary tract (congenital)

High-risk sexual behaviors that can lead to STDs also put you at risk of sexually transmitted orchitis. They include having:

#Multiple sexual partners

#Sex with a partner who has an STD

#Sex without a condom

#A personal history of an STD

Complications:
Complications of orchitis may include:

#Testicular atrophy. Orchitis may eventually cause the affected testicle to shrink.

#Scrotal abscess. The infected tissue fills with pus.

#Repeated epididymitis. Orchitis can lead to recurrent episodes of epididymitis.

#Infertility. In a small number of cases, orchitis can reduce fertility; however, if orchitis affects only one testicle, sterility is less likely.

Diagnosis:
A physical examination may reveal enlarged lymph nodes in your groin and an enlarged testicle on the affected side; both may be tender to the touch. Your doctor may do a rectal examination to check for prostate enlargement or tenderness and order blood and urine tests to check for infection and other abnormalities.

Other tests many times  required to determine the presence of an STD and to rule out the possibility of testicular torsion, which requires immediate treatment, include:

#STD screening. This involves obtaining a sample of discharge from your urethra. Your doctor may insert a narrow swab into the end of your penis to obtain the sample, which will be viewed under a microscope or cultured to check for gonorrhea and chlamydia.

#Urinalysis. A sample of your urine, collected either at home first thing in the morning or at your doctor’s office, is analyzed in a lab for abnormalities in appearance, concentration or content.Ultrasound imaging. This test, which uses high-frequency sound waves to create precise images of structures inside your body, may be used to rule out twisting of the spermatic cord (testicular torsion).

#Ultrasound with color Doppler can determine if the blood flow to your testicle is reduced or increased, which helps confirm the diagnosis of orchitis.

#Nuclear scan of the testicles. Also used to rule out testicular torsion, this test involves injecting tiny amounts of radioactive material into your bloodstream. Special cameras can then detect areas in your testicles that receive less blood flow, indicating torsion, or more blood flow, confirming the diagnosis of orchitis.

Treatment :
Treatment depends on the cause of orchitis.

Treating viral orchitis
Treatment for viral orchitis, the type associated with mumps, is aimed at relieving symptoms. Your doctor may prescribe pain medication, nonsteroidal anti-inflammatory drugs, such as ibuprofen (Advil, Motrin, others) or naproxen (Aleve, others), and recommend bed rest, elevating your scrotum and applying cold packs.

Treating bacterial orchitis
In addition to steps to relieve discomfort, bacterial orchitis and epididymo-orchitis require antibiotic treatment. If the cause of the infection is an STD, your sexual partner also needs treatment.

Antibiotic drugs most commonly used to treat bacterial orchitis include ceftriaxone (Rocephin), ciprofloxacin (Cipro), doxycycline (Vibramycin, Doryx), azithromycin (Zithromax), and trimethoprim and sulfamethoxazole combined (Bactrim, Septra). Make sure your doctor is aware of any other medications you’re taking or any allergies you have. This information, as well as whether your infection is sexually transmitted and what type of STD you have, will help your doctor select the best treatment.

Be sure to take the entire course of antibiotics recommended by your doctor. Even if your symptoms clear up sooner, take all your antibiotics to ensure that the infection is gone.

Prognosis:
Prognosis is very good.If the diseases is properly diagnosed in time it is cured with proper  drug and rest.

Life Style & Home Remedies:
To ease your discomfort, try these suggestions:

*Rest in bed.

*Lie down so that your scrotum is elevated.

*Apply cold packs to your scrotum as tolerated.

Prevention:
*Practicing safer sex, such as having just one sex partner and using a condom, helps protect against STDs, which helps prevent
*STD-related bacterial orchitis.

*Getting immunized against mumps is your best protection against viral, mumps-related orchitis.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://www.bbc.co.uk/health/physical_health/conditions/epididymalcyst.shtml
http://www.mayoclinic.com/health/orchitis/DS00602
http://www.patient.co.uk/health/Epididymo-orchitis.htm
http://health.allrefer.com/health/orchitis-male-reproductive-system.html
http://www.sciencephoto.com/images/download_lo_res.html?id=778650061

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Costochondritis

Alternative Names:Chest wall pain,costosternal syndrome and costosternal chondrodynia.

