Baker’s Cyst: My Tale of This Painful Aspect of Psoriatic Arthritis

Baker’s Cysts: My experience with this painful complication with Psoriatic Arthritis.

Baker’s Cyst wasn’t even on my radar with inflammatory arthritis. I’ve lived 18 years with this disease and I’m still learning.

This is what ended up being one of the worst aspects of extreme leg pain in 2025.

I have lived with Psoriatic Arthritis for decades. I didn’t know I had PsA until doctors put the clues together in 2018 when I received my second Spondyloarthritis diagnosis. (I got my first diagnosis in 2009.)

That’s when Psoriatic Arthritis joined axSpA on my paperwork. Since then I’ve had several dermatologists and rheumatologists confirm my diagnoses. Since I live with atypical psoriasis, it took a long time to get my PsA diagnosis. The delay to diagnosis for me was 20+ years.

I just learned about Baker’s Cysts the hard way with psoriatic arthritis!

This summer I noticed that the constant swelling I have at the front of my knees and above my knees was now on the back of my knees as well.

When we flew back to Taiwan in August, the pain dialed up to unbearable levels. I’m used to arthritis pain but this pain was beyond comprehension. I couldn’t touch my legs, I couldn’t sit without agony, and obviously I couldn’t move because the swelling was so bad. The lumps on the back of my legs were huge and I had fluid everywhere in my legs. They were grotesquely swollen and I could see rivulets of fluid running down my legs under my skin.

It felt like I had water running down the inside of my legs. As it turns out, that was a vital clue that I didn’t know was a clue until later.

After seeing my specialist in August, I felt very discouraged. How was it possible that I couldn’t even touch my skin or tolerate pants without agony? Where was this coming from?

I was so desperate, I was pouring through anatomy books to find the exact location of my pain. He suggested that it’s possible to have something called Baker’s Cyst. I had read about this in the books I was looking through. I figured it was impossible because I’ve had an MRI and CT scans within the last 18 months. I ruled it out because those scans should have picked up the cysts.

Towards the end of my appointment, he told me to send a text to my case worker when I was ready and she’d line up a leg scan for me.

My case worker lined my leg scan up within a week.

On October 17, I hobbled into the hospital. On the best of days, I need a wheelchair past 2,000 steps. Imagine walking into a hospital on ruptured knee cysts on top of a limited step count. That’s what I ended up doing.

I was hoping the scan was going to reveal the cause of the searing pain and extreme swelling in my legs.

I also hoped they could rule out blood clots immediately so I could stop worrying about clots and just focus on pain relief and reducing inflammation.

Instead I learned that they were using the wrong machine for clots but I had cysts in the back of my knees called popliteal cysts. (Also known as Baker’s cysts.)

I had them behind both knees which is very rare. And they ruptured which is also very rare!

This explains the agony and fluid in my legs. I had no extra pain relief treatments for it. I warrior-ed through on my regular meds.

I know the day they ruptured (August 26, 2025) because I document all my symptoms. It felt like I had water running down the inside of my legs which I now know is a symptom of ruptured cysts in your legs.

Honestly, there are so many days I think my life is unbelievable but I couldn’t make this stuff up! Not in my wildest dreams could I come up with the insane things that have happened to me with inflammatory arthritis.

Baker’s Cysts are common with inflammatory arthritis.

No one has ever mentioned the possibility of having Baker’s cysts develop because of my arthritis.

Unfortunately this was the same symptom I had in 2009 when I got my axSpA diagnosis. I have had my knees aspirated several times in the past. I’m now wondering if I’ve had them all along and no one picked up on it.

It is uncommon to have them in both knees and to have both knees rupture at the same time.

So that, my friends, is the fluid that I was manually draining via lymphatic drainage from my legs when I should’ve been seeking emergency attention. I’m so lucky I didn’t get an infection or sepsis. In fact, sepsis was a huge concern and I posted about the bright red spots on the back of my legs and how hot they were to touch. I took the post down because people started commenting on the unlikelihood of it.

That’s how high my pain tolerance is and how much I can push through.

I had two doctors look at my legs. They never said it was something to worry about other than, ‘Your arthritis is really bad, Carrie.’

