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Tuesday, May 28, 2013

Ganglion Cyst Mimicking Sesamoid Injury: The Positive Role of an MRI

This young lady emailed me back in Dec 2012 to let me know that she fractured her sesamoid bone and was scheduled for surgery and should she seek another opinion. Her original email is at the bottom of this post. I encouraged her to get a second opinion. She cancelled the upcoming surgery and followed her gut. What was so different from other cases of sesamoid injuries was her feeling she was stepping on a golf ball. She was able to get another opinion and a MRI documenting the ganglion cyst with no fracture to the sesamoid. 

Dr. Blake,

 I am so sorry that is has taken so long to get back to you but I had an MRI yesterday and I am attaching 2 images. The Dr. suspected and the MRI confirmed that I don't have a sesamoid fracture but a very large ganglion cyst in my foot. I have been scheduled for surgery the end of May to remove the cyst and start the recovery process. Thank you so much for your encouragement to seek a third opinion, I consider you my second opinion,  I truly believe you have saved me a lifetime of suffering. 


Large Ganglion Cyst is seen next to a totally normal sesamoid

Large  Ganglion Cyst noted on MRI under the first metatarsal near the sesamoids

Dr. Blake,

I was diagnosed with a fibula sesamoid fracture on my left foot. I feel like I am walking on a golf ball and that is what I call it now. I walk on the side of my foot to keep the pressure off of the ball of my foot but that is causing knee pain and hip pain.  The podiatrist that I saw took one set of x-rays sold me cushions for my shoes and arch supports to wear. I tried those for 2 weeks and no relief. When I returned to the podiatrist he suggested since the arch supports provided no relief that I try a cortisone shot. The shot took the inflammation out of my foot, for about a week,  so it felt like the golf ball went away but the pain was more severe since there was not any extra padding on the ball of my foot. I returned to the Dr. 2 weeks later and he said there is nothing else he can do surgery is my only option and sent me home. I feel after reading your blog that I really need a second opinion before I let anyone do surgery on my foot. My question is do I get that second opinion from another podiatrist or do I try to see an orthopedic doctor? I am scheduled for surgery on December 28, 2012. Any help or advice is very much appreciated. I have cried with my husband over this whole situation and how frustrated I am please help. 


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Thank you very much for leaving a comment. Due to my time restraints, some comments may not be answered.I will answer questions that I feel will help the community as a whole.. I can only answer medical questions in a general form. No specific answers can be given. Please consult a podiatrist, therapist, orthopedist, or sports medicine physician in your area for specific questions.