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Ganglion Cysts

What Is a Ganglion Cyst?

RUBBERY MASS ON THE TOP OF THE FOOT

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.

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What Causes Ganglion Cyst on Foot?

They generally occur without any apparent cause. Ganglions arise spontaneously from a weakness in the soft tissue covering of a joint or tendon sheath. Ballooning out of the tissue occurs and it fills with a thick mucoid fluid. In many instances, ganglions are not painful until they reach a size that causes irritation from shoe pressure. On occasion, they will compress a nearby skin nerve and cause tingling into the top of the toes. Tapping on the ganglion will often result in this same tingling sensation into the toes. Other common masses on the foot are giant cell tumors, fibromas and lipomas.

Ganglion Cyst On Foot Diagnosis 

The diagnosis is made by taking a thorough history of the clinical course of the condition. A physical exam will reveal a firm, rubbery mass that appears encapsulated and has a discreet boundary. They tend to firmly adhere to the underlying deep tissues under the skin. An x-ray will reveal the shadow of the soft tissue swelling. On occasion, there may be a small bone spur in the area of the ganglion. Spurring indicates a level of arthritis in the joint near the ganglion. An MRI or CT scan will clearly define the mass but is not necessary to make the diagnosis. If a ganglion were suspected within the deep structures of the foot an MRI would be useful to identify the size and extent of the mass. .

Ganglion Cyst Treatment

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.

Our Board Certified Podiatrists

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Arash R. Hassid, DPM

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Daniel L. Altchuler, DPM

Board Certified Foot & Ankle Specialist

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Location: Santa Monica

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