Ganglion Cyst

What is a ganglion?       

Ganglion Cysts are a benign fluid-filled lump (cyst) that can occur in many areas of the body, but is most common on the hands and feet.  They typically arise over a joint or tendon.  Although the exact causes are not known, a ganglion likely occurs due to a weakness in the covering of the tendon or joint space. Direct injury or everyday minor trauma can potentially be a cause.  Motions of a tendon over a bony prominence or pressure from a shoe on a tendon or joint are examples of minor trauma.  Weakness in the covering with a subsequent swelling of liquid into a confined space causes the lump to form.  The growth is usually very firm but may be somewhat soft, depending on the fluid content.  The fluid itself is usually similar in appearance to a thick clear jelly.

Diagnosis

A diagnosis of ganglion cyst is usually made on clinical examination based on location of the growth and pertinent history.  An x-ray may be taken to rule out a bone spur as the aggravating factor behind the formation of the cyst.  If there is any question as to the extent of the growth, an MRI may be ordered for a more detailed evaluation.

Treatment 

Proper treatment is based on pain, size, location and aggravating factors. Once a mass is diagnosed as a ganglion cyst it may be left alone, untreated, if it is not painful or causing problems with shoes. Occasionally these growths will spontaneously disappear.  Cysts can be drained by needle aspiration followed by a cortisone injection in an effort to prevent the cyst from filling again.  Once drained, a compression dressing is worn over the site for a period of time in an attempt to reduce recurrence.  Over half of the cysts will refill with this form of treatment, but the upside is that the procedure can be repeated again if needed.  If the growth is a source of pain or irritation and drawing fluid out (aspiration) has failed, then surgical excision may be necessary. Although surgical excision reduces the chance for recurrence ganglions will sometimes come back.  Surgical excision is an outpatient procedure.   Crutches and non-weight bearing are not usually needed.   A surgical shoe is usually worn for 2 to 3 weeks during the time that the incision is healing.  There really is no preventative care for ganglion cysts due to their spontaneous nature.

It is important to be evaluated by a foot and ankle specialist to ensure proper diagnosis.  More information can be found on our website, alaskapodiatry.com.