Synovial Cysts

Updated 8/21/2018
Synovial Cyst, University Foot and Ankle Institute

A Synovial Cyst, also known as Gideon’s Disease or Bible Bump, is a small, fluid-filled sac or pouch that develops over a tendon or joint on the top of the foot. The benign mass under the skin may or may not be painful.

 

The size of the sac or cyst can change with activity and may disappear for some time, only to recur. The mass is often soft, but with time it may become firmer to the touch.

 

UFAI, the Right Choice for Cyst Treatment

 

It is important to have a synovial cyst properly evaluated by a medical professional to eliminate a more serious medical condition. Our podiatrists are experts in the identifying and treating cysts of the foot and ankle. We offer the latest technologies available to ensure an accurate diagnosis and proper treatment.

What causes a Synovial Cyst?

During your examination, your doctor will explain to you why you have developed a synovial cyst. Though the cause of the mass is sometimes unknown, the cyst may be caused by trauma from repetitive activities such as sports. Genetic risk factors include osteoarthritis and rheumatoid arthritis.

 

 

Treating a Synovial Cyst

If the mass is not causing pain and is relatively small, your doctor will likely take a watch-and-wait approach, asking you to return to the office to monitor the cyst. If there is pain, limitation of motion or difficulty wearing shoes, immediate treatment may be necessary.

 

Non-surgical treatment options for a Synovial Cyst

Patients typically find pain relief with non-invasive treatment options, including:

  • Ice, especially if pain is related to activity
  • Pain medications including non-steroidal anti-inflammatory medications (Advil) or acetaminophen
  • Rest

In some cases, non-invasive treatment options are not successful and a more aggressive treatment plan is necessary.

 

Non-invasive treatment options

The least-aggressive form of treatment is called aspiration (drainage). The area is numbed with local anesthetic and a large-gauge needle is used to remove the fluid. Often a corticosteroid, and sometimes Hyalauroindase (a dissolving enzyme), is injected to reduce the likelihood of recurrence. While aspiration is quite effective, synovial cysts often reoccur.

 

 

Surgical treatment options for a Synovial Cyst

Depending on the size and location of the cyst, excision surgery may be an appropriate treatment option. This procedure is done in one our onsite surgical centers. Rest and reduction of activities may be required after the procedure.

 

The excision procedure has a significantly higher success rate than aspiration, although complications such as joint stiffness, scar formation, and infection are possible.

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