Hygroma of foot

In most cases, the hygroma of the foot is found in the ankle or outside the phalanal bones.

The growing hygroma causes discomfort when walking, responds with pain in the place of contact with the shoes. Tight shoes in turn provoke an increase in the pathological focus in the amount that compresses the nearby nerve fibers and blood vessels.

Hygroma or ganglion (from the Greek "hygros" - moisture, "oma" - tumor, "ganglion" - node) is called a kind of benign tumor of a single type, formed due to the accumulation of fluid more often in the area of the serosa. Liquid contents often include impurities of mucus or fibrin. Serous neoplasm is localized in the immediate vicinity of the joint or tendon sheaths. Ganglion is a degenerative type of synovial cyst.

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

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

Hygroma of the foot 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 region after treatment renews the multiplication of pathological cells.

Causes of foot hygroma

Factors affecting the possibility and frequency of development of hygroma remain at the level of assumptions. Most often, the tumor is detected from the back of the foot in the place of the superficial location of the synovial bag undergoing mechanical action.

Traumatologists point out the following causes of foot hygroma: 

• presence of hereditary predisposition among blood relatives; 
• single or repeated traumatization; 
• the presence of excessive physical exertion; 
• prolonged squeezing incorrectly matched shoes.

The emergence of tumor formation is also promoted by chronic inflammatory diseases - bursitis (joint damage) and tendovaginitis (tendon pathology).

The stage of inflammation is characterized by the growth of cells inside the capsular surface. As a result of this process, the multi-chamber of the bag itself is formed by means of jumpers, cavities and strands. The small foot hygroma contains a dense liquid, large - serous mass with cholesterol crystals and blood inclusions.

[1], [2]

Symptoms of foot hygroma

Benign tumor formation is slowly increasing. Existing for a long time, a small foot hygroma (up to 3 cm) can not cause any inconvenience. The process of growth is accompanied by stretching of the synovial bag and dull pain of a local nature, the strengthening of which occurs during exercise. An increase in the tumor focus in size disrupts the sensitivity of nerve endings, leading to stagnation of blood in the bloodstream.

Tumor formation on the sole may not even be probed. To suspect pathology allows a rough surface of the epidermis over the hygroma, as well as pain syndrome during movement.

The following symptoms of hygroma of the foot stand out: 

• from the side of the skin - roughness and thickening or vice versa smoothness and immobility of the surface; 
• with increasing education without inflammation - a mobile, soft-elastic rounded tumor with a pronounced little soreness is palpated; 
• reaction to pressure and movement - the pain of the pulling character arises in the tendon / joint; 
• the sign of inflammation is the redness of the skin of the skin.

Clinically, the symptoms of foot hygroma manifest themselves in different ways, depending on the individual course of the pathological process, the localization of the tumor. Some patients report decreased mobility of the joint.

With palpation, the neoplasm can be either soft, elastic, or dense mobile. All cases indicate a clear limitation of hygroma, tightly bound by the base with adjacent tissues. The epidermis over the tumor freely shifts.

The course of the disease can take a chronic form with bouts of prolonged, severe pain. As a result of the injury from the hygroma, the liquid content begins to ooze, and when infected, redness, swelling, and the like are added.

Hygroma of the tendon of the foot

The tendon ganglion or hygroma of the tendon of the foot is formed in the zone of the tendon sheaths and is benign, tumor, cystic neoplasm. In the majority of cases, the tumor is localized to the ankle.

Tendon hygroma of small size does not cause unpleasant sensations, does not represent danger. With the growth of the neoplasm it is possible to squeeze the tendon, restrict the mobility of the foot, the appearance of pain and discomfort during movement.

The causes of the appearance of the tendon ganglion may be a constant pressure or friction on the tendon area, as well as the resulting injury. Often, the development of the tumor is preceded by bursitis (articular bag disease) and tendovaginitis (a problem with the tendon sheath).

Hygroma has a capsule, often multilayered, filled with a thick synovial fluid. Inside the capsule is a single or multi-chambered formation. The ganglion cavity is isolated or communicating with the parental synovial bag.

Stages of development of tendon neoplasm: 

1. colloidal transformation of the synovium; 
2. formation of cystic protrusion; 
3. the presence of a developed tumor.

