Cysts

A liquid or gel-filled growth that can cause pain and restricted movement in a joint. A ganglion or synovial cyst is excised under local or general anaesthetic using minimally invasive surgery.

What is it?

A cyst is a closed sac which can be filled with fluid or a semi-solid material.

A ganglion cyst is a firm, rubbery mass that usually appears on the front or the side of the ankle, although can exist deeper within the joint. It often appears as a result of a tendon injury. Tendons run inside a sheath, and are lubricated by a thick, gel-like liquid. If the sheath has been weakened, the liquid can leak out, causing a membrane to balloon up and fill with the fluid. Ganglion cysts are firmly attached by a stalk to the underlying deep tissue.

A synovial cyst is a lump that forms on the smooth membrane that lines the inside of the joint called the synovium.

How does it feel?

A cyst can cause pain, usually if under pressure. It can cause a tingling sensation if it is being pressed against a nearby nerve. If your footwear presses against a ganglion cyst, it can cause irritation and soreness.

If the cyst is deeper in the ankle, it can cause restricted movement and impingement on surrounding soft tissues and nerves. This can be painful, and even lead to an electric-shock type feeling on some movements.

Diagnosis

Physical examination will reveal a firm, rubbery mass that has a definite boundary. An x-ray can show the shadow of the soft tissue swelling. If the surgeon suspects that a ganglion or synovial cyst exists deep in the ankle, an MRI scan or ultrasound will be used to identify the size and extent of the mass.

Surgery

A ganglion or synovial cyst is excised under local or general anaesthetic using minimally invasive surgery. The surgeon removes the sac, taking care to remove the stem that attaches it to the tendon sheath or joint below. Care is also taken to avoid damaging any nerves or other soft tissue in the area.

Recovery

If the cyst is on the surface of the ankle, recovery is very quick. After excision of a deeper cyst, recovery is likely to take 10-14 days.

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