Ganglion Cyst

Dr. Leo Krawetz of Healthy Feet Podiatry in Tampa and Brooksville removes fluid from a ganglion cyst.

Hi, I’m Dr. Leo Krawetz of Healthy Feet Podiatry.  Today, I have a patient in the office that has a ganglion cyst on the top of her foot and if you look, you can see that this is a very large fluid-filled cyst.  It’s coming off one of her extensor tendons on the top of her foot.  The extensor tendon is what pulls her toes upward.  So, what I did already was numb it up and I’m going to drain the fluid from it, and I’m gonna drain it the way that you could actually see what type of fluid is inside the ganglion cyst.  So now that it’s numb, I’m gonna take a 22-gauge needle and insert it into the cyst itself.  I’m also gonna break the cyst up because she is numb and that will allow the fluid to pour out of here in just a second and you will see this.  The ganglion fluid is a thick fluid and you can see that it’s a little bloody here too, and this is a thick fluid that is like a gel-like fluid.  It’s actually the lubricant for the tendon and it’s around the tendon sheath.  You also see the same fluid around the joint as well and you can see the fluid coming out of here.  After I do this, I’m gonna put an injection of a combination of alcohol, local anesthetic, and some cortisone and that’s going to hopefully cause the lining of the ganglion cyst to shrink and then it will heal itself in the correct position over the tendon and then the tendon will be able to glide again without having a very large cyst here.  This can become painful because they get close to the nerves and they rub on the nerves.  I’m actually gonna insert the needle back in again.  I’m gonna break up the cyst and then I’m gonna inject it again with the alcohol and the cortisone combination and this is breaking it up and you can see what’s gonna happen here in just a second is that I can actually disperse the remaining part of the ganglion fluid throughout the foot, which is gonna flatten it and then after I put the injection in of the alcohol with the cortisone and local anesthetic, I’ll put a compression dressing on and that will cause it to shrink over the next 48 hours.  This is the last injection.  This is gonna make it actually look larger, but what it’s actually doing is shrinking it and more of the ganglion fluid will come out of the hole that I created with the needle and now, I’m gonna put a compression dressing on top and this should go down within the next 48 hours to a flat surface.