Ganglion Cyst
What Is a Ganglion Cyst?
A ganglion
cyst is a sac filled with a jellylike fluid that originates from a tendon
sheath or joint capsule. The word “ganglion” means knot and is used to describe
the knot-like mass or lump that forms below the surface of the skin.
Ganglion
cysts are among the most common benign soft-tissue masses. Although they most
often occur on the wrist, they also frequently develop on the foot—usually on
the top, but elsewhere as well. Ganglion cysts vary in size, may get smaller
and larger and may even disappear completely, only to return later.
Causes
Although the
exact cause of ganglion cysts is unknown, they may arise from trauma—whether a
single event or repetitive microtrauma.
Symptoms
A ganglion
cyst is associated with one or more of the following symptoms:
·
A noticeable lump—often this is the
only symptom experienced
·
Tingling or burning, if the cyst is
touching a nerve
·
Dull pain or ache, which may
indicate the cyst is pressing against a tendon or joint
·
Difficulty wearing shoes due to
irritation between the lump and the shoe
Diagnosis
To diagnose a
ganglion cyst, the foot and ankle surgeon will perform a thorough examination
of the foot. The lump will be visually apparent, and, when pressed in a certain
way, it should move freely underneath the skin. Sometimes the surgeon will
shine a light through the cyst or remove a small amount of fluid from the cyst
for evaluation. Your doctor may take an x-ray, and in some cases, additional
imaging studies may be ordered.
Nonsurgical Treatment
There are
various options for treating a ganglion cyst on the foot:
·
Monitoring but no treatment. If the cyst causes no pain and does not interfere with walking,
the surgeon may decide it is best to carefully watch the cyst over a period of
time.
·
Shoe modifications. Wearing shoes that do not rub the cyst or cause irritation may
be advised. In addition, placing a pad inside the shoe may help reduce pressure
against the cyst.
·
Aspiration and injection. This technique involves draining the fluid and then injecting a
steroid medication into the mass. More than one session may be needed. Although
this approach is successful in some cases, in many others, the cyst returns.
When Is Surgery Needed?
When other
treatment options fail or are not appropriate, the cyst may need to be
surgically removed. While the recurrence rate associated with surgery is much
lower than that experienced with aspiration and injection therapy, there are
nevertheless cases in which the ganglion cyst returns.
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