Ganglion Cysts

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Summary

Ganglion cysts are masses filled with a clear jelly-like fluid, that originate from a joint or a tendon sheath. They typically occur when there is a weakness in the lining of a joint or tendon that allows synovial fluid (fluid from the joint or tendon) to extravasate out, forming an outpouching. This leads to a smooth mass in the foot, usually in the midfoot or near the ankle. This mass can create discomfort and irritation with shoe wear. The mass will often fluctuate in size over time, intermittently getting larger and smaller.

Treatment

Non-Operative Treatment

Often Ganglion cysts can be treated symptomatically, by ensuring that there is adequate padding over the area of the cyst or space provided in the shoes.

The cysts can be aspirated with a needle under sterile conditions, although the mass regularly returns over time as the underlying reason why it occurred (a rent in the joint or tendon lining) was not addressed.

Surgical Treatment

Surgical resection of the ganglion cyst can be successful provided the origin of the cyst is removed.

Potential Complications

Surgical resection of ganglion cysts may be associated with a surprisingly high rate of wound complications, as there is a tendency for synovial fluid to continue to drain from the wound. Other risks of surgery include:

  • Wound infection
  • Nerve injury Nearby sensory nerves may be stretched or irritated by scar tissue, leading to localized numbness or burning
  • Recurrence of the cyst, especially when deep or multi-lobulated

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