Hygroma of the foot

In the vast majority of cases, foot hygroma is found in the ankle area or on the outer side of the phalangeal bones.

A growing hygroma causes discomfort when walking, and is felt as pain in the place of contact with shoes. Tight shoes, in turn, provoke an increase in the size of the pathological focus, compressing nearby nerve fibers and blood vessels.

Hygroma or ganglion (from the Greek "hygros" - moisture, "oma" - tumor, "ganglion" - node) is a type of benign tumor of a single type, formed due to the accumulation of fluid, most often in the area of the serous sac. The liquid content often includes admixtures of mucus or fibrin. The serous neoplasm is localized in close proximity to the joint or tendon sheaths. The ganglion is a degenerative type of synovial cyst.

The hygroma capsule, like a cystic formation, has a dense wall of connective tissue filled with viscous contents. The internal fluid is a transparent or yellowish jelly. Depending on the location, a soft, elastic and hard (like bone, cartilage) type of neoplasm is distinguished.

It is believed that the primary cause of hygroma formation is metaplasia (degeneration process) of capsule cells. Degenerative changes form cells of the following structure: spindle-shaped (from which the capsule develops) and spherical (filled with liquid contents) type.

Foot hygroma has a high percentage of relapses after surgery, and conservative therapy does not give the expected effect. The presence of even a small residual degenerative area after treatment resumes the proliferation of pathological cells.

Causes of foot hygroma

Factors influencing the possibility and frequency of hygroma development remain at the level of assumptions. Most often, the neoplasm is detected on the dorsum of the foot in the place of the superficial location of the synovial bag, which undergoes mechanical action.

Traumatologists point out the following causes of foot hygroma:

• the presence of a hereditary predisposition in blood relatives;
• single or repeated trauma;
• presence of excessive physical exertion;
• prolonged pressure from improperly fitted shoes.

The development of tumor formation is also facilitated by chronic inflammatory diseases – bursitis (joint damage) and tendovaginitis (tendon pathologies).

The inflammation stage is characterized by cell growths inside the capsule surface. As a result of this process, the bag itself is formed into a multi-chambered bag by means of bridges, cavities and strands. A small foot hygroma contains thick fluid, a large one contains a serous mass with cholesterol crystals and blood inclusions.

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Symptoms of foot hygroma

A benign tumor formation grows slowly. Having existed for a long time, a small foot hygroma (up to 3 cm) may not cause any inconvenience. The process of growth is accompanied by stretching of the synovial bag and dull pain of a local nature, which intensifies during physical activity. An increase in the size of the tumor lesion disrupts the sensitivity of nerve endings, leading to stagnation of blood in the bloodstream.

A tumor formation on the sole may not even be palpable. The rough surface of the epidermis over the hygroma, as well as pain when moving, allow one to suspect pathology.

The following symptoms of foot hygroma are distinguished:

• from the skin side – roughness and thickening or, conversely, smoothness and immobility of the surface;
• as the formation grows without inflammation, a mobile, soft-elastic, rounded tumor with pronounced slight pain can be felt;
• reaction to pressure and movement - a pulling pain occurs in the tendon/joint;
• A sign of inflammation is redness of the skin.

Clinically, the symptoms of foot hygroma manifest themselves differently, depending on the individual course of the pathological process, the localization of the tumor. Some patients note a decrease in joint mobility.

On palpation, the neoplasm may be either soft, elastic, or dense and mobile. All cases indicate a clear limitation of the hygroma, tightly connected by the base with the adjacent tissues. The epidermis above the tumor moves freely.

The course of the disease can take a chronic form with attacks of prolonged, severe pain. As a result of injury, liquid contents begin to ooze from the hygroma, and when infected, redness, swelling, etc. join in.

Hygroma of the tendon of the foot

Tendon ganglion or hygroma of the tendon of the foot is formed in the area of tendon sheaths and is a benign, tumor, cystic neoplasm. In the vast majority of cases, the tumor is localized on the ankle.

A small tendon hygroma does not cause discomfort and is not dangerous. As the neoplasm grows, it may compress the tendon, limit the mobility of the foot, and cause pain and discomfort when moving.

Causes of tendon ganglion formation may include constant pressure or friction on the tendon area, as well as trauma. Often, the development of the tumor is preceded by bursitis (a disease of the joint capsule) and tendovaginitis (a problem with the tendon sheath).

The hygroma has a capsule, often multilayered, filled with thick synovial fluid. From the inside, the capsule is a single- or multi-chamber formation. The ganglion cavity can be isolated or communicate with the parent synovial sac.

Stages of development of tendon neoplasm:

1. colloidal transformation of the synovial membrane;
2. formation of a cyst-like protrusion;
3. the presence of a developed tumor.

