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Update your knowledge on post-bariatric care and obesity management by attending this series of six ECHO Ontario Bariatric Network (OBN) sessions starting on June 3rd. Register online at obn.echoontario.ca. For more information contact ECHOobnadmin@stjosham.on.ca
- A Baker’s cyst is a common swelling in the medial posterior fossa.
- Commonly, it is secondary to an extension of the synovial space posteriorly, and accordingly will worsen with activities that will worsen a knee effusion
- Given its prevalence and ease of diagnosis, imaging is rarely indicated
- Treatment mainstay is addressing the primary knee pathology (ex: osteoarthritis treatment)
Popliteal synovial cysts are a common sighting in the primary care setting. Commonly known as Baker’s cysts, they refer to a swelling in the medial popliteal fossa.
While many patients are often distressed by their appearance, these swellings are benign. Simplistically, Baker’s cysts can be explained to the patient as an extension of their knee effusion. As the joint swelling worsens, a posterior extension into the popliteal cyst acts as a reservoir for the effusion.
The diagnosis of a Baker’s cyst is typically done clinically. It is typified by a medial popliteal cystic mass that increases in prominence with the knee in full extension and reduces with partial knee flexion.
The differential diagnosis for Baker’s cysts includes DVT, tumours (including sarcomas and lymphoma), and popliteal artery aneurysm. These diagnoses should be suspected if the location is atypical (ex: lateral popliteal fossa), the mass is firm or pulsatile, or if there is surrounding erythema, warmth, or tenderness.
Imaging, including X-rays and ultrasound, is only necessary if the diagnosis is uncertain or if another condition is suspected.
The treatment of Baker’s cysts typically relies on the treatment of the underlying joint disorder. For osteoarthritis, this involves activity modification, physiotherapy, and bracing when appropriate. When symptomatic, an intraarticular glucocorticoid injection may be indicated with or without prior drainage. As the cyst typically communicates with the joint, there is no need to target the cyst directly. Should this approach fail, an ultrasound-guided direct aspiration and injection of the cyst may be attempted.
Patients should be reminded that the Baker’s cyst is likely to recur as their primary joint disorder worsens and the effusion reforms. Accordingly, invasive interventions should be reserved for symptomatic cysts (i.e. pain and stiffness).
Should you or your patient continue to have questions or concerns, a referral to your local sports medicine specialist may be appropriate. A referral to orthopedic surgery may be appropriate following failed interventions for consideration of a cyst resection or joint replacement.
Nitai Gelber, MD, CFPC
PGY-3 Sports and Exercise Medicine, University of Ottawa
Advisor: Dr. Taryn Taylor, BKin, MSC, MD, CCFP (SEM), Dip Sport Med
Acebes JC, Sánchez-Pernaute O, Díaz-Oca A, Herrero-Beaumont G. Ultrasonographic assessment of Baker’s cysts after intra-articular corticosteroid injection in knee osteoarthritis. J Clin Ultrasound 2006; 34:113.
Bandinelli F, Fedi R, Generini S, et al. Longitudinal ultrasound and clinical follow-up of Baker’s cysts injection with steroids in knee osteoarthritis. Clin Rheumatol 2012; 31:727.
Chen Y, Lee PY, Ku MC, et al. Extra-articular endoscopic excision of symptomatic popliteal cyst with failed initial conservative treatment: A novel technique. Orthop Traumatol Surg Res 2019; 105:125.
Fritschy D, Fasel J, Imbert JC, et al. The popliteal cyst. Knee Surg Sports Traumatol Arthrosc 2006; 14:623.
Han JH, Bae JH, Nha KW, et al. Arthroscopic Treatment of Popliteal Cysts with and without Cystectomy: A Systematic Review and Meta-Analysis. Knee Surg Relat Res 2019; 31:103.
Handy JR. Popliteal cysts in adults: a review. Semin Arthritis Rheum 2001; 31:108.
Marra MD, Crema MD, Chung M, et al. MRI features of cystic lesions around the knee. Knee 2008; 15:423.