It blows my mind these cysts were visible and my legs are a complete disaster. It shocks I ended up hobbling into the hospital on ruptured knees!

I finally have disability transport services set up and will never again have to face this on my own two legs.

What is a Baker’s Cyst anyways?

Also known as Popliteal Cyst, these cysts are fluid-filled lumps/sacs behind your knees are filled with synovial fluid.

When your knee joint is irritated or injured, the synovial membrane creates extra fluid to help protect your knee joint. If that fluid cannot drain, it pushes its way into weak areas around the joint. This leads to the formation of a cyst in the popliteal area located directly behind the knee.

Your knee could be making more fluid because of an injury, active inflammation, or other problems tied to knees.

It turns out my anatomy books were right and I was able to hone in on the popliteal fossa. I mentioned it directly to the doctor who did my CT scan in October. I remember her giving me a strange look. Maybe she had never had a patient mention that area before?

When people experience pain and swelling behind their knee, especially if they have arthritis and inflammation, it’s important to see someone immediately. In fact, doctors should suspect Baker’s Cyst, especially if a patient has arthritis. You definitely do not want them to rupture!

My Baker’s Cysts ruptured in late August!

The doctor who did my scan in October asked me if my knees had been aspirated recently. The last time I had them aspirated was in 2022 and she was surprised to hear I had also had them drained in 2009 and 2014.

That’s how I learned they had ruptured.

While I Iive with mostly med resistant and difficult to treat inflammatory arthritis, I still feel relief that I have confirmed diagnoses.

For one, I don’t ever have to listen to another medical professional blame my Psoriatic Arthritic or psoriasis on:

• allergies
• eczema
• hives
• ‘summer skin in Taiwan’
• doing too much

Knowing the name of the beast helps me help myself. I’ve made significant lifestyle changes to minimize flare-ups. Knowledge is power!

As it turns out, now I don’t have to think about doctors suspecting I’m making my leg pain up! There is now hard evidence from 2009 that my knees are wrecked.

What causes Baker’s Cysts?

In short, anything that causes joint swelling, damage to the cartilage, and problems that hurt your knee can lead to Baker’s Cyst. Here are some examples:

• Arthritis leads to long-term inflammation, which makes the body produce too much synovial fluid. Studies show that people with arthritis are 60% more likely to get Baker’s cysts than those who don’t have knee problems.
• Knee injuries
• Accidents during sports, workplace injuries, and normal wear with age can add to your risk
• Gout and other inflammatory diseases and conditions also raise your risk of developing Baker’s Cyst

The bad news is that once it happens, inflammation makes it easier for new cysts to form!

Inflammatory diseases like Psoriatic Arthritis, lupus, and Rheumatoid arthritis increase your risk of getting Baker’s cysts because these diseases cause such serious joint swelling.

It has not been a good year in this respect but every bit of knowledge I learn about Psoriatic Arthritis and psoriasis helps other patients.

It has been 18 years since my Ankylosing Spondylitis diagnosis. Even the best and most knowledgeable patients continue to be shocked by how our bodies betray us.

I hope you never have to deal with Baker’s cysts. If you’ve found this page because you’re looking for info, I hope your recovery is better than mine and you found this info helpful.

Further Resource Reading For Baker’s Cysts

• MSD Manual: Baker Cysts (Bursa, muscle and tendon disorder, muskuloskeletal and connective tissue disorders )
• Risk Factors That Increase The Chances of Developing A Baker’s Cyst – Prakash Hospital
• Taipei Medical University publication on how Baker’s Cysts Are Often Missed in Clinical Settings
• Pyogenic Baker cyst in a patient with psoriatic arthritis during etanercept therapy – BCs can occur in patients with autoimmune diseases such as RA, Behçet disease, and SpA. The most common etiology of a BC is recurrent synovitis or arthritis-induced accumulation of fluid in the joint space. Most patients with BCs are asymptomatic; however, acute calf pain may occur. Many diseases should be included in the differential diagnosis of acute calf pain and swelling, including deep vein thrombosis, BC, trauma, tendonitis, cellulitis, and arterial aneurysm