# Baker's Cyst (Popliteal Cyst) - Category: chronic - Review status: reviewed (every claim checked against a document named on this page) - Sources: Ibuprofen 100 mg/5 ml SmPC section 4.2 (eMC product 4560) · Kenalog Intra-articular SmPC section 4.2 (eMC product 6748) · StatPearls: Ibuprofen (NCBI Bookshelf NBK542299) - Verified date: 2026-08 ## Verified against - Ibuprofen 100 mg/5 ml SmPC section 4.2 (eMC product 4560) - Kenalog Intra-articular SmPC section 4.2 (eMC product 6748) - MSF Essential Drugs 2024 (ibuprofen oral monograph) ## Treatment metadata - Ibuprofen — 400 mg — oral.solid - Triamcinolone acetonide — 40 mg — injection ## Complete treatment card ```text BAKER'S CYST (POPLITEAL CYST) Sources: Ibuprofen 100 mg/5 ml SmPC section 4.2 (eMC product 4560) · Kenalog Intra-articular SmPC section 4.2 (eMC product 6748) · StatPearls: Ibuprofen (NCBI Bookshelf NBK542299) Review status: REVIEWED against Ibuprofen 100 mg/5 ml SmPC section 4.2 (eMC product 4560), Kenalog Intra-articular SmPC section 4.2 (eMC product 6748), MSF Essential Drugs 2024 (ibuprofen oral monograph) (2026-08) IS IT THIS? - reference only, to read alongside your own examination SYMPTOMS - what the patient reports (3) - Behind-the-knee tightness, discomfort, or an ache is a common complaint - Increased activity tends to make the pain worse and can limit fully bending or straightening the knee - A rupture can cause sudden sharp calf and knee pain with a feeling of fluid trickling down the leg [calf pain · joint pain · knee pain] SIGNS - what you find (5) - The bulge behind the knee is most obvious with the patient standing and the knee straight - Bending the knee to 45 degrees makes the swelling soften or vanish (Foucher's sign) - If the cyst dissects into the calf it can mimic a clot, with leg swelling, redness, and a positive Homan's sign [cyst · leg swelling · redness] - A ruptured cyst can trap the posterior tibial nerve, causing numbness in the sole and calf pain [calf pain · cyst · numbness] - Posterior compartment syndrome after rupture brings calf swelling, weak toes, and worsening pain when the toes are passively extended TESTS (3) - A supine exam moving the knee from fully straight to at least 90 degrees of bend checks the joint itself - When physical findings are inconclusive, plain x-ray and ultrasound are the first imaging steps - MRI is added mainly when surgery is being considered IF NOT THIS - what else fits (9) - An abscess behind the knee - Arteriovenous fistula - Deep venous thrombosis - Ganglion cyst - Hemangioma - Hematoma (blood collection) - A lipoma (fatty lump) - Lymphadenopathy - Malignancy such as fibrosarcoma or liposarcoma Source StatPearls "Baker's Cyst" - disease-level clinical article Status traced to the source above 1. IBUPROFEN [1st line] Adult 400 mg three times daily after food PRN for popliteal discomfort and intra-articular knee pain x 7-14 days Peds 5-10 mg/kg/dose [child max 400 mg] (Every 6-8 hours PRN Primary popliteal cysts in children are usually benign and self-limiting; conservative observation recommended. Child over 3 months: 5 to 10 mg/kg 3 to 4 times daily, maximum 30 mg/kg daily. The suspension's own label caps pain-and-fever use lower still, at 20 mg/kg/day. Never exceed 400 mg in a single dose.) 3kg -> 15-30 mg/dose 4kg -> 20-40 mg/dose 5kg -> 25-50 mg/dose 6kg -> 30-60 mg/dose 7kg -> 35-70 mg/dose 8kg -> 40-80 mg/dose 9kg -> 45-90 mg/dose 10kg -> 50-100 mg/dose 11kg -> 55-110 mg/dose 12kg -> 60-120 mg/dose 13kg -> 65-130 mg/dose 14kg -> 70-140 mg/dose 15kg -> 75-150 mg/dose 16kg -> 80-160 mg/dose 17kg -> 85-170 mg/dose 18kg -> 90-180 mg/dose 19kg -> 95-190 mg/dose 20kg -> 100-200 mg/dose 21kg -> 105-210 mg/dose 22kg -> 110-220 mg/dose 23kg -> 115-230 