Torreggiani WC, Al-Ismail K, Munk PL, et al. The imaging spectrum of Baker’s (Popliteal) cysts. Clin Radiol 2002; 57:681.
Do you know how to work with your patients living with obesity who have received specialty care from the Bariatric Centre of Excellence at The Ottawa Hospital?
A new series of 6 sessions focused on obesity management and post-bariatric care will be offered at no cost to primary care providers interested in building clinical expertise. The sessions start on January 15, 2019, and are held bi-weekly from 12 – 1:30 pm.
Click to learn more: 2020 Curriculum ECHO Flyer The Ottawa Hospital
Project ECHO OBN is an innovative technology-enabled collaborative learning program where primary care providers and an interdisciplinary team of clinicians from the BCoE work together to discover new ways of providing care more effectively to patients with obesity.
Build clinical expertise by joining our six-week series to discuss patient cases from your practice and learn about leading surgical and medical treatment options for patients with obesity, strategies to identify and prevent potential post-operative complications after bariatric surgery as well as tools and resources to assist you to manage obesity-related issues seen in primary care.
The Champlain Regional Cancer Program is pleased to invite you to Cancer Update 2019.
This annual event takes place on Friday, December 6, 2019.
For details, please see the Cancer Update 2019 and feel free to share with others in your organization.
Register online Now!
For more information contact Champlain Primary Care at 613-798-5555 x 15811 or firstname.lastname@example.org
Project ECHO® OBN
Update Your Knowledge on Post Bariatric Care and Obesity Management
The Ontario Bariatric Network (OBN) is launching an exciting new initiative Project ECHO™ OBN that partners primary care providers with a multi-disciplinary team of specialists from the Bariatric Centres of Excellence (BCOE) to share best practices on bariatric care and obesity management.
This series of 6 sessions hosted by The Ottawa Hospital begin on October 2, 2019 and is open to physicians, residents and medical students, nurse practitioners and allied health professionals working in primary care. There is no cost to attend.
- Changing practices in the surgical and medical management of patients with obesity
- BCOE and primary care collaboration to implement the Shared Care Model
- Obesity-related co-morbidities and treatment options
- Evidence-based approaches to effectively manage patient complications
Managing the care of post-bariatric surgery patients can be complex. Register soon to take advantage of this no-cost learning opportunity!
For more information on session dates, curriculum details and to register, please visit https://obn.echoontario.ca
Click to view PDF with details: ECHO Flyer with curriculum Aug 2019
Register to attend the OntarioMD EMR: Every Step Conference on September 26, 2019 in Toronto.
If you register before Friday, July 5, you can take advantage of the Super Early Bird Rate of just $160 for a full day of learning, networking and CME credits!
Register now at https://lnkd.in/eRVcQbm
The EMR: Every Step Conference is for physicians, nurse practitioners, allied health professionals and administrative staff.
This conference will be accredited for CME pending approval from the Ontario College of Family Physicians.
In preparation for the June 2019 roll-out of Fecal Immunochemical Testing in June 2019, the Champlain Regional Cancer Program invites you to attend: “FIT Implementation – Are you ready?” part of the Continuing Professional Development Series.
When: Wednesday, May 29, 2019
5:30pm – 8:00pm
You can attend in person or by webcast or OTN.
In person at:
The Ottawa Hospital, General Campus, Critical Care Wing
Room CCW 5225
501 Smyth Road
For webcast or OTN, details are available at www.cancerprimarycare.eventbrite.ca
Registration for this event can be made directly on our event registration site: www.cancerprimarycare.eventbrite.ca
Please feel free to forward this email and information to your colleagues.
This Group Learning program has been certified by the College of Family Physicians of Canada and the Ontario Chapter for up to 2 Mainpro+ credits.
ECHO stands for Extensions for Community Healthcare Outcomes.
