56YOF presents with a slowly enlarging fluctuating subcutane | Figure 1

TheFastDoctor

Family Medicine

56YOF presents with a slowly enlarging fluctuating subcutaneous nodule about 2 cm in diameter directly lateral of the 5th Tarso-Matatarsal joint of the left foot. This developed after a rather painful experience of hyper-dorsal flexion of all 5 T-M joints when a combined speed and weight on the M-P area of this foot resulted in a hyper-dorsiflexion with immediate pain.

What is the chance of this being a synovial cyst in communication with this T-M joint? If it was a simple ganglion I would quickly excise it under local anaesthesia but I would definitely not like to introduce microbial life into a synovial joint...

Intra operative pics of the ganglion cyst on the elbow for those wanting it. Opened it to let the synovial fluid.

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