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

• isolated form - the capsule of the ganglion exists separately from the parent shell, it has attachment only at the base of the cavity. The contents of the hygroma are located in a closed cavity; 
• anastomosis - there is a communicating canal that connects the hygroma with the maternal cavity, providing a two-way outflow of the contents (into the parental cavity and back from it into the tumor capsule); 
• valve - in the area of attachment of the tumor to the parental cavity there is a valve. Increased pressure in the maternal area (in case of trauma or excessive exercise) contributes to the unilateral penetration of synovial contents into the hygroma capsule.

Hygroma of the foot does not harm the patient's health, but it 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 exertion, especially if the human activity is related to active and regular movement. Hygroma of the foot develops in the area of the fingers or on the tendon. Factors-provocateurs are often individual characteristics of the patient's body and lifestyle.

In clinical practice, the hygroma of the left foot is more common, which is explained by the greater burden that the right-handed have on the left extremity. Neoplasm is localized in the ankle zone or from the outside of phalanal bones.

The decision on the method of treatment is taken by the doctor after a visual examination and additional studies.

Hygroma of right foot

Tumor neoplasm develops from that side and in that place which experiences constant friction, pressure, excessive loading. Risk factors are: injuries, active sports, discomfortable shoes.

The hygroma of the right foot is mainly formed in left-handers, since the main load is on the right side. In addition to aesthetic discomfort, the growing neoplasm causes a painful aching, pulling character, which increases with physical activity or movement.

The presence of hygroma of the foot is an occasion for consultation with a specialist who will offer optimal treatment.

Hygroma of the foot in the child

In children, the hygroma is a tumor-like, spherical new growth, the magnitude of which varies within the range of 5-70 mm. The appearance of a tumor is associated with pathological processes of connective tissue around the joint structures. Provocators are - great physical activity and trauma. Small backyards in an active game can easily dislocate a finger on the leg, pull a bunch or hit a foot. Often, medicine is faced with cases of causeless development of a pathological focus.

Whatever it was, the growing foot hygroma in a child causes inconvenience in the process of walking. The proximity of tumor formation to the nerve endings causes a severe pain syndrome, which causes the child's unwillingness to wear shoes and even move.

Small neoplasms are treated conservatively: 

• irradiating with ultraviolet; 
• applying paraffin / mud applications; 
• acting by electrophoresis.

Ganglia of large size in children are subject to prompt removal. For children older than 10 years, surgical intervention is performed under local anesthesia, the children are shown with general anesthesia. However, the choice of anesthesia is selected individually.

The foot hygroma in the child is treated: 

• puncture - a small puncture is made in the tumor region through which the contents of the ganglion are evacuated, and the free cavity is filled with a sclerosing substance; 
• method of excision - education is cut to the base, hemmed. Be sure to apply a tight bandage.
• laser beam treatment is a bloodless method with a minimum of complications, while the healthy process does not affect healthy tissues.

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

Diagnosis of foot hygroma

Differentiate the typical hygroma (adjacent to the skin surface) by an orthopedist or surgeon by visual inspection and palpation. An accurate diagnosis is made on the basis of clinical symptoms and anamnesis. For the purpose of excluding osteoarticular lesions, radiography is recommended.

In some cases, the diagnosis of foot hygroma requires additional methods of examination - ultrasound, MRI, puncture. Ultrasound gives an idea of the structure of education, indicates the presence of blood vessels in the capsular walls, etc. Magnetic resonance imaging is used to determine the nodal formations, which makes it possible 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 an aneurysm of the artery, an abscess.

[3], [4]

Treatment of foot hygroma

The hygroma of the foot is the sphere of activity of the 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 physiotherapy (ultrasound, electrophoresis using iodine); 
• puncture with the removal of liquid contents and subsequent filling of the cavity with glucocorticoid hormones, antibiotics and other drugs (especially with suppuration); 
• Immobilization with an orthopedic bandage or gypsum fixator for up to a week to reduce the production of synovial fluid (requires a patient to have a long absence in the workplace).

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 remains a surgical operation.

Indications for surgical intervention: 

• pain syndrome of a persistent nature (in a state of rest or movement); 
• stitching, limitation of joint mobility; 
• unaesthetic appearance; 
• a rapid increase in education in size; 
• the appearance of complications - suppuration, puffiness, redness of the skin.

The operation is performed by excision or by laser therapy. Bursectomy (excision of the synovial bag) is performed with local anesthesia. To cut the capsule of hygroma is necessary completely, including all areas of pathological tissue. The surgeon pays maximum attention to the base of the hygroma of the foot, as well as the nearby nerves and vessels, so as not to injure them. The emptied cavity should be washed, hemmed and drained. On the limb, a pressure bandage and a gypsum longite are applied for reliable fixation. Drainage is withdrawn on the first-second day after surgery. Recovery occurs after 7-20 days.