Definition:
Costochondritis is a benign inflammation of the costal cartilage, which is a length of cartilage which connects each rib, except the eleventh and twelfth, to the sternum. It causes sharp pain in the costosternal joint — where your ribs and breastbone are joined by rubbery cartilage. Pain caused by costochondritis may mimic that of a heart attack or other heart conditions.

You may click to see the pictures

This pain can be quite excruciating, especially after rigorous exercise. When the pain of costochondritis is accompanied by swelling, it’s referred to as Tietze syndrome.

Most cases of costochondritis have no apparent cause. In these cases, treatment focuses on easing your pain while you wait for costochondritis to improve on its own. While it can be extremely painful, it is considered to be a benign condition that generally resolves in 6–8 weeks.

Costochondritis occurs most often in women and in people older than 40. However, costochondritis can affect anyone, including infants and children.

Symptoms:
Costochondritis symptoms can be similar to the chest pain associated with a heart attack.It is the most common cause of chest pain originating in the chest wall.

Costochondritis usually develops gradually with increasing tenderness over the breastplate and pain if you put pressure on the ribs in this area. The pain is made worse by anything that moves the ribs and pulls on the cartilage connecting them to the sternum.

Symptoms include:

*Pain and tenderness in the locations where your ribs attach to your breastbone (costosternal joints)
*Often sharp pain, though also dull and gnawing pain
*Location often on left side of breastbone, but possible on either side of chest

Other costochondritis symptoms may include:
*Pain when taking deep breaths
*Pain when coughing
*Difficulty breathing

Causes:
Costochondritis often results from a physical strain or minor injury, but the true causes are not well understood. . It was at one time thought to be associated with, or caused by, a viral infection acquired during surgery, but this is now known not to be the case. Most sufferers have not had recent surgery. Only some cases of costochondritis have a clear cause. Those causes include:

*Injury.•Mechanical pressure or stress on the sternum or A blow to the chest could cause costochondritis.

*Physical strain. Heavy lifting and strenuous exercise have been linked to costochondritis.

*Upper respiratory illness. An infection that produces sneezing or a cough may produce costochondritis.

*Infection. Infection can develop in the costosternal joint, causing pain.

*Fibromyalgia. Recurring costochondritis could be a symptom of fibromyalgia. People with fibromyalgia often have several tender spots. The upper part of the breastbone is a common tender spot.

*Pain from other areas of your body. Pain signals can sometimes be misinterpreted by your brain, causing pain in places far away from where the problem occurs. Your doctor might refer to this as “referred pain.” Pain in your chest can sometimes be caused by problems with the bones in your spine compressing the nerves.

Diagnosis:
Doctor can diagnose costochondritis by pressing on the area where the ribs meet the chest bone (sternum). If this area is tender and sore, costochondritis is the most likely cause of your chest pain. He or she will ask you to describe your pain and what influences it. The pain of costochondritis can be very similar to the pain associated with heart disease, lung disease, gastrointestinal problems and osteoarthritis. Your doctor will feel along your breastbone for areas of tenderness or swelling.

Costochondritis generally can’t be seen on chest X-rays or other imaging tests used to see inside your body. Sometimes your doctor may orders these tests or others to rule out other conditions.

Treatment:
Treatment mostly consists of finding pain relief that works for you while waiting for the body to heal.

Start with simple analgesics such as paracetamol, which must be taken at regular intervals and not just when the pain is bothering you. Pain killers which also reduce inflammation such as ibuprofen (these are known as non-steroidal anti-inflammatory drugs or NSAIDs) may be particularly helpful. Local heat (such as from a warm pack) can also be soothing.

Vigorous exercise might not be a good idea. When you exercise, you need to increase your breathing depth and rate, increasing the movement of your ribs. This is more likely to aggravate any inflammation. Gentle exercise, however, is fine and some research suggests that gentle stretching of the pectoral muscles 2-3 times a day may help.

