Harnessing the Power of MSK Ultrasound to Detect and Treat Baker Cysts in International Medical Mission Trips: A Case Series

Case Diagnosis: Bakert Cyst

Case Description or Program Description: We present a case series of seven patients, ranging in age from 45 to 70, living in rural areas in the Dominican Republic. They presented with chronic posterior knee pain and associated gait dysfunction, negatively impacting their ability to engage in daily activities, prolonged walks, or physical labor, which is common in their communities. Advanced imaging studies were limited to X-rays. We completed MSK point-of-care ultrasound, and patients were ultimately diagnosed with Baker cysts and subsequently underwent Baker cyst aspiration under ultrasound guidance. Patients experienced posterior knee pain resolution, gait mechanics, and overall function improvement

Setting: Internal Medical Mission Trips

Assessment/Results: Seven patients with chronic posterior knee pain and gait dysfunction with MSK ultrasound confirmed Baker cysts underwent ultrasound-guided aspiration resulting in pain resolution, improvement in gait mechanics, and improvement in overall function

Discussion (relevance): If left untreated, Baker cysts can result in gait dysfunction and overall functional decline, as seen in our patients. While MRI is considered the gold standard for diagnosing Baker cysts, access to advanced imaging is often limited to X-rays. This is particularly true with international medical mission trips or underserved communities, such as in our recent project. Our initiative highlights the benefits of using MSK ultrasound for both diagnosing and safely aspirating Baker cysts. This demonstrates that MSK ultrasound is an ideal tool for both diagnosing and treating Baker cysts, leading to symptom relief and improvement in overall function.

Conclusions: MSK ultrasound could prove a valuable tool in establishing a diagnosis, particularly in resource-limited communities where advanced imaging studies are scarce. As technology advances, portable ultrasound machines have become more available, making them a practical inclusion in the physiatry toolbox. This allows for the incorporation of a diagnostic and guidance-optimizing tool that effectively diagnoses and aids in the treatment of Baker cysts in resource-limited settings.