Synovial Cysts: symptoms, causes and treatments

Updated 3/17/2021
Synovial Cyst, University Foot and Ankle Institute

What is a Synovial Cyst?

 

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.

What causes synovial cysts?

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 the 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 our on-site surgical centers. Rest and reduction of activities may be required after the procedure.

 

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

 

UFAI, the best 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 identifying and treating cysts of the foot and ankle. We offer the latest technologies available to ensure an accurate diagnosis and proper treatment.

  • Foot and Ankle Surgeon at University Foot and Ankle Institute
    Dr. Avant Redkar DPM, Podiatrist at University Foot and Ankle Institute

    Dr. Avanti Redkar, DPM, is board certified in podiatric medicine and joined UFAI under a fellowship in sports medicine and ankle reconstruction. She specializes in foot and ankle pathology and also completed a dermatopathology fellowship in Alpharetta, Georgia.

     

    She attended undergrad at the University of Scranton and graduated with a degree in biology. From there, she attended SUNY Buffalo to earn a Master’s degree in nutrition, and then podiatry school at the New York College of Podiatric Medicine. She completed her surgical residency at Good Samaritan Hospital in West Islip, New York, where she was trained in foot and rearfoot surgery, wound care, and hyperbaric medicine.

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