Although most people find that the pain soon settles, a significant number still have some discomfort and tenderness several months later. In persistent cases local injections of anaesthetic and steroids to the rib area may be recommended.

Prognosis :With treatment, the condition usually goes away in a few days.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://www.bbc.co.uk/health/physical_health/conditions/costochondritis.shtml
http://www.mayoclinic.com/health/costochondritis/DS00626
http://en.wikipedia.org/wiki/Costochondritis
http://www.nlm.nih.gov/medlineplus/ency/article/000164.htm

http://www.graphicshunt.com/health/images/costochondritis-1030.htm

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Bornholm Disease

Alternative Name : Epidemic pleurodynia,Sylvest’s disease , epidemic benign dry pleurisy,Bamble disease, the devil’s grip, devil’s grippe, epidemic myalgia, epidemic pleurodynia, epidemic transient diaphragmatic spasm or The Grasp of the Phantom

Definition:
Bornholm disease is a temporary illness that is a result of virus infection. The disease features fever and intense abdominal and chest pains with headache. The chest pain is typically worsened by breathing or coughing. The illness usually lasts from 3 to 14 days.

click to see the pictures

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The most common virus causing Bornholm disease is an enterovirus called Coxsackie B.

Group B coxsackieviruses are transmitted from person to person by fecal-oral contamination or direct mouth to mouth contact. Other people become infected with the virus if they touch contaminated items then put their fingers in their mouth before washing them properly. Contaminated items can include soiled diapers, shared toys and toilets.

Bornholm disease is also called epidemic myalgia and pleurodynia (because of inflammation of the lining tissue of the lungs).

Epidemic pleurodynia is contagious and occurs in clusters, meaning many people in an area get it around the same time. Up to 90% of epidemics occur in the summer and early fall. The illness most commonly strikes people younger than age 30, although older people also may be affected.

Coxsackie B virus is spread by contact and epidemics usually occur during warm weather in temperate regions and at any time in the tropics. As is typical with this virus family, it is shed in large amounts in the feces of infected persons. The disease can be spread by sharing drink containers, and has been contracted by laboratory personnel working with the virus

The disease is named after the Danish island where the first documented cases arose.

In 1872, Daae-Finsen reported an epidemic of “acute muscular rheumatism” occurring in a community called Bamble, giving rise to the name “Bamble disease” in Norway. Subsequent reports, published only in Norwegian, referred to the disease by this name. In 1933, Ejnar Sylvest gave a doctoral thesis describing a Danish outbreak of this disease on Bornholm Island entitled, “Bornholm disease-myalgia epidemica”, and this name has persisted

Symptoms:
The sudden onset of fever and pain occurs about four days after infection. Flu-like symptoms may be experienced during this incubation period.

There is pain in the chest or upper abdomen, usually on one side. It varies in intensity, but is often described as stabbing, or ‘grip-like’. The pain is spasmodic, lasting for 15 to 30 minutes at a time. Coughing, sneezing and sudden movements can make it worse.

The symptoms usually last about one to two days in children and about two to six days in adults. Sometimes, the pain and fever return after a day or two.

On rare occasions, there are several recurrences of pain and fever over a period of three weeks or more.

Complications are rare, but include inflammation of the testes (orchitis) or the heart (pericarditis, myocarditis), and meningitis.

Cause:
Inoculation of throat washings taken from people with Bornholm disease into the brains of newborn mice revealed that enteroviruses in the Coxsackie B virus group were likely to be the cause of Bornholm disease, and those findings were supported by subsequent studies of IgM antibody responses measured in serum from people with Bornholm disease. Other viruses in the enterovirus family, including echovirus and Coxsackie A virus, are infrequently associated with Bornholm disease.

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Group B coxsackieviruses are transmitted from person to person by fecal-oral contamination or direct mouth to mouth contact. Other people become infected with the virus if they touch contaminated items then put their fingers in their mouth before washing them properly. Contaminated items can include soiled diapers, shared toys and toilets.

