Ganglion cysts are the most common soft tissue masses of the foot and ankle. Although they are benign, they can cause significant pain and disability. They form when the fluid which surrounds tendons and joints leaks out and creates a fluid-filled mass. They may be associated with trauma, overuse, or sometimes just bad luck! Patients may notice that the cyst changes in size, especially with physical activity.
In the 19th and early 20th centuries, treatment involved trying to flatten the cyst by hitting it with a large textbook or bible. Suffice it to say, treatment of ganglion cyst has evolved! First line management involves imaging the mass by obtaining x-rays, ultrasound, or possibly an MRI. If the mass is large enough it may be aspirated in the office. This involves using a needle to remove the fluid from the mass. Alternatively, the area can be anesthetized, a small incision can be made, and the fluid can be evacuated in the office. Patients who have larger, reoccurring cysts may need surgical consultation so that the cyst be removed in its entirety in the operating room.
Below is an example of a large ganglion cyst. The patient presented to our office with a large mass around the tendons of her foot. In fact, the mass was so large that the patient was experiencing numbness in her toes because the mass was compressing the nerves of her foot. A physical exam and in-office ultrasound of the area were consistent with ganglion cyst. After the foot was anesthetized, a small incision was made and the mass was drained. One day following the procedure the patient was pain free and the numbness in her toes completely subsided.
Although they are benign, ganglion cysts can cause a myriad of symptoms and should be evaluated by one of the doctors of our practice as soon as possible.