Dear Dr. Donohue: I have been diagnosed with Baker’s cyst in my left knee. Must I take medicine for it? Is surgery necessary? – G.H.
Dear G.H.: Baker’s cysts are not cysts at all. They more properly are described as swollen bursa. The bursa are miniature sacs between tendons and bone. They cushion against friction. Any fluid-filled bursa can be mighty painful. With a Baker’s cyst, the location, just behind the knee, calls attention to it with the slightest leg movement.
It’s a behind-the-knee version of “housemaid’s knee,” a similarly swollen bursa problem, below the kneecap, that is of great discomfort to anyone whose work involves kneeling.
Anti-inflammation drugs of the indomethacin-ibuprofen kind help resolve pain in either condition, and if you can add rest and leg elevation, the chances of the bursa regressing are fairly good. If the bursa does not respond to those measures, a cortisone injection might be the answer. Only when those steps fail do you turn to surgery.
Dear Dr. Donohue: What causes dark circles under the eyes? Contact lenses? Alcohol (which I don’t do)? Am I lacking a vitamin? Is it a kidney problem? – V.L.
Dear V.L.: It’s not contacts, alcohol or a vitamin deficiency. People with fair complexions and delicate skin around their eyes have the darkness. The color is a cast of blood seen through the skin.
For most people, the degree of darkness is a genetic endowment. Some people show such darkness because of an allergy that makes the veins dilate, enhancing the bluish blood cast.
Some folks show circles after long hours of work, for reasons that are less clear.
Dear Dr. Donohue: Which drugs do they test for in the Olympics? What about marijuana? – K.B.
Dear K.B.: They are the so-called performance enhancers. The International Olympic Committee recognizes six classes of banned substances: muscle-building anabolic steroids, stimulants, diure tics, narcotics, hormones and beta blockers.
The large list of banned drugs and drug combi-nations is expanded as new ones appear on the scene.
Marijuana is not considered performance-en hancing. In most cases, national prohibitions would get you in the soup anyway. U.S. officials do ask for marijuana testing of boxers and basketball players.
Write to Paul Donohue, M.D., P.O. Box 5539, Riverton, NJ 08077-5539.