Diagnosis:
Diagnosis is commonly simplified in an epidemic, although different causes of acute chest and abdominal pain must be excepted. Your doctor may push on muscles in your chest to notice if the pressure actuate a spasm of pain. Often, your doctor can examine the difficulty without any specific tests, particularly if there is an outbreak of the disease in your area. The infection from time to time disperse to cause inflammation in other organs, including the pleura (membrane surrounding the lungs), lungs, heart, liver, brain and testes.

Treatment :
The illness lasts about a week and is rarely fatal. Treatment includes the administration of nonsteroidal anti-inflammatory agents or the application of heat to the affected muscles. Relapses during the weeks following the initial episode are a characteristic feature of this disease.Painkillers and drugs can be used to reduce the fever.

The best treatment of Bornholm Disease is terminate bed rest, and fever and pain can be decreased by paracetamol for children or aspirin for adults. Recovery in uncomplicated cases is commonly finish within a week. Here is the list of several of the preclusion tips or tips for treating Bornholm Disease:

*People of any age may be involved although it frequently pretend people under the age of 30.
*Intravenous immune globulin may be utilised to treat newborns and those with a decreased immune system.

Prognosis:
Almost all generally healthy individuals recover completely from pleurodynia. However, about 5% of people develop acute viral meningitis as a complication of the coxsackievirus infection, and about 5% of adult males develop orchitis. Less common complications include hepatitis, pericarditis and myocarditis.

Prevention:
The viruses that cause epidemic pleurodynia can spread very easily among young children, who tend to put toys or fingers into their mouth. The disease is most likely to spread in day care centers. The best way to prevent infection is to wash hands thoroughly, especially before meals or after changing a diaper or using the bathroom. There is no vaccine to prevent pleurodynia.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://www.bbc.co.uk/health/physical_health/conditions/bornholmdisease1.shtml
http://www.intelihealth.com/IH/ihtPrint/WSIHW000/9339/24698.html?hide=t&k=basePrint
http://en.wikipedia.org/wiki/Bornholm_disease

http://www.associatedcontent.com/article/2914192/what_is_bornholm_disease.html

http://www.patient.co.uk/doctor/Coxsackie-Virus-Infection.htm

http://www.health-issues.org/rare-diseases/bornholm-disease.htm

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Baker’s cyst

Alternative Names:  Popliteal cyst; Bulge-knee

Definition:
Like all joints, the knee needs lubrication to function properly. This lubricant is a jelly-like substance called  synovial (si-NO-vee-ul)  fluid.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.

Although a Baker’s cyst may cause swelling and make you uncomfortable, treating the probable underlying problem usually provides relief.

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When the knee’s damaged, more synovial fluid is produced. Under pressure, this fluid stretches the lining of the joint, called the joint capsule, out into the back of the knee. This causes a bulge, known as a Baker’s cyst.

Herniation of the joint capsule is responsible for most Baker’s cysts in adults.

The most common cause of damage that triggers the process is arthritis, usually osteoarthritis. Other types of knee injury, such as tears to the cartilage, may also be responsible.

It is named after the surgeon who first described it, Dr. William Morrant Baker (1838–1896).This is not a “true” cyst, as an open communication with the synovial sac is often maintained.

Symptoms:
In some cases, a Baker’s cyst causes no pain, and you may not even notice it. If you do experience signs and symptoms, you may notice:

*Swelling behind your knee, and sometimes in your leg
*Knee pain
*Stiffness
*Texture similar to a balloon filled with water

A large cyst may cause some discomfort or stiffness, but there are often no symptoms. There may be a painless or painful swelling behind the knee.

The cyst may feel like a water-filled balloon. Sometimes, the cyst may break open (rupture), causing pain, swelling, and bruising on the back of the knee and calf.

It is important to know whether pain or swelling is caused by a Baker’s cyst or a blood clot. A blood clot (deep venous thrombosis) can also cause pain, swelling, and bruising on the back of the knee and calf. A blood clot may be dangerous and requires immediate medical attention.

