What is a ganglion cyst?
A ganglion cyst is a soft tissue mass commonly found in the wrists and feet. It is more often found in women then men. It is a movable, soft tissue mass, that can feel firm and rubbery. It is typically located on the top of the foot or ankle. If you have a ganglion cyst, it can expand and bigger at the end of the day after being on your feet for long periods of time.
How do ganglion cysts form?
No one knows how ganglion cysts form exactly. They can spontaneously arise and are typically the result of an out-pouching of fluid from either a joint or tendon sheath. The fluid forms a balloon-type effect and is typically comprised of a thick, mucous-like substance. The mass itself is typically not painful. Pain can arise from pressure of the cyst on structures beneath it, such as nerves, or from pressure from shoe usage.
How are Ganglion Cysts diagnosed?
Your doctor will first obtain an in-depth history of how and when the cyst first appeared. Next, diagnostic studies can be used, such as X-rays (to rule out any underlying boney deformity), MRI, and ultrasound. Ultrasound usage can give you a better picture of the size and location of the mass and an MRI can give you an in depth analysis of all the soft tissue structures, as well as bone, in the foot. Above all of this, clinical diagnosis is most commonly used to diagnose a ganglion cyst. Your doctor will examine the area in detail and may even perform an aspiration (suck out the fluid) and send the fluid off to a lab for further analysis.
How are Ganglion Cysts treated?
Ganglion cysts can be treated in a variety of ways. If the cyst is not causing any pain, it can typically be left untreated. If it is painful, the fluid can be taken out via a needle in a technique known as aspiration. This is performed in the office and is a quick and easy way to have relief. The area is numbed first with local anesthetic and the procedure in then performed. Ultrasound guidance can be used as an aid. Sometimes, the fluid is too thick and becomes difficult to aspirate. Typically, cortisone is injected into the area to help break up the capsule and prevent the cyst from coming back and a compression dressing is used to help prevent the sac from refilling with fluid.
Surgically excising the ganglion cyst is an option if aspiration is unsuccessful. It can be performed in the operating room or office setting with either under local anesthesia, IV sedation, or general anesthesia. An incision is made over the cyst, and soft tissue surrounding the cyst is freed. The cyst is then removed in total and typically sent for pathology for further analysis. Sutures are then used to close the skin incision. Your doctor will have you resting and in a special walking shoe/boot for up to 3 weeks after the surgery. The sutures will typically be removed two weeks after the procedure. A special dressing is used over the incision site and your doctor will tell you to keep that dressing clean, dry and intact until you see him/her in the office. You will be unable to get the foot wet until the stitches are removed. In some cases, a cast or splint may be used after surgery with crutches, depending on the location of the cyst. During the recovery period, it is crucial to rest and elevate the leg to prevent any post-operative swelling from occurring. Like with any surgery, there is always the risk for complications. Complications are rare but can include infection, inflammation, excessive swelling, numbness, and recurrence of the cyst.
If you have a soft tissue mass and have pain or are unsure of what it is, call us today for an appointment. Call us at 813-875-0555. Our doctors are highly trained and can help customize an appropriate treatment plan for you!