Hygroma of the tendon of the foot is divided into the following main types:

• isolated form - the ganglion capsule exists separately from the parent membrane, has an attachment only at the base of the cavity. The contents of the hygroma are located in a closed cavity;
• anastomosis - there is a communicating channel that connects the hygroma with the parent cavity, ensuring a two-way outflow of contents (into the parent cavity and back from it into the tumor capsule);
• valve - there is a valve in the area where the tumor attaches to the parent cavity. Increased pressure in the parent area (during trauma or excessive load) promotes one-sided penetration of synovial contents into the hygroma capsule.

Hygroma of the foot does not harm the patient's health, but causes a lot of inconvenience to its owner. This fact makes it necessary to remove the tendon ganglion.

Hygroma of the left foot

The foot undergoes great physical strain, especially if the person's occupation is associated with active and regular movement. Hygroma of the foot develops in the area of the toes or on the tendon. The provoking factors are often the individual characteristics of the patient's body and his lifestyle.

In clinical practice, hygroma of the left foot is more common, which is explained by the greater load on the left limb in right-handed people. The neoplasm is localized in the ankle area or on the outer side of the phalangeal bones.

The decision on the treatment method is made by the doctor after a visual examination and additional research.

Hygroma of the right foot

The tumor growth grows on the side and in the place that experiences constant friction, pressure, excessive load. Risk factors are: injuries, active sports, uncomfortable shoes.

Hygroma of the right foot is formed mainly in left-handed people, since the main load falls on the right side. In addition to aesthetic discomfort, the growing neoplasm causes aching, pulling pain, which intensifies with physical exertion or movement.

The presence of a foot hygroma is a reason to consult a specialist who will offer the best treatment.

Hygroma of the foot in a child

In children, a hygroma is a tumor-like, spherical neoplasm, the size of which varies within 5-70 mm. The appearance of a tumor is associated with pathological processes of connective tissue structures near the joints. Provocateurs are heavy physical exertion and injuries. Little fidgets in an active game can easily dislocate a toe, pull a ligament or hit a foot. Often, medicine is faced with cases of causeless development of a pathological focus.

Be that as it may, a growing hygroma of the foot in a child causes discomfort during walking. The proximity of the tumor to the nerve endings causes severe pain syndrome, which makes the child unwilling to put on shoes or even move.

Small neoplasms are treated conservatively:

• by irradiating with ultraviolet light;
• using paraffin/mud applications;
• by electrophoresis.

Large ganglia in children are subject to surgical removal. For children over ten years of age, surgical intervention is performed under local anesthesia, while general anesthesia is indicated for babies. However, the choice of anesthesia is selected individually.

Hygroma of the foot in a child is treated:

• puncture - a small puncture is made in the area of the tumor, through which the contents of the ganglion are evacuated, and the free cavity is filled with a sclerosing substance;
• by excision method - the formation is cut out to the base and sutured. A tight bandage is necessarily applied.
• Laser beam treatment is a bloodless method with minimal complications; healthy tissues are not affected during the heating process.

Modern technologies allow the child to go home two to three hours after surgery, and the duration of the procedure itself does not exceed twenty minutes.

Diagnosis of foot hygroma

A typical hygroma (adjacent to the skin surface) can be differentiated by an orthopedist or surgeon by visual examination and palpation. An accurate diagnosis is made based on clinical symptoms and anamnesis. In order to exclude bone and joint lesions, it is recommended to undergo radiography.

In some cases, diagnostics of foot hygroma requires additional research methods - ultrasound, MRI, taking a puncture. Ultrasound gives an idea of the structure of the formation, indicates the presence of blood vessels in the capsular walls, etc. Magnetic resonance imaging is used to determine nodular formations, allowing you to study the structure of the hygroma and the contents of its bag.

The method of differential diagnosis is selected by the doctor, especially in cases of arterial aneurysm and abscess.

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Treatment of foot hygroma

Hygroma of the foot is the area of activity of an orthopedist, surgeon and traumatologist, who determine the method of therapy. In the initial stage of the disease, conservative treatment is used:

• applications of paraffin, mud;
• thermal and physical procedures (ultrasound, electrophoresis using iodine);
• punctures with removal of liquid contents and subsequent filling of the cavity with glucocorticoid hormones, antibiotics and other drugs (especially in case of suppuration);
• immobilization with an orthopedic bandage or plaster cast for up to a week to reduce the production of synovial fluid (requires the patient to be absent from work for a long time).

Unfortunately, conservative treatment of foot hygroma is ineffective and gives almost 100% relapses. Clinical practice shows that the only effective way to get rid of the tumor is surgery.

Indications for surgical intervention:

• pain syndrome of a persistent nature (at rest or in motion);
• stiffness, limitation of joint mobility;
• unaesthetic appearance;
• rapid increase in the size of the formation;
• the appearance of complications - suppuration, swelling, redness of the skin.

The operation is performed by excision or laser therapy. Bursectomy (cutting out the synovial bursa) is performed under local anesthesia. The hygroma capsule must be excised completely, including all areas of pathological tissue. The surgeon pays maximum attention to the base of the foot hygroma, as well as nearby nerves and vessels, so as not to injure them. The released cavity should be washed, sutured and drained. A pressure bandage and plaster splint are applied to the limb for reliable fixation. Drainage is removed on the first or second day after surgery. Recovery occurs in 7-20 days.

