A ganglion is a common benign synovial cyst. Ganglia are 1.5 to 2.5 cm in diameter and are often attached to a joint capsule or tendon sheath. Although ganglions typically occur in the wrist, they may also occur in the foot. These lesions typically arise in the anterolateral aspect of the ankle but can occur in many areas of the foot. The pathogenesis of these lesions is unknown. The two most popular theories are (1) that they are produced by herniation of the tendon sheath, and (2) that they arise from focal myxomatous degeneration of collagenous tissues caused by trauma. Ganglions may appear suddenly or gradually, may enlarge and diminish in size, and may be painful or asymptomatic. On examination one notes a firm, usually nontender, cystic lesion. Diagnosis is usually made clinically, although ultrasound and MRI are useful if there is any question of the diagnosis. Aspiration and instillation of glucocorticoids leads to the complete resolution of ganglions in some cases. Most ganglions require complete surgical excision.2829
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