How is Becker's hernia under the knee diagnosed and treated?

Becker's hernia under the knee is a benign neoplasm that forms and is located in the popliteal fossa. The frequency of the disease is up to 50% in the population. Such a tumor-like structure is essentially a cyst containing fluid.

The problem is that many do not pay attention to it, and regard the neoplasm as a temporary edema. Indeed, at first, the disease appears as a slight swelling, which in no way suggests the presence of a hernia.

The size of the hernia does not exceed three centimeters. As a rule, such a disease affects one joint (unilateral lesion).

Anatomical features and the formation process

The knee is a large structure containing many muscles and ligaments. It is the most complex joint in the human body. On the back of the knee joint are the muscles and their holding tendons with ligaments. In the depths of the joint, between the connective fibers, there is a tendon bag, it is the core of the pathology, namely its inflammation.

When an inflammatory process occurs, the bag increases in volume, local edema is formed. In the same place, osmotic pressure is disturbed, which leads to a violation of the water balance. These changes lead to the fact that the liquid in the bag smoothly passes (diffuses) into the intercellular space, where it accumulates in large quantities.

This volumetric presence of fluid protruding through the skin is the so-called hernia of the knee joint.  

Reasons for education

The main factor provoking the occurrence of a hernia is the aging of the human body. Namely, the processes associated with this aging. However, there are cases when people no more than 30 years old also suffer from this disease.

Other factors include:

• systemic lupus erythematosus (in women);
• skin diseases - psoriasis;
• hemophilia - a violation of blood clotting;
• joint diseases: osteoarthritis, rheumatoid arthritis;
• past injuries of the knee joint;
• congenital or acquired connective tissue pathologies;
• damage to the elements of the joint, damage to the menisci or discs;

Given the occupation, the following categories of people suffering from frequent inflammation of the popliteal bursa can be distinguished:

1. Athletes . Especially those who are involved in serious professional sports.
2. People whose occupations are associated with constant physical activity (loaders, builders).

In children, this disease is extremely rare.

Clinical picture

Pathogenesis (the mechanism of the course of the disease) is associated with a gradual increase in the volume of the bag. Sooner or later, the act of growth leads to compression of the surrounding tissues, namely: nerves, arteries, veins, ligaments, tendons, muscles. From this follows all the symptoms of the disease. However, at first, the course of the disease is asymptomatic, latent, without causing any suspicion in the patient.

In addition, at first, the hernia on the leg is so small (about a few millimeters in size) that outwardly it does not even attract attention. However, later, when the fluid in the joint becomes more and more, it makes itself felt.

You should know that the disease develops over time. It can take years for a hernia to grow.

Symptoms:

1. Outwardly, a rapidly growing bulge is observed , which is visible without special examination.
2. Pain . An enlarged bag constantly compresses the nerves, causing them to become irritated, which leads to severe pain in the affected area. In addition, pain along the course of the nerve can spread up or down, reaching the foot or pelvis. Pain is also transmitted to nearby muscles. It is known that the severity of pain depends on the size of the bulge, on the proximity of its contact with the tissues. The pain intensifies when the patient tries to move the knee, bend or unbend.
3. Paresthesias in the joint area : numbness, tingling, crawling sensation on the skin, cooling of the limb. The threshold of sensitivity rises: in order to cause a sensation on the skin, exposure to a strong stimulus is necessary.
4. When palpation (palpation), the patient, as a rule, experiences severe pain. Under the arms, there is an elastic, dense protrusion.
5. Swelling and swelling of the back of the knee . The skin around the joint may change its color towards a bluish tint.
6. After some time, the patient loses all ability to fully bend the knee, and the range of motion also decreases.
7. Outwardly, the knee joint is modified : it becomes larger.
8. Pain in the affected area when walking.

Signs of general malaise may also be associated with specific symptoms:

• fever, often subfebrile (37-38 degrees);
• headache;
• fatigue at work;
• sleep disturbance;
• disturbed appetite;
• low mood, irritability.

Diagnostics

The study of Becker's hernia under the knee begins with a general examination by a doctor. First of all, the specialist studies complaints, examines the limbs, compares the knees. For the doctor, the systemic or local diseases of the joints transferred to the patient, their course and outcome are of great importance.

An accurate diagnosis can only be made using instrumental research methods, such as:

1. Diaphanoscopy . This tool examines the presence of liquid in the bag by shining a bright beam of light.
2. Magnetic resonance imaging . This is an excellent procedure that gives accurate characteristics to the parameters of the neoplasm.
3. Arthrography is an x-ray of the knee joint itself. Based on it, the specialist can exclude other similar pathologies.
4. Ultrasound examination of the joint.

Auxiliary are clinical and laboratory studies, such as a complete blood count, biochemical analysis. The last two can exclude or confirm the development of a malignant tumor.

Treatment

Therapeutic measures are carried out on the basis of:

• conservative therapy;
• surgical methods;
• folk funds.

Due to the fact that the Baker's cyst is an atypical hernia, this means that the disease is partially amenable to traditional medicine.

Conservative therapy involves the passage of a course of ointments, pills, physiotherapy exercises. It also includes physiotherapy. If a hernia of the knee joint occurs against the background of an existing disease, the underlying disease is treated. It should be remembered that this method of treatment is additional, but not the main one.

With the help of conservative therapy, it is impossible to eliminate the cause of the pathology. This way of treatment is aimed at eliminating the symptoms. Treatment with folk remedies also eliminates only the clinical picture of the disease. It is important to know that treating with traditional medicine without seeing a doctor is a direct path to the development of complications and serious consequences.

The main way to completely cure a popliteal hernia is surgery.

The indications include:

• large size of the protrusion;
• low joint mobility;
• compression of nerve fibers;
• lack of effect from conservative therapy, or a weak effect from it;
• frequent recurring cases of hernias.

The operation is performed under local anesthesia. The duration of the intervention does not exceed half an hour (the time depends on the complexity of the patient).

The course of the operation consists of the following points:

1. A small incision is made at the site of the cyst.
2. The surgeon examines and evaluates the situation.
3. Manipulations are being carried out to eliminate the hernia.
4. The incision is sutured.
5. After suturing, a fixing bandage or plaster is applied to the patient's knee.

The entire surgical process is based on the use of an arthroscope. After surgery, the person is released the next day. Over the next month, the attending physician should conduct an examination, monitor the condition and give advice on rehabilitation.

It is necessary to treat with traditional medicine only after surgery and conservative therapy.

The following activities are common:

• compresses based on tincture of golden mustache leaves;
• compresses from the leaves of celandine and burdock;
• the use of gauze soaked in unrefined solar oil;
• aloe juice mixed with lemon juice.