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

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

Do not open or crush the hygroma yourself, these actions can lead to the spread of its contents and the subsequent inflammatory process. In addition to infection, self-medication leads to damage to nerve endings and vessels.

Removal of foot hygroma

Removal of hygroma of foot not more than 10 cm in diameter is carried out in an outpatient setting without hospitalization. The duration of the operation is about 20 minutes. Manipulation is carried out under local anesthesia. The surgeon cuts the scalpel, the value of which depends on the parameters of the hygroma itself (size, location, appearance). The formations of the segmental structure are dissected in each of the segments for a more thorough purification from the contents. Tumor neoplasms exceeding 10 cm and neighboring neuromuscular bundles are removed in the operating room.

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

The liquid contents of the hygroma are subject to medical research in order to exclude cancer cells.

Treatment of foot hygroma with alternative means

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

The following treatment of foot hygroma is distinguished by alternative means: 

• on a previously washed leaf of cabbage, thinly spread honey. Place the hygroma on the site, fix it with a bandage for two hours, after which the compress should be replaced; 
• dissolved in a glass of water sea salt (1-2 tablespoons) is mixed with red clay to obtain a consistency of sour cream. Thick, uniform layer distribute the composition to the site of the tumor and cover with a bandage of gauze / bandage. They go with the compress all day, as it dries, moistening it with water; 
• rub the fresh wormwood (twigs and leaves), spread on the pathological focus, fixing with a bandage; 
• prepare the gruel from equal parts of natural honey, pulp of aloe, rye flour. This mixture is kept at night, warmed with cellophane and pribintovav to gigroma; 
• compresses of beef bile, changed every three hours; 
• a positive effect is observed when lubricating the neoplasm with the juice of a golden mustache.

If no improvement is observed, you should consult your doctor for prompt treatment.

Prevention of foot hygroma

Safety rules against the possible appearance of tumor formation: 

• doing physical exercises, watch for a uniform distribution of the load on both limbs, so as not to overload the same group of joints; 
• fix the joints with elastic bandage while actively playing sports; 
• any injury to the joint should be examined by a specialist.

Prevention of hygroma of the foot consists in wearing comfortable shoes, using individual and correctly selected prostheses, excluding permanent loading, absence of traumatization, timely treatment of associated pathological processes.

Unfortunately, the quality removal of gigrom is quite rare. The surgeon must possess high skill to remove the formation completely. Therefore, before the final decision to go for surgery, it is necessary to take into account preventive measures to eliminate postoperative relapse: 

• the doctor must appoint a number of tests and radiography of the affected area, and not lead you to an operation after a five-minute consultation; 
• the duration of the operation takes at least 20 minutes, so the phrase about minute manipulation should alert you; 
• In advance, learn about the postoperative regime, requiring the imposition of a tight bandage and immobility of the limb for several weeks.

Forecast of foot hygroma

Spontaneous damage to the hygroma, which violates the integrity of its capsule, leads to the outflow of liquid contents outward. Some cases of special or accidental injury to the capsule of tumor formation do not lead to opening to the outside. At the same time, the liquid spreads through the tissues. In medicine up to the year 80 there was a method of "crushing" the hygroma, which was deservedly forgotten, as it gave a large number of relapses of the disease. When the capsule contents of the hygroma were overflowed, the shell in most cases restored its structure and was filled with a liquid. In place of the "crushed" hygroma, several pathological foci often developed.

Self-medication, accidental trauma provoke inflammatory reactions, cause exacerbations in the form of suppuration and infection. Be careful not to interfere with the use of "folk" means, as some recipes include real toxic substances. Hygroma of the foot is treated more often by surgical methods, which give a stable positive effect. A competent consultation and suitable therapy can be prescribed only by an experienced surgeon.

After surgery (punching, excision, removal by laser), the forecast of foot hygroma is favorable. The surgical method gives the least number of repeated cases of development of education. Of course, much depends on the individual characteristics of the organism, hereditary predisposition and the surgeon's qualification.

The hygroma of the foot is a common disease, especially at a young age. To keep your foot beautiful and healthy should be timely (if you find the first alarming symptoms), contact a specialist.

[5], [6], [7]