Causes:
Synovial fluid circulates throughout your knee and passes in and out of various tissue pouches (bursae) throughout your knee. A valve-like system exists between your knee joint and the bursa on the back of your knee (popliteal bursa). This regulates the amount of synovial fluid going in and out of the bursa.

But sometimes the knee produces too much synovial fluid, resulting in buildup of fluid in the bursa and what is called a Baker’s cyst. This can be caused by:

CLICK TO SEE

•A tear in the meniscal cartilage of the knee……
•Knee arthritis (in older adults)
•Rheumatoid arthritis
•Other knee problems

Diagnosis:
During a physical exam, the doctor will look for a soft mass in the back of the knee. If the cyst is small, comparing the affected knee to the normal knee can be helpful. There may be limitation in range of motion caused by pain or by the size of the cyst. In some cases there will be signs and symptoms of a meniscal tear.

Transillumination, or shining a light through the cyst, can show that the growth is fluid filled.

If the mass grows quickly, or you have night pain, severe pain, or fever, you will need more tests to make sure you do not have other types of tumors.

X-rays will not show the cyst or a meniscal tear, but they will show other problems that may be present, including arthritis.

Ultrasound  and or MRIs can help the health care provider see the cyst and look for any meniscal injury.
Treatment:
Baker’s cysts usually require no treatment unless they are symptomatic. Often rest and leg elevation are all that is needed. If necessary, the cyst can be aspirated to reduce its size, then injected with a corticosteroid to reduce inflammation. Surgical excision is reserved for cysts that cause a great amount of discomfort to the patient. A ruptured cyst is treated with rest, leg elevation, and injection of a corticosteroid into the knee. Recently, prolotherapy has shown encouraging results as an effective way to treat Baker’s cysts and other types of musculoskeletal conditions.

Baker’s cysts in children, unlike in older people, nearly always disappear with time, and rarely require excision.

Cryotherapy:
Ice pack therapy may sometimes be effective way of controlling the pain caused by Baker’s cyst. Ice must not be applied directly onto the skin but be separated by a thin cloth. Alternatively, cooling packs may be used, but the total application time for any product is for no more than 15 minutes at a time.

Medication:
Medications bought at pharmacies may be used to help soothe pain. Painkillers with paracetamol, a.k.a. Tylenol(c) (acetaminophen), or with the additional anti-inflammatory action (such as ibuprofen or naproxen), may be used. Stronger non-steroidal anti-inflammatory drugs may be required by prescription from one’s general practitioner.

Heat:
Heat is also a commonly used. The application of a heating pad on a low setting for 10–20 minutes may relieve some pain, but only if instructions are followed carefully.

Bracing:
A knee brace can offer support giving the feel of stability in the joint. If only support is necessary, a simple elastic bandage is recommended; however, braces compress the back of the knee, where it is most tender, and can cause pain.

Rest and specific exercise:
Many activities can put strain on the knee, and cause pain in the case of Baker’s cyst. Avoiding activities such as squatting, kneeling, heavy lifting, climbing, and even running can help prevent pain. Despite this, some exercises can help relieve pain, and a physiotherapist may instruct on stretching and strengthening the quadriceps and/or the patellar ligament.
Prognosis: A Baker’s cyst will not cause any long-term harm, but it can be annoying and painful. The symptoms of Baker’s cysts usually come and go.Long-term disability is rare. Most people improve with time or arthroscopic surgery.

Possible Complications:
Complications are unusual, but may include:

•Long-term pain and swelling
•Complications from related injuries, like meniscal tears

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://www.bbc.co.uk/health/physical_health/conditions/bakerscyst1.shtml
http://www.nlm.nih.gov/medlineplus/ency/article/001222.htm
http://www.mayoclinic.com/health/bakers-cyst/DS00448
http://en.wikipedia.org/wiki/Baker’s_cyst

http://www.healthcentral.com/osteoarthritis/h/tai-chi-and-arthritis-of-the-hip.html

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