mg/dose 24kg -> 120-240 mg/dose 25kg -> 125-250 mg/dose 26kg -> 130-260 mg/dose 27kg -> 135-270 mg/dose 28kg -> 140-280 mg/dose 29kg -> 145-290 mg/dose 30kg -> 150-300 mg/dose 31kg -> 155-310 mg/dose 32kg -> 160-320 mg/dose 33kg -> 165-330 mg/dose 34kg -> 170-340 mg/dose 35kg -> 175-350 mg/dose 36kg -> 180-360 mg/dose 37kg -> 185-370 mg/dose 38kg -> 190-380 mg/dose 39kg -> 195-390 mg/dose 40kg -> 200-400 mg/dose 41kg -> 205-400 mg/dose (upper capped) 42kg -> 210-400 mg/dose (upper capped) 43kg -> 215-400 mg/dose (upper capped) 44kg -> 220-400 mg/dose (upper capped) 45kg -> 225-400 mg/dose (upper capped) 46kg -> 230-400 mg/dose (upper capped) 47kg -> 235-400 mg/dose (upper capped) 48kg -> 240-400 mg/dose (upper capped) 49kg -> 245-400 mg/dose (upper capped) 50kg -> 250-400 mg/dose (upper capped) Source Ibuprofen 100 mg/5 ml SmPC section 4.2 (eMC product 4560) for the adult dose: "The recommended dose is 200 mg-400 mg (10-20 ml), up to three times a day as required... do not take more than 1200 mg (60 ml) in any 24 hour period". That label's paediatric section gives weight bands and a 20 mg/kg/day pain-and-fever ceiling but states no mg/kg per dose, so the paediatric 5 to 10 mg/kg per dose is from MSF Essential Drugs 2024 (ibuprofen oral monograph): "Child over 3 months: 5 to 10 mg/kg 3 to 4 times daily (max. 30 mg/kg daily)". Why Baker's cyst is secondary to underlying intra-articular knee disease (OA, meniscal tear, RA). Conservative management targets the primary knee pathology. Caution URGENT DVT EXCLUSION: Acute rupture of a Baker's cyst causes sudden painful calf swelling and erythema (Pseudothrombophlebitis), which mimics DVT. Perform urgent venous Doppler ultrasound. Take NSAIDs with food; avoid in active GI bleeding, renal impairment, or third trimester pregnancy. Aspiration of popliteal cyst without treating underlying joint pathology results in high cyst recurrence. The 400 mg per-dose ceiling comes from the reference literature, not from the suspension label - that label's largest paediatric single dose is 200 mg. Below about 40 kg the weight calculation binds first and the ceiling never comes into it. Egypt DAJUANOFEN 400 MG 20 F.C. TABS. COPAD PHARMA 5.00 EGP (0.25/unit) FLABU 400MG 10 F.C.TAB. DELTA PHARMA 3.75 EGP (0.38/unit) NOVA-PROFEN 400MG 30 F.C. TABLETS SANOFI 12.75 EGP (0.42/unit) IBUPROFEN 400 MG 10 TAB. SEDICO 6.00 EGP (0.60/unit) MAFO 400 MG 30 F.C.TABS EIPICO 42.00 EGP (1.40/unit) BRUFEN 400 MG 30 TABS. KAHIRA > ABBO... 78.00 EGP (2.60/unit) PROFUSOL 400MG 20 S.G CAPS. EUROPEAN EGYP... 31.00 EGP ANALGIPROF 400 MG 25 SACHETS EVA PHARMA 37.50 EGP NOVA-PROFEN 100MG/5ML ORAL SUSP. 100ML SANOFI 2.25 EGP -> ? strength differs, ? different route - not oral solid BRUFEMOL-N SUSP. 60 ML ARAB DRUG COM... 4.50 EGP -> ? strength differs, ? different route - not oral solid 2. TRIAMCINOLONE ACETONIDE [2nd line] Adult 20-40 mg intra-articular knee injection (with optional cyst aspiration) under sterile technique - Single intra-articular injection Peds Not routinely recommended in children. Source Kenalog Intra-articular SmPC section 4.2 (eMC product 6748) Why Intra-articular knee steroid injection reduces synovial effusion and popliteal cyst volume. Caution Aseptic technique mandatory to prevent intra-articular infection. Direct aspiration/injection into popliteal fossa should be ultrasound-guided to avoid neurovascular structures (popliteal artery/vein, tibial nerve). Egypt PHARCOCINOLONE 40MG/ML I.M AMP. CHEMIPHARM > ... 8.00 EGP AMCINOL 40MG/ML I.M AMP. SIGMA TEC 11.00 EGP EPIRELEFAN 40MG/ML I.M AMP. EIPICO 38.00 EGP SYNTHECORTIN 40MG/ML I.M AMP. MUP 54.00 EGP Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. 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