The ECHO model™ links specialist/ resource team (Hub) with primary care community-based partners (Spokes) to form the Hub and Spokesmodel. It uses a combination of live online sessions and in-person skills training to build health care capacity. The online sessions are live 2 hours weekly and include a short educational lecture, followed by case-based learning from the participants’ own patients.
The resource team (Hub) puts together the content of the ECHO educational lectures. Participants present de-identified cases of their own patients during the live online sessions. Participants also contribute to case discussions and evaluation surveys. They also receive continuing education/ continuous professional development credits (CE/ CPD).
Through the ECHO model™, community providers and specialists learn from each other, acquire knowledge, skills, increase competency and build a strong community of practice. Participants become part of a supportive community of practice and an inter-professional team.
What Is It?
- FREE case-based learning on: wound bed preparation, pressure injuries (ulcers), diabetic foot ulcers, venous leg ulcers, interprofessional team building and other topics
- No cost mentorship on skin and wound care best practices
- Access to physicians, nurses and allied health providers who will offer you guidance on your patients with complex skin and wound care needs.
Who Should Join?
- Health care providers based in Ontario who have an interest in skin and wound care, including nurses, physicians, and allied health providers.
Benefits for Participants
- Enhanced care for patients with skin and wound care issues
- Certificate of Attendance, if a regular participant
- Continuing Medical Education (CME) Credits awarded by Queen’s University
- Being part of an interprofessional community of practice
- Weekly 2-hour sessions: 15-minute didactic lecture, based on International Interprofessional Wound Care Course (IIWCC) curriculum, followed by a discussion of real clinical cases submitted by participants
- Topics discussed: diabetic foot ulcers, leg ulcers, pressure injuries, wound bed prep, infection, malignant, post-surgical wounds, traumatic injuries, peristomal, lymphedema, acute infection and other wound and skin care issues
- Hands-on learning at semi-annual boot camp sessions held across Ontario
Interested? Here’s What You’ll Need
- Internet connection and webcam-enabled device like a laptop or smartphone
- Minimum two hours per week of committed time
- Willingness to present your patient cases for group discussion
To Express Interest in Joining
For More Information:
Follow on Twitter: @ECHOWound
In the summer of 2018, the Integrated Cancer Screening and Prevention Program (ICS team) partnered with Cancer Care Ontario (CCO) to conduct a mapping exercise based on census data to identify areas where screening rates are low, for the following screening programs in the region:
- Ontario Breast Screening Program (OBSP)
- ColonCancerCheck (CCC)
- Ontario Cervical Screening Program (OCSP)
- Lung Cancer Screening Pilot for People at High Risk (HR LCSP) pilot
The ICS team also conducted an environmental scan focusing on primary care providers, cancer screening managers, and most importantly, patients, to identify and understand challenges to cancer screening. We are now reaching out to regional stakeholders in order to work together to develop improvement initiatives focused on increasing screening rates and facilitating healthier populations. For this reason, we would like to invite you to a series of information sessions being held in key areas including Hawkesbury, Cornwall, Petawawa, Pembroke and Renfrew.
To learn more about the impact you can have on the screening rates for the four cancer screening programs in the Champlain region, we invite you to register for an event in your area.
|Pembroke||March 4, 2019||17:30||Carefor Health & Community Services: 700 MacKay St.|
|Renfrew||March 18, 2019||17:30||GEM Hall: Groves Park Lodge,127 Raglan St. S|
|Cornwall||March 19, 2019||17:30||The Cornwall Knights of Columbus Hall: 205 Amelia St.|
|Hawkesbury||March 25, 2019||17:30||Stephanie’s Grill and Bar: 1680 Highway 34|
To register for an event or for further information regarding the sessions, please call: 613-798-5555 ext. 15811 or email me: email@example.com.
We thank you for your support in working together to improve screening rates and promoting healthier populations in your area.
The Champlain Regional Cancer Program invites you to attend its’ annual Breast Imaging Update 2019, part of the Continuing Professional Development Series. Please find details below. You can attend in person or by OTN. Please feel free to forward to your colleagues.