Copyright (c) 2010 Bruce Lashley
It is a single or multi-chambered soft tissue mass with thin walls that is filled with high-protein fluid. The fluid color ranges from amber to clear and located beneath the skin and can be attached to muscle tendons, joint capsules or nerves.
What are is the causes? The causes of these cysts are still unknown. However, it is suggested that they are caused by repetitive trauma or joint fluid projecting out of its contained area. In the case of repetitive trauma, the cysts may form if there is friction or excessive rubbing between a bone and/or shoe against a tendon.
What are the symptoms? These cysts can be found all over body. Most commonly, on the hand and wrist, then followed by the foot. In the case of the foot, ganglion cysts are the most common soft tissue masses found in the foot and ankle; in addition most are located on top of the foot. When a ganglion cyst becomes large, it may appear frightening and worrisome because patients may believe they have developed a cancerous growth. Fortunately, ganglion cysts tend to be harmless and painless and may even resolve on it’s own. However, if the ganglion cysts become large enough, it can begin to cause pain. This is because the enlargement produces increased pressure on the surrounding tissues such as skin and nerve. Additionally, large cysts can interfere with shoe gear.
How to diagnose? These soft tissue masses are usually diagnosed clinically. The podiatrist will test if the soft tissue mass has characteristics of ganglion cysts. These characteristics are that the mass is movable and soft.
X-ray studies are used in examining these cyst. The cysts are soft tissue and do not appear on x-ray, however, x-rays can rule out other diagnostic possibilities, such as calcified masses or bone invading tumors.
Diagnostic ultrasound is inexpensive and very effective at diagnosing and revealing the nature of the cyst. By studying the cyst with the ultrasound, the doctor can see the size, shape and the number of chambers in the mass.
MRIs may also be requested usually to determine the size and the degree of how much soft tissue is involved with the ganglion cyst. This is an expensive test and is most often used for surgical planning.
How do you treat a ganglion cyst? Non-surgical treatment: It is often difficult to treat ganglion cysts without surgery. However, non-surgical treatment can help relieve pain and symptoms from the ganglion cysts. Padding may be placed around the ganglion to decrease pressure and irritation to the area. Change in footwear may also be suggested to reduce friction and pressure to the area as well.
Aspiration of a Ganglion Cyst: This is done by first numbing the area with local anesthesia. Next, the site of aspiration is cleansed with antiseptic skin cleaner. Then, using an empty syringe and needle the fluid is pulled out of the ganglion cyst. After aspiration of the ganglion cyst, a syringe with steroid maybe injected. Also, it must be noted that there is a high risk of recurrence of the ganglion cyst after aspiration.
Surgical treatment: Surgery as a treatment for ganglion cysts is only considered if conservative treatment failed, the ganglion is recurring, or there is significant pain. Surgical removal of a ganglion cyst consists of removing the entire ganglion wall and surrounding soft tissue that is associated with the ganglion cyst. Since surrounding soft tissue needs to be removed, the incision site will need to be longer then the cyst. Pain, swelling, numbness, or tingling may occur after the surgery. As with aspiration procedure noted above, it must be noted that there is risk of recurrence rate after surgery as well.