GANGLION CYSTS OF THE FOOT

An insight into the most common benign lump of the foot. Can it be bothersome? If so, What to do?!

 

Let’s start with briefly describing the Ganglion cysts over the foot. Ganglion cysts are benign, fluid-filled tumours/masses that often develop on the tendons or joints of the foot. One of the most common benign tumours of the foot and ankle, ganglion cysts are more found to be common in women than in men. They account for almost 40 per cent of the lesions encountered by the foot surgeons1. These cysts are typically spherical, round or oval in shape. They can vastly vary in size, from small pea-sized cysts to larger cysts that can measure several centimetres in diameter.

Causes of Ganglion Cysts

The exact cause of ganglion cysts is not well understood, but they are thought to have a multifactorial origin, including joint or tendon irritation, trauma, and degenerative changes in the joint or tendon. They are most commonly found on the dorsum of the foot, around the ankle joint, and on the back of the heel over the tendocalcaneus (Achilles tendon).

The pathophysiology of ganglion cysts is that they form from the synovial lining of a joint or tendon sheath. The cyst forms a sac filled with a thick, clear or straw-coloured fluid, similar to the fluid that normally lubricates the joint or tendon. As the cyst grows, it can pressure surrounding nerves and cause pain, weakness, or numbness. In most cases, ganglions are not painful unless they are rubbed against by shoes that are too restrictive. Most nodules have restricted mobility and can be partially compressed by applying direct pressure or shifting the foot’s position.

Ganglion cysts can mimic many different lesions of the foot, such as lipomas and synovial cysts, as well as other causes of foot pain, such as plantar fasciitis, heel spurs, and arthritis. Dr Kim can diagnose properly through physical examination, imaging studies, and possibly a cyst biopsy. Dr Kim uses in-house ultrasound to diagnose ganglion cysts in the office.

Treatment of Ganglion Cysts

Treatment options for ganglion cysts of the foot can vary depending on the size and location of the cyst and the symptoms the patient is experiencing.

Non-Surgical Options

Non-surgical treatment options include observation, protection of the area, and physical therapy to help relieve pain and improve the strength and flexibility of the foot. If the cyst is causing pain or other symptoms, a physician may recommend injecting the cyst with a corticosteroid or other medication to reduce inflammation and pain.

Surgical Option

  • Aspiration: where the fluid is removed from the cyst using a needle and syringe, and excision, where the cyst and a surrounding margin of tissue are removed2.
  • Surgical Excision: The goal of surgery is to remove the cyst and prevent a recurrence. Recovery time can vary depending on the patient’s overall health but patients return to normal activities within a month.  (Brisbane Gold Coast Foot Surgery is equipped with a state-of-the-art procedure room where this surgery can be done in the clinic. It is a cost-effective option but we still maintain hospital standard sterilisation in the clinic. If patients are anxious about needles, Dr Kim can operate under general anesthesia in private hospitals)

 

In conclusion, Ganglion cysts are benign, fluid-filled nodules that often develop on the tendons or joints of the foot. They are usually harmless and can practically have no symptoms in a great number of individuals. If the symptoms become bothersome, the treatment options include observation, protection of the area, physical therapy, aspiration and excision. It is essential to consult with a physician to determine the best treatment plan for you.

  1. Macdonald, Duncan JM, et al. “The differential diagnosis of foot lumps: 101 cases treated surgically in North Glasgow over 4 years.” The Annals of The Royal College of Surgeons of England3 (2007): 272-275.
  2. Ahn, Jae Hoon, Won-Sik Choy, and Ha-Yong Kim. “Operative treatment for ganglion cysts of the foot and ankle.” The Journal of foot and ankle surgery5 (2010): 442-445.

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