Laser treatment of foot hygroma is a bloodless method and has a number of advantages:

• complete destruction of the formation is carried out by heating without damaging healthy cells;
• there is no scar after the procedure;
• the laser provides anti-inflammatory and antibacterial effects;
• complications are reduced to a minimum;
• healing occurs quickly.

You should not open or crush the hygroma yourself, as these actions can lead to the spread of its contents and subsequent inflammation. In addition to infection, self-medication leads to damage to nerve endings and blood vessels.

Removal of foot hygroma

Removal of a foot hygroma no more than 10 cm in diameter is performed in an outpatient setting without hospitalization. The duration of the operation is about 20 minutes. The manipulation is performed under local anesthesia. The surgeon makes an incision with a scalpel, the size of which depends on the parameters of the hygroma itself (size, location, type). Segmental formations are dissected along each segment for more thorough cleaning from the contents. Tumor formations exceeding 10 cm and adjacent to neurovascular bundles are removed in operating rooms.

In clinical practice, removal of foot hygroma is performed using endoscopic equipment. The advantages of this method include: a small incision, minimal tissue trauma, and a short period of postoperative rehabilitation.

The liquid contents of the hygroma are subject to medical examination to exclude cancer cells.

Treatment of foot hygroma with folk remedies

Hygroma of the foot brings both physical and aesthetic discomfort. The growth of the tumor and the increase in pain syndrome are a reason for conservative therapy under the supervision of a specialist. At this stage, it is possible to use folk recipes. Such a comprehensive approach allows you to get rid of the pathology.

The following treatments for foot hygroma are used using folk remedies:

• spread honey thinly on a pre-washed cabbage leaf. Place it on the site of the hygroma, secure with a bandage for two hours, then replace the compress;
• sea salt (1-2 tbsp) dissolved in a glass of water is mixed with red clay until the consistency of sour cream is obtained. The composition is spread in a thick, even layer on the site of the tumor and covered with a gauze/bandage. Walk around with the compress all day, wetting it with water as it dries;
• grind fresh wormwood (twigs and leaves), place it on the pathological site, securing it with a bandage;
• prepare a gruel from equal parts of natural honey, aloe pulp, rye flour. Keep this mixture overnight, insulated with cellophane on top and bandaged to the hygroma;
• beef bile compresses, changed every three hours, help;
• A positive effect is observed when lubricating the neoplasm with golden mustache juice.

If there is no improvement, you should consult a doctor about surgical treatment.

Prevention of foot hygroma

Safety rules against the possible appearance of a tumor:

• When doing physical exercises, ensure that the load is evenly distributed on both limbs so as not to overload the same group of joints;
• fix your joints with an elastic bandage when actively engaging in sports;
• Any joint injury should be examined by a specialist.

Prevention of foot hygroma consists of wearing comfortable shoes, using individual and properly selected prostheses, avoiding constant stress, avoiding trauma, and timely treatment of concomitant pathological processes.

Unfortunately, high-quality removal of hygromas is quite rare. The surgeon must have high skill to remove the formation completely. Therefore, before the final decision to undergo surgery, preventive measures to eliminate postoperative relapses should be taken into account:

• the doctor must definitely prescribe a series of tests and an X-ray of the affected area, and not take you to surgery after a five-minute consultation;
• the duration of the operation takes at least 20 minutes, so the phrase about a minute-long manipulation should alert you;
• Find out in advance about the post-operative regime, which requires the application of a tight bandage and immobilization of the limb for several weeks.

Prognosis of foot hygroma

Spontaneous damage to the hygroma, which disrupts the integrity of its capsule, leads to the outflow of liquid contents. Some cases of deliberate or accidental injury to the capsule of a tumor formation do not lead to an opening to the outside. In this case, the liquid spreads through the tissues. In medicine, until the 1980s, there was a method of "crushing" the hygroma, which was deservedly forgotten, since it gave a large number of relapses of the disease. When the capsular contents of the hygroma poured out, the membrane in most cases restored its structure and filled with liquid. Several pathological foci often grew in place of the "crushed" hygroma.

Self-medication and accidental trauma provoke inflammatory reactions, cause exacerbations in the form of suppuration and infection. It would not hurt to be careful when using "folk" remedies, since some recipes include real poisonous substances. Hygroma of the foot is treated more often by surgical methods, which give a lasting positive effect. Only an experienced surgeon can prescribe competent advice and appropriate therapy.

After surgical intervention (puncture, excision, laser removal) the prognosis for foot hygroma is favorable. The surgical method gives the least number of repeated cases of formation development. Of course, much depends on the individual characteristics of the body, hereditary predisposition and the qualifications of the surgeon.

Hygroma of the foot is a common disease, especially at a young age. To keep your foot beautiful and healthy, you should consult a specialist in a timely manner (when the first alarming symptoms are detected).

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